Current Medical Imaging - Volume 15, Issue 3, 2019

Background: Medical imaging is to assume greater and greater significance in an efficient and precise diagnosis process. Discussion: It is a set of various methodologies which are used to capture internal or external images of the human body and organs for clinical and diagnosis needs to examine human form for various kind of ailments. Computationally intelligent machine learning techniques and their application in medical imaging can play a significant role in expediting the diagnosis process and making it more precise. Conclusion: This review presents an up-to-date coverage about research topics which include recent literature in the areas of MRI imaging, comparison with other modalities, noise in MRI and machine learning techniques to remove the noise.

Background: Neurometabolic diseases are a group of diseases secondary to disorders in different metabolic pathways, which lead to white and/or gray matter of the brain involvement. Discussion: Neurometabolic disorders are divided in two groups as dysmyelinating and demyelinating diseases. Because of wide spectrum of these disorders, there are many different classifications of neurometabolic diseases. We used the classification according to brain involvement areas. In radiological evaluation, MRI provides useful information for these disseases. Conclusion: Magnetic Resonance Spectroscopy (MRS) provides additional metabolic information for diagnosis and follow ups in childhood with neurometabolic diseases.

Background: Fibrolamellar Carcinoma (FLC) and Combined Hepatocellular- Cholangiocarcinoma (CHC) are rare primary liver tumours, which are related to different clinical settings. In both tumours, correlation with clinical data and laboratory tests are extremely important. Discussion: Typically, FLC is diagnosed in young patients without any chronic disease and with normal biochemical tests, whereas CHC arises in cirrhotic patients with elevated tumour markers: AFP and/or CA 19-9. The review describes epidemiology, aetiology, pathogenesis, radiological features and treatment of these tumours. Imaging features typical for FLC are: The presence of central scar, calcifications, the large size, heterogeneous and early contrast-enhancement. Conclusion: The diagnosis of CHC may be suggested in case of elevation of both AFP and CA 19- 9 or inconsistency between elevated tumour markers and imaging findings (i.e., elevated CA 19-9 and radiological features of HCC, or elevated AFP with imaging findings characteristic of ICC).

Background: In order to overcome the limitation of long scanning time, compressive sensing (CS) technology exploits the sparsity of image in some transform domain to reduce the amount of acquired data. Therefore, CS has been widely used in magnetic resonance imaging (MRI) reconstruction. Discussion: Blind compressed sensing enables to recover the image successfully from highly under- sampled measurements, because of the data-driven adaption of the unknown transform basis priori. Moreover, analysis-based blind compressed sensing often leads to more efficient signal reconstruction with less time than synthesis-based blind compressed sensing. Recently, some experiments have shown that nonlocal low-rank property has the ability to preserve the details of the image for MRI reconstruction. Methods: Here, we focus on analysis-based blind compressed sensing, and combine it with additional nonlocal low-rank constraint to achieve better MR images from fewer measurements. Instead of nuclear norm, we exploit non-convex Schatten p-functionals for the rank approximation. Results & Conclusion: Simulation results indicate that the proposed approach performs better than the previous state-of-the-art algorithms.

Background: Medical images are widely used within healthcare and medical research. There is an increased interest in precisely correlating information in these images through registration techniques for investigative and therapeutic purposes. This work proposes and evaluates an improved measure function for registration of carotid ultrasound and magnetic resonance images (MRI) taken at different times. Methods: To achieve this, a morphological edge detection operator has been designed to extract the vital edge information from images which is integrated with the Mutual Information (MI) to carry out the registration process. The improved performance of proposed registration measure function is demonstrated using four quality metrics: Correlation Coefficient (CC), Structural Similarity Index (SSIM), Visual Information Fidelity (VIF) and Gradient Magnitude Similarity Deviation (GMSD). The qualitative validation has also been done through visual inspection of the registered image pairs by clinical radiologists. Results: The experimental results showed that the proposed method outperformed the existing method (based on integrated MI and standard edge detection) for both ultrasound and MR images in terms of CC by about 4.67%, SSIM by 3.21%, VIF by 18.5%, and decreased GMSD by 37.01%. Whereas, in comparison to the standard MI based method, the proposed method has increased CC by 16.29%, SSIM by 16.13%, VIF by 52.56% and decreased GMSD by 66.06%, approximately. Conclusion: Thus, the proposed method improves the registration accuracy when the original images are corrupted by noise, have low intensity values or missing data.

Background: Cardiac magnetic resonance evaluations generally require a radiofrequency coil setup comprising a transmit whole-body coil and a receive coil. In particular, radiofrequency phased-array coils are employed to pick up the signals emitted by the nuclei with high signal-tonoise ratio and a large region of sensitivity. Methods: Literature discussed different technical issues on how to minimize interactions between array elements and how to combine data from such elements to yield optimum Signal-to-Noise Ratio images. However, image quality strongly depends upon the correct coil position over the heart and of one array coil portion with respect to the other. Results: In particular, simple errors in coil positioning could cause artifacts carrying to an inaccurate interpretation of cardiac magnetic resonance images. Conclusion: This paper describes the effect of array elements misalignment, starting from coil simulation to cardiac magnetic resonance acquisitions with a 1.5 T scanner. Phased-array coil simulation was performed using the magnetostatic approach; moreover, phantom and in vivo experiments with a commercial 8-elements cardiac phased-array receiver coil permitted to estimate signal-to-noise ratio and B1 mapping for aligned and shifted coil.

Background: Optical Coherence Tomography (OCT) is a non-invasive medical imaging technique that provides high-resolution cross-sectional images of the retina. There is a need to develop algorithms for obtaining quantitative and qualitative information about the retina which are essential for assessing and managing eye conditions. Methods: This work emphasizes on an automated image processing algorithm for segmenting retinal layers. It involves preprocessing of the acquired retinal SD-OCT image (B-scan) using the proposed automatic Anisotropic diffusion filter, followed with contrast stretching to suppress intrinsic speckle noise without blurring structural edges. Graph search segmentation using Dijkstra algorithm with a combination of threshold and axial gradient as the cost function is used to segment the retinal layer boundaries. Results: The algorithm was performed and the average thickness of the segmented retina was computed for the 3D retinal scan (128 B-scans) of 8 subjects (4 normal and 4 abnormal) using Early Treatment Diabetic Retinopathy Screening (ETDRS) chart. Conclusion: Segmentation was evaluated using manually segmented B-scan by an Ophthalmologist as ground truth and accuracy was found to be 99.14 ± 0.27%.

Objectives: In the present study, we investigated the relationship between olfactory fossa, cribriform plate, crista galli and nasal Septal Deviation (SD). Keros classification of olfactory fossa was also performed. Methods: This study was performed retrospectively. Computerized Tomography (CT) images of 200 adult subjects were observed. Unilateral nasal Septal Deviation (SD) cases were included into the study. On coronal CT scans, SD side and location, SD angle, cribriform plate width, olfactory fossa depth (Keros classification) and width, area of the olfactory fossa, crista galli length, width and pneumatization were evaluated. Results: Anterior and anteroposterior deviations were detected mainly. In females, 64.0% and in males, 45.3% of the SDs were located anteriorly. In males, anteroposterior SDs (40.0%) were detected more than females. In anteroposterior SDs, SD angle was higher than anterior SDs. With higher SD angle, crista galli width and height decreased. Cribriform plate width, olfactory fossa height, width and area values of contralateral side were significantly higher than those of the ipsilateral side. For Keros classification, in male group, type 1 (53.3%) and in females, type 2 (57.6%) was detected at ipsilateral side. For contralateral side, type 2 Keros was detected in both genders. Complete crista galli pneumatization was observed in 4.0% and partial pneumatization was detected in 12.0%. In 84% of the patients, there is no Crista galli pneumatization. With the presence of pneumatized crista galli, contralateral Keros values decreased. Crista galli height and contralateral olfactory fossa width showed positive correlation. In older patients, cribriform plate width decreased. Conclusion: In our study, there was no Keros type 3 olfactory fossa. In males’ contralateral side of SD; and in females both ipsilateral and contralateral side of SD, Keros type 2 olfactory fossa were detected. Therefore, during sinus surgery, surgeons should work carefully not to made intracranial penetration.

Background: Patients diagnosed with cancer do not have sufficient clinical data for the management of incidental parotid lesions. We aimed to reveal the importance of randomized parotid lesions encountered during oncologic F-18 fluorodeoxyglucose positron emission tomography (FDG PET/CT) imaging in our clinical practice and the diagnostic algorithm of such lesions. Methods: We performed a database search of PET/CT records generated from 2009 to 2015 for “parotid” in reports of patients who underwent PET/CT examination for a known malignancy elsewhere, or cancer screening. Results: Incidental parotid FDG uptake on PET/CT had a prevalence of 1.1%. The incidence of parotid metastasis in our series was 36.4%, and 75% of them had malign melanoma metastasis. Of the 11 cases, 5 were of Warthin tumours, and Warthin tumours showed stronger GLUT1 expression than metastatic parotid lesions. Conclusion: In patients with malignancy elsewhere, focal involvement of FDG by the parotid gland, especially if malignant melanoma or SCC is absent, should not be considered a metastatic disease without histopathologic confirmation. If parotid disease would change the patient’s treatment plan and disease stage, the parotid lesion should be evaluated by additional methods, such as fine needle aspiration biopsy.

Purpose: In this study, we aim to evaluate the diagnostic value of echogenicity ratio with histogram analyses. Materials & Methods: This retrospective study was performed on 22 patients with 44 hands. The patients had clinical presentations consistent with CTS, in at one hand. Quantitative ultrasound scanning and image capture were completed using a diagnostic sonography machine. For gray scale histogram analysis, image J software was used. Results: Mean flexor tendons histogram analysis echogenicity/Mean median nerve histogram analysis echogenicity was significantly high for 1,7 cutoff value. Conclusion: Mean FTE/MNE ratio may be a useful sonographic parameter for CTS.

Background and Objectives: The purpose of this study was to evaluate the mammographic, sonographic and MRI findings of metaplastic breast carcinoma. Methods: In this retrospective review study, we analyzed the medical files of 9600 patients who were treated for invasive breast cancers. Clinical information, histopathologic and radiologic findings of 65 patients were included in this study. All existing radiologic images and medical reports were reviewed retrospectively. Thirty-three patients had MG, 58 patients had US and 7 patients had MRI imaging results. Results: Mammographically, the most frequent presentations of MPBC were round shape, microlobulated margin and high density masses. Calcifications with or without masses were not a frequent finding. The most common sonographic findings were round shape, partially indistinct angular margin, hypoechoic and heterogeneous echo patterns and no posterior feature masses. All lesions were presented as masses rather than non-mass enhancements on magnetic resonance imaging. Features of masses had more malignant feature on MRI than other modalities in all 7 patients. Conclusion: Metaplastic breast carcinoma is one of the rarest poorly differentiated invasive breast carcinomas. Interestingly, these aggressive tumors demonstrate benign or moderately malign features on imaging methods. This appearance of MPBC can cause it to be misdiagnosed as a benign breast lesion especially in young women. MPBC should be kept in mind in the differential diagnosis of large palpable breast masses. Therefore, follow-up at short intervals and/or multimodality imaging studies which include breast MRI are important for the diagnosis of MPBC.

Introduction: Epithelioid Hemangioendothelioma (EHE) is a rare vascular neoplasm. Common locations of EHE are the bone, soft tissue, liver, and lung, but the mediastinal location is extremely rare. Few cases of mediastinal EHE, invading the Superior Vena Cava (SVC) have been reported. Case Presentation: We report a case of a 21-year-old man with EHE invading the SVC, which was incidentally detected on performing chest radiography. A contrast-enhanced chest Computed Tomography (CT) scan demonstrated a well-defined, oval mass located on the right side of the anterior mediastinum. The mass showed homogeneous enhancement with punctate calcifications, and it invaded the SVC at the confluence area of the right and left brachiocephalic veins. Conclusion: Mediastinal EHE invading the SVC may present as a homogeneously enhancing mass with punctate calcifications. It should be added to the differential diagnosis of tumors of the mediastinum. Accurate preoperative diagnosis of EHE is critical for surgical planning; therefore, knowledge of the radiologic features of EHE is important.