Current Medical Imaging - Volume 20, Issue 1, 2024

MRI of patients with locally advanced rectal cancer (LARC) can predict the pathological complete response (pCR) to preoperative chemoradiation therapy (CRT). Our purpose was to use MRI results to evaluate the diagnostic value of combined changes in signal intensity (SI) and volume (V) of patients with LARC for predicting pCR to CRT.

This retrospective study on 100 patients with LARC analyzed clinical and imaging data that were collected from March, 2018, to March, 2020. Before and after CRT, T2-weighted (T2W), apparent diffusion coefficient (ADC), and contrast-enhanced T1-weighted (ceT1W) data were analyzed. Percent changes of V (%∆V) and relative SI ratio (%∆SIR) on different sequences were calculated. After CRT, patients had pathological confirmation as pCR or non-pCR. Data were analyzed using nonparametric tests and receiver operating characteristic (ROC) analysis.

There were 34 pCR and 66 non-pCR patients. Except for ADC-%∆SIR, the combined parameters and single parameters had a greater decrease in the pCR group. The combination of ADC-%∆V and T2W-%∆SIR had the greatest diagnostic value (AUC=0.85,cutoff=0.23%) and the combination of ADC-%∆V% and ∆SIR had the best accuracy (89%, cutoff=44.11%). Except for T2W-%∆V and T2W-%∆SIR, the different sequences had moderate differences in diagnostic performance. The diagnostic performance of combined parameters or single parameters on ADC and T2W was significantly better than those on ceT1W (p<0.01).

All sequences except ADC-%∆SIR provided reliable predictions of pCR, although ceT1W data had limited usefulness.

Modern medical imaging modalities used by clinicians have many applications in the diagnosis of complicated diseases. These imaging technologies reveal the internal anatomy and physiology of the body. The fundamental idea behind medical image fusion is to increase the image's global and local contrast, enhance the visual impact, and change its format so that it is better suited for computer processing or human viewing while preventing noise magnification and accomplishing excellent real-time performance.

The top goal is to combine data from various modal images (CT/MRI and MR-T1/MR-T2) into a solitary image that, to the greatest degree possible, retains the key characteristics (prominent features) of the source images.

The clinical accuracy of medical issues is compromised because innumerable classical fusion methods struggle to conserve all the prominent features of the original images. Furthermore, complex implementation, high computation time, and more memory requirements are key problems of transform domain methods. With the purpose of solving these problems, this research suggests a fusion framework for multimodal medical images that makes use of a multi-scale edge-preserving filter and visual saliency detection. The source images are decomposed using a two-scale edge-preserving filter into base and detail layers. Base layers are combined using the addition fusion rule, while detail layers are fused using weight maps constructed using the maximum symmetric surround saliency detection algorithm.

The resultant image constructed by the presumed method has improved objective evaluation metrics than other classical methods, as well as unhindered edge contour, more global contrast, and no ringing effect or artifacts.

The methodology offers a dominant and symbiotic arsenal of clinical symptomatic, therapeutic, and biomedical research competencies that have the prospective to considerably strengthen medical practice and biological understanding.

Castleman's disease is an extremely rare disease in the abdomen region characterized by benign lymphoepithelial proliferation.

We report a case of a 63-year-old female who presented with abdominal pain. Abdominal CT Angio and dynamic contrast-enhanced abdominal MRI revealed a mass lesion showing markedly contrast enhancement, no vascular invasion sign, and diffusion restriction lesion in the truncus coelicus bifurcation region. The mass was surgically resected completely. Pathological evaluation showed a hyaline-vascular type of Castleman’s disease.

Castleman's disease should be kept in mind in the differential diagnosis of an isolated intra-abdominal mass.

Hepatic artery aneurysms (HAAs) exhibit a notable risk of rupture, with both true aneurysms and pseudoaneurysms being exceptionally uncommon (incidence rate approximately 2 per 100,000). Symptoms include epigastric and right upper quadrant pain, jaundice, and potentially life-threatening bleeding upon rupture. This bleeding can extend into the portal vein, hepatic vein, biliary system, or abdominal cavity. While existing literature lacks reports of delayed post-therapeutic complications, this case report discusses a 27-year-old female who developed a pseudoaneurysm six months after bilateral biliary drain insertion, underscoring the potential for delayed complications.

The patient underwent gastric endoscopy revealing an extensive lower esophageal varix protruding into the proximal stomach, subsequently treated with banding. The stomach and duodenum were found to contain fresh blood and blood clots indicating acute bleeding.

An urgent CT scan identified active bleeding (extravasation) at segment V and blood accumulation at the confluence of the right and left biliary drains. This was followed by celiac and selective hepatic digital subtraction angiography (DSA).

This case study outlines the occurrence of a hepatic artery pseudoaneurysm six months after percutaneous insertion of bilateral biliary drains. The pseudoaneurysm manifested precisely at the confluence of the right and left drains. The reported delayed complication may have resulted from friction between the drains at the confluence or erosion of the adjacent artery by the drains. The insights gained from this case shed light on the causes and preventive measures for potential delayed complications associated with percutaneous biliary drain placement.

Ovarian cancer is a common gynecological malignant tumor in women. Most patients have reached the advanced stage when they visit the hospital. In order to diagnose ovarian cancer at an early stage, treat it at an early stage, and improve the survival rate of patients, this study has used the imaging computed tomography (CT) method to diagnose stage IA ovarian cancer.

The purpose of this work was to study CT features of stage IA ovarian cancer, and compare the borderline tumor and stage IC ovarian cancer at the same time so as to improve the CT diagnosis of early ovarian cancer.

We retrospectively collected clinical and CT data of patients with stage I ovarian cancer and borderline ovarian tumor admitted to Nantong Tumor Hospital from 2013 to 2021. Altogether, 23 cases of patients (borderline ovarian tumor, 9 cases; stage IA ovarian cancer, 5 cases; stage IC ovarian cancer, 9 cases) were involved. CT characteristics of these patients were analyzed in terms of the tumor diameter, cystic solid structure, solid component, septation, enhancement, peritoneal thickening, ascites, and abdominal lymph nodes.

CT features of stage IA ovarian cancer included large tumor size (average diameter: 15 cm), cystic solid structure (4/5; 80%), septation (4/5; 80%), and enhanced cystic wall, septum, or solid components of the tumor on contrast-enhanced CT (5/5; 100%), no peritoneal thickening (0/5; 0%), no ascites (0/5; 0%), and no abdominal lymph node enlargement (0/5; 0%). The tumor structure did not differ significantly between stage IA and IC ovarian cancers (p > 0.05), while intraperitoneal ascites did (χ² = 0.031; p < 0.05). Stage IA and borderline ovarian tumors did not differ significantly in ovarian tumor structure (p > 0.05).

CT features of stage IA ovarian cancer included large tumor size, cystic solid structure, septation, and enhanced cystic wall and solid parts in the tumors. No pelvic or abdominal metastasis was observed.

Lung ultrasound (LUS) is gaining recognition as an indispensable diagnostic tool in critical care.

The study aimed to characterize the global research landscape and trend of LUS with quantification and visualization approaches.

Documents related to LUS published between 2007 and 2023 were selected from the Web of Science Core Collection and identified. Visualization and statistical analysis were conducted with the VOSviewer 1.6.18, CiteSpace 5.7.R5, and Bibliometrix 4.1.0 Package, including analysis of the trend of global publications, prominent countries, active institutions, and funding agencies, key authors and journals, co-cited references, and keywords.

A total of 3010 publications, including 2434 articles and 576 reviews, were retrieved. The output of LUS-related research has increased steadily over the years, especially after 2018. Italy (n=756; 25.12%) has shown the highest output, being the country with the highest total citations (23423 times). The most influential author was Gargani Luna with 52 documents, who worked at the Consiglio Nazionale delle Ricerche. Chest and Intensive Care Medicine with high citations and impact factor scores were the most influential journals. Besides “lung ultrasonography”, the keywords developed included “coronavirus disease 2019 (COVID-19)”, “acute respiratory distress syndrome”, and “acute heart failure”.

Research output on LUS has increased steadily, especially after 2018. Italy and the United States are staying ahead in this field. Research collaboration still needs to be strengthened. This comprehensive analysis has presented the global research landscape and trends of LUS-related research, providing valuable information for researchers to pursue further exploration.

The fat attenuation index (FAI) of pericoronary adipose tissue is associated with coronary inflammatory reactions.

This study aimed to analyze the difference in the FAI ratio between pericoronary adipose tissue volume and aortic root epicardial adipose tissue volume (AO-EATV) using computed tomography (CT) in various plaques.

In total, 645 coronary artery CT angiogram images from 215 patients were collected. The types and number of coronary plaques were recorded, and the plaque volume and pericoronary FAI of each branch were compared between the groups. The ratio of the FAI in branches with or without plaques to the AO-EATV was determined and statistically analyzed between the groups.

No significant difference in the plaque volume among the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) (P > 0.05) as well as in the FAI was observed among various plaque groups (P > 0.05). FAI[LAD]/AO-EATV was in the following order: noncalcified plaques (0.70 ± 0.06) < mixed plaques (0.72 ± 0.06) < calcified plaques (0.73 ± 0.08) < no plaques (0.74 ± 0.07); FAI[LCX]/AO-EATV was in the following order: noncalcified plaques (0.71 ± 0.06) < mixed plaques (0.72 ± 0.08) < calcified plaques (0.73 ± 0.09) < no plaques (0.74 ± 0.06); and FAI[RCA]/AO-EATV was in the following order: noncalcified plaques (0.71 ± 0.06) < mixed plaques (0.73 ± 0.07) < calcified plaques (0.74 ± 0.07) < no plaques (0.75 ± 0.09); the differences were statistically significant in each group (P = 0.041, 0.043, and 0.028, respectively).

Compared to simply comparing FAI, FAI/AO-EATV varied in the coronary arteries in various plaque groups. FAI/AO-EATV was lower in noncalcified or mixed plaques and was associated with coronary inflammatory reactions.

Klippel-Trenaunay syndrome (KTS) is a rare congenital disease that mainly involves blood vessels and is characterized by the presence of capillary malformations (port wine stains), varicose veins, soft tissue and/or bone hypertrophy.

We report a 28-year-old man who was diagnosed 20 years ago with Klippel-Trenaunay syndrome. Approximately 3 years ago, he found enlarged masses on both upper extremities and a new dark red mass that was pathologically diagnosed as cavernous haemangioma appeared on the right index finger.

KTS is a rare and potentially multisystem disease requiring multidisciplinary management for which imaging examination is an important auxiliary diagnostic method. Various complications may occur during its development, so regular follow-up is required to prevent serious accidents.

Meniscal tears are among the most common indications for knee arthroscopy. Artificial polyurethane scaffolds have demonstrated efficacy in reducing pain and promoting the growth of normal meniscal tissue, with high absorption rates facilitating full tissue regeneration.

This study aimed to evaluate the remodeling of polyurethane meniscal implants post-reconstruction using ultrasonography. This imaging technique not only assesses changes in implant properties, such as echogenicity, but also the shape changes during functional examination.

The assessment of meniscal extrusion, comparing size at rest and under weight-bearing, is an indirect parameter that provides insight into the physical properties of the remodeling implant, with greater extrusion indicating reduced stiffness and inferior physical properties of the meniscus. Ultrasonography has the valuable advantage of allowing for assessment of the blood supply to the meniscus through Power Doppler imaging.

The presence of vessels within the meniscal implants serves as evidence of ongoing remodeling. The study included 35 patients (13 female, 22 male; mean age 41.6 years, range 18-66) who underwent arthroscopic meniscal reconstruction with polyurethane implants, with an average time from surgery of 2.8 years (range 0.3-4.5 years). Results showed complete (29.7%), significant (45.9%), or moderate (16.2%) remodeling into natural meniscal tissue in 91.8% of the implants.

The mean values of extrusion in the supine position and during 90-degree flexion were significantly greater in the operated limb (2.603) compared to the contralateral limb (1.978; t(35) = 2.442; P < 0.05). No significant differences in extrusion were found between the limbs in a standing position, indicating favorable physical properties of the polyurethane meniscal implants. Further ultrasonography studies of meniscal scaffolds are deemed relevant.

It has been reported in the literature that Vitamin D can inhibit the growth of uterine fibroids, but the evaluation index is only the size of the uterine fibroids. The purpose of this study was to evaluate the effect of vitamin D on the size, hardness, and blood flow of uterine fibroids in pre-menopausal women by multimodal ultrasound.

A total of 64 pre-menopausal women with uterine fibroids complicated vitamin D deficiency were enrolled in this study and randomly divided into two groups: the vitamin D group (n=32) which received oral vitamin D (1600 IU/ day) and the control group (n=32) without vitamin D supplementation. After three months of intervention, the mean diameter of uterine fibroids, elastic strain ratio, and blood flow grade were evaluated by multimodal ultrasound, and the clinical symptoms of the two groups were evaluated by questionnaire.

The vitamin D group reported a significant increment in the serum 25-hydroxyvitamin D (P < 0.001). In addition, there were significant reductions in the mean diameter, and elastic strain ratio of uterine fibroids (P =.043 and P =.038, respectively), but no significant difference in the blood flow grade of uterine fibroids was observed (P =.272). Compared with the control group, the vitamin D group achieved significant relief in dysmenorrhea and frequent urination, as well as improvement in heavy menstrual bleeding.

The application of multimodal ultrasound provides a more comprehensive theoretical basis for vitamin on uterine fibroids. Vitamin D can effectively reduce the size of uterine fibroids in pre-menopausal women and relieve their symptoms. It is highly likely to be a promising, safe, effective, and inexpensive drug for uterine fibroids, which has good application value and promotion prospects.

Osteoarthritis is a condition that poses a risk to the knee joint, resulting in pain and impaired function. However, traditional knee X-ray evaluations using the Kellgren-Lawrence grading system have proven to be inefficient. These evaluations are subjective, time-consuming, and labor-intensive, particularly in busy hospital settings.

The objective of this research was to present a deep learning-based approach that can detect knee joint regions in medical images. By addressing the limitations of traditional methods, the aim was to develop a more efficient and automated approach for knee joint analysis.

The proposed method utilizes the Faster R-CNN model, which consists of a region proposal network (RPN) and Fast R-CNN. The RPN generates region proposals that potentially contain knee joint regions, while the Fast R-CNN network categorizes and extracts features from these proposals. To train the model, a dataset of knee joint images was employed. The performance of the model was evaluated using metrics, such as accuracy, precision, recall, F1-score, and mean IoU (Intersection Over Union).

The results demonstrated the high accuracy of the proposed method in detecting knee joint regions. The model achieved a mean IoU of 94.5, indicating a strong overlap between the predicted and ground truth regions. These findings highlight the potential of deep learning-based approaches in automating medical image analysis, specifically in the diagnosis and management of knee joint disorders.

This study emphasizes the significance of leveraging advanced technologies, such as deep learning, in medical imaging. By developing more efficient and accurate methods for identifying knee joint regions in medical images, it becomes feasible to enhance patient outcomes and healthcare delivery. The proposed deep learning-based approach showcases promising results, paving the way for further advancements in the field of medical image analysis and contributing to improved diagnostic capabilities for knee joint disorders.

The aim of this study was to explore the criteria that can predict bladder cancer among the lesions that could not be differentiated from intravesical prostate protrusion (IPP) and to create a scoring system using these criteria.

A retrospective analysis was made of patients with an ultrasound report indicating lesions in the bladder neck, for which differentiation between bladder cancer and IPP could not be determined. A total of 174 patients diagnosed with bladder cancer (n=102) or benign prostate lesion (n=72) according to the biopsy results were enrolled in the study. Hemoglobin, prostate-specific antigen (PSA), prostate volume (PV), bladder wall thickness (BWT), lesion height (LH), and the ratio of lesion width to base (LW/B) were compared between the two groups.

ROC analysis revealed an AUC value >0.7 for all factors, and the best cut-off value was identified for each factor. In the multivariate analysis, by determining a score for each factor according to the ORs, the BCa-IPP scoring system was developed to provide a total score in the range of minimum 0 and maximum 15. In the ROC analysis, the AUC value was 0.954 (95% CI: 0.923–0.986) for the BCa-IPP score. The best cut-off value was found to be 10, with sensitivity of 0.93 and specificity of 0.85.

Using simple laboratory and ultrasound findings, the BCa-IPP scoring system was created, which was seen to have high predictive value and can be easily applied in the clinic. The BCa-IPP scoring system is a non-invasive test that can be successfully applied for the differentiation of bladder cancer from benign lesions.

Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) is usually used for the semi-quantitative evaluation of joint changes in Rheumatoid Arthritis (RA). However, this method cannot evaluate early changes in bone marrow edema (BME).

To determine whether T1 mapping of wrist BME predicts early treatment response in RA.

This study prospectively enrolled 48 RA patients administered oral anti-rheumatic drugs. MRI of the most severely affected wrist was performed before and after 4 (48 patients) and 8 weeks of treatment (38 patients). Mean T1 values of BME in the lunate, triangular, and capitate bones; RAMRIS for each wrist; Erythrocyte-Sedimentation Rate (ESR); and 28-joint Disease Activity Score (DAS28)-ESR score were analyzed. Patients were divided into responders (4 weeks, 30 patients; 8 weeks, 32 patients) and non-responders (4 weeks, 18 patients; 8 weeks, 6 patients), according to EULAR response criteria. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T1 values.

ESR and DAS28-ESR were not correlated with T1 value and RAMRIS at each examination (P > 0.05). Changes in T1 value and DAS28-ESR relative to the baseline were moderately positively correlated with each other at 4 and 8 weeks (r = 0.555 and 0.527, respectively; P < 0.05). At 4 weeks, the change and rate of change in T1 value significantly differed between responders and non-responders (-85.63 vs. -19.92 ms; -12.89% vs. -2.81%; P < 0.05). The optimal threshold of the rate of change in T1 value at 4 weeks for predicting treatment response was -5.32% (area under the ROC curve, 0.833; sensitivity, 0.900; specificity, 0.667).

T1 mapping provides a new imaging method for monitoring RA lesions; changes in wrist BME T1 values reflect early treatment response.

This study sought to analyze the ¹⁸F-FDG PET/CT and contrast-enhanced computed tomography (CT) images of synchronous colorectal cancer (CRC) and renal clear cell carcinoma (ccRCC) and identify the shared genes between these two types of cancer through bioinformatic analysis.

A retrospective analysis was conducted on a patient with synchronous CRC and ccRCC who underwent ¹⁸F-FDG PET/CT and contrast-enhanced CT before treatment. Databases were analyzed to identify differentially expressed genes between CRC and ccRCC, and co-expression genes were extracted for RCC and CRC.

¹⁸F-FDG PET/CT revealed intense metabolic activity in the primary colorectal lesion (SUVmax 13.2), while a left renal mass (diameter = 35 mm) was observed with no significant uptake. Contrast-enhanced CT during the arterial phase showed heterogeneous intense enhancement of the renal lesion, and the lesion washed out earlier than in the renal cortex in the nephrographic and excretory phases, indicating ccRCC. The histopathological results confirmed synchronous double primary malignant tumors. Our bioinformatic analysis results showed that synchronous occurrence of CRC and ccRCC may correlate with simultaneous expression of Carbonic Anhydrase 9 (CA9), integrin-binding sialoprotein (IBSP), and Fibrinogen γ chain (FGG).

¹⁸F-FDG PET/CT combined with contrast-enhanced CT is an effective diagnostic tool in evaluating synchronous CRC and RCC. By analyzing this clinical case and conducting bioinformatic analysis, we improved our current understanding of the mechanisms underlying synchronous tumors.

The aim of this study is to evaluate (i) the reasons for requesting ultrasonography (USG) in a dentistry faculty and (ii) the scanning regions, the type of probe used, and the use of Doppler USG.

USG request forms of patients who applied to our radiology clinic for USG were analyzed retrospectively. According to the clinical information of the patients in the request forms, the reasons for requesting USG were divided into four groups: soft tissue swelling, soft tissue calcification, lymph node, and other examinations. Data were statistically compared between sex (female and male) and age groups (≤40−years−old and ˃40−years−old).

The USG request forms of 50 patients were obtained. The mean patient age was 45.06±14.50 years. Twenty-six patients were female (52%), while twenty-four patients were male (48%). Soft tissue swelling, soft tissue calcification, lymph node, and other examinations were noted as the reasons for requesting USG in 42%, 26%, 18%, and 14% of the patients, respectively. The most scanned regions were the submandibular (56%), parotid (16%), and cheek (10%) regions. Extraoral probe was used more frequently than intraoral probe (78% vs. 22%). Doppler USG was used in most patients (98%). A statistically significant difference was found between age groups and calcification examination (p<0.05).

The reasons for requesting USG were mostly soft tissue swelling, soft tissue calcification, and lymph node examinations. The most commonly scanned region and used type of probe were the submandibular region and extraoral probe, respectively. Doppler USG was used in most patients.

High-altitude pulmonary edema (HAPE) is a serious life-threatening disease that occurs after rapid ascent to high altitude; its main early-stage presentations include fatigue, headache, low-grade fever, dyspnea, and cough. X-ray and computed tomography (CT) images show pulmonary shadows and patches, which may be localized (initial right lung field predomination) or generalized to the bilateral lung base.

In this report, we present a case of a 25-year-old man diagnosed with HAPE combined with spontaneous pneumomediastinum. After a quick descent and effective medical treatment, this patient made a full recovery. The case may provide helpful information for the prevention and treatment of this disease since an increased number of people, especially young men, currently travel and work at high altitudes.

After accurate clinical diagnosis with the help of CT or X-ray, immediate descent and appropriate oxygen supplementation are the most effective treatments for HAPE at high altitude.

Non-neoplastic liver lesions show low signal intensity in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) after biliary stenting and require differentiation from liver metastases.

The study aimed to evaluate the imaging findings and clinical association of non-neoplastic liver lesions showing hypointensity in the HBP of EOB-MRI after biliary stenting, and assess their differentiation from liver metastases.

This study included 30 patients who underwent EOB-MRI after biliary stenting for pancreaticobiliary malignancies. Among these, 7 patients had pathologically diagnosed non-neoplastic liver lesions, which appeared hypointense in the HBP, and were categorized into the non-neoplastic group. The remaining 23 patients without non-neoplastic liver lesions were included in the control group. Additionally, 29 patients with liver metastasis were included in the liver metastasis group. Clinical associations and imaging features were compared between the groups.

A history of cholangitis and two or more biliary interventional procedures were significantly more frequently observed in the non-neoplastic group (p=0.002 and p=0.01, respectively) than in the control groups. Regarding the imaging findings, the liver-to-lesion signal intensity ratio in the HBP in the liver metastasis group was significantly higher than that in the non-neoplastic group (2.13 vs. 1.53, p=0.002). Additionally, liver metastases were visualized significantly more clearly on diffusion-weighted images (p=0.033) and HBP images (p<0.001) in comparison to non-neoplastic lesions.

Non-neoplastic liver lesions due to biliary inflammation may be observed in the HBP of EOB-MRI in patients after biliary stenting. These lesions may be associated with a history of cholangitis and repeated biliary intervention procedure, and need to be differentiated from liver metastases.

Generative adversarial networks (GANs) have demonstrated superior data generation capabilities compared to other methods, making them popular for use in medical image applications. These features have intrigued researchers in the medical imaging field, resulting in a swift implementation of these techniques in various conventional and novel applications such as image reconstruction, segmentation, detection, classification, and cross-modality synthesis. A comprehensive review of recent medical imaging breakthroughs will benefit researchers interested in this field. In this review, we aimed to introduce the origin, principle, and extended forms of GANs and summarize the state-of-the-art progress of GAN-based medical image processing methods.

We searched the literature for studies on Google Scholar and PubMed using the keywords “Segmentation,” “Classification,” “medical image,” and “generative adversarial network.” Specifically, the initial search revealed 5423 publications after the removal of duplicated and non-accessible full-text publications. Then, after the title and abstract screening, 680 underwent full-text screening. Finally, 121 studies were included in our final analysis after full-text screening.

The date range of the studies covered in this review is from January 1, 2017, to the present. After a thorough screening and qualification assessment, 121 studies involving GAN-based applications in seven areas of medical images were included in the final methodological review. These areas included synthesis, classification, segmentation, conversion, reconstruction, denoising, and lesion detection. We further classified and summarized these papers into clinical applications, classification methods, and imaging modalities.

We thoroughly examined the latest research progress of GAN-based medical image augmentation. These techniques effectively alleviate the challenge of limited training samples for medical image diagnosis and treatment models. Furthermore, several critical issues associated with GANs, such as pattern collapse, instability, and lack of interpretability, require attention in future research.

The objective of this study was to analyze the relationship between quantitative parameters of spectral CT and the Ki67 expression index of tumor cells in hepatocellular carcinoma (HCC).

A total of 19 patients who underwent preoperative spectral CT dual-phase enhancement and who were diagnosed with HCC by postoperative pathology were prospectively selected. Patients with ≥10% Ki67-positive tumor cells formed a high-Ki67 group, and those with <10% Ki67-positive cells formed a low-Ki67 group. The iodine concentrations (ICs) of the lesion and the descending aorta were measured during the arterial and venous phases. Relative iodine concentration (RIC) was calculated thus: RIC=IClesion/ICdescending aorta. CT values of the lesions at 40 and 70 keV were measured during the enhanced arterial and venous phases. The slope of the spectral curve (λ) was calculated thus: λ = (40 keV-70 keV) /(70-30). To compare the differences in quantitative parameters between the high- and low-Ki67 groups, either an independent samples t-test (normal distribution) or a Mann–Whitney U test (non-normal distribution) was used. Receiver operating characteristic curves were used to evaluate the effectiveness of spectral CT parameters in distinguishing between high-Ki67 and low-Ki67 groups. Pearson correlation analysis was used to evaluate the correlation between spectral CT quantitative parameters and Ki67 expression.

IC, RIC and λ values for the high-Ki67 group in arterial and venous phases were higher than those for the low-Ki67 group, P < 0.05. IC, RIC, and λ values in the arterial phase were 0.83, 0.89, and 0.75, respectively; in the venous phase, the values of these three parameters were 0.76, 0.77, and 0.69, respectively. IC, RIC, and λ were positively correlated with Ki67 expression in both arterial and venous phases, with a highest correlation of 0.82 for arterial-phase RIC.

The quantitative parameters of spectral CT in HCC were correlated with Ki67 expression. This finding may make it easier for clinicians to determine whether a tumor is high or low in Ki67 before surgery.

The use of breast MRI for screening has increased over the past decade, mostly in women with a high risk of breast cancer. Abbreviated breast MRI (AB-MR) is introduced to make MRI a more accessible screening modality. AB-MR decreases scanning and reporting time and the overall cost of MRI.

This study aims to evaluate the diagnostic efficacy of abbreviated MRI protocol in detecting breast cancer in screening and diagnostic populations, using histopathology as the reference standard.

This is a single-centre retrospective cross-sectional study of 134 patients with 198 histologically proven breast lesions who underwent full diagnostic protocol contrast-enhanced breast MRI (FDP-MR) at the University Malaya Medical Centre (UMMC) from 1st January 2018 to 31st December 2019. AB-MR was pre-determined and evaluated with regard to the potential to detect and exclude malignancy from 3 readers of varying radiological experiences. The sensitivity of both AB-MR and FDP-MR were compared using the McNemar test, where both protocols' diagnostic performances were assessed via the receiver operating characteristic (ROC) curve. Inter-observer agreement was analysed using Fleiss Kappa.

There were 134 patients with 198 lesions. The average age was 50.9 years old (range 27 – 80). A total of 121 (90%) MRIs were performed for diagnostic purposes. Screening accounted for 9.4% of the cases, 55.6% (n=110) lesions were benign, and 44.4% (n=88) were malignant. The commonest benign and malignant lesions were fibrocystic change (27.3%) and invasive ductal carcinoma (78.4%). The mean sensitivity, specificity, positive predictive value, and negative predictive value for AB-MR were 0.96, 0.57, 0.68 and 0.94, respectively. Both AB-MR and FDP-MR showed excellent diagnostic performance with AUC of 0.88 and 0.96, respectively. The general inter-observer agreement of all three readers for AB-MR was substantial (k=0.69), with fair agreement demonstrated between AB-MR and FDP-MR (k=0.36).

The study shows no evidence that the diagnostic efficacy of AB-MR is inferior to FDP-MR. AB-MR, with high sensitivity, has proven its capability in cancer detection and exclusion, especially for biologically aggressive cancers.

The diagnosis and quantification of early-stage alcoholic liver fibrosis (ALF) are vital and the objective is to establish a noninvasive PET technique to quantify the collagenogenesis of hepatic stellate cells (HSC) in an ALF mouse model.

To establish the ALF animal model, a liquid alcohol diet (8 weeks), and CCl4 were injected intraperitoneally at 5-8 weeks. A liquid scintillation counter was used to measure [³H]proline uptake by rats HSC in vitro experiment. Collagen type 1 production was tested by ELISA in a culture medium. The expression of type 1 collagen and proline transporters in ex vivo experiments was compared between ALF rats and mice. Different doses of unlabeled proline and benztropine were ex vivo quantified [³H]proline in liver tissues. Tracer uptake in different organs including the liver in ALF and control mice in vivo was quantified using [¹⁸F]fluoro-proline microPET/CT.

The optimal dose and time of [³H]proline uptake by HSC was 19-37MBq/L and 30-90min after culture. Higher [³H]proline uptake and type 1 collagen production in HSC were found in ALF and control rats. There was a high correlation between [³H]proline uptake and type 1 collagen in ALF rats. To cut the costs of tracer usage and imaging in vivo, the mouse-to-rat model was compared. Type 1 collagen levels of ALF mice liver tissue in ex vivo were similar to ALF rats, as was proline transporter protein. Unlabeled proline of type 1 collagen and [³H]proline uptake of ALF mice was blocked by benztropine. in vivo [¹⁸F]fluoro-proline PET/CT imaging, SUVmax in the liver, normalized liver/brain and liver/thigh ratio were significantly different between ALF mice and controls and there was a strong positive correlation among these three indexes in ALF mice.

[¹⁸F]fluoro-proline microPET/CT is feasible to quantify collagenogenesis in HSC in early-stage ALF animal models, which may be used as a promising and reliable noninvasive diagnostic technique.

Breast cancer is one of the leading causes of mortality among women. In addition, 1 in 8 women and 1 in 833 men will be diagnosed with breast cancer in 2022. The detection of breast cancer can not only lower treatment costs but also increase survival rates. Due to increased cancer awareness, more women are undergoing breast cancer screening, leading to more cases being diagnosed worldwide, but doctors' ability to analyze these images is limited. As a result, they get overloaded leading to misinterpretations. The advent of computer-aided diagnosis (CAD) minimized man’s involvement and achieved good results. CAD helps medical doctors automatically detect and analyze abnormalities found in the breast. Such abnormalities may be benign or malignant tumors.

The goal of this study is to evaluate the effectiveness of using seven layers to classify breast cancer as either benign or malignant using mammograms.

The open-source MIAS dataset of 322 images was used for our study, of which 207 were normal images and 115 were abnormal images. The proposed CNN model convolves an image into seven layers that extract features from the input images, and these features are used to classify breast cancer as malignant or benign.

The proposed CNN used a limited data set and achieved the best result compared to previous work. The method achieved results with a 0.39% loss, 99.89% accuracy, 99.85% precision, 99.89% recall, 99.87% F1-score, and an area under the curve noted to be 100.0%.

CNN uses a small amount of data to determine abnormalities; the method will assist a medical doctor in determining whether or not a specific patient has cancer.

Ultrasound is extensively used for soft tissue pathology. Scanning bone superficial structures may reveal clear pathologic features to aid diagnosis.

We present the case of a stress fracture in the second metatarsal, with the clinical aspect of a gouty attack. Ultrasound examination showed cortical thickening and disruption, hypoechoic periosteal swelling, hyperemia, soft tissue edema, and displacement of the extensor tendon. The diagnosis was confirmed by X-ray and MRI. The value of different diagnostic tools is discussed, and the importance of gray-scale and color Doppler ultrasound as a first-hand modality is underlined.

Sonography clearly identifies cortical and periosteal abnormalities, differentiates surrounding soft tissue pathologies, and offers dynamic evaluation, and follow-up possibility with low cost, high accessibility, and no risks. Periosteal and cortical irregularities are important diagnostic issues when performing ultrasound examinations for soft tissue pathology.

Liposarcoma (LPS) is a malignant mesenchymal tumor that mostly occurs in the extremities and retroperitoneum and rarely in the scrotum.

In this case report, we introduced a patient who was diagnosed with LPS in the scrotum. In his right scrotum, we found a large soft tissue mass, including fat and calcification.

We reviewed the clinical, pathological and computed tomography (CT) features of patients diagnosed with LPS of the scrotum to help improve the understanding of the disease and the accuracy of diagnosis.

This work aimed to evaluate the level set segmentation algorithm on ocular surface thermograms. In addition, the vascularity functioning between the contralateral portions of two eyes (right and left) was identified using statistical analysis methods.

A total of 25 healthy participants with an average age of 35 years (20 men and 5 women) were selected in April 2022. Thermogram images were captured using a FLIR T series thermal camera. Conventional image processing techniques, such as filtering and edge detection, were used to preprocess thermograms. Next, the level set approach was used with the edge-detected pattern as an input to an automated segmented region of interest (ROI).

Five metrics, namely Dice Coefficient, Tanimoto Index, Jaccard Index, Volume Similarity, and Structural Similarity, were used to assess the performance of the segmentation technique compared to ground truth, which showed 97.5%, 92.5%, 94.5%, 96.5%, and 96.5% correlation, respectively, between the segmented and the ground truth images with average values for both the eyes. Statistical analysis demonstrated that the contralateral portions of the ocular thermograms were significantly different in terms of vascular distribution between the left and right eyes (p < 0.005).

The level set method efficiently segmented the ROI in ocular thermograms with maximum correlation. According to the segmentation’s results, the model showed the dissimilarity between the contralateral parts of the left and right eyes in healthy cases.

This study aims to investigate the efficiency of a radiomics model in identifying high-frequency microsatellite instability (MSI-H) and microsatellite stability (MSS) of colorectal liver metastasis (CRLM) according to machine learning radiomics features of enhanced CT liver images.

A total of 12 patients with MSI-H CRLM and 96 patients with MSS CRLM were randomly divided into the training group and internal validation group according to the ratio of 7: 3 (training: 75 cases, validation: 33 cases). From the enhanced CT (portal phase) image data of patients, 788 radiomics features were extracted, and a random forest model was established with the optimal features selected. The receiver operating characteristics (ROC) curve analysis was performed to assess the model’s diagnostic efficacy.

The training group comprised 8 patients with MSI-H CRLM and 67 patients with MSS CRLM, and the internal validation group included 4 patients with MSI-H CRLM and 29 patients with MSS CRLM. After feature selection, 7 radiomics features good for distinguishing MSI-H CRLM and MSS CRLM were screened out. The ROC curve analysis demonstrated that the random forest model had the AUC (area under the ROC curve) value 0.88, accuracy 0.85, sensitivity 0.85, specificity 0.92, and F1 score 0.88 in the training group. The model had an AUC value of 0.75, accuracy of 0.74, sensitivity of 0.81, specificity of 0.85, and F1_score of 0.78 in the internal validation group in identifying the MSI-H from the MSS CRLM. In order to evaluate the robustness of the overall model, the 788 features obtained were all applied to the 5-fold cross-validation, with the model being built on the random forest and analyzed with the ROC curve analysis. The AUC value of the model was 0.86 (P<0.05), accuracy value 0.91, sensitivity 0.60, and specificity 0.95.

The random forest prediction model built on the radiometric features extracted from enhanced CT images can be used to identify the MSI-H from the MSS CRLM and may provide effective guidance for clinical immunotherapy of CRLM patients with unknown MSI status.

Betel nut chewing is very common in Southeast Asia and other tropical countries. Much clinical evidence suggests that chewing betel nut has pro-inflammatory and carcinogenic effects, but there are few clinical reports of acute toxicity caused by it, especially involving esophageal damage.

We presented a case of a 72-year-old female who was admitted to our hospital for chest pain and hematemesis within several minutes after chewing betel nut. Gastroscopy showed two longitudinal ridge-like mucosal eminences in the esophagus located 20 cm from the incisors down to the gastric cardia, which was similar to varices. At last, a CT scan showed concentric-circle thickening of the esophagus wall, suggesting hematomas. Our treatment included fasting, inhibiting gastric acid and maintaining blood volume. After one week of medical treatment, rechecked gastroscopy showed that esophageal hematomas were gradually absorbed, with the formation of multiple shallow ulcers.

The acute toxicity of chewing betel nut can be easily overlooked. Patients who experience chest pain or hematemesis after chewing betel nut products,especially those who take aspirin at the same time, need to be alert to esophageal hematoma.

Primary anorectal malignant melanoma (ARMM) is a rare tumor. It is often misdiagnosed as hemorrhoids, polyps or colorectal cancer due to the lack of specificity of their clinical symptoms and imaging manifestations.

In this study, we reported an 83-year-old female patient with ARMM. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed uneven thickening of the intestinal wall about 7.0 cm from the anal margin, and no typical T1 high signal was seen on MRI. Dual-energy spectral CT showed that the effective atomic number (Zeff) of the tumor and the iodine concentration in the arterial phase (AP) and venous phase (VP) were different from other rectal malignancies reported in the previous literature. Sigmoidoscopy showed a large polypoid mass approximately 7.0 cm from the anal verge. Immunohistochemical staining showed that about 60% of Melan A and HMB-45 were positive, S-100 protein and Ki-67 were positive, and the pathological diagnosis was ARMM.

This was the first dual-energy spectral CT imaging report of ARMM. The Zeff and iodine concentration in the arterial phase and venous phase could help distinguish between ARMM and other rectal malignancies.

Millions of people have been infected with COVID-19, which has spread quickly worldwide since the start of 2020, resulting in numerous fatalities. Identification of infected individuals is essential to control the spread of the virus.

In this study, we propose a hybrid architecture that combines Convolutional Neural Networks (CNNs) with Recurrent Neural Networks (RNNs) and leverages transfer learning to enhance the accuracy of COVID-19 detection from X-ray images.

The proposed work utilizes 4 pre-trained CNN architectures, namely, InceptionnetV3, Densenet121, Inception-ResNet V2, and VGG19, to extract high-level features from the input X-ray images. These features are then fed into the second component, an RNN-based network, which captures the temporal dependencies within the extracted features. To evaluate the performance of the proposed architecture, a comprehensive dataset consisting of X-ray images from COVID-19 positive cases, non-COVID-19 pneumonia cases, and healthy individuals is used. Gradient class activation map (Grad-CAM) analysis has been applied to the obtained results to provide heat-map pictures specific to each class and coloured visualizations of the COVID-19-infected areas in CXR images.

: Experimental results demonstrate that the proposed hybrid CNN-RNN architecture achieves promising results in COVID-19 detection from X-ray images. The model exhibits high accuracy, precision, recall, area under the receiver operating characteristics (ROC) curve (AUC), and F1-score, outperforming other state-of-the-art methods.

The combination of CNNs and RNNs enables the model to effectively capture spatial and temporal information, leading to improved performance in COVID-19 detection. The proposed hybrid architecture with transfer learning from X-ray images provides a robust and efficient solution for COVID-19 detection. The model can potentially assist healthcare professionals in making accurate and timely diagnoses, thereby contributing to the global efforts to combat the COVID-19 pandemic. In the present work, VGG19-RNN architecture outperformed all other networks in terms of accuracy. The most effective training and validation accuracy for the VGG19-RNN architecture is 99% & 97.70%, respectively, and the loss was 0.02 & 0.09 at epoch 100.

Liesegang rings (LR) are concentric acellular lamellar structures, usually found in cystic and inflammatory tissues but can also be seen in neoplastic conditions. They have been mistakenly interpreted as various structures like psammomatous calcification, parasites, and algae. This study has aimed to systematically review and summarize the existence of LRs in both non-neoplastic and neoplastic conditions of the kidney. The systematic search in PUBMED, PUBMED CENTRAL, and EMBASE along with Google Scholar was performed by using Kidney, Liesegang Rings, or Liesegang structure or pseudo parasitic structure in combination with the Boolean operators ‘’and” as searching terms. Data was collected for demographic characteristics and histopathology diagnosis. The search function was limited to human subjects. Two reviewers independently performed the eligibility assessment and data extraction. Eligibility inclusion criteria were all publications in the English literature worldwide related to Liesegang rings in association with kidney’s non-neoplastic and neoplastic conditions, regardless of the years of publication. Also included were those cases whose full articles were unavailable, but the abstract was well-described, fulfilling our inclusive criteria. Eligibility exclusion criteria included LRs found elsewhere in the body organs apart from the kidney and availability of full text in a different language, non-human, and duplicate article/case.

After the exclusion of the articles as per the exclusion criteria, the total articles that fulfilled the inclusive criteria were reviewed. In addition, all the articles were further cross-referenced for additional articles. All published papers retrieved from this search were considered for this review. A total of 22 records (26 cases) were found with a diagnosis of LRs in the kidney to date. Some articles were published as case series. Accordingly, 26 patients were reported to have Liesegang rings associated with kidney neoplastic and non-neoplastic conditions, 12 were male and 14 were female. For one case the gender was not mentioned. LRs presented a higher frequency in individuals between 4^th and 5^th decades of life. No single case was reported in infants and younger children. Regarding predisposing factors for LRs, cystic fluid contents were the most common underlying condition.

In our practice, we encountered an unusual case of a 55-year-old female with a complaint of pain in the left upper quadrant of the abdomen. The ultrasound revealed nephrolithiasis and chronic kidney disease for which a nephrectomy was performed. On the histopathological examination, there was an incidental finding of Liesegang rings and a papillary adenoma along with features of chronic pyelonephritis. Our review will provide insight about LRs in different spectrums of kidney diseases.

This study represents the first available systematic review of the literature demonstrating LRs in the kidney. Although Liesegang rings have no great clinical significance, these, presence in both tissue and cytological specimens should be kept in mind while dealing with different lesions of the kidney as these are good mimickers of many organic and inorganic substances, parasites, and malignancies.

In some hospitals in remote areas, due to the lack of MRI scanners with high magnetic field intensity, only low-resolution MRI images can be obtained, hindering doctors from making correct diagnoses. In our study, high-resolution images can be obtained through low-resolution MRI images. Moreover, as our algorithm is a lightweight algorithm with a small number of parameters, it can be carried out in remote areas under the condition of the lack of computing resources. Moreover, our algorithm is of great clinical significance in providing references for doctors' diagnoses and treatment in remote areas.

We compared different super-resolution algorithms to obtain high-resolution MRI images, including SRGAN, SPSR, and LESRCNN. A global skip connection was applied to the original network of LESRCNN to use global semantic information to get better performance.

Experiments reported that our network improved SSMI by 0.8% and also achieved an obvious increase in PSNR, PI, and LPIPS compared to LESRCNN in our dataset. Similar to LESRCNN, our network has a very short running time, the small number of parameters, low time complexity, and low space complexity while ensuring high performance compared to SRGAN and SPSR. Five MRI doctors were invited for a subjective evaluation of our algorithm. All agreed on significant improvements and that our algorithm could be used clinically in remote areas and has great value.

The experimental results demonstrated the performance of our algorithm in super-resolution MRI image reconstruction. It allows us to obtain high-resolution images in the absence of high-field intensity MRI scanners, which has great clinical significance. The short running time, a small number of parameters, low time complexity, and low space complexity ensure that our network can be used in grassroots hospitals in remote areas that lack computing resources. We can reconstruct high-resolution MRI images in a short time, thus saving time for patients. Our algorithm is biased towards clinical and practical applications, and doctors have affirmed the clinical value of our algorithm.

The lack of knowledge of the relation of the maxillary sinus with the apexes of maxillary posterior teeth can lead to important complications during common dental procedures. This can be avoided using different imaging techniques, such as orthopantomography (OPG) and cone beam computed tomography (CBCT). The present study aims to compare the performance of OPG with CBCT in measuring the vertical distance of the apexes of posterior-superior teeth to the maxillary sinus.

This study corresponded to a cross-sectional study. OPGs and CBCT scans were obtained from the same individuals, and the qualitative and quantitative vertical distance of the apexes in relation to the maxillary sinus was categorized and measured in mm.

A total of 28 pairs of OPGs and CBCT scans from the same patients were obtained. About 381 roots were analysed, which included 89 upper first premolars, 51 upper second premolars, 115 upper first molars, and 126 upper second molars. Projection/protrusion was observed with more frequency in molars, specially 1º molars in both OPG (n= 75, 65.2%) and CBCT (n= 31, 27%); however, 106 more cases (27.9%) were classified as projected in the OPG compared to CBCT (p < 0.05). When comparing the performance of the OPG and CBTC for analysing all roots qualitatively, there was a 57.8% agreement between both techniques. This difference was statistically significant (p <0.0001). Statistically significant differences were also observed when comparing the millimetric differences.

This study showed that OPG is not an accurate technique to observe the relationship between the maxillary sinus and the apexes of the upper posterior teeth. In those cases where precision is required when performing dental procedures in this area, CBCT should be used. When not available, the clinicians should be aware of the limitations of the OPG and add other complementary techniques.

Gastric teratoma (GT) occurs as a rule in infancy and is an extremely unusual gastric tumor in adult patients.

In this paper, we present the clinical and imaging findings of a 56-year-old female patient with a GT. The patient's main symptoms were increasing abdominal discomfort and pain. After the physical examination, she underwent ultrasound (US) and computed tomography (CT), which showed a large mass at the posterior wall of the stomach, and a teratoma was initially considered. After surgery, pathology confirmed the diagnosis of GT. The patient recovered after surgery and was discharged in good health. To the best of our knowledge, this study is the first reported case of gastric teratoma in an adult woman in the literature.

Gastric teratoma of the adult period is a rare benign neoplasm that may have several complications; therefore, imaging is crucial for diagnosis and accurate treatment management. The aim of this study is to emphasize the value of US and CT in the diagnosis and treatment monitoring of mature gastric teratomas.

Brain tumors are predicted from Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scan images. In recent years, image processing-based automated tools are developed to predict tumor areas with less human interference. However, such automated tools are suffering from computational complexity and reduced accuracy in certain critical images. In the proposed work, an Ideal Shallow Neural Network (ISNN) is utilized to improve the prediction accuracy, and the computational complexity is reduced by implementing an Artificial Jellyfish Optimization (AJO) algorithm for minimizing the feature dimensionality.

The proposed method utilizes MRI images for the verification process as they are more informative than the CT scan image. The BRATS and the Kaggle datasets are used in this work and a Gabor filtering technique is used for noise reduction and a histogram equalization is used for enhancing the tumor boundary regions. The classification results observed from the AJO-ISNN are further forwarded towards the segmentation process and which uses the Centroid Weighted Segmentation (WCS) along with a Grasshopper Optimization Algorithm (GOA) for improving the segmentation over the boundary regions of the brain tumor.

The experimental result indicates a classification accuracy of 95.14% on the proposed AJO-ISNN model and AJO-ISNN is comparatively better than the Convolutional Neural Network (CNN) model accuracy of 85.41% and VGG 19 model accuracy of 93.75% while implemented with the AJO optimization model. Similarly, the Dice Similarity Coefficient of the proposed CWS-GOA also reaches 93.15% when performed with both BRATS and Kaggle datasets.

Apart from the accuracy attainments the proposed work classifies and segments the tumor region in around 65 seconds on average of 200 image verifications and that is comparatively better than the previous multi-cascaded CNN and the InceptionV3 models.

Hepatocellular carcinoma (HCC) is the leading type of liver cancer in adults, often resulting in fatal outcomes for those with cirrhosis. Dysplastic nodule (DN) is a liver nodule that is substantial in size, ranging from 1-2 cm. However, accurately distinguishing between DN and HCC on imaging has posed a challenge.

The aim of this study is to assess the usefulness of Gd-EOB-DTPA-enhanced MRI T1 mapping in distinguishing between DN and HCC.

This study analyzed 66 patients with confirmed HCC or DN who underwent Gd-EOB-DTPA-enhanced MRI T1 mapping before surgery or puncture at the Army Medical Center in China. The T1 values of each lesion were measured before and after Gd-EOB-DTPA administration, and various calculations were made, including absolute and percentage reduction in T1 value and coefficient of variation. The t-test was used to compare these values between the two groups, and the efficacy of T1 mapping values for differential diagnosis of HCC and DN was evaluated using the receiver operating characteristic curve (ROC).

The study found that T1pre, T1hp, ΔT1, ΔT1%, and CV in the HCC group were significantly higher than in the DN group (p < 0.01). The accuracy of T1hp, ΔT1, and CVT1-hp in identifying HCC from DN was high, with AUCs of 0.955, 0.910, and 0.932, respectively. ΔT1% also had some accuracy, with an AUC of 0.818.

Our results provide preliminary evidence that Gd-EOB-DTPA-enhanced MRI T1 mapping, can be a valuable tool in diagnosing and differentiating between HCC and DN.

Spectral-Domain Optical Coherence Tomography (SD-OCT) provides non-invasive, high-speed, high-resolution, three-dimensional cross-section imaging of the macula.

This study aimed to investigate the diagnostic value of the multimodal imaging technique of three-dimension (3D) optical coherence tomography (OCT) (3D-OCT) for the diagnosis and characterization of acute central serous chorioretinopathy (CSC).

In this prospective clinical study 3D-OCT examinations of 82 cases with acute CSC were performed on the macular area, and the image characteristics were analyzed. Our study included a total of 87 eyes from 82 cases of CSC patients, 67 males and 15 females (mean age ± standard deviation (SD): 42.89 ±7.80 years old; age range: 27 to 56 years old. The 3D-OCT images were evaluated for the presence of subretinal fluid, subretinal space, fluctuation of the internal limiting membrane (ILM), folds of retinal pigment epithelial (RPE), retinal pigment epithelium detachment (PED), and flat irregular PED. The foveal thickness was measured using the manual caliper of OCT software.

The OCT B-scan images showed 87 (100%) eyes had exudative retinal detachment (ERD), 38 (44%) had flat irregular PED, 36 (41%) had PED, 8 (9%) had subretinal turbidity structure, 2 (2%) had subretinal dot-like precipitates, 1 (1%) had focal choroidal excavation (FCE), and 1 (1%) eye had fluctuation of internal limiting membrane (FI). In the ILM-RPE thickness map, all eyes had a round or round like regular uniform domes. Fifty-seven (66%) domes were limited in the examination area and 30 (44%) domes were beyond the scope of this examination and only a partial section of the dome could be observed. In the en-face image, all eyes had a round or round-like black figure that corresponded with domes in the ILM-RPE thickness map. In RPE surface, 76 (87%) eyes had a shallow plate depression, 71(82%) had small focal uplift, and 1 (1%) eye had a focal concave feature.

In the OCT ILM-RPE thickness, en-face image, and RPE surface maps, acute CSC exhibited specific imaging characteristics that can be helpful for reliable diagnosis and differential diagnosis of CSC.

The characteristic imaging findings of breast cancer in young women are not yet fully understood. It causes a delay in diagnosis by mixing with benign findings.

To evaluate the relationship between the imaging and histopathological features of breast cancer in women aged under 40 years.

In our center, 537 suspicious lesions were detected in a total of 15,223 adult female patients under 40 years who were evaluated by breast ultrasonography (US). As a result of the mammographic, histopathological, and immunohistochemical analysis, 101 lesions meeting the study criteria were included in the sample.

The luminal subtypes of breast cancer mostly visualized as irregularly shaped spiculated lesions with calcification and architectural distortion mammography and presented as masses that were sometimes accompanied by increased echogenicity in the surrounding tissue on US. The human epidermal growth factor receptor 2 (HER2) enriched subtypes mostly had microlobulated or indistinct margins with heterogeneous echoes accompanied by high calcification on mammography. The triple-negative (TN) subtypes generally appeared as microlobulated lesions with angular or indistinct margins, hypo echogenicity, posterior enhancement or shadowing, and vascularization.

Some radiological features of breast cancer in young women were found to be associated with molecular subtypes similar to other age groups in the literature. However, unlike other age groups, the incidences of the HER2-enriched subtype presenting with only calcification, TN subtypes presenting with circumscribed masses, and calcification were found to be low among the young women in our study.

A large jejunal diverticulum has been reported as a possible cause of volvulus and acute mesenteric ischemia (AMI) in adults. A large diverticulum of the small bowel complicated with volvulus has been reported before in literature. However, imaging findings of a large diverticulum of the small bowel complicated with both volvulus and AMI on MDCT are rarely described and reported. In this study, we reported a case with a large diverticulum, volvulus, and AMI concurrently; these three imaging findings were reviewed and described on MDCT, and the relevant literature was briefly introduced.

We reported the case of a 69-year-old man who presented to our hospital with acute abdominal pain and vomiting. An emergent abdominal enhanced MDCT imaging was performed and demonstrated the volvulus secondary to a large diverticulum of the jejunum complicated with AMI. Here, a case was presented that highlighted unique imaging findings on MDCT, as well as a literature review.

A review of the literature revealed that a single jejunal diverticulum causing both volvulus and AMI is rare in adults. To our knowledge, a systemic description of their signs on MDCT in a case has not been reported yet.

Agenesis of the corpus callosum (ACC) is a rare hereditary nervous system defect present at birth. ACC is an uncommon condition that is unrepresentative in the general population because some cases do not present with any identifiable symptoms in the early stage.

We present a case of ACC in a two-month-old male patient who was diagnosed after birth. Although the initial brain ultrasound (US) showed dilation of the lateral ventricles and the absence of the corpus callosum, these findings were not fully confirmed. Therefore, magnetic resonance imaging (MRI) of the brain was conducted to confirm the complex diagnosis, and the examination revealed complete ACC. Diagnosing ACC in a neonate demonstrates the complexity of diagnosis through the clinical presentation, especially at an early age.

The clinical utility of neonatal US and MRI highlights the importance of an early diagnosis of ACC. MRI is more effective than the US in detecting this condition, and these imaging modalities provide the patient with an early diagnosis, which helps in treatment management.

We aimed to examine all-cause mortality risk in relation to the extent of non-obstructive coronary artery disease (CAD) by coronary computed tomography angiography (CTA) in Chinese middle-aged and older patients in a multicenter study with nine-year follow-up.

This was a retrospective, observational, multicentre study. The study population consisted of 3,240 consecutive middle-aged and older patients (age ≥ 40 years) with suspected CAD who underwent coronary CTA between June 2011 and December 2013 at three hospitals in Wuhan, China. Patients were grouped according to CAD extent for the final analysis: no CAD, 1-vessel non-obstructive CAD, 2-vessels non-obstructive CAD, and 3-vessels non-obstructive CAD. The primary endpoint was all-cause mortality. Kaplan-Meier method and Cox proportional hazards regression models were used for analysis.

A total of 2,522 patients were included in the present analysis. Of these, 188 (7.5%) deaths occurred during the median 9.0 years (interquartile range 8.6–9.4) of study follow-up. The annualized all-cause mortality rate was 0.54 (95% CI: 0.44–0.68), 0.91 (95% CI: 0.68–1.21), 1.44 (95% CI: 1.01–1.93), and 2.00 (95% CI: 1.46–2.69) for the no CAD, 1-vessel non-obstructive CAD, 2-vessels non-obstructive CAD, and 3-vessels non-obstructive CAD group, respectively. Kaplan–Meier survival curves showed a significant increase in the cumulative events associated with the extent of non-obstructive CAD (P < 0.001). In multivariate Cox regression, after adjustment for age and sex, the presence of 3-vessels non-obstructive CAD was a significant predictor of all-cause mortality (HR 1.60, 95% CI: 1.04–2.45, P = 0.032).

In this cohort of Chinese middle-aged and older patients undergoing coronary CTA, the presence and extent of non-obstructive CAD, compared to no CAD, were associated with a significantly greater nine-year risk of all-cause mortality. The present findings suggest the clinical importance of the stage of non-obstructive CAD and warrant investigation of the optimal risk stratification to improve outcomes among these patients.

The aims were to assess different branching patterns of segmental bronchi in the right superior lobe (RSL), as well as to investigate the anatomical diversity and sex-related variations of these branches in a large sample of the research population.

10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups.

Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05).

The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

This study aimed to investigate the diagnosis of the external jugular venous aneurysm on color Doppler ultrasound and its relationship with pathological characteristics.

A retrospective analysis of 17 patients with external jugular venous aneurysm admitted to the Provincial Hospital Affiliated with Shandong First Medical University from May, 2010, to June, 2020, was performed. The color Doppler ultrasound characteristics of 17 patients with external jugular vein aneurysms were analyzed and summarized, which were then compared with postoperative pathological outcomes.

All 17 patients with external jugular venous aneurysms were presented with cystic structures adjacent to and communicated with the external jugular vein. Color Doppler flow imaging showed a bidirectional venous flow signal in the communication between the cystic structure and the external jugular vein. Among the 17 patients, ultrasound diagnosis showed true venous aneurysm due to degenerative changes in the venous wall in 8 cases, venous pseudoaneurysm in 4 cases, and external jugular venous aneurysm in 5 cases, and postoperative pathology indicated degenerative changes in the venous wall in all 17 patients.

Bidirectional blood flow at the communication between the cystic lesion and the external jugular vein on color Doppler ultrasound should not be the criterion for the diagnosis of external jugular venous pseudoaneurysm, which requires pathological support.