Utility of 3D magnetic resonance imaging in preoperative evaluation of hepatobiliary diseases

LAVA HyperSense and deep-learning reconstruction for near-isotropic (3D) enhanced magnetic resonance enterography in patients with Crohn's disease: utility in noise reduction and image quality improvement

PURPOSE

This study aimed to compare near-isotropic contrast-enhanced T1-weighted (CE-T1W) magnetic resonance enterography (MRE) images reconstructed with vendor-supplied deep-learning reconstruction (DLR) with those reconstructed conventionally in terms of image quality.

METHODS

A total of 35 patients who underwent MRE for Crohn's disease between August 2021 and February 2022 were included in this retrospective study. The enteric phase CE-T1W MRE images of each patient were reconstructed with conventional reconstruction and no image filter (original), with conventional reconstruction and image filter (filtered), and with a prototype version of AIRTM Recon DL 3D (DLR), which were then reformatted into the axial plane to generate six image sets per patient. Two radiologists independently assessed the images for overall image quality, contrast, sharpness, presence of motion artifacts, blurring, and synthetic appearance for qualitative analysis, and the signal-to-noise ratio (SNR) was measured for quantitative analysis.

RESULTS

The mean scores of the DLR image set with respect to overall image quality, contrast, sharpness, motion artifacts, and blurring in the coronal and axial images were significantly superior to those of both the filtered and original images (P < 0.001). However, the DLR images showed a significantly more synthetic appearance than the other two images (P < 0.05). There was no statistically significant difference in all scores between the original and filtered images (P > 0.05). In the quantitative analysis, the SNR was significantly increased in the order of original, filtered, and DLR images (P < 0.001).

CONCLUSION

Using DLR for near-isotropic CE-T1W MRE improved the image quality and increased the SNR.

Evaluation of Age- and Radical-Prostatectomy Related Changes in Male Pelvic Floor Anatomy Based on Magnetic Resonance Imaging and 3-Dimensional Reconstruction

Purpose

Puborectalis muscles (PRM) and ischiocavernosus muscles (ICM) play important roles in urinary continence and male erectile functions. Understanding of anatomy and surgical-injury related changes to these muscles is critical to monitor changes in continence or erectile function. Anatomical description of these muscles has undergone revisions because these conclusions were derived from cadavers. Our objectives were to: (i) elucidate male pelvic muscles by in-vivo magnetic resonance imaging (MRI) and 3-dimensional (3-D) reconstruction of these images and (ii) compare PRM and ICM thickness in healthy volunteers and symptomatic patients.

Materials and Methods

Healthy young male (mean age, 25 years; n=5), older male (age, 65–70 years; n=5), and post-prostatectomy patients with erectile dysfunction and urinary incontinence (age, 65–70 years; n=5) were scanned on a 3T-magnetic resonance scanner. Images were acquired from slices above urinary bladder base to urethra entry into penis. Pelvic bone, bladder/urethra, corpus cavernosum, ICM, PRM, and prostate were segmented. 3-D models of each structure were generated and assembled into composite images, and ICM and PRM thicknesses were calculated.

Results

We successfully reconstructed 3-D male pelvic floor anatomy including ICM, PRM, bladder, urethra, bulbospongiosus, corpus cavernosa, prostate and bones from the two groups. We documented significant reduction in PRM and ICM thickness in older men.

Conclusions

This is perhaps the first 3-D reconstruction of male pelvic floor structures based on in-vivo MRI in healthy and symptomatic patients. Observed reduction in PRM and ICM thickness is possibly due to age-related atrophy.

Effects of Preoperative Virtual Reality Magnetic Resonance Imaging on Preoperative Anxiety in Patients Undergoing Arthroscopic Knee Surgery: A Randomized Controlled Study

PURPOSE

To assess the effect of a preoperative virtual reality (VR) experience of 3-dimensional (3D) reconstructed magnetic resonance images (MRIs) on anxiety reduction in patients undergoing arthroscopic knee surgery.

METHODS

Patients in the VR group watched a 3D model of their own MRI through a VR headset describing the anatomy of the knee as well as their own lesion of interest for an arthroscopic procedure. Patients in the non-VR (NR) group received standard preoperative information about their MRI. The primary outcome for analysis was the Amsterdam Preoperative Anxiety and Information Scale score to measure level of anxiety and the need for information in patients undergoing arthroscopic knee surgery. Secondary outcomes were rated with visual analog scale (VAS) scores measuring patient pain, preparedness, satisfaction, and stress.

RESULTS

Regarding the Amsterdam Preoperative Anxiety and Information Scale score, the sum S (surgery-related anxiety) and sum C (combined anxiety component) subscales showed significantly better outcomes in the VR group (median [interquartile range] for sum S = 2.0 [2.0-4.0], median [quartile 1-quartile 3] sum C = 4.0 [4.0-8.5]) than in the NR group (median [interquartile range] for sum S = 4.9 [3.0-5.0], median [quartile 1-quartile 3] sum C = 8.0 [5.3-9.8]) (P = .014 and P = .005, respectively). Regarding VAS scores, preoperative measures showed significantly better outcomes in satisfaction among VR group patients (95 [90.0-100.0]) in comparison to NR group patients (85 [70.0-96.0]) (P = .010). For postoperative VAS measures, the VR group (satisfaction score = 95 [90.0-100.0], stress score = 15 [2.5-37.5]) showed significantly better outcomes in satisfaction and stress in comparison to the NR group (satisfaction score = 85 [70.0-97.5], stress score = 30 [30.0-50.0]).

CONCLUSIONS

Application of preoperative VR experience of 3D reconstructed knee MRIs in patients undergoing arthroscopic knee surgery reduces anxiety around surgical encounters. The VR patient group was more satisfied overall and less stressed postoperatively. However, perioperative pain and preparedness were not affected by VR exposure.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

Iliopsoas snapping hip: improving the diagnostic value of magnetic resonance imaging with a novel parameter

OBJECTIVE

To illustrate an advanced imaging parameter that describes the course of the iliopsoas tendon, and evaluate its correlations with iliopsoas internal hip snapping syndrome.

METHODS

This retrospective cohort study reviewed hip MRI images of all patients seen by a single surgeon between January 2015 and March 2016. The comparison group included all patients with clinical internal hip snapping, versus the control group that did not. MRI images were processed using minimum intensity projection. Measurements obtained of the pelvis and course of the iliopsoas tendon included: pelvic incidence, coronal angle, and sagittal opening angle (SOA). Comparison of measurements between the groups was performed with Mann-Whitney U analysis and receiver operator curve (ROC) plotting, with a significance cutoff of p = 0.05.

RESULTS

The control group (n = 85) and comparison group (n = 48) demonstrated no difference in age or gender. Pelvic incidence was similar [51.3 (± 10.7) degrees control versus 52.2 (± 7.7) degrees comparison (p = 0.36)], as was coronal angle [13.9 (± 4.6) degrees control versus 14.8 (±4.8) degrees comparison (p = 0.15)]. There was a significant difference in SOA [137.0 (± 5.9) degrees control versus 141.9 (± 6.5) degrees comparison (p < 0.01)]. ROC analysis revealed SOA threshold of 140 degrees for clinical IP hip snapping (p < 0.01), with odds ratio 5.2 (2.4-11.3) for SOA > 140 degrees.

CONCLUSIONS

Iliopsoas hip snapping is often part of a more complex disease process. While challenging to diagnose, advanced imaging parameters, like the sagittal opening angle, relate with clinical pathology. The SOA offers diagnostic value, with a threshold of greater than 140 degrees significantly correlating with clinical presentation.

Novel Noninvasive Brain Disease Detection System Using a Facial Image Sensor

Brain disease including any conditions or disabilities that affect the brain is fast becoming a leading cause of death. The traditional diagnostic methods of brain disease are time-consuming, inconvenient and non-patient friendly. As more and more individuals undergo examinations to determine if they suffer from any form of brain disease, developing noninvasive, efficient, and patient friendly detection systems will be beneficial. Therefore, in this paper, we propose a novel noninvasive brain disease detection system based on the analysis of facial colors. The system consists of four components. A facial image is first captured through a specialized sensor, where four facial key blocks are next located automatically from the various facial regions. Color features are extracted from each block to form a feature vector for classification via the Probabilistic Collaborative based Classifier. To thoroughly test the system and its performance, seven facial key block combinations were experimented. The best result was achieved using the second facial key block, where it showed that the Probabilistic Collaborative based Classifier is the most suitable. The overall performance of the proposed system achieves an accuracy −95%, a sensitivity −94.33%, a specificity −95.67%, and an average processing time (for one sample) of <1 min at brain disease detection.

Three-dimensional visualisation of developmental stages of an apicomplexan fish blood parasite in its invertebrate host

Background

Although widely used in medicine, the application of three-dimensional (3D) imaging to parasitology appears limited to date. In this study, developmental stages of a marine fish haemogregarine, Haemogregarina curvata (Apicomplexa: Adeleorina), were investigated in their leech vector, Zeylanicobdella arugamensis; this involved 3D visualisation of brightfield and confocal microscopy images of histological sections through infected leech salivary gland cells.

Findings

3D assessment demonstrated the morphology of the haemogregarine stages, their spatial layout, and their relationship with enlarged host cells showing reduced cellular content. Haemogregarine meronts, located marginally within leech salivary gland cells, had small tail-like connections to the host cell limiting membrane; this parasite-host cell interface was not visible in two-dimensional (2D) light micrographs and no records of a similar connection in apicomplexan development have been traced.

Conclusions

This is likely the first account of the use of 3D visualisation to study developmental stages of an apicomplexan parasite in its invertebrate vector. Elucidation of the extent of development of the haemogregarine within the leech salivary cells, together with the unusual connections between meronts and the host cell membrane, illustrates the future potential of 3D visualisation in parasite-vector biology.