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Shim J, Lee Y. No-Reference-Based and Noise Level Evaluations of Cinematic Rendering in Bone Computed Tomography. Bioengineering (Basel) 2024; 11:563. [PMID: 38927799 PMCID: PMC11201129 DOI: 10.3390/bioengineering11060563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Cinematic rendering (CR) is a new 3D post-processing technology widely used to produce bone computed tomography (CT) images. This study aimed to evaluate the performance quality of CR in bone CT images using blind quality and noise level evaluations. Bone CT images of the face, shoulder, lumbar spine, and wrist were acquired. Volume rendering (VR), which is widely used in the field of diagnostic medical imaging, was additionally set along with CR. A no-reference-based blind/referenceless image spatial quality evaluator (BRISQUE) and coefficient of variation (COV) were used to evaluate the overall quality of the acquired images. The average BRISQUE values derived from the four areas were 39.87 and 46.44 in CR and VR, respectively. The difference between the two values was approximately 1.16, and the difference between the resulting values increased, particularly in the bone CT image, where metal artifacts were observed. In addition, we confirmed that the COV value improved by 2.20 times on average when using CR compared to VR. This study proved that CR is useful in reconstructing bone CT 3D images and that various applications in the diagnostic medical field will be possible.
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Affiliation(s)
- Jina Shim
- Department of Diagnostic Radiology, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
| | - Youngjin Lee
- Department of Radiological Science, Gachon University, Incheon 21936, Republic of Korea
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2
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Pedraja F, Sawtell NB. Collective sensing in electric fish. Nature 2024; 628:139-144. [PMID: 38448593 DOI: 10.1038/s41586-024-07157-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024]
Abstract
A number of organisms, including dolphins, bats and electric fish, possess sophisticated active sensory systems that use self-generated signals (for example, acoustic or electrical emissions) to probe the environment1,2. Studies of active sensing in social groups have typically focused on strategies for minimizing interference from conspecific emissions2-4. However, it is well known from engineering that multiple spatially distributed emitters and receivers can greatly enhance environmental sensing (for example, multistatic radar and sonar)5-8. Here we provide evidence from modelling, neural recordings and behavioural experiments that the African weakly electric fish Gnathonemus petersii utilizes the electrical pulses of conspecifics to extend its electrolocation range, discriminate objects and increase information transmission. These results provide evidence for a new, collective mode of active sensing in which individual perception is enhanced by the energy emissions of nearby group members.
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Affiliation(s)
- Federico Pedraja
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, NY, USA.
| | - Nathaniel B Sawtell
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, NY, USA.
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3
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Schwartz FR, Ronald JS, Kalisz KR, Fu W, Ramirez-Giraldo JC, Koweek LMH, Churchill S, Southerland KW, Marin D. First experience of evaluation of the impact of high-matrix size reconstruction in image quality in arterial CT runoff studies of the lower extremities. Eur Radiol 2023; 33:8745-8753. [PMID: 37382617 DOI: 10.1007/s00330-023-09841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To determine whether image reconstruction with a higher matrix size improves image quality for lower extremity CTA studies. METHODS Raw data from 50 consecutive lower extremity CTA studies acquired on two MDCT scanners (SOMATOM Flash, Force) in patients evaluated for peripheral arterial disease (PAD) were retrospectively collected and reconstructed with standard (512 × 512) and higher resolution (768 × 768, 1024 × 1024) matrix sizes. Five blinded readers reviewed representative transverse images in randomized order (150 total). Readers graded image quality (0 (worst)-100 (best)) for vascular wall definition, image noise, and confidence in stenosis grading. Ten patients' stenosis scores on CTA images were compared to invasive angiography. Scores were compared using mixed effects linear regression. RESULTS Reconstructions with 1024 × 1024 matrix were ranked significantly better for wall definition (mean score 72, 95% CI = 61-84), noise (74, CI = 59-88), and confidence (70, CI = 59-80) compared to 512 × 512 (wall = 65, CI = 53 × 77; noise = 67, CI = 52 × 81; confidence = 62, CI = 52 × 73; p = 0.003, p = 0.01, and p = 0.004, respectively). Compared to 512 × 512, the 768 × 768 and 1024 × 1024 matrix improved image quality in the tibial arteries (wall = 51 vs 57 and 59, p < 0.05; noise = 65 vs 69 and 68, p = 0.06; confidence = 48 vs 57 and 55, p < 0.05) to a greater degree than the femoral-popliteal arteries (wall = 78 vs 78 and 85; noise = 81 vs 81 and 84; confidence = 76 vs 77 and 81, all p > 0.05), though for the 10 patients with angiography accuracy of stenosis grading was not significantly different. Inter-reader agreement was moderate (rho = 0.5). CONCLUSION Higher matrix reconstructions of 768 × 768 and 1024 × 1024 improved image quality and may enable more confident assessment of PAD. CLINICAL RELEVANCE STATEMENT Higher matrix reconstructions of the vessels in the lower extremities can improve perceived image quality and reader confidence in making diagnostic decisions based on CTA imaging. KEY POINTS • Higher than standard matrix sizes improve perceived image quality of the arteries in the lower extremities. • Image noise is not perceived as increased even at a matrix size of 1024 × 1024 pixels. • Gains from higher matrix reconstructions are higher in smaller, more distal tibial and peroneal vessels than in femoropopliteal vessels.
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Affiliation(s)
- Fides R Schwartz
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA.
| | - James S Ronald
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Kevin R Kalisz
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Wanyi Fu
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | | | - Lynne M Hurwitz Koweek
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Susan Churchill
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
| | - Kevin W Southerland
- Department of Vascular Surgery, Duke University Health System, Durham, NC, USA
- Department of Surgery, Duke University Health System, 2301 Erwin Road, Box 3704, Durham, NC, 27110, USA
| | - Daniele Marin
- Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA
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4
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Pedraja F, Sawtell NB. Collective Sensing in Electric Fish. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.13.557613. [PMID: 37745367 PMCID: PMC10515903 DOI: 10.1101/2023.09.13.557613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
A number of organisms, including dolphins, bats, and electric fish, possess sophisticated active sensory systems that use self-generated signals (e.g. acoustic or electrical emissions) to probe the environment1,2. Studies of active sensing in social groups have typically focused on strategies for minimizing interference from conspecific emissions2-4. However, it is well-known from engineering that multiple spatially distributed emitters and receivers can greatly enhance environmental sensing (e.g. multistatic radar and sonar)5-8. Here we provide evidence from modeling, neural recordings, and behavioral experiments that the African weakly electric fish Gnathonemus petersii utilizes the electrical pulses of conspecifics to extend electrolocation range, discriminate objects, and increase information transmission. These results suggest a novel, collective mode of active sensing in which individual perception is enhanced by the energy emissions of nearby group members.
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Affiliation(s)
- Federico Pedraja
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, NY 10027
| | - Nathaniel B Sawtell
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, NY 10027
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5
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Zhao H, Liu Z, Tang J, Gao B, Qin Q, Li J, Zhou Y, Yao P, Xi Y, Lin Y, Qian H, Wu H. Energy-efficient high-fidelity image reconstruction with memristor arrays for medical diagnosis. Nat Commun 2023; 14:2276. [PMID: 37081008 PMCID: PMC10119144 DOI: 10.1038/s41467-023-38021-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
Medical imaging is an important tool for accurate medical diagnosis, while state-of-the-art image reconstruction algorithms raise critical challenges in massive data processing for high-speed and high-quality imaging. Here, we present a memristive image reconstructor (MIR) to greatly accelerate image reconstruction with discrete Fourier transformation (DFT) by computing-in-memory (CIM) with memristor arrays. A high-accuracy quasi-analogue mapping (QAM) method and generic complex matrix transfer (CMT) scheme was proposed to improve the mapping precision and transfer efficiency, respectively. High-fidelity magnetic resonance imaging (MRI) and computed tomography (CT) image reconstructions were demonstrated, achieving software-equivalent qualities and DICE scores after segmentation with nnU-Net algorithm. Remarkably, our MIR exhibited 153× and 79× improvements in energy efficiency and normalized image reconstruction speed, respectively, compared to graphics processing unit (GPU). This work demonstrates MIR as a promising high-fidelity image reconstruction platform for future medical diagnosis, and also largely extends the application of memristor-based CIM beyond artificial neural networks.
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Affiliation(s)
- Han Zhao
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Zhengwu Liu
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Jianshi Tang
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China.
- Beijing Innovation Center for Future Chips (ICFC), Tsinghua University, Beijing, 100084, China.
| | - Bin Gao
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
- Beijing Innovation Center for Future Chips (ICFC), Tsinghua University, Beijing, 100084, China
| | - Qi Qin
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Jiaming Li
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Ying Zhou
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Peng Yao
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Yue Xi
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - Yudeng Lin
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
| | - He Qian
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
- Beijing Innovation Center for Future Chips (ICFC), Tsinghua University, Beijing, 100084, China
| | - Huaqiang Wu
- School of Integrated Circuits, Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing, 100084, China
- Beijing Innovation Center for Future Chips (ICFC), Tsinghua University, Beijing, 100084, China
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6
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Cardobi N, Nocini R, Molteni G, Favero V, Fior A, Marchioni D, Montemezzi S, D’Onofrio M. Path Tracing vs. Volume Rendering Technique in Post-Surgical Assessment of Bone Flap in Oncologic Head and Neck Reconstructive Surgery: A Preliminary Study. J Imaging 2023; 9:jimaging9020024. [PMID: 36826943 PMCID: PMC9967273 DOI: 10.3390/jimaging9020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/15/2022] [Accepted: 12/26/2022] [Indexed: 01/22/2023] Open
Abstract
This study aims to compare a relatively novel three-dimensional rendering called Path Tracing (PT) to the Volume Rendering technique (VR) in the post-surgical assessment of head and neck oncologic surgery followed by bone flap reconstruction. This retrospective study included 39 oncologic patients who underwent head and neck surgery with free bone flap reconstructions. All exams were acquired using a 64 Multi-Detector CT (MDCT). PT and VR images were created on a dedicated workstation. Five readers, with different expertise in bone flap reconstructive surgery, independently reviewed the images (two radiologists, one head and neck surgeon and two otorhinolaryngologists, respectively). Every observer evaluated the images according to a 5-point Likert scale. The parameters assessed were image quality, anatomical accuracy, bone flap evaluation, and metal artefact. Mean and median values for all the parameters across the observer were calculated. The scores of both reconstruction methods were compared using a Wilcoxon matched-pairs signed rank test. Inter-reader agreement was calculated using Spearman's rank correlation coefficient. PT was considered significantly superior to VR 3D reconstructions by all readers (p < 0.05). Inter-reader agreement was moderate to strong across four out of five readers. The agreement was stronger with PT images compared to VR images. In conclusion, PT reconstructions are significantly better than VR ones. Although they did not modify patient outcomes, they may improve the post-surgical evaluation of bone-free flap reconstructions following major head and neck surgery.
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Affiliation(s)
- Nicolò Cardobi
- Radiology Unit, Department of Pathology and Diagnostics, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
- Correspondence:
| | - Riccardo Nocini
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Gabriele Molteni
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Vittorio Favero
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Andrea Fior
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Daniele Marchioni
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Stefania Montemezzi
- Radiology Unit, Department of Pathology and Diagnostics, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Mirko D’Onofrio
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, 37134 Verona, Italy
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7
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Khan HH, Subedi S, Kumar S, Lyons H. The Pattern of CT Scan Use in the Diagnosis of Abdominal Pain in Children Presenting to the Emergency Department of a Tertiary Community Hospital. Cureus 2021; 13:e19162. [PMID: 34873505 PMCID: PMC8631058 DOI: 10.7759/cureus.19162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background and objective Pediatric populations are highly sensitive to ionizing radiations and, therefore, are more at risk of their harmful outcomes. Our study aimed to determine the percentage of children who underwent a CT scan after presenting to the ED with abdominal pain. The secondary aim was to determine the change in management related to the CT results. In addition, we also wanted to determine the predictors associated with the use of abdominal CT scans in the evaluation of children presenting to ED with abdominal pain as well as the predictors associated with positive CT scan results in children with abdominal pain. Materials and methods We retrospectively reviewed the medical records of children with abdominal pain seen in our ED from 01/01/2011 through 12/30/2012. Patients aged 4-18 years presenting with abdominal pain were identified from the medical records. Data on demographics, clinical characteristics, associated factors, CT use, CT findings, and change in management were collected. Data were analyzed using Chi-square (χ2) analysis and Student’s t-test. Results A total of 1,780 charts were reviewed and 1,272 children were included in the study. The mean age of the cohort was 12.6 ± 4.6 years; 62.6% were female and 68.7% were African American. Of note, 14% (181/1,272) of the study group had received a CT scan; change in medical management was noted in 34.8% (63/181) of the scanned patients. Predictors of CT use included older age (p<0.0001), male gender (p<0.0001), white race (p<0.0001), an attending without advanced training in pediatric emergencies (p=0.001), acute onset of symptoms (p<0.0001), higher pain score (p<0.0001), right lower quadrant pain (p<0.0001), abdominal wall rebound tenderness (p<0.0001), abdominal tenderness (p<0.0001), fever (p<0.0001), and absence of constipation (p=0.04). Positive CT scan results were predicted by the presence of fever (p=0.013), lack of constipation (p=0.025), and white race (p=0.022). A multivariate analysis could not be done because not all data were available for each patient. Conclusion The use of the CT scan in children with abdominal pain affected the management in one out of three patients (34.8%). Fever, constipation, and white race were the factors associated with an increased likelihood of performing a CT scan and were also linked to positive results.
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Affiliation(s)
- Hamza H Khan
- Medicine, Shifa International Hospital, Islamabad, PAK.,Pediatrics, Ascension St. John Hospital, Detroit, USA.,Pediatric Gastroenterology, Medical University of South Carolina, Charleston, USA
| | - Shova Subedi
- Pediatric Gastroenterology, Brown University, Providence, USA
| | - Sanjay Kumar
- Pediatric Gastroenterology, Ascension St. John Hospital, Detroit, USA
| | - Hernando Lyons
- Pediatric Gastroenterology, Ascension St. John Hospital, Detroit, USA
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8
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Hayes JW, Montoya J, Budde A, Zhang C, Li Y, Li K, Hsieh J, Chen GH. High Pitch Helical CT Reconstruction. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3077-3088. [PMID: 34029189 DOI: 10.1109/tmi.2021.3083210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To avoid severe limited-view artifacts in reconstructed CT images, current multi-row detector CT (MDCT) scanners with a single x-ray source-detector assembly need to limit table translation speeds such that the pitch p (viz., normalized table translation distance per gantry rotation) is lower than 1.5. When , it remains an open question whether one can reconstruct clinically useful helical CT images without severe artifacts. In this work, we show that a synergistic use of advanced techniques in conventional helical filtered backprojection, compressed sensing, and more recent deep learning methods can be properly integrated to enable accurate reconstruction up to p=4 without significant artifacts for single source MDCT scans.
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9
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Ahmed AN, Abozeed M, Aziz MU, Singh SP. Role of computed tomography in adult congenital heart disease: A review. J Med Imaging Radiat Sci 2021; 52:S88-S109. [PMID: 34483084 DOI: 10.1016/j.jmir.2021.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
Due to advances in cardiac surgery, perioperative care and transcatheter interventions, the majority of infants with congenital heart disease (CHD) now survive and reach adulthood. Transthoracic Echocardiography (TTE) is considered the primary imaging modality in evaluation of patients with CHD. However, in adults it can be limited due to several reasons. Although cardiac magnetic resonance (CMR) is extremely useful in evaluating cardiac morphology and function, it is not widely available, takes a long time to obtain images, and cannot be done in severely ill patients or patients that have claustrophobia. Due to high spatial and temporal resolution, isotropic imaging fast imaging and wide availability, multidetector computed tomography (MDCT) has emerged as an excellent alternative modality in the evaluation of adult congenital heart disease (ACHD). It can be performed on patients with hardware and those with claustrophobia, due to shorter image acquisition time. In this article, the commonly encountered congenital heart disorders in adults are reviewed, whether incidentally discovered on a computed tomography (CT), on a CT done to evaluate sequela of unknown CHD, or known treated CHD. To appropriately perform and evaluate CT imaging for postoperative correction or palliation congenital heart disease in adults, the imager should know the detailed cardiac anatomy, details of the operative technique used, and be familiar with the common short and long term post-operative complications.
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Affiliation(s)
- Asmaa Naguib Ahmed
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States.
| | - Mostafa Abozeed
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
| | - Muhammad Usman Aziz
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
| | - Satinder P Singh
- The University of Alabama at Birmingham, Department of Diagnostic Radiology, 619 South 19th Street, Birmingham, AL JTN370, United States
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10
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Stewart HL, Siewerdsen JH, Nelson BB, Kawcak CE. Use of cone-beam computed tomography for advanced imaging of the equine patient. Equine Vet J 2021; 53:872-885. [PMID: 34053096 DOI: 10.1111/evj.13473] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 04/14/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Abstract
Access to volumetric imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT), has increased over the past decade and has revolutionised the way clinicians evaluate equine anatomy. More recent advancements have resulted in the development of multiple commercially available cone-beam CT (CBCT) scanners for equine use. CBCT scanners modify the traditional fan-shaped beam of ionising radiation into a three-dimensional pyramidal- or cone-shaped beam of radiation. This modification enables the scanner to acquire sufficient data to create diagnostic images of a region of interest after a single rotation of the gantry. The rapid acquisition of data and divergent X-ray beam causes some artifacts to be more prominent on CBCT images-as well as the unique cone-beam artifact-resulting in decreased contrast resolution. While the use of CT for evaluation of the equine musculoskeletal anatomy is not new, there is a paucity of literature and scientific studies on the capabilities of CBCT for equine imaging. CBCT units do not require a specialised table for imaging and in some cases are portable for imaging in the standing or anaesthetised patient. This review article summarises the basic physics of CT technology, including how CBCT imaging differs, and provides objective information about the strengths and limitations of this modality. Finally, potential future applications and techniques for imaging with CT which will need to be explored in order to fully consider the capabilities of CT imaging in the horse are discussed.
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Affiliation(s)
- Holly L Stewart
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jeffery H Siewerdsen
- The Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Brad B Nelson
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher E Kawcak
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
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11
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Deep learning method for aortic root detection. Comput Biol Med 2021; 135:104533. [PMID: 34139438 DOI: 10.1016/j.compbiomed.2021.104533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Computed tomography angiography (CTA) is a preferred imaging technique for a wide range of vascular diseases. However, extensive manual analysis is required to detect and identify several anatomical landmarks for clinical application. This study demonstrates the feasibility of a fully automatic method for detecting the aortic root, which is a key anatomical landmark in this type of procedure. The approach is based on the use of deep learning techniques that attempt to mimic expert behavior. METHODS A total of 69 CTA scans (39 for training and 30 for validation) with different pathology types were selected to train the network. Furthermore, a total of 71 CTA scans were selected independently and applied as the test set to assess their performance. RESULTS The accuracy was evaluated by comparing the locations marked by the method with benchmark locations (which were manually marked by two experts). The interobserver error was 4.6 ± 2.3 mm. On an average, the differences between the locations marked by the two experts and those detected by the computer were 6.6 ± 3.0 mm and 6.8 ± 3.3 mm, respectively, when calculated using the test set. CONCLUSIONS From an analysis of these results, we can conclude that the proposed method based on pre-trained CNN models can accurately detect the aortic root in CTA images without prior segmentation.
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12
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Mlynarski R, Mlynarska A, Stasiow B. Temporal changes of the diameter of the coronary sinus during the cardiac cycle. Clin Physiol Funct Imaging 2020; 41:192-198. [PMID: 33296555 DOI: 10.1111/cpf.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Currently, there are no studies that analyse the changes in the cardiac venous system that are dependent on the phase (RR interval) of reconstruction. The aim of the study was to assess the size of the coronary sinus at two measurement sites depending on the phase of the heart cycle. METHODS Fifty patients were included. Cardiac computed tomography was performed in all of the patients due to a suspicion of coronary artery disease (typical indications) using a dual-source Siemens Somatom Force scanner. The "MM reading" presets were used to measure the coronary sinus ostium (measurement 1) and the coronary sinus trunk, which is close to the great cardiac vein (measurement 2) in millimetres. All of the calculations were performed on axial scans using 0%-100% and a 256 × 256 matrix. RESULTS The largest CS was found at the 30%, 40% and 50% RR interval-this phenomenon occurred in 37 of the 50 cases (74%). The CS was largest in the 30% phase (9/50 cases; 18%), in the 40% phase (17/50 cases; 34%) and in the 50% phase, and it was the largest in 11 of the 50 cases (22%). There were also no gender-related differences. CONCLUSIONS The size of the coronary sinus varies with the phase of the heart cycle. At the 40% phase, it is largest in most cases.
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Affiliation(s)
- Rafal Mlynarski
- Department of Electrocardiology and Heart Failure, School of Health Sciences, Medical University of Silesia, Katowice, Poland.,Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland
| | - Agnieszka Mlynarska
- Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland.,Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Bartłomiej Stasiow
- Department of Radiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
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13
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Fiorentino V, Goerne H, Rajiah P. Cinematic Rendering Technique in Adult Congenital Heart Disease. Semin Roentgenol 2020; 55:241-250. [PMID: 32859341 DOI: 10.1053/j.ro.2020.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Victor Fiorentino
- Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico
| | - Harold Goerne
- Department of Radiology, Western National Medical Center IMSS, Guadalajara, Jalisco, Mexico; Department of Radiology, Imaging and diagnostic Center CID, Guadalajara, Jalisco, Mexico
| | - Prabhakar Rajiah
- Department of Radiology, Cardiovascular Imaging, Mayo Clinic, Rochester, MN.
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Warin Fresse K, Isorni MA, Dacher JN, Pontana F, Gorincour G, Boddaert N, Jacquier A, Raimondi F. Cardiac computed tomography angiography in the paediatric population: Expert consensus from the Filiale de cardiologie pédiatrique et congénitale (FCPC) and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV). Arch Cardiovasc Dis 2020; 113:579-586. [PMID: 32522436 DOI: 10.1016/j.acvd.2020.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/30/2022]
Abstract
This paper aims to provide a paediatric cardiac computed tomography angiography expert panel consensus based on the opinions of experts from the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) and the Filiale de cardiologie pédiatrique congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, computed tomography angiography radiation dose reduction techniques and postprocessing techniques. We think that to realize its full potential and to avoid pitfalls, cardiac computed tomography angiography in children with congenital heart disease requires training and experience. Moreover, paediatric cardiac computed tomography angiography protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible, to prevent unnecessary radiation exposure. We also provide a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.
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Affiliation(s)
- Karine Warin Fresse
- Imagerie cardiovasculaire fédération des cardiopathies congénitales, CHU de Nantes HGRL, 44093 Nantes, France
| | - Marc Antoine Isorni
- Unité de radiologie diagnostique et thérapeutique, hôpital Marie-Lannelongue, 92350 Le Plessis Robinson, France
| | - Jean Nicolas Dacher
- Cardiac MR/CT Unit, University Hospital, 76031 Rouen, France; Inserm U1096, UFR Médecine-Pharmacie, 76183 Rouen, France
| | - François Pontana
- Inserm UMR 1011, Department of Cardiovascular Radiology, EGID (European Genomic Institute for Diabetes), université de Lille, Institut Cœur-Poumon, Institut Pasteur de Lille, CHU de Lille, FR3508, 59000 Lille, France
| | - Guillaume Gorincour
- Image(2), institut méditerranéen d'imagerie médicale appliquée à la gynecologie, grossesse et enfance, 13008 Marseille, France
| | - Nathalie Boddaert
- Paediatric Radiology Unit, Hôpital Universitaire Necker-Enfants Malades, 75743 Paris, France
| | - Alexis Jacquier
- Department of Radiology, University of Marseille Méditerranée, CHU La Timone, Marseille, France
| | - Francesca Raimondi
- Unité médicochirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes (M3C), hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris cedex 15, France.
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15
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Li RF, Hou CL, Zhou H, Dai YS, Jin LQ, Xi Q, Zhang JH. Comparison on radiation effective dose and image quality of right coronary artery on prospective ECG-gated method between 320 row CT and 2nd generation (128-slice) dual source CT. J Appl Clin Med Phys 2020; 21:256-262. [PMID: 32510768 PMCID: PMC7484880 DOI: 10.1002/acm2.12911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/09/2020] [Accepted: 04/21/2020] [Indexed: 12/21/2022] Open
Abstract
This retrospective study was to compare the image quality of right coronary artery (RCA) and effective radiation dose on prospective ECG‐gated method between 320 row computed tomography (CT) and 2nd generation (128‐slice) dual source CT. A total of 215 candidates underwent CT coronary angiography using prospective ECG‐gated method, 120 patients enrolled in 320 row CT group, and 95 patients in dual source CT group. We divided RCA image quality scores as 1/2/3/4, which means excellent/good/adequate/not assessable and heart rates were considered, as well as the radiation dose. There is no statistically significant difference of RCA image quality of Score 1/2 between 320 row CT and 2nd generation dual source CT, but lower heart rate (<70/min) improved RCA image quality. Meanwhile, the 2nd generation dual source CT scan have significant lower radiation dose. For patients with high level heart rate variation, both prospective ECG‐gated method of 320 row CT scan (Toshiba) and 2nd generation dual source CT scan (Siemens) basically provided good image quality on RCA. There is an advantage of effective radiation dose reduction in prospective ECG‐gated method using the 2nd generation dual source CT scan. After the iodine contrast agent was injected into elbow vein, the threshold triggering method was used to carry out prospective gated scanning, and the acquired fault image was reconstructed by the standard post‐processing software of each manufacturer. The radiation dose value is obtained through the dose report automatically generated after each scan.
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Affiliation(s)
- Ren-Feng Li
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chang-Long Hou
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huang Zhou
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan-Shan Dai
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li-Qin Jin
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian Xi
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian-Hua Zhang
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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16
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Warin-Fresse K, Isornii MA, Dacher JN, Pontana F, Gorincour G, Boddaert N, Jacquier A, Raimondi F. Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d'Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV). Diagn Interv Imaging 2020; 101:335-345. [PMID: 32029386 DOI: 10.1016/j.diii.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d'Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.
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Affiliation(s)
- K Warin-Fresse
- Department of Cardiovascular Imaging, CHU Nantes HGRL, 44093 Nantes, France
| | - M-A Isornii
- Department of Radiology, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France
| | - J-N Dacher
- Department of Radiology, Rouen University Hospital, 76031 Rouen, France; Inserm U1096, UFR Médecine-Pharmacie, University of Rouen, 76000 Rouen, France
| | - F Pontana
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU Lille, INSERM UMR 1011, Institut Pasteur de Lille, EGID, FR3508, Univ Lille, 59000 Lille, France
| | - G Gorincour
- Image2, Mediterranean Institute of Medical Imaging, 13008 Marseille, France
| | - N Boddaert
- Pediatric Radiology Unit, Hôpital Universitaire Necker Enfants-Malades, 75015 Paris, France; Université de Paris, Descartes-Paris 5, 75006 Paris, France
| | - A Jacquier
- Department of Radiology, University of Marseille Méditerranée, CHU la Timone, 13000 Marseille, France
| | - F Raimondi
- Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, 75015 Paris, France.
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17
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A simple method to visualize the bicuspid aortic valve pathology by cardiac computed tomography. J Cardiovasc Comput Tomogr 2020; 14:195-198. [DOI: 10.1016/j.jcct.2019.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/09/2019] [Accepted: 08/06/2019] [Indexed: 11/22/2022]
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18
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Is CT-based cinematic rendering superior to volume rendering technique in the preoperative evaluation of multifragmentary intraarticular lower extremity fractures? Eur J Radiol 2020; 126:108911. [PMID: 32171910 DOI: 10.1016/j.ejrad.2020.108911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/07/2020] [Accepted: 02/16/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Cinematic rendering (CR), a recently launched, FDA-approved rendering technique converts CT image datasets into nearly photorealistic 3D reconstructions by using a unique lighting model. The purpose of this study was to compare CR to volume rendering technique (VRT) images in the preoperative visualization of multifragmentary intraarticular lower extremity fractures. METHOD In this retrospective study, CT datasets of 41 consecutive patients (female: n = 13; male: n = 28; mean age: 52.3 ± 17.9y) with multifragmentary intraarticular lower extremity fractures (calcaneus: n = 16; tibial pilon: n = 19; acetabulum: n = 6) were included. All datasets were acquired using a 128-row dual-source CT. A dedicated workstation was used to reconstruct CR and VRT images which were reviewed independently by two experienced board-certified traumatologists trained in special trauma surgery. Image quality, anatomical accuracy and fracture visualization were assessed on a 6-point-Likert-scale (1 = non-diagnostic; 6=excellent). The regular CT image reconstructions served as reverence standard. For each score, median values between both readers were calculated. Scores of both reconstruction methods were compared using a Wilcoxon-Ranksum test with p < 0.05 indicating statistical significance. Inter-reader agreement was calculated using Spearman's rank correlation coefficient. RESULTS Compared to VRT, CR demonstrated a higher image quality (VRT:2.5; CR:6.0; p < 0.001), a higher anatomical accuracy (VRT:3.5; CR:5.5; p < 0.001) and provided a more detailed visualization of the fracture (VRT:2.5; CR:6.0; p < 0.001). An additional benefit of CR reconstructions compared to VRT reconstructions was reported by both readers in 65.9 % (27/41) of all patients. CONCLUSIONS CR reconstructions are superior to VRT due to higher image quality and higher anatomical accuracy. Traumatologists find CR reconstructions to improve visualization of lower extremity fractures which should thus be used for fracture demonstration during interdisciplinary conferences.
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19
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Automatic detection of anatomical landmarks of the aorta in CTA images. Med Biol Eng Comput 2020; 58:903-919. [DOI: 10.1007/s11517-019-02110-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022]
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20
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Jiang L, Ning D, Chen X. Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status and future directions. Front Med 2019; 14:251-261. [PMID: 31840199 DOI: 10.1007/s11684-019-0727-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/12/2019] [Indexed: 02/08/2023]
Abstract
Postoperative pancreatic fistula (POPF) is the most common and critical complication after pancreatic body and tail resection. How to effectively reduce the occurrence of pancreatic fistula and conduct timely treatment thereafter is an urgent clinical issue to be solved. Recent research standardized the definition of pancreatic fistula and stressed the correlation between POPF classification and patient prognosis. According to the literature, identification of the risk factors for pancreatic fistula contributed to lowering the rate of the complication. Appropriate management of the pancreatic stump and perioperative treatment are of great significance to reduce the rate of POPF in clinical practice. After the occurrence of POPF, the treatment of choice should be determined according to the classification of the pancreatic fistula. However, despite the progress and promising treatment approaches, POPF remains to be a clinical issue that warrants further studies in the future.
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Affiliation(s)
- Li Jiang
- Department of Biliary and Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Deng Ning
- Department of Biliary and Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaoping Chen
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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21
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Moore CS, Wood TJ, Saunderson JR, Beavis AW. The usefulness of large sample size patient dose audits for optimisation of CT automatic exposure control (AEC) settings. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:938-949. [PMID: 31382249 DOI: 10.1088/1361-6498/ab3894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of this study was to demonstrate the usefulness of large sample size patient dose audits for optimisation of CT automatic exposure control (AEC) settings, even when the investigation is limited to only three scanners at a single institution. Pre-optimisation patient dose audits of common CT examinations (n > 200 for each protocol) on three CT scanners (two Philips Brilliance and one Toshiba Aquilion) using radiology information system (RIS) data were conducted showing sub-optimal CT AEC performance on the Toshiba scanner. Based on these results, an optimisation exercise was carried out on the non-optimally performing scanner by phantom measurement and investigation of system configuration. Post-optimisation patient dose audits were subsequently carried out to assess the success of the optimisation exercise demonstrating standardisation of doses; median dose-length-product values were reduced by up to 43% on the sub-optimal scanner without any adverse effect on clinical image quality. This study has demonstrated that large sample patient dose audits using RIS data can be instrumental in identifying and rectifying sub-optimal CT AEC performance, even when the investigation is limited to only three scanners at a single institution.
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Affiliation(s)
- Craig S Moore
- Medical Physics Service, Queen's Centre, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Castle Road, Hull, HU16 5JQ, United Kingdom
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22
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Pugh CM. Advanced Volumetric 3-Dimensional Visualization of Surgical Anatomy-Are We There Yet? JAMA Surg 2019; 154:744-745. [PMID: 31141145 DOI: 10.1001/jamasurg.2019.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Carla M Pugh
- Surgery, Stanford University, Stanford, California
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23
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Sarıaltın Y, Ortak T, Öz C, Kuş E, Yunusoğlu GU, Doğan Ş, Çetin M. Radiological assessment of the lateral osteotomy line-lacrimal system distance on three-dimensional models. J Craniomaxillofac Surg 2019; 47:1608-1616. [PMID: 31400844 DOI: 10.1016/j.jcms.2019.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/17/2019] [Accepted: 07/21/2019] [Indexed: 01/09/2023] Open
Abstract
AIMS One of the most commonly performed operations in aesthetic, plastic, and reconstructive surgery is rhinoplasty, the aim of which is to construct an altered nasal shape, either for aesthetic or functional reasons. The lateral osteotomy is the most traumatic step of rhinoplasty, and is generally difficult to perform. The lacrimal system can be damaged during the lateral osteotomy procedure. In this study, we aimed to measure the distance between the lacrimal system and the lateral osteotomy line, and to determine the safe and ideal osteotomy level, which is very important in rhinoplasty procedures. We also evaluated the safe relationship of this osteotomy level with the lacrimal system by constructing a three-dimensional model. MATERIALS AND METHODS The three-dimensional models were constructed on axial planes using paranasal computed tomographic (CT) images of 40 male and 40 female patients. The 'lateral osteotomy model' was designed in three dimensions. The axial CT images were obtained from the model. On the CT images, the distance between the lateral osteotomy line and the lacrimal system was assessed by measuring three distances. The first was the distance between the anterior lacrimal crest and the lateral osteotomy line. The second was the distance from the midpoint between the anterior lacrimal crest and the inferior meatus to the lateral osteotomy line. The third was the distance between the opening of the lacrimal canal to the inferior meatus and the lateral osteotomy line. RESULTS No lacrimal system injury was seen on any of the models. The shortest distance was found between the anterior lacrimal crest and the lateral osteotomy line, measured at 4.5 mm and 5.0 mm in the female and male patients, respectively. CONCLUSION Performing the lateral osteotomy meticulously while paying attention to remaining anterior to the medial canthal ligament will not lead to any lacrimal system injury.
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Affiliation(s)
- Yücel Sarıaltın
- Barbaros Mah, Al Zambak Sok, Varyap Meridian A Blok No: 9, Ataşehir, Istanbul, Turkey.
| | | | - Cem Öz
- Adana Seyhan Devlet Hastanesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Kliniği, Adana, Turkey.
| | - Emel Kuş
- Afyon Devlet Hastanesi, Radyoloji Kliniği, Turkey.
| | | | - Şevket Doğan
- Mimar Sinan Mah, Ali İhsan Paşa BLV. No: 67/1, Efeler Aydın, Turkey.
| | - Meltem Çetin
- İzmir Katip Çelebi Üniversitesi Tıp Fak., Radyoloji AD, Turkey.
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Maxim PG, Tantawi SG, Loo BW. PHASER: A platform for clinical translation of FLASH cancer radiotherapy. Radiother Oncol 2019; 139:28-33. [PMID: 31178058 DOI: 10.1016/j.radonc.2019.05.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/25/2019] [Accepted: 05/03/2019] [Indexed: 01/19/2023]
Abstract
Pluridirectional high-energy agile scanning electronic radiotherapy (PHASER) is next-generation medical linac technology for ultra-rapid highly conformal image-guided radiation, fast enough to "freeze" physiological motion, affording improved accuracy, precision, and potentially superior FLASH radiobiological therapeutic index. Designed for compactness, economy, and clinical efficiency, it is also intended to address barriers to global access to curative radiotherapy.
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Affiliation(s)
- Peter G Maxim
- Department of Radiation Oncology, Indiana University School of Medicine, United States.
| | - Sami G Tantawi
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, CA 94025, United States.
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States.
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25
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Smelt JLC, Suri T, Valencia O, Jahangiri M, Rhode K, Nair A, Bille A. Operative Planning in Thoracic Surgery: A Pilot Study Comparing Imaging Techniques and Three-Dimensional Printing. Ann Thorac Surg 2018; 107:401-406. [PMID: 30316856 DOI: 10.1016/j.athoracsur.2018.08.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 08/13/2018] [Accepted: 08/22/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Careful preoperative planning in thoracic surgery is essential for positive outcomes, especially in video-assisted thoracic surgery (VATS), where palpation and 3-dimensional (3D) imaging is restricted. This study evaluated the ability of different imaging techniques, such as computed tomography (CT) scanning, maximal intensity projection imaging, 3D reconstruction, and 3D printing, to define the anatomy of the hilar structures before anatomical lung resection. METHODS All patients undergoing elective lung resections by VATS for cancer under a single surgeon were identified over a 3-month period. The surgeon was asked to record the number of pulmonary artery branches supplying the lobe to be resected by using the preoperative CT scans, maximal intensity projection images, and 3D-reconstructed CT images. The lung hilum in 3 patients was printed. These were then compared with the intraoperative findings. RESULTS The preoperative imaging of 16 patients was analyzed. The lung hilum was printed in a further 3 patients. Although not statistically significant, the 3D prints of the hilum were the most accurate measurement, with a correlation of 0.92. CT, 3D-reconstructed CT, and maximal intensity projection images tended to underrecognize the number of arterial branches and therefore scored between 0.26 and 0.39 in absolute agreement with the number of arteries found at operation. CONCLUSIONS 3D printing in the planning of thoracic surgery may suggest a benefit over contemporary available imaging modalities, and the use of 3D printing in practicing operations is being established.
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Affiliation(s)
- Jeremy L C Smelt
- Department of Thoracic Surgery, Guy's and St Thomas' Hospital National Health Service Foundation Trust, London.
| | - Tanay Suri
- Department of Biomedical Engineering, King's College London, London
| | - Oswaldo Valencia
- Department of Cardiothoracic Surgery, St. George's Hospital, London
| | - Marjan Jahangiri
- Department of Cardiothoracic Surgery, St. George's Hospital, London
| | - Kawal Rhode
- Department of Biomedical Engineering, King's College London, London
| | - Arjun Nair
- Department of Radiology, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Andrea Bille
- Department of Thoracic Surgery, Guy's and St Thomas' Hospital National Health Service Foundation Trust, London
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Guchlerner L, Wichmann JL, Tischendorf P, Albrecht M, Vogl TJ, Wutzler S, Ackermann H, Eichler K, Frellesen C. Comparison of thick- and thin-slice images in thoracoabdominal trauma CT: a retrospective analysis. Eur J Trauma Emerg Surg 2018; 46:187-195. [PMID: 30267119 DOI: 10.1007/s00068-018-1021-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/25/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare thick (5 mm) and thin slice images (1.5 mm) of lung, soft tissue, and bone window in thoracoabdominal trauma computed tomography. MATERIALS AND METHODS 167 Patients that underwent thoracoabdominal trauma CT between November 2014 and December 2015 were included in the study. CT data were reconstructed in a transverse direction with 5 mm and 1.5 mm slice images of lung, soft tissue, and bone window. Two blinded raters (radiologists) evaluated the collected data by detecting predefined injuries in different organ areas. Reconstruction and evaluation times as well as detected injuries were noted and compared. RESULTS Reconstruction and evaluation times were significantly higher with 1.5 mm thin-slice images, and the effect strength according to Rosenthal displayed a strong effect of 0.61 (< 0.1 small effect, 0.3 middle effect, and > 0.5 strong effect). Average evaluation time differences were 62.7 s (33.9 s-91.5 s) in bone window between 1.5 mm and 3 mm for rater 1 (p < 0.001) and 71.4 s (43.1 s-99.7 s) for rater 2 (p < 0.001). Average time differences between 1.5 mm and 5 mm were 68,7 s (43.9 s-93.5 s) for rater 1 and 75.3 s (44.7 s-105.9 s) for rater 2 in lung window (p < 0.001) and 66.6 s (28.8 s-104.4 s) for rater 1 and 114 s (74.4 s-153.6 s) for rater 2 in soft-tissue window (p < 0.001). There was no significant difference regarding soft-tissue and lung injuries, except non-significant improvement in the detection of bone fractures. CONCLUSION Thin-slice images do not bring any significant benefit in thoracoabdominal trauma CT of soft-tissue and lung injuries, but they can be helpful for the diagnosis of bone fractures and incidental findings.
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Affiliation(s)
- Leon Guchlerner
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - Julian Lukas Wichmann
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Patricia Tischendorf
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Moritz Albrecht
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Thomas Josef Vogl
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Sebastian Wutzler
- Department of Trauma, Hand and Reconstructive Surgery, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Hanns Ackermann
- Department of Biostatistics and Mathematical Modelling, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Katrin Eichler
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Claudia Frellesen
- Department of Diagnostic and Interventional Radiology, Institut fuer Diagnostische und Interventionelle Radiologie, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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27
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Chacón G, Rodríguez JE, Bermúdez V, Vera M, Hernández JD, Vargas S, Pardo A, Lameda C, Madriz D, Bravo AJ. Computational assessment of stomach tumor volume from multi-slice computerized tomography images in presence of type 2 cancer. F1000Res 2018; 7:1098. [PMID: 30473775 PMCID: PMC6234734 DOI: 10.12688/f1000research.14491.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The multi–slice computerized tomography (MSCT) is a medical imaging modality that has been used to determine the size and location of the stomach cancer. Additionally, MSCT is considered the best modality for the staging of gastric cancer. One way to assess the type 2 cancer of stomach is by detecting the pathological structure with an image segmentation approach. The tumor segmentation of MSCT gastric cancer images enables the diagnosis of the disease condition, for a given patient, without using an invasive method as surgical intervention. Methods: This approach consists of three stages. The initial stage, an image enhancement, consists of a method for correcting non homogeneities present in the background of MSCT images. Then, a segmentation stage using a clustering method allows to obtain the adenocarcinoma morphology. In the third stage, the pathology region is reconstructed and then visualized with a three–dimensional (3–D) computer graphics procedure based on marching cubes algorithm. In order to validate the segmentations, the Dice score is used as a metric function useful for comparing the segmentations obtained using the proposed method with respect to ground truth volumes traced by a clinician. Results: A total of 8 datasets available for patients diagnosed, from the cancer data collection of the project, Cancer Genome Atlas Stomach Adenocarcinoma (TCGASTAD) is considered in this research. The volume of the type 2 stomach tumor is estimated from the 3–D shape computationally segmented from the each dataset. These 3–D shapes are computationally reconstructed and then used to assess the morphopathology macroscopic features of this cancer. Conclusions: The segmentations obtained are useful for assessing qualitatively and quantitatively the stomach type 2 cancer. In addition, this type of segmentation allows the development of computational models that allow the planning of virtual surgical processes related to type 2 cancer.
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Affiliation(s)
- Gerardo Chacón
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia.,Grupo de Automatización y Control, Universidad de Pamplona, Cúcuta, 540004, Colombia
| | - Johel E Rodríguez
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Miguel Vera
- Universidad Simón Bolívar, Facultad de Ciencias Básicas y Biomédicas, Cúcuta, 540004, Colombia.,Grupo de Investigación en Procesamiento Computacional de Datos, Universidad de Los Andes-Táchira, San Cristóbal, 5001, Venezuela
| | | | - Sandra Vargas
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Aldo Pardo
- Grupo de Automatización y Control, Universidad de Pamplona, Cúcuta, 540004, Colombia
| | - Carlos Lameda
- Universidad Nacional Experimental Politécnica Antonio José de Sucre, Barquisimeto, 3001, Venezuela
| | - Delia Madriz
- Programa Calidad y Productividad Organizacional, Decanato de Investigación, Universidad Nacional Experimental del Táchira, San Cristóbal, 5001, Venezuela
| | - Antonio J Bravo
- Programa Calidad y Productividad Organizacional, Decanato de Investigación, Universidad Nacional Experimental del Táchira, San Cristóbal, 5001, Venezuela
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Chacón G, Rodríguez JE, Bermúdez V, Vera M, Hernández JD, Vargas S, Pardo A, Lameda C, Madriz D, Bravo AJ. Computational assessment of stomach tumor volume from multi-slice computerized tomography images in presence of type 2 cancer. F1000Res 2018; 7:1098. [PMID: 30473775 PMCID: PMC6234734 DOI: 10.12688/f1000research.14491.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/12/2023] Open
Abstract
Background: The multi-slice computerized tomography (MSCT) is a medical imaging modality that has been used to determine the size and location of the stomach cancer. Additionally, MSCT is considered the best modality for the staging of gastric cancer. One way to assess the type 2 cancer of stomach is by detecting the pathological structure with an image segmentation approach. The tumor segmentation of MSCT gastric cancer images enables the diagnosis of the disease condition, for a given patient, without using an invasive method as surgical intervention. Methods: This approach consists of three stages. The initial stage, an image enhancement, consists of a method for correcting non homogeneities present in the background of MSCT images. Then, a segmentation stage using a clustering method allows to obtain the adenocarcinoma morphology. In the third stage, the pathology region is reconstructed and then visualized with a three-dimensional (3-D) computer graphics procedure based on marching cubes algorithm. In order to validate the segmentations, the Dice score is used as a metric function useful for comparing the segmentations obtained using the proposed method with respect to ground truth volumes traced by a clinician. Results: A total of 8 datasets available for patients diagnosed, from the cancer data collection of the project, Cancer Genome Atlas Stomach Adenocarcinoma (TCGASTAD) is considered in this research. The volume of the type 2 stomach tumor is estimated from the 3-D shape computationally segmented from the each dataset. These 3-D shapes are computationally reconstructed and then used to assess the morphopathology macroscopic features of this cancer. Conclusions: The segmentations obtained are useful for assessing qualitatively and quantitatively the stomach type 2 cancer. In addition, this type of segmentation allows the development of computational models that allow the planning of virtual surgical processes related to type 2 cancer.
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Affiliation(s)
- Gerardo Chacón
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
- Grupo de Automatización y Control, Universidad de Pamplona, Cúcuta, 540004, Colombia
| | - Johel E. Rodríguez
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Miguel Vera
- Universidad Simón Bolívar, Facultad de Ciencias Básicas y Biomédicas, Cúcuta, 540004, Colombia
- Grupo de Investigación en Procesamiento Computacional de Datos, Universidad de Los Andes-Táchira, San Cristóbal, 5001, Venezuela
| | | | - Sandra Vargas
- Universidad Simón Bolívar, Facultad de Ingeniería, Cúcuta, 540004, Colombia
| | - Aldo Pardo
- Grupo de Automatización y Control, Universidad de Pamplona, Cúcuta, 540004, Colombia
| | - Carlos Lameda
- Universidad Nacional Experimental Politécnica Antonio José de Sucre, Barquisimeto, 3001, Venezuela
| | - Delia Madriz
- Programa Calidad y Productividad Organizacional, Decanato de Investigación, Universidad Nacional Experimental del Táchira, San Cristóbal, 5001, Venezuela
| | - Antonio J. Bravo
- Programa Calidad y Productividad Organizacional, Decanato de Investigación, Universidad Nacional Experimental del Táchira, San Cristóbal, 5001, Venezuela
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Kong M, Jo H, Lee CH, Chun SW, Yoon C, Shin H. Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study. Ann Rehabil Med 2018; 42:137-144. [PMID: 29560334 PMCID: PMC5852217 DOI: 10.5535/arm.2018.42.1.137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/13/2017] [Indexed: 12/21/2022] Open
Abstract
Objective To evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT). Methods The 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (≥4 and <6 years), group 2 (≥6 and <8 years), and group 3 (≥8 and <10 years). Initial and follow-up FAAs were measured using 3D-CT. Mean changes in FAAs were calculated and compared. Results A total of 200 lower limbs of 100 children (48 males and 52 females, mean age of 6.1±1.6 years) were included. The mean follow-up period was 18.0±5.4 months. Average initial and follow-up FAA in children with intoeing gait was 31.1°±7.8° and 28.9°±8.2°, respectively. The initial FAA of group 1 was largest (33.5°±7.7°). Follow-up FAA of group 1 was significantly reduced to 28.7°±9.2° (p=0.000). FAA changes in groups 1, 2, and 3 were −6.5°±5.8°, −6.4°±5.1°, and −5.3°±4.0°, respectively. These changes of FAA were not significantly (p=0.355) different among the three age groups. However, FAA changes were higher (p=0.012) in females than those in males. In addition, FAA changes showed difference depending on initial FAA. When initial FAA was smaller than 30°, mean FAA change was −5.6°±4.9°. When initial FAA was more than 30°, mean FAA change was −6.8°±5.4° (p=0.019). Conclusion FAA initial in children with intoeing gait was the greatest in age group 1 (4–6 years). This group also showed significant FAA decrease at follow-up. FAA changes were greater when the child was a female, younger, and had greater initial FAA.
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Affiliation(s)
- Minsik Kong
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hongsik Jo
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chang Han Lee
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Se-Woong Chun
- Department of Rehabilitation Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Chulho Yoon
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Heesuk Shin
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
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Min MK, Ryu JH, Kim YI, Park MR, Yeom SR, Han SK, Park SW. Factors affecting the urologist's decision to administer ureteral stone therapy: a retrospective cohort study. Clin Exp Emerg Med 2018; 4:238-243. [PMID: 29306265 PMCID: PMC5758622 DOI: 10.15441/ceem.16.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/13/2017] [Accepted: 11/14/2017] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to evaluate the factors influencing treatment option selection among urologists for patients with ureteral stones, according to the stone diameter and location. Methods We retrospectively reviewed the records of 360 consecutive patients who, between January 2009 and June 2014, presented to the emergency department with renal colic and were eventually diagnosed with urinary stones via computed tomography. The maximal horizontal and longitudinal diameter and location of the stones were investigated. We compared parameters between patients who received urological intervention (group 1) and those who received medical treatment (group 2). Results Among the 360 patients, 179 (49.7%) had stones in the upper ureter and 181 (50.3%) had stones in the lower ureter. Urologic intervention was frequently performed in cases of upper ureteral stones (P<0.001). In groups 1 and 2, the stone horizontal diameters were 5.5 mm (4.8 to 6.8 mm) and 4.0 mm (3.0 to 4.6 mm), stone longitudinal diameters were 7.5 mm (6.0 to 9.5 mm) and 4.4 mm (3.0 to 5.5 mm), and ureter diameters were 6.4 mm (5.0 to 8.0 mm) and 4.7 mm (4.0 to 5.3 mm), respectively (P<0.001). The cut-off values for the horizontal and longitudinal stone diameters in the upper ureter were 4.45 and 6.25 mm, respectively (sensitivity 81.3%, specificity 91.4%); those of the lower ureter were 4.75 and 5.25 mm, respectively (sensitivity 79.4%, specificity 79.4%). Conclusion The probability of a urologic intervention was higher for patients with upper ureteral stones and those with stone diameters exceeding 5 mm horizontally and 6 mm longitudinally.
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Affiliation(s)
- Mun Ki Min
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Ji Ho Ryu
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong In Kim
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Maeng Real Park
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Seok Ran Yeom
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Kyoon Han
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Seong Wook Park
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
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Gascho D, Thali MJ, Niemann T. Post-mortem computed tomography: Technical principles and recommended parameter settings for high-resolution imaging. MEDICINE, SCIENCE, AND THE LAW 2018; 58:70-82. [PMID: 29310502 DOI: 10.1177/0025802417747167] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Post-mortem computed tomography (PMCT) has become a standard procedure in many forensic institutes worldwide. However, the standard scan protocols offered by vendors are optimised for clinical radiology and its main considerations regarding computed tomography (CT), namely, radiation exposure and motion artefacts. Thus, these protocols aim at low-dose imaging and fast imaging techniques. However, these considerations are negligible in post-mortem imaging, which allows for significantly increased image quality. Therefore, the parameters have to be adjusted to achieve the best image quality. Several parameters affect the image quality differently and have to be weighed against each other to achieve the best image quality for different diagnostic interests. There are two main groups of parameters that are adjustable by the user: acquisition parameters and reconstruction parameters. Acquisition parameters have to be selected prior to scanning and affect the raw data composition. In contrast, reconstruction parameters affect the calculation of the slice stacks from the raw data. This article describes the CT principles from acquiring image data to post-processing and provides an overview of the significant parameters for increasing the image quality in PMCT. Based on the CT principles, the effects of these parameters on the contrast, noise, resolution and frequently occurring artefacts are described. This article provides a guide for the performance of PMCT in morgues, clinical facilities or private practices.
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Affiliation(s)
- Dominic Gascho
- 1 Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Michael J Thali
- 1 Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Tilo Niemann
- 2 Department of Radiology, Cantonal Hospital Baden, Switzerland
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Madhuripan N, Atar OD, Zheng R, Tenenbaum M. Computed Tomography Angiography in Head and Neck Emergencies. Semin Ultrasound CT MR 2017; 38:345-356. [DOI: 10.1053/j.sult.2017.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique. AJR Am J Roentgenol 2017; 209:370-379. [DOI: 10.2214/ajr.17.17850] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Comparison of contrast-enhanced multidetector computed tomography angiography and splenoportography for the evaluation of portosystemic-shunt occlusion after cellophane banding in dogs. BMC Vet Res 2016; 12:283. [PMID: 27938359 PMCID: PMC5148836 DOI: 10.1186/s12917-016-0910-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/02/2016] [Indexed: 01/23/2023] Open
Abstract
Background Many patients with a congenital extrahepatic portosystemic shunt (PSS) do not tolerate an immediate shunt closure. Therefore, slow progressive techniques were developed. To evaluate the success of shunt closure diagnostic imaging is essential to identify possible residual blood flow through the shunt vessel. There is a lack of information about the reliability of computed tomography angiography (CTA) for evaluating residual flow through a PSS after treatment. The purpose of this prospective study was to compare the results of CTA with splenoportography. Three months after cellophane banding CTA and splenoportography were performed in 20 dogs and reviewed by three independent examiners, respectively. In both imaging modalities the presences of a residual shunt was judged as present or absent and the extent of visibility of portal vasculature was recorded. Results Based on the evaluation of the splenoportography residual flow through shunt was present in 6 dogs. The classification of residual shunt present or absent showed a substantial to perfect agreement (κ = 0.65–1.00) between the observers in splenoportography and a slight to moderate agreement (κ = 0.11–0.51) for CTA. Sensitivity and specificity varied between 0.50 and 1.00 and 0.57–0.85, respectively. Significant correlation between CTA and splenoportography for the classification of residual shunt was present only in one observer but not in the other two. Conclusion More studies were classified as residual shunt positive with CTA compared to splenoportography. It remains unclear which methods do reflect reality better and thus which method is superior. The greater inter-rater agreement for splenoportography suggests a greater reliability of this technique.
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Reihani H, Mahmoudi V, Abbasi B, Akhavan R. A Young Woman with Puffy Face. J Emerg Med 2016; 51:e97-e99. [PMID: 27545855 DOI: 10.1016/j.jemermed.2016.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Hamidreza Reihani
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Mahmoudi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Abbasi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Akhavan
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Dovales ACM, da Rosa LAR, Kesminiene A, Pearce MS, Veiga LHS. Patterns and trends of computed tomography usage in outpatients of the Brazilian public healthcare system, 2001-2011. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:547-560. [PMID: 27460769 DOI: 10.1088/0952-4746/36/3/547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
While the patterns and trends of computed tomography (CT) are well documented in developed countries, relatively little is known about CT usage in developing countries, including Brazil. We evaluated CT usage among outpatients from the public healthcare system in Brazil (SUS), which is the unique healthcare provider to about 75% of the Brazilian population. We collected the annual number of CT procedures and type of CT examinations performed in SUS for the period 2001-2011. Age at examination was evaluated for 2008-2011. CT usage in Brazil has more than tripled during the study period, but the most striking annual increase (17.5%) was observed over the years 2008-2011. Head was the most frequently examined region for all age groups, but a decreasing trend of proportional contribution of head CT, with a simultaneous increase of abdomen/pelvis and chest CT over time was observed. CT examination for pediatric and young adult patients was about 13% of all CTs (9% if we considered age-standardized CT rates). CT usage has grown rapidly in Brazil and may still be increasing. Increased CT usage may certainly be associated with improved patient care. However, given the high frequency of pediatric and young adult CT procedures and the suggested associated cancer risk, efforts need to be undertaken to reduce unwarranted CT scans in Brazil.
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Affiliation(s)
- Ana C M Dovales
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Av. Salvador Allende, Barra da Tijuca, Rio de Janeiro, RJ, 22783-127, Brazil
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Abstract
As endoscopic sinus surgery (ESS) has evolved since its introduction to the United States, so has technology for imaging the sinonasal cavities. Although imaging is most frequently performed for evaluating chronic sinusitis refractory to medical therapy, its uses have expanded beyond inflammatory sinus disease. Multidetector Computed Tomography is the current workhorse for both diagnosis and preoperative planning in prospective ESS patients, while MR imaging remains a complementary tool for evaluating suspected tumors or intracranial and orbital complications of rhinosinusitis. In this article, the authors review current trends and potential future directions in the use of these modalities for sinus imaging.
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Affiliation(s)
- Benjamin Y Huang
- Department of Radiology, University of North Carolina, CB# 7510, 101 Manning Drive, Chapel Hill, NC 27599, USA.
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, CB# 7070, 170 Manning Drive, Chapel Hill, NC 27599, USA
| | - Mauricio Castillo
- Department of Radiology, University of North Carolina, CB# 7510, 101 Manning Drive, Chapel Hill, NC 27599, USA
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Hoshino T, Ichikawa K, Hara T, Terakawa S, Hosomi K, Nishimura K, Takayama K. Optimization of scan timing for aortic computed tomographic angiography using the test bolus injection technique. Acta Radiol 2016; 57:829-36. [PMID: 26468389 DOI: 10.1177/0284185115608659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 08/24/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND With fast computed tomography (CT), it is possible for the scanning to outpace the contrast medium bolus during aortic CT angiography (CTA). PURPOSE To evaluate the effectiveness of a new method for reducing the risk of outpacing in which the scan start timing (ST) and speed can be estimated from the peak enhancement time measured at the femoral artery using a single test-bolus injection (femoral artery test injection method [FTI method]). MATERIAL AND METHODS In 30 cases of aortic CTA, we measured the time to peak enhancement at the femoral artery (TPF) and the ascending aorta (TPA) with test-bolus injection performed twice in each examination. From the resultant linear relationship between TPF and transit time (TT = TPF - TPA), we developed a method for determining the ST and TT from TPF. One hundred patients were assigned to two groups: FTI and bolus tracking (BT), each with 50 patients. CT values were measured in main vessels (ascending aorta, descending aorta, femoral artery). The CT values of the vessels and the rate of cases with more than 300 HU (good cases) were compared between the two groups. RESULTS The enhancement in the FTI method was significantly higher than that of the BT method (average CT values: FTI, 388.3 ± 52.4; BT, 281.2 ± 59.1; P < 0.001). The rates of good cases for FTI and BT were 86.0% and 46.0%, respectively. CONCLUSION The FTI method was very effective in reducing the risk of outpacing of the contrast medium transit in aortic CTA without the need for an additional contrast medium dose.
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Affiliation(s)
- Takashi Hoshino
- Department of Radiology, Ishinkai Yao General Hospital, Osaka, Japan
- Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Katsuhiro Ichikawa
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takanori Hara
- Department of Medical Technology, Nakatsugawa Municipal General Hospital, Nakatsugawa, Gifu, Japan
| | - Shoichi Terakawa
- Department of Radiology, Osaka City General Hospital, Osaka, Japan
| | - Kazuhiro Hosomi
- Department of Radiology, Ishinkai Yao General Hospital, Osaka, Japan
| | - Kenji Nishimura
- Department of Radiology, Ishinkai Yao General Hospital, Osaka, Japan
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Kim BK, Cho I, Hong MK, Chang HJ, Shin DH, Kim JS, Shin S, Ko YG, Choi D, Jang Y. Usefulness of Intraprocedural Coronary Computed Tomographic Angiography During Intervention for Chronic Total Coronary Occlusion. Am J Cardiol 2016; 117:1868-76. [PMID: 27134060 DOI: 10.1016/j.amjcard.2016.03.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/16/2016] [Accepted: 03/16/2016] [Indexed: 11/18/2022]
Abstract
Although intraprocedural coronary computed tomographic angiography (CCTA) allows for scanning during intervention without relocation of the patient, studies have yet to report on its use during chronic total occlusion (CTO) intervention. Therefore, we investigated the role of CCTA during CTO intervention, particularly whether CCTA could be used to evaluate the location of guidewires. A total of 61 patients scheduled for elective CTO intervention were consecutively enrolled and underwent CCTA and on-site analyses during intervention. Transverse axial and the curved multiplanar images in a 360-degree view were interactively used together to identify the location of guidewires, along with the adjustment of window condition. Intracoronary contrast injection was used for specific cases requiring enhancement of the distal part of the CTO. Most CCTAs were performed to confirm the location of a single guidewire; CCTA was also performed to evaluate parallel (3 patients) or retrograde wires (5 patients). The initial identification rate for guidewire location was 56% with immediate transaxial images, but it significantly increased to 87% after interactive on-site uses of the curved multiplanar images (p <0.001). Cases in which guidewire location could be predicted with CCTA evaluation show a numerically higher success rate than those that could not (83% vs 63%) but not statistical significance (p = 0.174). The mean time for CCTA evaluation and mean radiation dose were 8.6 minutes and 2.9 mSv, respectively. No specific complications occurred after CCTA and CTO procedures. Intraprocedural CCTA for identifying the location of the guidewires is feasible and safe when used for various CTO procedural steps.
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Affiliation(s)
- Byeong-Keuk Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Iksung Cho
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myeong-Ki Hong
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Ho Shin
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Sun Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sanghoon Shin
- Cardiology Division, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang-si, Korea
| | - Young-Guk Ko
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yangsoo Jang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
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Byun HY, Shin H, Lee ES, Kong MS, Lee SH, Lee CH. The Availability of Radiological Measurement of Femoral Anteversion Angle: Three-Dimensional Computed Tomography Reconstruction. Ann Rehabil Med 2016; 40:237-43. [PMID: 27152273 PMCID: PMC4855117 DOI: 10.5535/arm.2016.40.2.237] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/24/2015] [Indexed: 01/25/2023] Open
Abstract
Objective To assess the intra-rater and inter-rater reliability for measuring femoral anteversion angle (FAA) by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT). Methods The study included 82 children who presented with intoeing gait. 3D-CT data taken between 2006 and 2014 were retrospectively reviewed. FAA was measured by 3D-CT. FAA is defined as the angle between the long axis of the femur neck and condylar axis of the distal femur. FAA measurement was performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coefficient (ICC). Results One hundred and sixty-four lower limbs of 82 children (31 boys and 51 girls, 6.3±3.2 years old) were included. The ICCs of intra-rater measurement for the angle of femoral neck axis (NA) were 0.89 for rater A and 0.96 for rater B, and those of condylar axis (CA) were 0.99 for rater A and 0.99 for rater B, respectively. The ICC of inter-rater measurement for the angle of NA was 0.89 and that of CA was 0.92. By each rater, the ICCs of the intrarater measurement for FAA were 0.97 for rater A and 0.95 for rater B, respectively and the ICC of the inter-rater measurement for FAA was 0.89. Conclusion The 3D-CT measures for FAA are reliable within individual raters and between different raters. The 3D-CT measures of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion.
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Affiliation(s)
- Ha Young Byun
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Heesuk Shin
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Eun Shin Lee
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Min Sik Kong
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Seung Hun Lee
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Chang Hee Lee
- Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea
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Li Q, Gavrielides MA, Sahiner B, Myers KJ, Zeng R, Petrick N. Statistical analysis of lung nodule volume measurements with CT in a large-scale phantom study. Med Phys 2016; 42:3932-47. [PMID: 26133594 DOI: 10.1118/1.4921734] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine inter-related factors that contribute substantially to measurement error of pulmonary nodule measurements with CT by assessing a large-scale dataset of phantom scans and to quantitatively validate the repeatability and reproducibility of a subset containing nodules and CT acquisitions consistent with the Quantitative Imaging Biomarker Alliance (QIBA) metrology recommendations. METHODS The dataset has about 40 000 volume measurements of 48 nodules (5-20 mm, four shapes, three radiodensities) estimated by a matched-filter estimator from CT images involving 72 imaging protocols. Technical assessment was performed under a framework suggested by QIBA, which aimed to minimize the inconsistency of terminologies and techniques used in the literature. Accuracy and precision of lung nodule volume measurements were examined by analyzing the linearity, bias, variance, root mean square error (RMSE), repeatability, reproducibility, and significant and substantial factors that contribute to the measurement error. Statistical methodologies including linear regression, analysis of variance, and restricted maximum likelihood were applied to estimate the aforementioned metrics. The analysis was performed on both the whole dataset and a subset meeting the criteria proposed in the QIBA Profile document. RESULTS Strong linearity was observed for all data. Size, slice thickness × collimation, and randomness in attachment to vessels or chest wall were the main sources of measurement error. Grouping the data by nodule size and slice thickness × collimation, the standard deviation (3.9%-28%), and RMSE (4.4%-68%) tended to increase with smaller nodule size and larger slice thickness. For 5, 8, 10, and 20 mm nodules with reconstruction slice thickness ≤0.8, 3, 3, and 5 mm, respectively, the measurements were almost unbiased (-3.0% to 3.0%). Repeatability coefficients (RCs) were from 6.2% to 40%. Pitch of 0.9, detail kernel, and smaller slice thicknesses yielded better (smaller) RCs than those from pitch of 1.2, medium kernel, and larger slice thicknesses. Exposure showed no impact on RC. The overall reproducibility coefficient (RDC) was 45%, and reduced to about 20%-30% when the slice thickness and collimation were fixed. For nodules and CT imaging complying with the QIBA Profile (QIBA Profile subset), the measurements were highly repeatable and reproducible in spite of variations in nodule characteristics and imaging protocols. The overall measurement error was small and mostly due to the randomness in attachment. The bias, standard deviation, and RMSE grouped by nodule size and slice thickness × collimation in the QIBA Profile subset were within ±3%, 4%, and 5%, respectively. RCs are within 11% and the overall RDC is equal to 11%. CONCLUSIONS The authors have performed a comprehensive technical assessment of lung nodule volumetry with a matched-filter estimator from CT scans of synthetic nodules and identified the main sources of measurement error among various nodule characteristics and imaging parameters. The results confirm that the QIBA Profile set is highly repeatable and reproducible. These phantom study results can serve as a bound on the clinical performance achievable with volumetric CT measurements of pulmonary nodules.
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Affiliation(s)
- Qin Li
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
| | - Marios A Gavrielides
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
| | - Berkman Sahiner
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
| | - Kyle J Myers
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
| | - Rongping Zeng
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
| | - Nicholas Petrick
- Division of Imaging, Diagnostics and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland 20993
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Puyalto P, Miró N, Guerrero D, Pérez M, Cuadras P, Sánchez JJ. Cochlear linear reconstruction with multidetector computed tomography. Clin Otolaryngol 2016; 42:1435-1437. [PMID: 26939712 DOI: 10.1111/coa.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2016] [Indexed: 11/27/2022]
Affiliation(s)
- P Puyalto
- Radiology Department, Hospital Universitary Germans Trias I Pujol, Barcelona, Spain.,Facultad de Ciencias de la Salud- Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
| | - N Miró
- Otorhinolaryngology Department, Hospital Universitary Germans Trias I Pujol, Barcelona, Spain
| | - D Guerrero
- Otorhinolaryngology Department, Hospital Universitary Germans Trias I Pujol, Barcelona, Spain
| | - M Pérez
- Otorhinolaryngology Department, Hospital Universitary Germans Trias I Pujol, Barcelona, Spain
| | - P Cuadras
- Radiology Department, Hospital Universitary Germans Trias I Pujol, Barcelona, Spain
| | - J J Sánchez
- Facultad de Ciencias de la Salud- Medicina, Universitat Internacional de Catalunya, Barcelona, Spain.,Institut de Diagnòstic per la Imatge, Hospital Universitary Bellvitge, Barcelona, Spain
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Chan KS, Jiao F, Mikulski MA, Gerke A, Guo J, Newell JD, Hoffman EA, Thompson B, Lee CH, Fuortes LJ. Novel Logistic Regression Model of Chest CT Attenuation Coefficient Distributions for the Automated Detection of Abnormal (Emphysema or ILD) Versus Normal Lung. Acad Radiol 2016; 23:304-14. [PMID: 26776294 PMCID: PMC4744594 DOI: 10.1016/j.acra.2015.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 11/07/2015] [Accepted: 11/16/2015] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES We evaluated the role of automated quantitative computed tomography (CT) scan interpretation algorithm in detecting interstitial lung disease (ILD) and/or emphysema in a sample of elderly subjects with mild lung disease. We hypothesized that the quantification and distributions of CT attenuation values on lung CT, over a subset of Hounsfield units (HUs) range (-1000 HU, 0 HU), can differentiate early or mild disease from normal lung. MATERIALS AND METHODS We compared the results of quantitative spiral rapid end-exhalation (functional residual capacity, FRC) and end-inhalation (total lung capacity, TLC) CT scan analyses of 52 subjects with radiographic evidence of mild fibrotic lung disease to the results of 17 normal subjects. Several CT value distributions were explored, including (1) that from the peripheral lung taken at TLC (with peels at 15 or 65 mm), (2) the ratio of (1) to that from the core of lung, and (3) the ratio of (2) to its FRC counterpart. We developed a fused-lasso logistic regression model that can automatically identify sub-intervals of -1000 HU and 0 HU over which a CT value distribution provides optimal discrimination between abnormal and normal scans. RESULTS The fused-lasso logistic regression model based on (2) with 15-mm peel identified the relative frequency of CT values of over -1000 HU and -900 and those over -450 HU and -200 HU as a means of discriminating abnormal versus normal lung, resulting in a zero out-sample false-positive rate, and 15% false-negative rate of that was lowered to 12% by pooling information. CONCLUSIONS We demonstrated the potential usefulness of this novel quantitative imaging analysis method in discriminating ILD and/or emphysema from normal lungs.
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Affiliation(s)
- Kung-Sik Chan
- Department of Statistics and Actuarial Science, University of Iowa, Schaeffer Hall 241, Iowa City, IA 52242.
| | - Feiran Jiao
- Department of Occupational and Environmental Health, University of Iowa, USA
| | - Marek A Mikulski
- Department of Occupational and Environmental Health, University of Iowa, USA
| | - Alicia Gerke
- Department of Internal Medicine, University of Iowa, USA
| | - Junfeng Guo
- Department of Radiology and Biomedical Engineering, University of Iowa, USA
| | - John D Newell
- Department of Radiology and Biomedical Engineering, University of Iowa, USA
| | - Eric A Hoffman
- Department of Radiology and Biomedical Engineering, University of Iowa, USA; Departments of Radiology, Internal Medicine and Biomedical Engineering, University of Iowa, USA
| | | | - Chang Hyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Laurence J Fuortes
- Department of Occupational and Environmental Health and Department of Epidemiology, University of Iowa, USA
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Cheng H, Liu L, Yu W, Zhang H, Luo D, Zheng G. Comparison of 2.5D and 3D Quantification of Femoral Head Coverage in Normal Control Subjects and Patients with Hip Dysplasia. PLoS One 2015; 10:e0143498. [PMID: 26599869 PMCID: PMC4658041 DOI: 10.1371/journal.pone.0143498] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/05/2015] [Indexed: 11/17/2022] Open
Abstract
Hip dysplasia is characterized by insufficient femoral head coverage (FHC). Quantification of FHC is of importance as the underlying goal of the surgery to treat hip dysplasia is to restore a normal acetabular morphology and thereby to improve FHC. Unlike a pure 2D X-ray radiograph-based measurement method or a pure 3D CT-based measurement method, previously we presented a 2.5D method to quantify FHC from a single anteriorposterior (AP) pelvic radiograph. In this study, we first quantified and compared 3D FHC between a normal control group and a patient group using a CT-based measurement method. Taking the CT-based 3D measurements of FHC as the gold standard, we further quantified the bias, precision and correlation between the 2.5D measurements and the 3D measurements on both the control group and the patient group. Based on digitally reconstructed radiographs (DRRs), we investigated the influence of the pelvic tilt on the 2.5D measurements of FHC. The intraclass correlation coefficients (ICCs) for absolute agreement was used to quantify interobserver reliability and intraobserver reproducibility of the 2.5D measurement technique. The Pearson correlation coefficient, r, was used to determine the strength of the linear association between the 2.5D and the 3D measurements. Student’s t-test was used to determine whether the differences between different measurements were statistically significant. Our experimental results demonstrated that both the interobserver reliability and the intraobserver reproducibility of the 2.5D measurement technique were very good (ICCs > 0.8). Regression analysis indicated that the correlation was very strong between the 2.5D and the 3D measurements (r = 0.89, p < 0.001). Student’s t-test showed that there were no statistically significant differences between the 2.5D and the 3D measurements of FHC on the patient group (p > 0.05). The results of this study provided convincing evidence demonstrating the validity of the 2.5D measurements of FHC from a single AP pelvic radiograph and proved that it could serve as a surrogate for 3D CT-based measurements. Thus it may be possible to use this method to avoid a CT scan for the purpose of estimating 3D FHC in diagnosis and post-operative treatment evaluation of patients with hip dysplasia.
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Affiliation(s)
- Hui Cheng
- Division of Joint Surgery, Dept. Orthopaedic Surgery, The First Affiliated Hospital of PLA General Hospital, Beijing, China.,Institute for Surgical Technology and Biomechanics, University of Bern, CH-3014, Bern, Switzerland
| | - Li Liu
- Institute for Surgical Technology and Biomechanics, University of Bern, CH-3014, Bern, Switzerland
| | - Weimin Yu
- Institute for Surgical Technology and Biomechanics, University of Bern, CH-3014, Bern, Switzerland
| | - Hong Zhang
- Division of Joint Surgery, Dept. Orthopaedic Surgery, The First Affiliated Hospital of PLA General Hospital, Beijing, China
| | - Dianzhong Luo
- Division of Joint Surgery, Dept. Orthopaedic Surgery, The First Affiliated Hospital of PLA General Hospital, Beijing, China
| | - Guoyan Zheng
- Institute for Surgical Technology and Biomechanics, University of Bern, CH-3014, Bern, Switzerland
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Wood TJ, Moore CS, Stephens A, Saunderson JR, Beavis AW. A practical method to standardise and optimise the Philips DoseRight 2.0 CT automatic exposure control system. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2015; 35:495-506. [PMID: 26083878 DOI: 10.1088/0952-4746/35/3/495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Given the increasing use of computed tomography (CT) in the UK over the last 30 years, it is essential to ensure that all imaging protocols are optimised to keep radiation doses as low as reasonably practicable, consistent with the intended clinical task. However, the complexity of modern CT equipment can make this task difficult to achieve in practice. Recent results of local patient dose audits have shown discrepancies between two Philips CT scanners that use the DoseRight 2.0 automatic exposure control (AEC) system in the 'automatic' mode of operation. The use of this system can result in drifting dose and image quality performance over time as it is designed to evolve based on operator technique. The purpose of this study was to develop a practical technique for configuring examination protocols on four CT scanners that use the DoseRight 2.0 AEC system in the 'manual' mode of operation. This method used a uniform phantom to generate reference images which form the basis for how the AEC system calculates exposure factors for any given patient. The results of this study have demonstrated excellent agreement in the configuration of the CT scanners in terms of average patient dose and image quality when using this technique. This work highlights the importance of CT protocol harmonisation in a modern Radiology department to ensure both consistent image quality and radiation dose. Following this study, the average radiation dose for a range of CT examinations has been reduced without any negative impact on clinical image quality.
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Affiliation(s)
- T J Wood
- Radiation Physics Department, Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Hull & East Yorkshire Hospitals NHS Trust, Castle Road, Hull, HU16 5JQ, UK. Faculty of Science, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
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Nordenmark LH, Taylor R, Jorup C. Feasibility of Computed Tomography in a Multicenter COPD Trial: A Study of the Effect of AZD9668 on Structural Airway Changes. Adv Ther 2015; 32:548-66. [PMID: 26043724 DOI: 10.1007/s12325-015-0215-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The aim of this study was to establish the feasibility of using computed tomography (CT) in a multicenter setting to assess structural airway changes. METHODS This was a 12-week, randomized, double-blind, placebo-controlled, Phase IIb trial using CT to investigate the effect of a novel, oral, reversible neutrophil elastase inhibitor, AZD9668 60 mg twice daily (BID), on structural airway changes in patients aged 50-80 years with chronic obstructive pulmonary disease (COPD) (ex-smokers). PRIMARY OUTCOME VARIABLE airway wall thickness at an extrapolated interior perimeter of 10 mm (AWT-Pi10). Secondary outcome variables: fifth-generation wall area %; air trapping index; pre- and post-bronchodilator forced expiratory volume in 1 s (FEV1); morning and evening peak expiratory flow and FEV1; body plethysmography; EXAcerbations of Chronic pulmonary disease Tool (EXACT); Breathlessness, Cough, and Sputum Scale (BCSS); St George's Respiratory Questionnaire for COPD; and proportion of reliever-medication-free trial days. Safety variables were also assessed. RESULTS There was no difference between placebo (n = 19) and AZD9668 (n = 17) for AWT-Pi10 at treatment end. This was consistent with results for most secondary variables. However, patients randomized to AZD9668 experienced an improvement versus placebo for morning and evening FEV1, and EXACT and BCSS cough and sputum scores. AZD9668 60 mg BID was well tolerated and no new safety concerns were identified. CONCLUSIONS This study confirmed the feasibility of using CT to assess structural airway changes in COPD. However, there was no evidence of improvements in CT structural measures following 12 weeks' treatment with AZD9668 60 mg BID. FUNDING AstraZeneca.
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Ramavathu KVM, Atwal SS, Garga UC. Multi-detector computed tomography in evaluating locally aggressive and malignant bone tumours. J Clin Diagn Res 2015; 9:TC10-3. [PMID: 26023618 DOI: 10.7860/jcdr/2015/10738.5796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 02/12/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the ability of Multi-Detector Computed Tomography in preoperative evaluation of locally aggressive and malignant bone tumours in correlation with histopathological findings. MATERIALS AND METHODS Twenty patients suspected of malignant bone tumours on the basis of their clinical profile were selected. Following a plain radiograph evaluation, all of them were subjected to CT scan examination. Multi Planar Reconstruction (MPR) was done in sagittal and coronal planes and also three-dimensional Volume Rendering (VR) and Maximum Intensity Projection (MIP) images were obtained. RESULTS Of the 20 patients, 18 underwent surgery, and their histopathological findings were compared and correlated with MDCT findings. MDCT was 92.8% sensitive and 100% specific in determining the vascularity of the tumour and also can detect displacement/ encasement/ involvement of adjacent vessels. It has a sensitivity and specificity of 100% in determining cortical break, calcification and periosteal reaction. However, it is less sensitive in detecting joint involvement. Post contrast enhancement gives details of the extent of the soft tissue component. CONCLUSION Although MRI is a preferred modality in preoperative evaluation of bone tumours, CT may be used an alternative in case of non-availability of MRI, which has faster acquisition time and better resolution. Using three dimensional MPR imaging, the location and extent of the tumour can be studied. It is also useful in determining cortical discontinuity, periosteal reaction, and calcification. By virtue of MIP and VR imaging, vascularity of the tumour and its relationship with the adjacent vasculature can be established. However, it is inferior to MRI in soft tissue characterization and has poor sensitivity in detecting marrow and joint involvement.
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Affiliation(s)
| | - Swapndeep Singh Atwal
- Senior Resident, Department of Radiodiagnosis, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
| | - U C Garga
- Professor and Head, Department of Radiodiagnosis, PGIMER and Dr. Ram Manohar Lohia Hospital , New Delhi, India
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Mazziotti S, Blandino A, Gaeta M, Bottari A, Sofia C, D'Angelo T, Ascenti G. Postprocessing in Maxillofacial Multidetector Computed Tomography. Can Assoc Radiol J 2015; 66:212-22. [PMID: 26002181 DOI: 10.1016/j.carj.2014.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 12/18/2022] Open
Abstract
Multidetector computed tomography (CT) and volumetric rendering techniques have always been a useful support for the anatomical and pathological study of the maxillofacial district. Nowadays accessibility to multidetector CT scanners allows the achievement of images with an extremely thin collimation and with high spatial resolution, not only along the axial plane but also along the patient's longitudinal axis. This feature is the main theoretical assumption for multiplanar imaging and for an optimal 3-dimensional postprocessing. Multiplanar reconstruction (MPR) techniques permit images along any plane in the space to be obtained, including curved planes; this feature allows the representation in a single bidimensional image of different anatomical structures that develop on multiple planes. For this reason MPR techniques represent an unavoidable step for the study of traumatic pathology as well as of malformative, neoplastic, and inflammatory pathologies. Among 3-dimensional techniques, Maximum Intensity Projection and Shaded Surface Display are routinely used in clinical practice. In addition, volumetric rendering techniques allow a better efficacy in representing the different tissues of maxillofacial district. Each of these techniques give the radiologist an undoubted support for the diagnosis and the characterization of traumatic and malformative conditions, have a critical utility in the neoplastic evaluation of primary or secondary bone involvement, and are also used in the planning of the most modern radiosurgical treatments. The aim of this article is to define the main technical aspects of imaging postprocessing in maxillofacial CT and to summarize when each technique is indicated, according to the different pathologies of this complex anatomical district.
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Affiliation(s)
- Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Michele Gaeta
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Antonio Bottari
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Choi HJ, Lee KH, Kim NH, Kim JH, Hyun IY, Ryu JS. The usefulness of combined axial and coronal computed tomography for the evaluation of metastatic supraclavicular lymph nodes. Clin Imaging 2015; 39:608-12. [PMID: 25940644 DOI: 10.1016/j.clinimag.2015.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 04/10/2015] [Indexed: 12/18/2022]
Abstract
The purpose is to assess the value of adding coronal images for the identification of metastatic supraclavicular lymph nodes (LNs). Two radiologists reviewed axial images and combined axial and coronal images using thoracic computed tomography (CT) of 386 patients whose maximum standardized uptake value measured in a supraclavicular LN was ≥2.0 on a positron emission tomography. We compared sensitivity and agreement between readers before and after the addition of coronal images. For combined images, agreement was almost perfect (κ=0.982), and sensitivity was significantly higher (90.4%, P<.001). Interpreting both axial and coronal images improves the diagnostic accuracy for supraclavicular metastasis.
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Affiliation(s)
- Hyun Jin Choi
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea
| | - Kyung Hee Lee
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea
| | - Na Hee Kim
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea
| | - Jun Ho Kim
- Department of Radiology, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea.
| | - In Young Hyun
- Department of Nuclear Medicine, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea
| | - Jeong-Seon Ryu
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Inhang-ro 27, Jung-gu, Incheon, Korea
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Rubin GD. Computed tomography: revolutionizing the practice of medicine for 40 years. Radiology 2015; 273:S45-74. [PMID: 25340438 DOI: 10.1148/radiol.14141356] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Computed tomography (CT) has had a profound effect on the practice of medicine. Both the spectrum of clinical applications and the role that CT has played in enhancing the depth of our understanding of disease have been profound. Although almost 90 000 articles on CT have been published in peer-reviewed journals over the past 40 years, fewer than 5% of these have been published in Radiology. Nevertheless, these almost 4000 articles have provided a basis for many important medical advances. By enabling a deepened understanding of anatomy, physiology, and pathology, CT has facilitated key advances in the detection and management of disease. This article celebrates this breadth of scientific discovery and development by examining the impact that CT has had on the diagnosis, characterization, and management of a sampling of major health challenges, including stroke, vascular diseases, cancer, trauma, acute abdominal pain, and diffuse lung diseases, as related to key technical advances in CT and manifested in Radiology.
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Affiliation(s)
- Geoffrey D Rubin
- From the Duke Clinical Research Institute and Department of Radiology, Duke University School of Medicine, PO Box 17969, 2400 Pratt St, Durham, NC 27715
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