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Muon radiography, which relies on measuring the absorption and attenuation of muons as they pass through matters, offers a new imaging technique capable of revealing the internal structure of large objects. Recent technological advancement allows for the application or testing of muon radiography in various fields, including mining, civil engineering, security check, etc. This study investigates the factors that influence muon radiography, which is used in density inversion, through simulations and experiments. The materials considered for density inversion include water, standard rock, and iron. Our simulation studies show that the number of events detected and selected has an impact on the reconstruction results, and several factors, such as multiple Coulomb scattering processes, recording time, and spatial resolution, which influence the number of muons, must be taken into account when measuring the rock density. We design and conduct a laboratory scale experiment based on the simulation results. We filter the 220 h of recording signals through time coincidence and straight-line fitting to obtain the selected events. Our results reveal that the statistical error of muons survival ratio in recording time significantly impacts the inversion result and decreases the error can improve accuracy greatly. In the experiment, the deviation between the inversion mean value and the expected value can be reduced to 2.4%–2.9% for iron, 7% for water, and 1.5% for standard rock. This density inversion approach provides insight into future density detection of underground structures. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Adipose tissue has been associated with knee osteoarthritis (KOA) pathogenesis, but the longitudinal changes in adipose tissue with KOA progression have not been carefully evaluated. This study aimed to determine if longitudinal changes of systemic and local adipose tissue is associated with radiographic progression of KOA. METHODS: This case-control study used data from the Osteoarthritis Initiative (OAI) and included 315 cases (all the right knees with a minimum of Kellgren-Lawrence score (KL) of 0 and an increase of ≥ 1 KL from baseline to 48 months) and 315 controls matched by age, sex, race, and baseline KL. Cross sectional area of IPFP (IPFP CSA) and subcutaneous adipose tissue around the distal thigh (SCATthigh) were measured using MRI images at baseline and 24 months. Conditional logistic regression models were fitted to estimate associations of obesity markers, IPFP CSA, and SCATthigh with radiographic KOA progression. Mediation analysis was used to assess whether IPFP CSA or SCATthigh mediates the relationships between baseline BMI and radiographic KOA progression. RESULTS: 24-month changes of IPFP CSA (ΔIPFP CSA) and SCATthigh (ΔSCATthigh) were significantly greater in cases compared to controls, whereas Δ BMI and Δ abdominal circumference were similar in both groups during follow-up. Adjusted ORs for radiographic KOA progression were 9.299, 95% CI (5.357-16.141) per 1 SD increase of Δ IPFP CSA and 1.646, 95% CI (1.288-2.103) per 1 SD increase of Δ SCATthigh. ΔIPFP CSA mediated the association between baseline BMI and radiographic KOA progression (87%). CONCLUSIONS: Subjects with radiographic progression of KOA, had significant increases in IPFP CSA and subcutaneous adipose tissue while BMI and abdominal circumference remained stable. Additional studies are needed to confirm these associations.

INTRODUCTION: Brace treatment is common to address radiological dysplasia in infants with developmental dysplasia of the hip (DDH); however, it is unclear whether bracing provides significant benefit above careful observation by ultrasound. If observation alone is non-inferior to bracing for radiological dysplasia, unnecessary treatment may be avoided. Therefore, the purpose of this study is to determine whether observation is non-inferior to bracing for infants with radiological dysplasia. METHODS AND ANALYSIS: This will be a multicentre, global, randomised, non-inferiority trial performed under the auspices of a global prospective registry for infants and children diagnosed with DDH. Patients will be included if they present with radiological dysplasia (centred hip, alpha angle 43-60°, percent femoral head coverage greater than 35% measured on ultrasound) of a clinically stable hip under 3 months old. Patients will be excluded if they present with clinical hip instability, have received prior treatment or have known/suspected neuromuscular, collagen, chromosomal or lower-extremity congenital abnormalities or syndromic-associated hip abnormalities. Patients will be enrolled and randomised to undergo observation alone or brace treatment with a Pavlik harness for a minimum of 6 weeks. Follow-up visits will occur at 6 weeks, 1 year and 2 years post-enrolment. The primary outcome will be the norm-referenced acetabular index measured on the 2-year radiograph with a 3° non-inferiority margin. A total of 514 patients will be included.The study is anticipated to start in April 2024 and end in September 2028.The primary outcome will be compared between arms with a mixed-effects model with a random intercept for study centre, and a single covariate for the treatment group. If the lower bound of the 95% CI lies within 3° of the mean, we will treat this as evidence for non-inferiority. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the lead sites ethics board (University of British Columbia, Childrens and Womens Research Ethics Board). Ethics approval will be obtained from the local ethics committees or institutional review boards at each institution prior to patient enrolment. It is intended that the results of this study shall be published in peer-reviewed journals and presented at suitable conferences. TRIAL REGISTRATION NUMBER: NCT05869851.

Adult degenerative scoliosis (ADS) is a coronal plane deformity often accompanied by sagittal plane malalignment. Surgical correction may involve the major and/or distally-located fractional curves (FCs). Correction of the FC has been increasingly recognized as key to ameliorating radicular pain localized to the FC levels. The present study aims to summarize the literature on the rationale for FC correction in ADS. Three databases were systematically reviewed to identify all primary studies reporting the rationale for correcting the FC in ADS. Articles were included if they were English full-text studies with primary data from ADS ( ≥ 18 years old) patients. Seventy-four articles were identified, of which 12 were included after full-text review. Findings suggest FC correction with long-segment fusion terminating at L5 increases the risk of distal junctional degeneration as compared to constructs instrumenting the sacrum. Additionally, circumferential fusion offers greater FC correction, lower reoperation risk, and shorter construct length. Minimally invasive surgery (MIS) techniques may offer effective radiographic correction and improve leg pain associated with foraminal stenosis on the FC concavity, though experiences are limited. Open surgery may be necessary to achieve adequate correction of severe, highly rigid deformities. Current data support major curve correction in ASD where the FC concavity and truncal shift are concordant, suggesting that the FC contributes to the patients overall deformity. Circumferential fusion and the use of kickstand rods can improve correction and enhance the stability and durability of long constructs. Last, MIS techniques show promise for milder deformities but require further investigation.

Pulsed-power-driven underwater electrical explosion of cylindrical or conical wire arrays produces supersonic water jets that emerge from a bath, propagating through the air above it. Interaction of these jets with solid targets may represent a new platform for attaining materials at high pressure (>1010 Pa) conditions in a university-scale laboratory. However, measurements of the internal structure of such jets and how they interact with targets are difficult optically due to large densities and density contrasts involved. We utilized multi-frame x-ray radiographic imaging capabilities of the ID19 beamline at the European Synchrotron Radiation Facility to explore the water jet and its interaction with a 50 μm thick copper foil placed a few mm from the surface of water. The jet was generated with a ∼130 kA-amplitude current pulse of ∼450 ns rise time applied to a conical wire array. X-ray imaging revealed a droplet-type structure of the jet with an average density of <400 kg/m3 propagating with a velocity of ∼1400 m/s. Measurements of deformation and subsequent perforation of the target by the jet suggested pressures at the jet–target interface of ∼5 × 109 Pa. The results were compared to hydrodynamic simulations for better understanding of the jet parameters and their interaction with the foil target. These results can be used in future research to optimize the platform, and extend it to larger jet velocities in the case of higher driving currents supplied to the wire array. [ABSTRACT FROM AUTHOR]

BACKGROUND: Global shortages of iodinated contrast media (ICM) during COVID-19 pandemic forced the imaging community to use ICM more strategically in CT exams. PURPOSE: The purpose of this work is to provide a quantitative framework for preserving iodine CNR while reducing ICM dosage by either lowering kV in single-energy CT (SECT) or using lower energy virtual monochromatic images (VMI) from dual-energy CT (DECT) in a phantom study. MATERIALS AND METHODS: In SECT study, phantoms with effective diameters of 9.7, 15.9, 21.1, and 28.5 cm were scanned on SECT scanners of two different manufacturers at a range of tube voltages. Statistical based iterative reconstruction and deep learning reconstruction were used. In DECT study, phantoms with effective diameters of 20, 29.5, 34.6, and 39.7 cm were scanned on DECT scanners from three different manufacturers. VMIs were created from 40 to 140 keV. ICM reduction by lowering kV levels for SECT or switching from SECT to DECT was calculated based on the linear relationship between iodine CNR and its concentration under different scanning conditions. RESULTS: On SECT scanner A, while matching CNR at 120 kV, ICM reductions of 21%, 58%, and 72% were achieved at 100, 80, and 70 kV, respectively. On SECT scanner B, 27% and 80% ICM reduction was obtained at 80 and 100 kV. On the Fast-kV switch DECT, with CNR matched at 120 kV, ICM reductions were 35%, 30%, 23%, and 15% with VMIs at 40, 50, 60, and 68 keV, respectively. On the dual-source DECT, ICM reductions were 52%, 48%, 42%, 33%, and 22% with VMIs at 40, 50, 60, 70, and 80 keV. On the dual-layer DECT, ICM reductions were 74%, 62%, 45%, and 22% with VMIs at 40, 50, 60, and 70 keV. CONCLUSIONS: Our work provided a quantitative baseline for other institutions to further optimize their scanning protocols to reduce the use of ICM.

Six decades after its conception, proton computed tomography (pCT) and proton radiography have yet to be used in medical clinics. However, good progress has been made on relevant detector technologies in the past two decades, and a few prototype pCT systems now exist that approach the performance needed for a clinical device.The tracking and energy-measurement technologies in common use are described, as are the few pCT scanners that are in routine operation at this time.Most of these devices still look like detector R\&D efforts as opposed to medical devices, are difficult to use, are at least factor of five slower than desired for clinical use, and are too small to image many parts of the human body.Recommendations are made for what to consider when engineering a pre-clinical pCT scanner that is designed to meet clinical needs in terms of performance, cost, and ease of use.

PURPOSE: Hip osteoarthritis (OA) is a major cause of pain and disability worldwide. Lack of effective therapies may reflect poor knowledge on its aetiology and risk factors, and result in the management of end-stage hip OA with costly joint replacement. The Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium was established to pool and harmonise individual participant data from prospective cohort studies. The consortium aims to better understand determinants and risk factors for the development and progression of hip OA, to optimise and automate methods for (imaging) analysis, and to develop a personalised prediction model for hip OA. PARTICIPANTS: World COACH aimed to include participants of prospective cohort studies with ≥200 participants, that have hip imaging data available from at least 2 time points at least 4 years apart. All individual participant data, including clinical data, imaging (data), biochemical markers, questionnaires and genetic data, were collected and pooled into a single, individual-level database. FINDINGS TO DATE: World COACH currently consists of 9 cohorts, with 38 021 participants aged 18-80 years at baseline. Overall, 71% of the participants were women and mean baseline age was 65.3±8.6 years. Over 34 000 participants had baseline pelvic radiographs available, and over 22 000 had an additional pelvic radiograph after 8-12 years of follow-up. Even longer radiographic follow-up (15-25 years) is available for over 6000 of these participants. FUTURE PLANS: The World COACH consortium offers unique opportunities for studies on the relationship between determinants/risk factors and the development or progression of hip OA, by using harmonised data on clinical findings, imaging, biomarkers, genetics and lifestyle. This provides a unique opportunity to develop a personalised hip OA risk prediction model and to optimise methods for imaging analysis of the hip.

Porous composite battery electrode performance is influenced by a large number of manufacturing decisions. While it is common to evaluate only finished electrodes when making process adjustments, one must then make inferences about the fabrication process dynamics from static results, which makes process optimization very costly and time-consuming. To get information about the dynamics of the manufacturing processes of these composites, we have built a miniature coating and drying apparatus capable of fabricating lab-scale electrode laminates while operating within an X-ray beamline hutch. Using this tool, we have collected the first radiography image sequences of lab-scale battery electrode coatings in profile, taken throughout drying processes conducted under industrially relevant conditions. To assist with interpretation of these image sequences, we developed an automated image analysis program. Here, we discuss our observations of battery electrode slurry samples, including stratification and long-term fluid flow, and their relevance to composite electrode manufacturing.

BACKGROUND: Meniscal root tears can lead to early knee osteoarthritis and pain. This study aimed (1) to compare clinical and radiological outcomes between patients who underwent arthroscopic meniscal root repair after meniscal root tears and those who received non-surgical treatment, and (2) to identify whether baseline MRI findings could be potential predictors for future treatment strategies. METHODS: Patients with meniscal root tears were identified from our picture archiving and communication system from 2016 to 2020. Two radiologists reviewed radiographs and MRI studies using Kellgren-Lawrence (KL) grading and a modified Whole Organ MRI Scoring (WORMS) at baseline and follow-up. The median (interquartile range [IQR]) of follow-up radiographs and MRI studies were 134 (44-443) days and 502 (260-1176) days, respectively. MR images were assessed for root tear-related findings. Pain scores using visual analogue scale (VAS) and management strategies (non-surgical vs. arthroscopic root repair) were also collected. Chi-squared tests and independent t-tests were used to assess differences regarding clinical and imaging variables between treatment groups. Logistic regression analyses were performed to evaluate the associations between baseline MRI findings and each future treatment. RESULTS: Ninety patients were included. VAS pain scores were significantly (p

Objective. In image-guided radiotherapy (IGRT), off-by-one vertebral body misalignments are rare but potentially catastrophic. In this study, a novel detection method for such misalignments in IGRT was investigated using densely-connected convolutional networks (DenseNets) for applications towards real-time error prevention and retrospective error auditing.Approach. A total of 4213 images acquired from 527 radiotherapy patients aligned with planar kV or MV radiographs were used to develop and test error-detection software modules. Digitally reconstructed radiographs (DRRs) and setup images were retrieved and co-registered according to the clinically applied alignment contained in the DICOM REG files. A semi-automated algorithm was developed to simulate patient positioning errors on the anterior-posterior (AP) and lateral (LAT) images shifted by one vertebral body. A DenseNet architecture was designed to classify either AP images individually or AP and LAT image pairs. Receiver-operator characteristic curves (ROC) and areas under the curves (AUC) were computed to evaluate the classifiers on test subsets. Subsequently, the algorithm was applied to the entire dataset in order to retrospectively determine the absolute off-by-one vertebral body error rate for planar radiograph guided RT at our institution from 2011-2021.Main results. The AUCs for the kV models were 0.98 for unpaired AP and 0.99 for paired AP-LAT. The AUC for the MV AP model was 0.92. For a specificity of 95%, the paired kV model achieved a sensitivity of 99%. Application of the model to the entire dataset yielded a per-fraction off-by-one vertebral body error rate of 0.044% [0.0022%, 0.21%] for paired kV IGRT including one previously unreported error.Significance. Our error detection algorithm was successful in classifying vertebral body positioning errors with sufficient accuracy for retrospective quality control and real-time error prevention. The reported positioning error rate for planar radiograph IGRT is unique in being determined independently of an error reporting system.

Objectives Methods Results Conclusion Chest x‐ray (CXR) plays an important role in childhood tuberculosis (TB) diagnosis, but access to quality CXR remains a major challenge in resource‐limited settings. Digital CXR (d‐CXR) can solve some image quality issues and facilitate their transfer for quality control. We assess the implementation of introducing d‐CXR in 12 district hospitals (DHs) in 2021–2022 across Cambodia, Cameroon, Ivory Coast, Mozambique, Sierra Leone and Uganda as part of the TB‐speed decentralisation study on childhood TB diagnosis.For digitisation of CXR, digital radiography (DR) plates were setup on existing analogue radiography devices. d‐CXR were transferred to an international server at Bordeaux University and downloaded by sites' clinicians for interpretation. We assessed the uptake and performance of CXR services and health care workers' (HCW) perceptions of d‐CXR implementation. We used a convergent mixed method approach utilising process data, individual interviews with 113 HCWs involved in performing or interpreting d‐CXRs and site support supervision reports.Of 3104 children with presumptive TB, 1642 (52.9%) had at least one d‐CXR, including 1505, 136 and 1 children with one, two and three d‐CXRs, respectively, resulting in a total of 1780 d‐CXR. Of them, 1773 (99.6%) were of good quality and 1772/1773 (99.9%) were interpreted by sites' clinicians. One hundred and sixty‐four children had no d‐CXR performed despite attending the radiography department: 126, 37 and 1 with one, two and three attempts, respectively. d‐CXRs were not performed in 21.6% (44/203) due to connectivity problem between the DR plate captor and the computer. HCW reported good perceptions of d‐CXR and of the DR plates provided. The main challenge was the upload to and download from the server of d‐CXRs due to limited internet access.d‐CXR using DR plates was feasible at DH level and provided good quality images but required overcoming operational challenges. [ABSTRACT FROM AUTHOR]

Background: Dark-field radiography imaging exploits the wave character of x-rays to measure small-angle scattering on material interfaces, providing structural information with low radiation exposure. We explored the potential of dark-field imaging of bone microstructure to improve the assessment of bone strength in osteoporosis. Methods: We prospectively examined 14 osteoporotic/osteopenic and 21 non-osteoporotic/osteopenic human cadaveric vertebrae (L2–L4) with a clinical dark-field radiography system, micro-computed tomography (CT), and spectral CT. Dark-field images were obtained in both vertical and horizontal sample positions. Bone microstructural parameters (trabecular number, Tb.N; trabecular thickness, Tb.Th; bone volume fraction, BV/TV; degree of anisotropy, DA) were measured using standard ex vivo micro-CT, while hydroxyapatite density was measured using spectral CT. Correlations were assessed using Spearman rank correlation coefficients. Results: The measured dark-field signal was lower in osteoporotic/osteopenic vertebrae (vertical position, 0.23 ± 0.05 versus 0.29 ± 0.04, p < 0.001; horizontal position, 0.28 ± 0.06 versus 0.34 ± 0.04, p = 0.003). The dark-field signal from the vertical position correlated significantly with Tb.N (ρ = 0.46, p = 0.005), BV/TV (ρ = 0.45, p = 0.007), DA (ρ = -0.43, p = 0.010), and hydroxyapatite density (ρ = 0.53, p = 0.010). The calculated ratio of vertical/horizontal dark-field signal correlated significantly with Tb.N (ρ = 0.43, p = 0.011), BV/TV (ρ = 0.36, p = 0.032), DA (ρ = -0.51, p = 0.002), and hydroxyapatite density (ρ = 0.42, p = 0.049). Conclusion: Dark-field radiography is a feasible modality for drawing conclusions on bone microarchitecture in human cadaveric vertebral bone. Relevance statement: Gaining knowledge of the microarchitecture of bone contributes crucially to predicting bone strength in osteoporosis. This novel radiographic approach based on dark-field x-rays provides insights into bone microstructure at a lower radiation exposure than that of CT modalities. Key Points: Dark-field radiography can give information on bone microstructure with low radiation exposure. The dark-field signal correlated positively with bone microstructure parameters. Dark-field signal correlated negatively with the degree of anisotropy. Dark-field radiography helps to determine the directionality of trabecular loss. [ABSTRACT FROM AUTHOR]

Background: Appropriate selection of surgical approach for associated fractures of the acetabulum that involves both columns is still elusive. Therefore, present study aimed to assess the quality of life of complex acetabulum fracture managed with combined anterior and posterior approach (dual approach) as well as the association of postoperative reduction and patient reported outcomes. Material and methods: This retrospective study was performed on 42 associated acetabular fracture patients with involvement of both columns, who were treated with a dual approach including combined anterior modified ilio-inguinal approach in combination with posterior Kocher-Langenbeck (K-L) approach in a single anaesthetic session having minimum two years follow-up. Postoperative reduction and radiological outcomes were assessed using Matta criteria. Functional outcome was assessed by a score system developed by Merle d'Aubigné-Postel. Patient-reported outcomes were assessed using the 36-Item Short Form Survey (SF-36). Results: The mean age of participants was 47.9 ± 11.95 years and mean follow-up period was 2.8 ± 0.49 years. Anatomical reduction was achieved in 32 (76.19%) cases in postoperative period. 8 (19.04%) cases had congruent and 2 (4.76%) had incongruent reduction. Radiological and functional outcome was excellent/good n = 35 (83.33%) cases. Patient-reported outcome on domains physical function and role physical showed a significant improvement between 6 to 24 months period (p < 0.001). Conclusions: The dual approach for complex acetabulum fracture with mid-term follow-up showed good to excellent radiological and functional outcomes. A significant improvement in patient-reported outcomes on Physical function and Role physical domains of SF-36 was also seen over the follow-up period. [ABSTRACT FROM AUTHOR]

Purpose: To develop a deep learning-based cascaded HRNet model, in order to automatically measure X-ray imaging parameters of lumbar sagittal curvature and to evaluate its prediction performance. Methods: A total of 3730 lumbar lateral digital radiography (DR) images were collected from picture archiving and communication system (PACS). Among them, 3150 images were randomly selected as the training dataset and validation dataset, and 580 images as the test dataset. The landmarks of the lumbar curve index (LCI), lumbar lordosis angle (LLA), sacral slope (SS), lumbar lordosis index (LLI), and the posterior edge tangent angle of the vertebral body (PTA) were identified and marked. The measured results of landmarks on the test dataset were compared with the mean values of manual measurement as the reference standard. Percentage of correct key-points (PCK), intra-class correlation coefficient (ICC), Pearson correlation coefficient (r), mean absolute error (MAE), mean square error (MSE), root-mean-square error (RMSE), and Bland–Altman plot were used to evaluate the performance of the cascade HRNet model. Results: The PCK of the cascaded HRNet model was 97.9–100% in the 3 mm distance threshold. The mean differences between the reference standard and the predicted values for LCI, LLA, SS, LLI, and PTA were 0.43 mm, 0.99°, 1.11°, 0.01 mm, and 0.23°, respectively. There were strong correlation and consistency of the five parameters between the cascaded HRNet model and manual measurements (ICC = 0.989–0.999, R = 0.991–0.999, MAE = 0.63–1.65, MSE = 0.61–4.06, RMSE = 0.78–2.01). Conclusion: The cascaded HRNet model based on deep learning algorithm could accurately identify the sagittal curvature-related landmarks on lateral lumbar DR images and automatically measure the relevant parameters, which is of great significance in clinical application. [ABSTRACT FROM AUTHOR]

Sarcoidosis staging primarily has relied on the Scadding chest radiographic system, although chest CT imaging is finding increased clinical use. Whether standardized chest CT scan assessment provides additional understanding of lung function beyond Scadding stage and demographics is unknown and the focus of this study. We used National Heart, Lung, and Blood Institute study Genomics Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) cases of sarcoidosis (n = 351) with Scadding stage and chest CT scans obtained in a standardized manner. One chest radiologist scored all CT scans with a visual scoring system, with a subset read by another chest radiologist. We compared demographic features, Scadding stage and CT scan findings, and the correlation between these measures. Associations between spirometry and diffusing capacity of the lungs for carbon monoxide (D lco) results and CT scan findings and Scadding stage were determined using regression analysis (n = 318). Agreement between readers was evaluated using Cohen's κ value. CT scan features were inconsistent with Scadding stage in approximately 40% of cases. Most CT scan features assessed on visual scoring were associated negatively with lung function. Associations persisted for FEV 1 and D lco when adjusting for Scadding stage, although some CT scan feature associations with FVC became insignificant. Scadding stage was associated primarily with FEV 1 , and inclusion of CT scan features reduced significance in association between Scadding stage and lung function. Multivariable regression modeling to identify radiologic measures explaining lung function included Scadding stage for FEV 1 and FEV 1 to FVC ratio (P <. 05) and marginally for D lco (P <. 15). Combinations of CT scan measures accounted for Scadding stage for FVC. Correlations among Scadding stage and CT scan features were noted. Agreement between readers was poor to moderate for presence or absence of CT scan features and poor for degree and location of abnormality. In this study, CT scan features explained additional variability in lung function beyond Scadding stage, with some CT scan features obviating the associations between lung function and Scadding stage. Whether CT scan features, phenotypes, or endotypes could be useful for treating patients with sarcoidosis needs more study. [ABSTRACT FROM AUTHOR]

To review the anatomy of the spiral groove, its clinical significance, and the imaging characteristics of common pathologies affecting this area, highlighting the strengths of different imaging modalities. A comprehensive review of the spiral groove anatomy and its clinical implications and an evaluation of various imaging techniques, including radiography, ultrasound, MRI, and CT, was conducted. The review covers pathologic conditions such as Saturday night palsy, humeral fractures, tumours, and infections, with an emphasis on their imaging findings and clinical implications. The spiral groove provides a pathway for the radial nerve and the deep brachial artery, both crucial for upper limb function. Each imaging modality offers unique advantages: radiography is useful for initial assessment, ultrasound provides dynamic visualisation, MRI offers high-resolution soft tissue imaging, and CT is ideal for detailed bone anatomy. Understanding these imaging characteristics is essential for diagnosing fractures, assessing humeral alignment, and detecting nerve entrapment or injury. Accurate imaging of the spiral groove is essential for diagnosing and treating pathologies related to this anatomical feature. The integrative approach of using appropriate imaging modalities enhances diagnostic precision and informs therapeutic strategies, ultimately improving patient outcomes. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is a rapidly growing field with significant implications for radiology. Acute abdominal pain is a common clinical presentation that can range from benign conditions to life-threatening emergencies. The critical nature of these situations renders emergent abdominal imaging an ideal candidate for AI applications. CT, radiographs, and ultrasound are the most common modalities for imaging evaluation of these patients. For each modality, numerous studies have assessed the performance of AI models for detecting common pathologies, such as appendicitis, bowel obstruction, and cholecystitis. The capabilities of these models range from simple classification to detailed severity assessment. This narrative review explores the evolution, trends, and challenges in AI applications for evaluating acute abdominal pathologies. We review implementations of AI for non-traumatic and traumatic abdominal pathologies, with discussion of potential clinical impact, challenges, and future directions for the technology. [ABSTRACT FROM AUTHOR]

Purpose: Scoliosis is a complex spine deformity with direct functional and cosmetic impacts on the individual. The reference standard for assessing scoliosis severity is the Cobb angle which is measured on radiographs by human specialists, carrying interobserver variability and inaccuracy of measurements. These limitations may result in lack of timely referral for management at a time the scoliotic deformity progression can be saved from surgery. We aimed to create a machine learning (ML) model for automatic calculation of Cobb angles on 3-foot standing spine radiographs of children and adolescents with clinical suspicion of scoliosis across 2 clinical scenarios (idiopathic, group 1 and congenital scoliosis, group 2). Methods: We retrospectively measured Cobb angles of 130 patients who had a 3-foot spine radiograph for scoliosis within a 10-year period for either idiopathic or congenital anomaly scoliosis. Cobb angles were measured both manually by radiologists and by an ML pipeline (segmentation-based approach—Augmented U-Net model with non-square kernels). Results: Our Augmented U-Net architecture achieved a Symmetric Mean Absolute Percentage Error (SMAPE) of 11.82% amongst a combined idiopathic and congenital scoliosis cohort. When stratifying for idiopathic and congenital scoliosis individually a SMAPE of 13.02% and 11.90% were achieved, respectively. Conclusion: The ML model used in this study is promising at providing automated Cobb angle measurement in both idiopathic scoliosis and congenital scoliosis. Nevertheless, larger studies are needed in the future to confirm the results of this study prior to translation of this ML algorithm into clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: We developed the deep neural network (DNN) model to automatically measure hallux valgus angle (HVA) and intermetatarsal angle (IMA) on foot radiographs. The objective is to assess the accuracy of the model by comparing to the manual measurement of foot and ankle surgeons. Materials and methods: A DNN was developed to predict the bone axes of the first proximal phalanx and all metatarsals from the first to the fifth in foot radiographs. The dataset used for model development consisted of 1798 radiographs collected from a population-based cohort and patients at our foot and ankle clinic. The retrospective validation cohort comprised of 92 radiographs obtained from 92 consecutive patients visiting our foot and ankle clinic. The mean absolute error (MAE) between automatic measurements by the model and the median of manual measurements by three foot and ankle surgeons was compared to 3° using one-tailed t-test and was also compared to the inter-rater difference in manual measurements among the three surgeons using two-tailed paired t-test. Results: The MAE for HVA was 1.3° (upper limit of 95% CI 1.6°), and this was significantly smaller than the inter-rater difference of 2.0 ± 0.2° among the surgeons, demonstrating the superior accuracy of the model. In contrast, the MAE for IMA was 0.8° (upper limit of 95% CI 1.0°) that showed no significant difference from the inter-rater difference of 1.0 ± 0.1° among the surgeons. Conclusion: Our model demonstrated the ability to measure the HVA and IMA with an accuracy comparable to that of specialists. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the potential of low-dose ultra-high-resolution CT (UHRCT) images to generate high-quality radiographic images on extremity phantoms and to estimate the radiation dose required for this. Materials and methods: A hand and knee phantom containing real human bones was imaged on an UHRCT scanner at full-dose, half-dose, and quarter-dose levels using a high-resolution extremity protocol. The raw data was reconstructed using both filtered back projection (FBP) and an iterative reconstruction algorithm (AIDR3D). Using custom designed software, each CT volume data set was converted to attenuation coefficients, and then a synthesized radiograph (synDX) was generated by forward projecting the volume data sets from a point source onto a 2D synthetic detector. The signal-to-noise ratio (SNR) was measured in the synDXs across all dose levels and the root-mean-squared error (RMSE) was computed with the FD synDXs as the reference. Results: The proposed workflow generates high-quality synDXs at any arbitrary angle. For FBP, the SNR largely tracked with the radiation dose levels for both the knee and hand phantoms. For the knee phantom, iterative reconstruction provided a 6.1% higher SNR when compared to FBP. The RMSE was overall higher for the lowest dose levels and monotonically decreased with increasing dose. No substantial differences were observed qualitatively in the visualization of skeletal detail of the phantoms. Conclusion: The fine detail provided by UHRCT acquisitions of extremities facilitates the ability to generate quality radiographs, potentially eliminating the need for additional scanning on a conventional digital radiography system. [ABSTRACT FROM AUTHOR]

Central hemangioma is a rare benign proliferation of blood vessels most often seen in the vertebral column and skull, but rarely in the jaws. It mainly occurs in the second decade of life with a female predilection. The diagnosis of central hemangioma is challenging due to its variable clinical and radiological characteristics and low incidence in the jaws. This article presents two cases of maxillary central hemangioma, analyzing their clinical, radiographic, and histological features and comparing them with existing literature on central hemangioma. KEY POINTS: The diagnosis of central hemangioma in the jaws is challenging due to its rarity and variable radiographic characteristics. Prompt and accurate diagnosis is crucial for effective management, highlighting the need for clinicians to recognize the diverse features of this lesion. [ABSTRACT FROM AUTHOR]

This study evaluated radiographic graft changes following maxillary sinus floor augmentation with (A) autogenous bone, (B) 1:1 autogenous bone and deproteinized porcine bone mineral, or (C) 1:1 autogenous bone and biphasic bone graft material. Sixty patients were randomly allocated to groups A, B, and C (20 in each). CBCT scans were obtained at enrolment, after surgery (T1), after prosthetic rehabilitation (T2), and 1 year after implant loading (T3). Significant decreases in graft volume (3D) and graft height (2D) from T1 to T3 were observed in all groups (P < 0.05). However, at T2 and T3, graft volume was significantly higher in group B than in groups A and C (P < 0.05), and graft height was significantly higher in group B than in group A (P < 0.05). Bone density increased significantly from T1 to T2 in all groups (P < 0.001). However, bone density was significantly higher in group B than in groups A and C, at T2 and T3 (P < 0.05). No significant correlation between graft volume or height and implant protrusion length or residual bone height was found. In conclusion, 1:1 autogenous bone and porcine bone resulted in significantly higher graft volume, height, and bone density when compared with autogenous bone or a 1:1 ratio of autogenous bone and biphasic bone. However the higher graft volume, height, and bone density did not appear to lead to improved outcomes at 1 year of functional loading when compared to the other groups. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Osteochondroma is the most common bone tumor and is a surface bone lesion that includes cortical and medullary bone with a hyaline cartilage cap. Benign osteochondroma is a common tumor in children that may be asymptomatic but can cause pain and limit joint movement when arising in a joint. This report describes the presentation, diagnosis, and management of an intra-articular osteochondroma of the right elbow joint in an 8-year-old boy. Case Report: An 8-year-old boy experienced persistent right elbow pain and limited motion, which were unresponsive to conservative measures. Examination revealed a firm swelling in the right cubital fossa. Radiographic and advanced imaging confirmed an osteochondroma originating from the capitellum and trochlea. Surgical exploration via a lateral approach and capsulotomy excised a lobulated intra-articular mass (5×2×1.5 cm). Histopathology showed a hyaline cartilage cap with typical chondrocytes and endochondral ossification, and normal fatty marrow and hematopoietic elements in the stroma. The procedure restored normal elbow function. This case is the first documented instance of an elbow joint intra-articular osteochondroma. Conclusions: This report has highlighted the importance of surgical removal and histopathology in the diagnosis of this common bone lesion to exclude the differential diagnoses of intra-articular masses that include a foreign body, enchondroma, chondroblastoma, periosteal chondroma, chondromyxoid fibroma, or malignant chondrosarcoma. [ABSTRACT FROM AUTHOR]

Background: Proximal caries datasets for training artificial intelligence (AI) algorithms commonly include clinician-annotated radiographs. These conventional annotations are susceptible to observer variability, and early caries may be missed. Micro-computed tomography (CT), while not feasible in clinical applications, offers a more accurate imaging modality to support the creation of a reference-standard dataset for caries annotations. Herein, we present the Academic Center for Dentistry Amsterdam—Diagnostic Insights for Radiographic Early-caries with micro-CT (ACTA-DIRECT) dataset, which is the first dataset pairing dental radiographs and micro-CT scans to enable higher-quality annotations. Methods: The ACTA-DIRECT dataset encompasses 179 paired micro-CT scans and radiographs of early proximal carious teeth, along with three types of annotations: conventional annotations on radiographs, micro-CT-assisted annotations on radiographs, and micro-CT annotations (reference standard). Three dentists independently annotated proximal caries on radiographs, both with and without micro-CT assistance, enabling determinations of interobserver agreement and diagnostic accuracy. To establish a reference standard, one dental radiologist annotated all caries on the related micro-CT scans. Results: Micro-CT support improved interobserver agreement (Cohen's Kappa), averaging 0.64 (95% confidence interval [CI]: 0.59–0.68) versus 0.46 (95% CI: 0.44–0.48) in its absence. Likewise, average sensitivity and specificity increased from 42% (95% CI: 34–51%) to 63% (95% CI: 54–71%) and from 92% (95% CI: 88–95%) to 95% (95% CI: 92–97%), respectively. Conclusion: The ACTA-DIRECT dataset offers high-quality images and annotations to support AI-based early caries diagnostics for training and validation. This study underscores the benefits of incorporating micro-CT scans in lesion assessments, providing enhanced precision and reliability. [ABSTRACT FROM AUTHOR]

Introduction: Narrowed tracheal lumen diameter (TLD) in dogs caused by congenital hypoplasia or acquired tracheal stenosis can result in adverse health effects. Standardized tracheal scores calculated from radiographic measurements have been used to assess tracheal diameter however comparisons have not been made to characterize differences in tracheal lumen among breeds. Methods: The main objective of this study was to compare tracheal scores at three regions of the trachea among non-brachycephalic dogs, non-bulldog brachycephalic dogs, and bulldogs. Medical records and thoracic radiographs of clinically normal dogs were reviewed. The TLDs 79 of three different tracheal regions (caudal cervical, thoracic inlet, and intrathoracic) were standardized by the manubrium length (ML) and thoracic inlet distance (Ti-D) to calculate the manubrium and thoracic inlet tracheal indexes (M-TI and Ti-TI) at each region. Statistical analysis was used to analyze the differences in tracheal scores among the three breed populations. Results: Overall, M-TI and Ti-TI varied significantly (p < 0.0001) at the three tracheal levels among the three breed populations. Bulldogs and non-bulldog brachycephalic breeds possessed lower (p < 0.016) M-TI and Ti-TI than nonbrachycephalic breeds at the three tracheal regions, and bulldogs possessed the lowest M-TI and Ti-TI scores at all measured regions. Conclusion: Averaged M-TIs <0.38, <0.34, <0.32 in non-brachycephalic, nonbulldog brachycephalic, and bulldog breeds, respectively, may indicate tracheal hypoplasia. Utilizing M-TI can be recommended for the assessment of canine TLD however further investigation in dogs with concurrent respiratory diseases is warranted. [ABSTRACT FROM AUTHOR]

Background: This study aimed to conduct a systematic review and meta-analysis to summarize the available evidence comparing the diagnostic accuracy of periapical radiography (PA) and cone-beam computed tomography (CBCT) for detection of vertical root fractures (VRFs). Methods: A search was conducted in PubMed, Scopus, and Web of Science for articles published regarding all types of human teeth. Data were analyzed by Comprehensive Meta-Analysis statistical software V3 software program. The I2 statistic was applied to analyze heterogeneity among the studies. Results: Twenty-three articles met the criteria for inclusion in the systematic review and 16 for the meta-analysis. The sensitivity and specificity for detection of VRFs were calculated to be 0.51 and 0.87, respectively for PA radiography, and 0.70 and 0.84, respectively for CBCT. Conclusions: The sensitivity of CBCT was higher than PA radiography; however, difference between the specificity of the two modalities was not statistically significant. [ABSTRACT FROM AUTHOR]

The accurate classification of bone tumours is crucial for guiding clinical decisions regarding treatment and follow-up. However, differentiating between various tumour types is challenging due to the rarity of certain entities, high intra-class variability, and limited training data in clinical practice. This study proposes a multimodal deep learning model that integrates clinical metadata and X-ray imaging to improve the classification of primary bone tumours. The dataset comprises 1,785 radiographs from 804 patients collected between 2000 and 2020, including metadata such as age, affected bone site, tumour position, and gender. Ten tumour types were selected, with histopathology or tumour board decisions serving as the reference standard. Methods: Our model is based on the NesT image classification model and a multilayer perceptron with a joint fusion architecture. Descriptive statistics included incidence and percentage ratios for discrete parameters, and mean, standard deviation, median, and interquartile range for continuous parameters. Results: The mean age of the patients was 33.62 ± 18.60 years, with 54.73% being male. Our multimodal deep learning model achieved 69.7% accuracy in classifying primary bone tumours, outperforming the Vision Transformer model by five percentage points. SHAP values indicated that age had the most substantial influence among the considered metadata. Conclusion: The joint fusion approach developed in this study, integrating clinical metadata and imaging data, outperformed state-of-the-art models in classifying primary bone tumours. The use of SHAP values provided insights into the impact of different metadata on the model's performance, highlighting the significant role of age. This approach has potential implications for improving diagnostic accuracy and understanding the influence of clinical factors in tumour classification. [ABSTRACT FROM AUTHOR]

Background: Sagittal balance, commonly impaired in lumbar spinal stenosis (LSS) patients, is typically assessed using the sagittal vertical axis (SVA) with EOS imaging. However, to limit X-ray exposure and medical costs, it could be interesting to evaluate the capacity of quantified motion analysis to estimate the 3D modeling of SVA in patients with symptomatic LSS. Methods: An estimation of the SVA in patients with LSS was performed with 3D motion analysis. SVA and "C7_PSI" (orthogonal horizontal distance between the vertical lines through the markers of the C7 vertebra and the middle of the posterosuperior iliac spine) were measured on 37 LSS patients using EOS radiography and postural and 3D motion analysis, respectively. Multiple stepwise linear regressions were performed with EOS SVA according to age, body mass index, C7_PSI and/or postural variables. Results: A highly significant relationship was found between SVA and C7_PSI, mediolateral amplitude of CoP displacements and age (adjusted R²=0.69, p < 0.0001). While the postural analysis did not reveal significant relationships, the model using 3D parameters revealed significant relationships between radiographic SVA and C7_PSI and age (adjusted R²=0.65, p < 0.0001). 3D motion parameters with or without postural parameters may explain more than 65% of the variance seen in EOS imaging performed on LSS patients. Conclusions: These promising results in LSS patients suggest that the estimation of SVA with 3D motion analysis offers an alternative to EOS. In addition, SVA could be assessed at rest and during dynamic tasks. Trial registration: This study has been published in Clinical Trial registration (reference NCT03194607). [ABSTRACT FROM AUTHOR]

Objectives: Compare the accuracy and diagnostic concordance of three commercially available AI-based lateral cephalometric tracing software. Materials and methods: Sixty-three lateral cephalometric radiographs were analyzed using semi-automatic (Dolphin Imaging Systems LLC) and AI-based software programs (WebCeph™, Cephio, and Ceppro DDH Inc.). Intra- and inter-observer reliability were assessed for human expert measurements, and repeated-measures one-way ANOVA was used to compare the AI and human expert measurements. The diagnostic performance was evaluated using sensitivity and specificity tests. Results: Human expert reliability was excellent (ICC > 0.9) for most cephalometric parameters. Compared to human experts, significant differences were observed for all three AI-based cephalometric programs (WebCeph™ – 10 of 11, Cephio – 7 of 11, and Ceppro DDH Inc. – 7 of 11 cephalometric measurements). Variations exceeding two units were noted for most parameters, and differences in defining the sagittal and vertical skeletal patterns, dental, and soft tissue characteristics were observed. Conclusion: All three AI-based tracing programs showed inaccuracies compared to human expert measurements and lacked reliability in measuring key cephalometric parameters. Clinicians should exercise caution when relying solely on AI-based analyses for orthodontic treatment planning and assessment. [ABSTRACT FROM AUTHOR]

Anatomical parameters of the pelvis, femur, and tibia derived from the full-length radiograph can be used to create a more accurate musculoskeletal model compared to marker-based linear scaling method. However, whether this model leads to more accurate estimations of medial knee contact force (MCF) and lateral knee contact force (LCF) than marker-based linear scaling method is still unknown. This main purpose of this study was to determine whether musculoskeletal model generated from full-length radiograph improves the estimations of MCF and LCF. An open-source dataset including marker trajectories, ground reaction forces, in vivo knee contact forces, and full-length radiograph was used to evaluate the accuracy of full-length radiograph musculoskeletal modeling method. Subject-specific musculoskeletal models were created using anatomical parameters derived from the full-length radiograph or marker-based linear scaling methods. MCF and LCF were estimated using musculoskeletal simulations of normal walking trails. The accuracy of modeling methods was determined by comparing the estimated and in vivo measured MCF and LCF. Compared to the marker-based linear scaling approach, the full-length radiograph musculoskeletal modeling method exhibited decreases of 38.3 % and 41.3 % in root mean square error for MCF and LCF respectively, as well as reductions of 50.0 % and 49.3 % in mean peak errors for MCF and LCF respectively. The full-length radiograph musculoskeletal modeling method provides a more accurate way to estimate MCF and LCF compared to the traditional maker-based linear scaling approach, which may contribute to understand the initiation, progression, and treatment of OA. • Validation of full-length radiograph musculoskeletal modeling method. • More accurate estimation of medial contact force than traditional method. • More accurate estimation of lateral contact force than traditional method. [ABSTRACT FROM AUTHOR]

Within Xenarthra (Eocene‐Recent), Folivora developed (late Eocene‐Recent) a remarkable diversity with respect to ecology and taxonomy over its evolutionary history. Knowledge of the diversity achieved by members of this clade in high‐altitude areas of South America (i.e., Altiplano and Puna regions of Peru, Bolivia, and northwestern Argentina) has been improved in recent decades. A particular example involves the late Neogene Mylodontidae Simomylodon uccasamamensis, known mostly from multiple specimens recovered from the Bolivian Altiplano. Although several anatomical descriptions of this ground sloth have been published, almost nothing is known about its ontogenetic development and the associated morphological changes. Here we describe and compare new specimens of S. uccasamamensis from the upper level of the Tafna Formation (Pliocene) in the eastern Puna (ca. 3800 masl), Argentina, representing the southernmost record of this species. The new material is represented by specimens showing different ontogenetic stages, from infant to adult. One subadult specimen reached an estimated body mass of ca. 232 kg. The comparative study of external and internal morphology (the latter obtained from CT scans and radiography) shows remarkable changes in the mandible and molariforms associated with ontogeny; in addition, evidence suggests that the mfs2‐3 are the first functional teeth, followed by mf1 and cf1. Based on our body mass estimates (ca. 232 kg.), we inferred an average lifespan of 14 years, 9‐month gestation time, and sexual maturation at 4.1 years, quite similar to the values we obtained based on estimated body masses of adult specimens from Bolivia published by previous authors. Along its latitudinal distribution (ca. 14° S‐21° S) S. uccasamamensis co‐occurred with other ground sloths (e.g., Megatheriinae, Thalassocninae, and Scelidotheriinae), suggesting niche partitioning. The presence of this medium‐sized ground sloth is consistent with the similarity between the faunas of eastern Puna and the Bolivian Altiplano during the Pliocene, which is also concordant with what was observed in other clades, such as Rodentia and Notoungulata. [ABSTRACT FROM AUTHOR]

AbstractPerovskite scintillators have garnered significant interest in the realm of gamma-ray imaging in the past few years. Here, a comprehensive investigation into the gamma-ray imaging properties of CsPbBr3-PP composite scintillators is presented, wherein the Monte Carlo simulation approach offered by Geant4 is utilized. The primary focus is on the point spread function and modulation transfer function of the material, elucidating the nuanced interactions between gamma-ray energy, scintillator thickness, and their resultant imaging capabilities. A key aspect of this study is the exploration of the nonlinear and inverse effect of scintillator thickness and the energy of the photon beam on the imaging quality, highlighting the trade-offs between energy deposition and image resolution.This research underscores the importance of optimizing the scintillator design to balance these factors, catering to specific applications in high-energy detection and imaging. This work not only contributes significantly to the field of material sciences and radiographic imaging, but also provides practical insights for the development of more effective scintillator-based detectors. The findings of this study have broad implications for the design and application of perovskite scintillators in various high-tech industries and scientific research. [ABSTRACT FROM AUTHOR]

The field of radiology imaging has experienced a remarkable increase in using of deep learning (DL) algorithms to support diagnostic and treatment decisions. This rise has led to the development of Explainable AI (XAI) system to improve the transparency and trust of complex DL methods. However, XAI systems face challenges in gaining acceptance within the healthcare sector, mainly due to technical hurdles in utilizing these systems in practice and the lack of human-centered evaluation/validation. In this study, we focus on visual XAI systems applied to DL-enabled diagnostic system in chest radiography. In particular, we conduct a user study to evaluate two prominent visual XAI techniques from the human perspective. To this end, we created two clinical scenarios for diagnosing pneumonia and COVID-19 using DL techniques applied to chest X-ray and CT scans. The achieved accuracy rates were 90% for pneumonia and 98% for COVID-19. Subsequently, we employed two well-known XAI methods, Grad-CAM (Gradient-weighted Class Activation Mapping) and LIME (Local Interpretable Model-agnostic Explanations), to generate visual explanations elucidating the AI decision-making process. The visual explainability results were shared through a user study, undergoing evaluation by medical professionals in terms of clinical relevance, coherency, and user trust. In general, participants expressed a positive perception of the use of XAI systems in chest radiography. However, there was a noticeable lack of awareness regarding their value and practical aspects. Regarding preferences, Grad-CAM showed superior performance over LIME in terms of coherency and trust, although concerns were raised about its clinical usability. Our findings highlight key user-driven explainability requirements, emphasizing the importance of multi-modal explainability and the necessity to increase awareness of XAI systems among medical practitioners. Inclusive design was also identified as a crucial need to ensure better alignment of these systems with user needs. [ABSTRACT FROM AUTHOR]

Background: Indications for total hip arthroplasty (THA) have evolved over recent decades, with a growing trend toward operating on younger and more active patients. With this shift in patient demographics, there has been a change in femoral stem designs and proximal femoral morphology encountered. This study aimed to evaluate the potential correlation between femoral stem osteointegration and proximal femoral morphology using the Dorr and Noble classifications. Materials and methods: We conducted a retrospective review of 122 uncemented femoral stems (AMIstem Medacta, triple tapered). The demographic data analyzed included sex, age, stem size, and surgical indications. Preoperative radiographs were reviewed to determine the Dorr classification as well as the canal-to-calcar isthmus ratio, cortical index, and canal flare index. Postoperative radiographs were carefully reviewed to identify the presence of potential postoperative radiolucencies. Inter- and intra-observer agreements for these parameters were also analyzed. Results: Significant radiolucencies (> 2 mm) were found in 19.5% of the patients. Of all the variables analyzed, the cortical index was the only parameter significantly associated with the appearance of clinically significant radiolucency, with a threshold value of 0.62. Conclusions: The appearance of radiolucencies is multi-factorial. Nevertheless, in this study, a high cortical index (> 0.62), representing the champagne flute morphology, was found to be associated with the development of significant radiolucencies. [ABSTRACT FROM AUTHOR]

Background: Detecting vertebral structural damage in patients with ankylosing spondylitis (AS) is crucial for understanding disease progression and in research settings. Objectives: This study aimed to use deep learning to score the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) using lateral X-ray images of the cervical and lumbar spine in patients with AS in Asian populations. Design: A deep learning model was developed to automate the scoring of mSASSS based on X-ray images. Methods: We enrolled patients with AS at a tertiary medical center in Taiwan from August 1, 2001 to December 30, 2020. A localization module was used to locate the vertebral bodies in the images of the cervical and lumbar spine. Images were then extracted from these localized points and fed into a classification module to determine whether common lesions of AS were present. The scores of each localized point were calculated based on the presence of these lesions and summed to obtain the total mSASSS score. The performance of the model was evaluated on both validation set and testing set. Results: This study reviewed X-ray image data from 554 patients diagnosed with AS, which were then annotated by 3 medical experts for structural changes. The accuracy for judging various structural changes in the validation set ranged from 0.886 to 0.985, whereas the accuracy for scoring the single vertebral corner in the test set was 0.865. Conclusion: This study demonstrated a well-trained deep learning model of mSASSS scoring for detecting the vertebral structural damage in patients with AS at an accuracy rate of 86.5%. This artificial intelligence model would provide real-time mSASSS assessment for physicians to help better assist in radiographic status evaluation with minimal human errors. Furthermore, it can assist in a research setting by offering a consistent and objective method of scoring, which could enhance the reproducibility and reliability of clinical studies. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the accuracy of detecting vertical root fractures in Biodentine™-filled teeth using the Promax 3Dmax cone-beam computed tomography (CBCT) unit compared to periapical radiographs. It tested hypotheses regarding CBCT's diagnostic superiority in non-root-filled and Biodentine™-root-filled maxillary central incisors and assessed the impact of smaller field of view and lower intensity settings on detection accuracy. Materials and methods: Extracted maxillary incisors were divided into groups based on fracture status and root filling material, then placed in a Thiel-embalmed skull to simulate clinical conditions. The teeth were imaged using periapical radiographs and the CBCT unit under different settings. Fracture thickness was measured with microcomputed tomography for accuracy benchmarking. Multiple observers assessed the images, and statistical analyses were conducted to evaluate diagnostic performance. Results: Intra-rater reliabilities of consensus scores ranged from good to very good. Specificities were generally higher than sensitivities across all imaging modalities, but sensitivities remained constantly low. None of the Area Under the Curve scores exceeded 0.6, indicating poor overall accuracy for all imaging modalities. Paired comparisons of the area differences under Receiver Operator Characteristic curves revealed no significant differences between the CBCT and periapical radiograph techniques for detecting vertical root fractures in either Biodentine™-filled or non-root-filled teeth. Conclusions: There was no significant accuracy improvement of the current CBCT device (Promax 3Dmax, Planmeca, Finland) over periapical radiographs in detecting small vertical root fractures in both non-root-filled and Biodentine™-root-filled maxillary central incisors. A smaller field of view with lower intensity did not enhance detection accuracy. These results highlight the challenges in accurately detecting small VRFs, emphasizing the need for further research and technological advancements in this domain. [ABSTRACT FROM AUTHOR]

Background • Lumbar spondylolysis (LS) poses a potential threat, and there is a need to evaluate and compare the effectiveness of direct pars repair techniques. Objective • To assess and compare the clinical and radiographic outcomes of direct pars repair techniques using the pedicle screw hook system (PSHS) and the pedicle screw rod system (PSRS) in young symptomatic patients with lumbar spondylolysis. Methods • A retrospective study was conducted to compare clinical and radiological data in young symptomatic LS patients after surgery. Records of 45 post-surgery LS patients with a minimum 24-month follow-up (January 2014 to June 2019) were reviewed. A total of 26 patients underwent PSHS, and 19 had PSRS. Treatment outcomes were analyzed using the visual analog pain scale (VAS), Oswestry disability index (ODI), MacNab criteria, lumbar fusion status, and Pfirrmann grading standards. Patient baseline characteristics were also compared between the two groups. Results • No disc degeneration was observed in either PSHS or PSRS groups at 24 months postoperatively, according to the Pfirrmann grading scale. The PSRS group outperformed the PSHS group in operative time, intraoperative blood loss, postoperative drainage, length of hospital stays, ODI, VAS values at 3 months postoperatively, and fusion status at 6 months postoperatively. No notable differences were observed in other parameters during the 24-month follow-up period, and no significant surgical complications were recorded. Conclusions • Direct pars repair techniques using PSHS and PSRS yielded satisfactory clinical and radiographic results in young patients with symptomatic LS. PSRS, compared to PSHS, demonstrated greater effectiveness in young individuals with LS and promoted early recovery. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to quantify and evaluate morphology of intervertebral space between neighboring cervical units using radiographic imaging indices, to help spine surgeons when performing anterior cervical discectomy and fusion (ACDF) surgery on the Chinese population. Methods: The background and imaging parameters of the subjects were assessed. Cervical lateral radiographs were employed to measure the intervertebral height (IH), intervertebral height index (IHI), and segmental lordosis (SL). Endplate parameters measurements were conducted on sagittal T2-weighted magnetic resonance imaging (MRI), including endplate sagittal diameter (ESD), and endplate concavity depth (ECD). All individuals were divided into three age groups: individuals aged 20–35 were in group A, individuals aged 36–50 were in group B, and individuals aged over 50 were in group C. A comparison of the variables was conducted among the three groups. Additionally, these radiographic parameters were also compared between males and females. Results: A total of 102 individuals were included in this study. IH was greater at C6/7 than those at other segmental levels (p < 0.001). The largest SL values were found at C6/7, while the least were found at C3/4. The superior ESD (ESDs) and ECD (ECDs) of the intervertebral space were significantly greater than those of the inferior endplates (p < 0.05). The ESD and ECD values were the largest at C6/7, while the least at C3/4. Additionally, age and gender had an influence on several parameters. IH was significantly lower in group A compared to group B (p < 0.05) and group C (p < 0.05) from C3/4 level to C6/7 level. ECDs were lower in group A compared to group B (p < 0.05) and group C (p < 0.05) at each level. IH and ESD in males were generally significantly greater than those in females at all levels (p < 0.05). Conclusion: The current study found that C6/7 had the greatest IH, SL, ESD, and ECD values in asymptomatic Chinese. SL gradually increased from C3/4 to C6/7 levels. IH and ECD were significantly associated with age. Males had greater IH and ESD values than females. These findings provide baseline information for planning for selection of anterior screws and intervertebral implants. [ABSTRACT FROM AUTHOR]

Lumbar artery pseudoaneurysms are a rare complication of penetrating trauma that can result in devastating retroperitoneal hemorrhage or embolic complications if left untreated. Prompt recognition in the trauma setting can lead to timely definitive diagnosis via spinal angiography and treatment via endovascular embolization. We present a case of lumbar artery pseudoaneurysm secondary to a gunshot wound to the spine treated via coil embolization. [ABSTRACT FROM AUTHOR]

Current procedures to establish vertebral column regionalization (e.g., histology) in fish are time consuming and difficult to apply. The aim of this study was to develop a more rapid and accurate radiology‐based method for Atlantic salmon (Salmo salar). A detailed analysis of 90 animals (4 kg) led to the establishment of region‐specific radiographic hallmarks. To elucidate its transferability to other salmonid species, radiography was carried out in brown trout (Salmo trutta), Arctic char (Salvelinus alpinus), rainbow trout (Oncorhynchus mykiss), pink salmon (Oncorhynchus gorbuscha), and Chinook salmon (Oncorhynchus tshawytscha). This method was also evaluated for whole ungutted fish. The vertebral column of Atlantic salmon can be subdivided into five regions (R1–R5) based on anatomy: postcranial (R1, V1, and V2), abdominal (R2, V3–V26), transitional (R3, V27–V36), caudal (R4, V37–V53), and ural (R5, V54–V59). The following specific radiographic hallmarks allow the identification of regions: (i) lack of ribs in R1, (ii) modified parapophysis of the first vertebra of R3, (iii) prominent hemal spine of the first vertebra of R4, and (iv) the separated hemal spine of the most cranial pre‐ural vertebra of R5. These hallmarks were all transferable to the other salmonid species assessed. The results include a further description of various region‐specific characteristics in Atlantic salmon. The method was found applicable for sedated/whole ungutted fish, verifying it as quick and easy compared to other regionalization methods. The regions defined by radiology in this study agree with the vertebral column regions recently defined for Chinook salmon (O. tshawytscha). Thus, and considering the results of this study on various salmonid species, the currently developed regionalization protocol can be generally used for salmonids. [ABSTRACT FROM AUTHOR]

Mary Bergstein's book, "Visual Culture in Freud's Vienna: Science, Eros, and the Psychoanalytic Imagination," explores the visual materials and texts that circulated in Vienna around 1900. Bergstein argues that popular visual mediums, such as photography and film, played a significant role in constructing the psychoanalytic visual environment. The book examines topics such as X-ray photography, the power of hypnosis in cinema, and the classical representation of nudity in Vienna. Bergstein demonstrates how these visual representations influenced Freud's thinking and contributed to the formation of psychoanalytic thought. This book provides valuable insights into the role of representation in psychoanalysis and is a must-read for those interested in the psychoanalytic formation of representation. [Extracted from the article]

Myofibroma is a rare benign mesenchymal tumor that frequently affects the pediatric population with a predilection for the head and neck region. About 10% of myofibroma cases, presenting atypical features, can be misinterpreted as low-grade myofibroblastic sarcoma (LGMS), with therapeutic and prognostic impact. Here, we report two pediatric cases of benign myofibroblastic tumors, one of them showing typical characteristics of myofibroma, the other was an atypical myofibroma, which initially mimicked low-grade myofibroblastic sarcoma. Atypical myofibromas, despite its distinctive characteristics, follow a benign course, similar with typical myofibroma. It is necessary to distinguish atypical myofibroma from low-grade myofibroblastic sarcoma and avoid unnecessary invasive therapy. [ABSTRACT FROM AUTHOR]

Availability of pertinent and detailed information for damaged ancient objects is vital for successful restorative, damage limitation intervention processes in archeology. Visual inspection and radiography testing (RT) constitute widely used non-destructive methods for conservators of such objects. Unfortunately, the quality of RT images is susceptible to blurring caused by the superimposed scattered X-rays. In this study, the no-black-pixel constraint (NBPC) algorithm on its own as well as in the form of an algorithm with the planar-scene assumption (NBPC + PA) was applied to RT images with a view to suppressing image blurring and enhancement of imaging contrast. The results of this study have shown, both qualitatively and quantitatively that the NBPC + PA and NBPC algorithms provide higher imaging contrast for identification and evaluation of damage in corroded ancient metallic relics than using unprocessed RT images alone. Contrast enhancement of up to about 120% and 78% was achieved in comparison with the original image by applying the NBPC+PA and NBPC algorithms, respectively. Practical application and effectiveness of using the processed images were evaluated by expert operators in the area and it was found that using the reconstructed images scored higher (on average by 88%) than the original RT images (on average by 73%) with the NBPC+PA scoring higher (on average by 91%) than the NBPC algorithm (on average by 85%). The operators have found utilizing the processed images leads to better inspection and evaluation of the object enabling better targeted informed for restorative intervention, damage limitation, and maintenance of such objects. [ABSTRACT FROM AUTHOR]

The article focuses on the use of point-of-care ultrasound (POCUS) for diagnosing a supracondylar humeral fracture in a 6-year-old girl with elbow pain after a fall. Topics include the child's initial presentation with limited elbow movement and tenderness, the role of POCUS in detecting fractures through the posterior fat pad sign and lipohemarthrosis, and confirmation of the diagnosis with radiographic imaging revealing a nondisplaced fracture.