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Trikoupis IG, Mavrodontis II, Papadopoulos DV, Goumenos SD, Georgoulis DA, Gavriil P, Melissaridou D, Savvidou OD, Kontogeorgakos VA, Papagelopoulos PJ. 3D-printed glenoid implant reconstruction, after partial scapulectomy for malignant tumors: a case series. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:1557-1562. [PMID: 38280074 PMCID: PMC10980628 DOI: 10.1007/s00590-024-03839-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE Glenoid tumors are extremely rare, and reconstruction remains very challenging. The aim of this study is to present the clinical and functional outcomes, of a new glenoid reconstruction method using 3-dimensional-printed implant. METHODS Four patients with primary glenoid tumors underwent reconstruction using 3-dimensional-printed glenoid implant linked with reverse shoulder arthroplasty. We retrospectively reviewed the clinical and functional outcome, using MSTS and DASH score, as well as complications' rate. RESULTS Wide excision was achieved in all patients. No local recurrence or distant metastasis was diagnosed at the follow-up period. The mean MSTS score was 80.5%, and DASH score was 15.2%. According to Hendersons' classification, there were no postoperative complications. CONCLUSION The use of 3-dimensional-printed implants, can be a very reliable solution with satisfying clinical and functional outcomes for reconstruction, in patients with musculoskeletal malignancies of the glenoid. Level of evidence IV Treatment Study.
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Affiliation(s)
- Ioannis G Trikoupis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Ioannis I Mavrodontis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitrios V Papadopoulos
- Second Department of Orthopedics, National and Kapodistrian University of Athens, 'Agia Olga' Hospital, Th. Konstantopoulou 3-5, Nea Ionia, 14233, Athens, Greece
| | - Stavros D Goumenos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitrios A Georgoulis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Panagiotis Gavriil
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitra Melissaridou
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Olga D Savvidou
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Vasileios A Kontogeorgakos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece.
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Bayona HHG, Inamoto Y, Saitoh E, Aihara K, Kobayashi M, Otaka Y. Prediction of Pharyngeal 3D Volume Using 2D Lateral Area Measurements During Swallowing. Dysphagia 2024:10.1007/s00455-023-10659-x. [PMID: 38245902 DOI: 10.1007/s00455-023-10659-x] [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: 08/28/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024]
Abstract
This study evaluated the validity of pharyngeal 2D area measurements acquired from the lateral view for predicting the actual 3D volume in healthy adults during swallowing. Seventy-five healthy adults (39 females, 36 males; mean age 51.3 years) were examined using 320-row area detector computed tomography (320-ADCT). All participants swallowed a 10 mL honey-thick barium bolus upon command while seated in a 45° semi-reclining position. Multi-planar reconstruction images and dynamic 3D-CT images were obtained using Aquilion ONE software. Pharyngeal 2D area and 3D volume measurements were taken before swallowing and at the frame depicting maximum pharyngeal constriction. Pharyngeal volume before swallowing (PVhold) was accurately predicted by 2D area (R2 = 0.816). Adding height and sex to the model increased R2 to 0.836. Regarding pharyngeal volume during maximum constriction (PVmax), 2D area also exhibited acceptable predictive power (R2 = 0.777). However, analysis of statistical residuals and outliers revealed a greater tendency for prediction errors when there is less complete constriction of the pharynx as well as asymmetry in bolus flow or movement. Findings highlight the importance of routinely incorporating anterior-posterior views during VFSS exams. Future work is needed to determine clinical utility of pharyngeal volume measurements derived from 320-ADCT.
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Affiliation(s)
- Howell Henrian G Bayona
- Graduate School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Eichii Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masanao Kobayashi
- Faculty of Radiology, School of Medical Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
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Scala M, Severino M. CT Scan Data Analysis in Malformations of Cortical Development. Methods Mol Biol 2024; 2794:271-280. [PMID: 38630236 DOI: 10.1007/978-1-0716-3810-1_22] [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] [Indexed: 04/19/2024]
Abstract
Malformations of cortical development (MCDs) are a diverse group of disorders that result from abnormal neuronal migration, proliferation, and differentiation during brain development. Head computed tomography (CT) has limited use in the diagnosis of MCDs and should be reserved for selected cases with specific indications or when magnetic resonance imaging is not available or contraindicated. CT can detect brain calcifications associated with MCDs, thus helping in the differential diagnosis between acquired and genetic MCDs or in the identification of different genetic patterns. Moreover, CT can provide high-resolution images of the skull and bones, thus identifying associated malformations, such as craniosynostosis, inner and middle ear malformations, and vertebral anomalies. In this chapter, we review the CT scan technique, data analysis, and indications in the investigation of MCDs.
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Affiliation(s)
- Marcello Scala
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- UOC Genetica Medica, IRCCS Giannina Gaslini, Genoa, Italy
| | - Mariasavina Severino
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Javed S, Mei Y, Zhang Y, Wan D, Liu H, Liu C, Liu S. Identification of anatomical types of segmental bronchi in left superior and lingular lobes using multi-slice CT. Surg Radiol Anat 2023; 45:1461-1470. [PMID: 37477718 DOI: 10.1007/s00276-023-03208-6] [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: 04/28/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE The objectives of this study were to evaluate various branching patterns of segmental bronchi in the left superior and lingular lobes and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. MATERIALS AND METHODS Overall, 10,000 participants (5428 males, and 4572 females, mean age 50 ± 13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans between September 2019 and December 2021 were retrospectively included. Using the syngo.via post-processing workstation, the data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree. The reconstructed images were then interpreted to identify and categorize distinct bronchial patterns in the left superior and lingular lobes. Cross-tabulation analysis and the Pearson Chi-square (χ2) test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. RESULTS Our results revealed mainly four distinct types for the left superior lobe (LSL) bronchial tree, i.e., (B1 + 2, B3, 76.13%); (B1 + 2 + 3, 17.32%); (B1 + 3, B2, 5.74%); (B1a + B3, B1b + B2, 0.81%) and two types for the left lingular lobe (LLL) bronchial tree, i.e., (B4, B5, 91.05%); (B4, B5, B*, 8.95%). There were no significant sex-related differences in the proportion of bronchial branches in LLL (P > 0.05). However, sex-related differences were significant in the proportion of bronchial branches in LSL (P < 0.05). CONCLUSION The current study has validated the presence of segmental bronchial variations in the left superior and lingular lobes. These findings may have a crucial effect on the diagnosis of symptomatic patients, as well as in carrying out procedures such as lung resections, endotracheal intubation, and bronchoscopies.
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Affiliation(s)
- Saeed Javed
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44#, Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yixuan Mei
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44#, Wenhua Xi Road, Jinan, 250012, Shandong, China
- Department of Medical Imaging, Dongying People's Hospital, Dongying, 257091, China
| | - Yi Zhang
- Department of Medical Imaging, Shandong Provincial Hospital, Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250014, China
| | - Dian Wan
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44#, Wenhua Xi Road, Jinan, 250012, Shandong, China
- Chengdu Institute of Biological Products, Chengdu, 610041, Sichuan, China
| | - Hailan Liu
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44#, Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Cheng Liu
- Department of Medical Imaging, Shandong Provincial Hospital, Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Shuwei Liu
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44#, Wenhua Xi Road, Jinan, 250012, Shandong, China.
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Liu D, Hu P, Cai ZJ, Lu WH, Pan LY, Liu X, Peng XJ, Li YS, Xiao WF. Valid and reliable diagnostic performance of dual-energy CT in anterior cruciate ligament rupture. Eur Radiol 2023; 33:7769-7778. [PMID: 37171489 PMCID: PMC10598075 DOI: 10.1007/s00330-023-09720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES To determine whether dual-energy CT (DECT) can be used to accurately and reliably detect anterior cruciate ligament (ACL) rupture. MATERIALS AND METHODS Participants with unilateral ACL rupture were prospectively enrolled, and the bilateral knees were scanned by DECT. A tissue-specific mapping algorithm was applied to improve the visualization of the ACLs. The 80-keV CT value, mixed-keV CT value, electron density (Rho), and effective atomic number (Zeff) were measured to quantitatively differentiate torn ACLs from normal ACLs. MRI and arthroscopy served as the reference standards. RESULTS Fifty-one participants (mean age, 27.0 ± 8.7 years; 31 men) were enrolled. Intact and torn ACLs were explicitly differentiated on color-coded DECT images. The 80-keV CT value, mixed-keV CT value, and Rho were significantly lower for the torn ACLs than for the intact ACLs (p < 0.001). The optimal cutoff values were an 80-keV CT value of 61.8 HU, a mixed-keV CT value of 60.9 HU, and a Rho of 51.8 HU, with AUCs of 98.0% (95% CI: 97.0-98.9%), 99.2% (95% CI: 98.6-99.7%), and 99.8% (95% CI: 99.6-100.0%), respectively. Overall, DECT had almost perfect reliability and validity in detecting ACL integrity (sensitivity = 97.1% [95% CI: 88.1-99.8%]; specificity = 98.0% [95% CI: 89.5-99.9%]; PPV = 98.0% [95% CI: 93.0-99.8%]; NPV = 97.1% [95% CI: 91.7-99.4%]; accuracy = 97.5% [95% CI: 94.3-99.2%]). There was no evidence of a difference between MRI and DECT in the diagnostic performance (p > 0.99). CONCLUSION DECT has excellent diagnostic accuracy and reliability in qualitatively and quantitatively diagnosing ACL rupture. CLINICAL RELEVANCE STATEMENT DECT could validly and reliably diagnose ACL rupture using both qualitative and quantitative methods, which may become a promising substitute for MRI to evaluate the integrity of injured ACLs and the maturity of postoperative ACL autografts. KEY POINTS • On color-coded DECT images, an uncolored ACL was a reliable sign for qualitatively diagnosing ACL rupture. • The 80-keV CT value, mixed-keV CT value, and Rho were significantly lower for the torn ACLs than for the intact ACLs, which contributed to the quantitative diagnosis of ACL rupture. • DECT had an almost perfect diagnostic performance for ACL rupture, and diagnostic capability was comparable between MRI and DECT.
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Affiliation(s)
- Di Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Ping Hu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Zi-Jun Cai
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Wen-Hao Lu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Lin-Yuan Pan
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Xu Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Xian-Jing Peng
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
| | - Yu-Sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
| | - Wen-Feng Xiao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Novales M, Lucena R, Hernández EM, Ginel PJ, Fernández JM, Blanco B. Three-Dimensional Volume Rendering in Computed Tomography for Evaluation of the Temporomandibular Joint in Dogs. Animals (Basel) 2023; 13:3231. [PMID: 37893955 PMCID: PMC10603686 DOI: 10.3390/ani13203231] [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: 09/05/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Based on computed tomography (CT) images, volume rendering was used to obtain a three-dimensional representation of data (3DVR). The aims of this study included: describing the bone anatomy of the temporomandibular joint (TMJ) of dogs; comparing the TMJs of each dog by skull type and age; comparing 3DVR images with three-standard-plane CTs; assessing soft tissues adjacent to the TMJ and assessing pathological cases. Multidetector computed tomography scans of bilateral TMJs of 410 dogs were observed. From a ventral view, slight displacements in the positions of the skulls were seen, whereas from a caudal view, differences in amplitude of the articular space were observed. Dolichocephalic and mesaticephalic dogs showed more similar TMJ features than brachycephalic dogs. The shape of the TMJ bones were irregular in dogs under 1 year old. The 3DVR images related to the three-standard-plane CT improved the overall comprehension of the changes in the articular space amplitude and condylar process morphology. The fovea pterygoidea, mandibular fossa and retroarticular process were perfectly shown. A better spatial situation of adjacent soft tissues was obtained. The 3DVR represents an ancillary method to the standard-plane CT that could help in the understanding of the anatomy and diagnoses of different pathologies of the TMJ in dogs.
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Affiliation(s)
- Manuel Novales
- Department of Animal Medicine and Surgery, University of Córdoba (Spain), Campus de Rabanales, Crtra Nacional IV A, Km 396, 14014 Córdoba, Spain; (R.L.); (P.J.G.); (B.B.)
| | - Rosario Lucena
- Department of Animal Medicine and Surgery, University of Córdoba (Spain), Campus de Rabanales, Crtra Nacional IV A, Km 396, 14014 Córdoba, Spain; (R.L.); (P.J.G.); (B.B.)
| | - Eduardo M. Hernández
- Department of Animal Medicine and Surgery, University of Córdoba (Spain), Campus de Rabanales, Crtra Nacional IV A, Km 396, 14014 Córdoba, Spain; (R.L.); (P.J.G.); (B.B.)
| | - Pedro J. Ginel
- Department of Animal Medicine and Surgery, University of Córdoba (Spain), Campus de Rabanales, Crtra Nacional IV A, Km 396, 14014 Córdoba, Spain; (R.L.); (P.J.G.); (B.B.)
| | - Jesús M. Fernández
- Department of Animal Medicine and Surgery, University Complutense of Madrid (Spain), Avda. Puerta de Hierro s/n, 28040 Madrid, Spain;
| | - Beatriz Blanco
- Department of Animal Medicine and Surgery, University of Córdoba (Spain), Campus de Rabanales, Crtra Nacional IV A, Km 396, 14014 Córdoba, Spain; (R.L.); (P.J.G.); (B.B.)
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Zhou J, See CW, Sreenivasamurthy S, Zhu D. Customized Additive Manufacturing in Bone Scaffolds-The Gateway to Precise Bone Defect Treatment. RESEARCH (WASHINGTON, D.C.) 2023; 6:0239. [PMID: 37818034 PMCID: PMC10561823 DOI: 10.34133/research.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023]
Abstract
In the advancing landscape of technology and novel material development, additive manufacturing (AM) is steadily making strides within the biomedical sector. Moving away from traditional, one-size-fits-all implant solutions, the advent of AM technology allows for patient-specific scaffolds that could improve integration and enhance wound healing. These scaffolds, meticulously designed with a myriad of geometries, mechanical properties, and biological responses, are made possible through the vast selection of materials and fabrication methods at our disposal. Recognizing the importance of precision in the treatment of bone defects, which display variability from macroscopic to microscopic scales in each case, a tailored treatment strategy is required. A patient-specific AM bone scaffold perfectly addresses this necessity. This review elucidates the pivotal role that customized AM bone scaffolds play in bone defect treatment, while offering comprehensive guidelines for their customization. This includes aspects such as bone defect imaging, material selection, topography design, and fabrication methodology. Additionally, we propose a cooperative model involving the patient, clinician, and engineer, thereby underscoring the interdisciplinary approach necessary for the effective design and clinical application of these customized AM bone scaffolds. This collaboration promises to usher in a new era of bioactive medical materials, responsive to individualized needs and capable of pushing boundaries in personalized medicine beyond those set by traditional medical materials.
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Affiliation(s)
- Juncen Zhou
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Carmine Wang See
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Sai Sreenivasamurthy
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
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Bertram U, Köveshazi I, Michaelis M, Weidert S, Schmidt TP, Blume C, Zastrow FSV, Müller CA, Szabo S. Man versus machine: Automatic pedicle screw planning using registration-based techniques compared with manual screw planning for thoracolumbar fusion surgeries. Int J Med Robot 2023:e2570. [PMID: 37690099 DOI: 10.1002/rcs.2570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE This study evaluates the precision of a commercially available spine planning software in automatic spine labelling and screw-trajectory proposal. METHODS The software uses automatic segmentation and registration of the vertebra to generate screw proposals. 877 trajectories were compared. Four neurosurgeons assessed suggested trajectories, performed corrections, and manually planned pedicle screws. Additionally, automatic identification/labelling was evaluated. RESULTS Automatic labelling was correct in 89% of the cases. 92.9% of automatically planned trajectories were in accordance with G&R grade A + B. Automatic mode reduced the time spent planning screw trajectories by 7 s per screw to 20 s per vertebra. Manual mode yielded differences in screw-length between surgeons (largest distribution peak: 5 mm), automatic in contrast at 0 mm. The size of suggested pedicle screws was significantly smaller (largest peaks in difference between 0.5 and 3 mm) than the surgeon's choice. CONCLUSION Automatic identification of vertebrae works in most cases and suggested pedicle screw trajectories are acceptable. So far, it does not substitute for an experienced surgeon's assessment.
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Affiliation(s)
- Ulf Bertram
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Istvan Köveshazi
- Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany
- M3i Industry-in-Clinic-Platform GmbH, Munich, Germany
| | | | - Simon Weidert
- Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany
- M3i Industry-in-Clinic-Platform GmbH, Munich, Germany
| | | | - Christian Blume
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Felix Swamy V Zastrow
- M3i Industry-in-Clinic-Platform GmbH, Munich, Germany
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | | | - Szilard Szabo
- M3i Industry-in-Clinic-Platform GmbH, Munich, Germany
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Javed S, Zhang Y, Wan D, Mei Y, Liu H, Liu C, Liu S. Identification of anatomical types of segmental bronchi in right middle lobe using multi-slice CT. Surg Radiol Anat 2023:10.1007/s00276-023-03159-y. [PMID: 37145163 PMCID: PMC10161992 DOI: 10.1007/s00276-023-03159-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/27/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The objectives of this study were to evaluate the various branching patterns of segmental bronchi in the right middle lobe (RML) and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. MATERIALS AND METHODS In this retrospective board-approved study with informed consent, 10,000 participants (5428 males and 4,572 females, mean age 50 ± 13.5 years [SD]; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The reconstructed images were then interpreted to locate and classify distinct bronchial patterns in the RML. Cross-tabulation analysis and the Pearson chi-square test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. RESULTS Our results revealed that the segmental bronchial ramifications of the RML were classified into two types mainly, i.e., bifurcation (B4, B5, 91.42%) and trifurcation (B4, B5, B*, 8.58%). There were no significant sex-related differences in the proportion of bronchial branches in the RML (P > 0.05). CONCLUSION The current study has confirmed the presence of segmental bronchial variations in the RML lobe using 3D reconstruction and virtual bronchoscopy. These findings may have significant implications for the diagnosis of symptomatic patients and for carrying out specific procedures like bronchoscopy, endotracheal intubation, and lung resection.
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Affiliation(s)
- Saeed Javed
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Yi Zhang
- Department of Medical Imaging, Shandong Provincial Hospital, Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250014, China
| | - Dian Wan
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Chengdu Institute of Biological Products, Chengdu, 610041, Sichuan, China
| | - Yixuan Mei
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Department of Medical Imaging, Dongying People's Hospital, Dongying, 257091, China
| | - Hailan Liu
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Cheng Liu
- Department of Medical Imaging, Shandong Provincial Hospital, Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Shuwei Liu
- Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Digital Human and Clinical Anatomy, Department of Anatomy and Neurobiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Research Center for Sectional and Imaging Anatomy, Shandong University School of Medicine, 44#, Wenhua Xi Road, Jinan, CN 250012, Shandong, China.
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10
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Kusmirek JE, Meyer CA. High-Resolution Computed Tomography of Cystic Lung Disease. Semin Respir Crit Care Med 2022; 43:792-808. [PMID: 36252611 DOI: 10.1055/s-0042-1755565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The cystic lung diseases (CLD) are characterized by the presence of multiple, thin-walled, air-filled spaces in the pulmonary parenchyma. Cyst formation may occur with congenital, autoimmune, inflammatory, infectious, or neoplastic processes. Recognition of cyst mimics such as emphysema and bronchiectasis is important to prevent diagnostic confusion and unnecessary evaluation. Chest CT can be diagnostic or may guide the workup based on cyst number, distribution, morphology, and associated lung, and extrapulmonary findings. Diffuse CLD (DCLDs) are often considered those presenting with 10 or more cysts. The more commonly encountered DCLDs include lymphangioleiomyomatosis, pulmonary Langerhans' cell histiocytosis, lymphoid interstitial pneumonia, Birt-Hogg-Dubé syndrome, and amyloidosis/light chain deposition disease.
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Affiliation(s)
- Joanna E Kusmirek
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Cristopher A Meyer
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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11
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Hayashi N, Kurata S, Saito Y, Ogawa S, Yasui K. Simple quality assurance based on filtered back projection for geometrical/irradiation accuracy in single-isocenter multiple-target stereotactic radiotherapy. Radiol Phys Technol 2022; 15:409-416. [PMID: 36261754 DOI: 10.1007/s12194-022-00683-1] [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: 06/25/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 10/24/2022]
Abstract
In single-isocenter multiple-target stereotactic radiotherapy (SIMT-SRT), it is difficult to evaluate both the geometrical accuracy and absorbed dose measurement when irradiating off-isocenter targets. This study aimed to develop a simple quality assurance (QA) method to evaluate off-isocenter irradiation position accuracy in SIMT-SRT and compare its feasibility with that of a commercial device. First, we created two types of inserts and metallic balls with a diameter of 5 mm to be inserted into a commercially available phantom (SIMT phantom). Second, we developed a dedicated analysis software using Python for the Winston-Lutz test (WLT). Third, an image processing software, including the filtered back-projection algorithm, was developed to analyze the images obtained using an electronic portal imaging device (EPID). Fourth, the feasibility of our method was evaluated by comparing it with the results of WLT using two commercially available phantoms: WL-QA and MultiMet-WL cubes. Notably, 92% of the results in one-dimensional deviations were within 0.26 mm (EPID pixel width). The correlation coefficients were 0.52, 0.92, and 0.96 in the left-right, superior-inferior, and anterior-posterior directions, respectively. In the WLT, a maximum two-dimensional deviation of 0.70 mm was detected in our method, while the deviation in the other method was within 0.5 mm. The advantage of our method is that it can evaluate the geometrical accuracy at any gantry angle during dynamic rotation irradiation using a filtered back-projection algorithm, even if the target is located off the isocenter. Our method can perform WLT at arbitrary positions and is suitable for the QA of dynamic rotation irradiation using an EPID.
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Affiliation(s)
- Naoki Hayashi
- School of Medical Sciences, Fujita Health University, Toyoake, Aichi, Japan.
| | - Shun Kurata
- School of Medical Sciences, Fujita Health University, Toyoake, Aichi, Japan.,Department of Radiology, Kindai University Hospital, Osakasayama, Osaka, Japan
| | - Yasunori Saito
- School of Medical Sciences, Fujita Health University, Toyoake, Aichi, Japan.,Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Shuta Ogawa
- Department of Radiology, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Keisuke Yasui
- School of Medical Sciences, Fujita Health University, Toyoake, Aichi, Japan
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12
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Shaller BD, Filsoof D, Pineda JM, Gildea TR. Malignant Central Airway Obstruction: What's New? Semin Respir Crit Care Med 2022; 43:512-529. [PMID: 35654419 DOI: 10.1055/s-0042-1748187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Malignant central airway obstruction (MCAO) is a debilitating and life-limiting complication that occurs in an unfortunately large number of individuals with advanced intrathoracic cancer. Although the management of MCAO is multimodal and interdisciplinary, the task of providing patients with prompt palliation falls increasingly on the shoulders of interventional pulmonologists. While a variety of tools and techniques are available for the management of malignant obstructive lesions, advancements and evolution in this therapeutic venue have been somewhat sluggish and limited when compared with other branches of interventional pulmonary medicine (e.g., the early diagnosis of peripheral lung nodules). Indeed, one pragmatic, albeit somewhat uncharitable, reading of this article's title might suggest a wry smile and shug of the shoulders as to imply that relatively little has changed in recent years. That said, the spectrum of interventions for MCAO continues to expand, even if at a less impressive clip. Herein, we present on MCAO and its endoscopic and nonendoscopic management-that which is old, that which is new, and that which is still on the horizon.
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Affiliation(s)
- Brian D Shaller
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Darius Filsoof
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Jorge M Pineda
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, California
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13
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Spake L, Hoppa RD, Blau S, Cardoso HFV. Biological mortality bias in diaphyseal growth of contemporary children: Implications for paleoauxology. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022. [PMCID: PMC9306609 DOI: 10.1002/ajpa.24486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Biological mortality bias is the idea that individuals who comprise skeletal samples (non‐survivors) are a specific subset of the overall population, who may have been exposed to greater stress during life. Because of this, it is possible that studying growth in a skeletal population misrepresents the growth and health of survivors in that population. Using a modern sample, this study investigates whether biological mortality bias in growth may be present in archaeological skeletal samples. Materials and methods Postmortem computed tomography scans of 206 children aged under 13 years were collected from two institutions in the United States and Australia. The sample was separated into children who died from natural causes as proxies for non‐survivors and from accidental causes as proxies for survivors. Differences in long bone length for age were assessed through analysis of covariance (ANCOVA) and z‐score analysis, and these results were compared with studies linking anthropometrics and mortality risk in nonindustrialized societies. Results Differences in growth favoring survivors were greater for girls than for boys and seemed to increase over age. The effect in nonindustrialized societies was 1.5 to 5 times the magnitude of that in our contemporary sample. Conclusions A greater growth delay in girls than in boys has been documented in historical identified collections, and skeletal samples consistently become more stunted relative to modern standards over the course of growth. Our findings on biological mortality bias could explain part of these growth delays and impact interpretations of past ontogenetic environments.
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Affiliation(s)
- Laure Spake
- Religion Programme and Centre for Research on Evolution, Belief and Behaviour University of Otago Dunedin New Zealand
- Department of Anthropology Western Washington University, Bellingham Washington USA
| | - Robert D. Hoppa
- Department of Anthropology University of Manitoba Winnipeg Canada
| | - Soren Blau
- Forensic Pathology The Victorian Institute of Forensic Medicine Southbank Victoria Australia
- Department of Forensic Medicine Monash University Melbourne Victoria Australia
| | - Hugo F. V. Cardoso
- Department of Archaeology and Centre for Forensic Research Simon Fraser University Burnaby Canada
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14
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Sánchez García D, Aguado del Hoyo A, Sánchez Pérez M, Larroca SGT, Ruiz Martín Y, Gordillo Gutiérrez I, Arribas CB, Alvarez-Mon M, Ortega MA, De Leon-Luis J. Effects of Sex, Age and Height on Symphysis–Ischial Spine Distance Measured on a Pelvic CT. J Clin Med 2022; 11:jcm11092395. [PMID: 35566521 PMCID: PMC9104774 DOI: 10.3390/jcm11092395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: To examine the influence of age, sex and height on the symphysis–ischial spine distance (SID) measured on pelvic Computed tomography (CT)images in subjects of reproductive age, and to determine the interobserver reproducibility. This measurement (SID) is of great importance because the use of intrapartum ultrasound is based on the assumption of a specific value (30 mm) of such a measurement. Methods: This was a cross-sectional descriptive study in which SID was measured in subjects aged 20 to 44 years who had been scheduled for pelvic CT at our centre from January 2018 to May 2021 for different reasons. Radiographic measurements of the pelvis were obtained through the multiplanar reconstruction of the CT image. The images obtained from all of the participants were independently assessed by three senior radiologists, and the SID measurements made by each one were blinded from those of the remaining observers. Correlations between the SID and patient age, height and sex were analyzed by univariate and multivariate linear regression. Results: The mean SID for 87 of the enrolled participants (45 women, 42 men) was 28.2 ± 6.25 mm. Among the observers, the mean difference in this distance was 1 to 2 mm, and was scarcely related to measurement size, with agreement being greater than 70%. The mean SID was significantly related to sex and height (SID = −24.9 − 6.51 × sex (0 or 1) + 0.34 × height (cm); p = 0.01; sex equals 1 for a man and 0 for a woman), such that it was a mean of 2.5 mm greater in women than men (29.50 mm vs. 26.99 mm). Conclusion: Measurements of SID on CT images show good interobserver reproducibility, and are related to sex and height.
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Affiliation(s)
- Daniel Sánchez García
- Department of Radiology, University Hospital Gregorio Marañón, 28009 Madrid, Spain; (D.S.G.); (A.A.d.H.); (M.S.P.); (Y.R.M.); (I.G.G.)
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
| | - Alejandra Aguado del Hoyo
- Department of Radiology, University Hospital Gregorio Marañón, 28009 Madrid, Spain; (D.S.G.); (A.A.d.H.); (M.S.P.); (Y.R.M.); (I.G.G.)
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
| | - María Sánchez Pérez
- Department of Radiology, University Hospital Gregorio Marañón, 28009 Madrid, Spain; (D.S.G.); (A.A.d.H.); (M.S.P.); (Y.R.M.); (I.G.G.)
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
| | - Santiago García-Tizón Larroca
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
| | - Yolanda Ruiz Martín
- Department of Radiology, University Hospital Gregorio Marañón, 28009 Madrid, Spain; (D.S.G.); (A.A.d.H.); (M.S.P.); (Y.R.M.); (I.G.G.)
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
| | - Isabel Gordillo Gutiérrez
- Department of Radiology, University Hospital Gregorio Marañón, 28009 Madrid, Spain; (D.S.G.); (A.A.d.H.); (M.S.P.); (Y.R.M.); (I.G.G.)
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
| | - Coral Bravo Arribas
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Correspondence:
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (M.A.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine (CIBEREHD), University Hospital Príncipe de Asturias, 28806 Alcala de Henares, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (M.A.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Juan De Leon-Luis
- Group of Pathophysiology in Women, Pregnancy, Labor, and Puerperium, Health Research Institute Gregorio Marañón, 28040 Madrid, Spain; (S.G.-T.L.); (J.D.L.-L.)
- Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
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15
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Application and Development of Modern 3D Printing Technology in the Field of Orthopedics. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8759060. [PMID: 35211626 PMCID: PMC8863440 DOI: 10.1155/2022/8759060] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/06/2022] [Accepted: 01/17/2022] [Indexed: 12/31/2022]
Abstract
3D printing, also known as additive manufacturing, is a technology that uses a variety of adhesive materials such as powdered metal or plastic to construct objects based on digital models. Recently, 3D printing technology has been combined with digital medicine, materials science, cytology, and other multidisciplinary fields, especially in the field of orthopedic built-in objects. The development of advanced 3D printing materials continues to meet the needs of clinical precision medicine and customize the most suitable prosthesis for everyone to improve service life and satisfaction. This article introduces the development of 3D printing technology and different types of materials. We also discuss the shortcomings of 3D printing technology and the current challenges, including the poor bionics of 3D printing products, lack of ideal bioinks, product safety, and lack of market supervision. We also prospect the future development trends of 3D printing.
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16
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Amalaraj T, Satharasinghe D, Pallewatte A, Jeyasugiththan J. Establishment of national diagnostic reference levels for computed tomography procedures in Sri Lanka: first nationwide dose survey. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:021504. [PMID: 34875641 DOI: 10.1088/1361-6498/ac40e8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/06/2021] [Indexed: 06/13/2023]
Abstract
The main purpose of this study was to establish for the first time national diagnostic reference levels (NDRLs) for common computed tomography (CT) procedures in Sri Lanka. Patient morphometric data, exposure parameters and dose data such as volume CT dose index (CTDIvol) and dose-length product (DLP) were collected from 5666 patients who underwent 22 types of procedure. The extreme dose values were filtered before analysis to ensure that the data come from standard size patients. The median of the dose distribution was calculated for each institution, and the third quartile value of the median distribution was considered as the NDRL. Based on the inclusion and exclusion criteria, data from 4592 patients and 17 procedure types were considered for establishment of a NDRL, covering 41% of the country's CT machines. The proposed NDRLs based on CTDIvoland DLP were: non-contrast-enhanced (NC) head, 82.2 mGy/1556 mGy cm; contrast-enhanced (CE) head, 82.2 mGy/1546 mGy cm; chest NC, 7.4 mGy/350 mGy cm; chest CE, 8.3 mGy/464 mGy cm; abdomen NC, 10.5 mGy/721 mGy cm; abdomen arterial (A) phase, 13.4 mGy/398 mGy cm; abdomen venous (V) phase, 10.8 mGy/460 mGy cm; abdomen delay (D) phase, 12.6 mGy/487 mGy cm; sinus NC, 30.2 mGy/452 mGy cm; lumbar spine NC, 24.1 mGy/1123 mGy cm; neck NC, 27.5 mGy/670 mGy cm; high-resolution CT of chest, 10.3 mGy/341 mGy cm; kidneys ureters and bladder NC, 19.4 mGy/929 mGy cm; chest to pelvis (CAP) NC, 10.8 mGy/801 mGy cm; CAP A, 10.4 mGy/384 mGy cm; CAP V, 10.5 mGy/534 mGy cm; CAP D, 16.8 mGy/652 mGy cm. Although the proposed NDRLs are comparable with those of other countries, the observed broad dose distributions between the CT machines within Sri Lanka indicate that dose optimisation strategies for the country should be implemented for most of the CT facilities.
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Affiliation(s)
- T Amalaraj
- Department of Nuclear Science, University of Colombo, Colombo, Sri Lanka
| | | | - Aruna Pallewatte
- Department of Radiology, National Hospital of Sri Lanka, Colombo, Sri Lanka
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17
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Kaesler A, Rudawski FL, Zander MO, Hesselmann F, Pinar I, Schmitz-Rode T, Arens J, Steinseifer U, Clauser JC. In-Vitro Visualization of Thrombus Growth in Artificial Lungs Using Real-Time X-Ray Imaging: A Feasibility Study. Cardiovasc Eng Technol 2021; 13:318-330. [PMID: 34532837 PMCID: PMC9114054 DOI: 10.1007/s13239-021-00579-y] [Citation(s) in RCA: 1] [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] [Received: 10/27/2020] [Accepted: 09/03/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Extracorporeal membrane oxygenation has gained increasing attention in the treatment of patients with acute and chronic cardiopulmonary and respiratory failure. However, clotting within the oxygenators or other components of the extracorporeal circuit remains a major complication that necessitates at least a device exchange and bears risks of adverse events for the patients. In order to better predict thrombus growth within oxygenators, we present an approach for in-vitro visualization of thrombus growth using real-time X-ray imaging. METHODS An in-vitro test setup was developed using low-dose anticoagulated ovine blood and allowing for thrombus growth within 4 h. The setup was installed in a custom-made X-ray setup that uses phase-contrast for imaging, thus providing enhanced soft-tissue contrast, which improves the differentiation between blood and potential thrombus growth. During experimentation, blood samples were drawn for the analysis of blood count, activated partial thromboplastin time and activated clotting time. Additionally, pressure and flow data was monitored and a full 360° X-ray scan was performed every 15 min. RESULTS Thrombus formation indicated by a pressure drop and changing blood parameters was monitored in all three test devices. Red and white thrombi (higher/lower attenuation, respectively) were successfully segmented in one set of X-ray images. CONCLUSION We showed the feasibility of a new in-vitro method for real-time thrombus growth visualization by means of phase contrast X-ray imaging. In addition, with more blood parameters that are clinically relevant, this approach might contribute to improved oxygenator exchange protocols in the clinical routine.
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Affiliation(s)
- Andreas Kaesler
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Freya Lilli Rudawski
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Mark Oliver Zander
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Felix Hesselmann
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Isaac Pinar
- Monash Institute of Medical Engineering and Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Thomas Schmitz-Rode
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Jutta Arens
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.,Chair of Engineering Organ Support Technologies, Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, The Netherlands
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.,Monash Institute of Medical Engineering and Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Johanna Charlotte Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University, Aachen, Germany.
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18
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Namugenyi KAF, Oompie FM, Kabambi KF. Maximum intensity projection aids in diagnosing acute appendicitis and mobile caecum: A case report and literature review. SA J Radiol 2021; 25:2153. [PMID: 34394973 PMCID: PMC8335754 DOI: 10.4102/sajr.v25i1.2153] [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] [Received: 03/18/2021] [Accepted: 05/11/2021] [Indexed: 11/12/2022] Open
Abstract
Appendicitis is a common childhood condition requiring surgical intervention and delayed diagnosis can have serious consequences. This report describes the case of a child who presented with an acute abdomen and intestinal obstruction. Multidetector (MD) CT demonstrated a left-sided caecum and an inflamed appendix with a faecolith. Maximum intensity projection (MIP) post-processing was key in identifying the appendicular artery and determine the diagnosis. At surgery, however, a mobile caecum and the appendix were positioned on the right side.
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Affiliation(s)
- Kakia A F Namugenyi
- Department of Surgery, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Ferdinand M Oompie
- Department of Radiology, Nelson Mandela Academic Hospital, Mthatha, South Africa
| | - Kasandji F Kabambi
- Department of Surgery, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
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19
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Orbach MR, Servaes SE, Mayer OH, Cahill PJ, Balasubramanian S. Quantifying lung and diaphragm morphology using radiographs in normative pediatric subjects, and predicting CT-derived lung volume. Pediatr Pulmonol 2021; 56:2177-2185. [PMID: 33860632 DOI: 10.1002/ppul.25429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/03/2021] [Accepted: 04/11/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To quantify the effect of age on two-dimensional (2D) radiographic lung and diaphragm morphology and determine if 2D radiographic lung measurements can be used to estimate computer tomography (CT)-derived lung volume in normative pediatric subjects. MATERIALS AND METHODS Digitally reconstructed radiographs (DRRs) were created using retrospective chest CT scans from 77 pediatric male and female subjects aged birth to 19 years. 2D lung and diaphragm measurements were made on the DRRs using custom MATLAB code, and Spearman correlations and exponential regression equations were used to relate 2D measurements with age. In addition, 3D lung volumes were segmented using CT scans, and power regression equations were fitted to predict each lung's CT-derived volume from 2D lung measurements. The coefficient of determination (R2 ) and standard error of the estimate (SEE) were used to assess the precision of the predictive equations with p < .05 indicating statistical significance. RESULTS All 2D radiographic lung and diaphragm measurements showed statistically significant positive correlations with age (p < .01), including lung major axis (Spearman rho ≥ 0.90). Precise estimations of CT-derived lung volumes can be made using 2D lung measurements (R2 ≥ 0.95), including lung major axis (R2 ≥ 0.97). INTERPRETATIONS The reported pediatric age-specific reference data on 2D lung and diaphragm morphology and growth rates could be clinically used to identify lung and diaphragm pathologies during chest X-ray evaluations. The simple, precise, and clinically adaptable radiographic method for estimating CT-derived lung volumes may be used when pulmonary function tests are not readily available or difficult to perform.
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Affiliation(s)
- Mattan R Orbach
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sabah E Servaes
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Oscar H Mayer
- Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Patrick J Cahill
- Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sriram Balasubramanian
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
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20
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Complex Bone Tumors of the Trunk-The Role of 3D Printing and Navigation in Tumor Orthopedics: A Case Series and Review of the Literature. J Pers Med 2021; 11:jpm11060517. [PMID: 34200075 PMCID: PMC8228871 DOI: 10.3390/jpm11060517] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
The combination of 3D printing and navigation promises improvements in surgical procedures and outcomes for complex bone tumor resection of the trunk, but its features have rarely been described in the literature. Five patients with trunk tumors were surgically treated in our institution using a combination of 3D printing and navigation. The main process includes segmentation, virtual modeling and build preparation, as well as quality assessment. Tumor resection was performed with navigated instruments. Preoperative planning supported clear margin multiplanar resections with intraoperatively adaptable real-time visualization of navigated instruments. The follow-up ranged from 2–15 months with a good functional result. The present results and the review of the current literature reflect the trend and the diverse applications of 3D printing in the medical field. 3D printing at hospital sites is often not standardized, but regulatory aspects may serve as disincentives. However, 3D printing has an increasing impact on precision medicine, and we are convinced that our process represents a valuable contribution in the context of patient-centered individual care.
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21
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Shwaiki O, Rashwan B, Fink MA, Kirksey L, Gadani S, Karuppasamy K, Melzig C, Thompson D, D'Amico G, Rengier F, Partovi S. Lower extremity CT angiography in peripheral arterial disease: from the established approach to evolving technical developments. Int J Cardiovasc Imaging 2021; 37:3101-3114. [PMID: 33997924 DOI: 10.1007/s10554-021-02277-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022]
Abstract
With the advent of multidetector computed tomography (CT), CT angiography (CTA) has gained widespread popularity for noninvasive imaging of the arterial vasculature. Peripheral extremity CTA can nowadays be performed rapidly with high spatial resolution and a decreased amount of both intravenous contrast and radiation exposure. In patients with peripheral artery disease (PAD), this technique can be used to delineate the bilateral lower extremity arterial tree and to determine the amount of atherosclerotic disease while differentiating between acute and chronic changes. This article provides an overview of several imaging techniques for PAD, specifically discusses the use of peripheral extremity CTA in patients with PAD, clinical indications, established technical considerations and novel technical developments, and the effect of postprocessing imaging techniques and structured reporting.
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Affiliation(s)
- Omar Shwaiki
- Department of Interventional Radiology, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Basem Rashwan
- Department of Interventional Radiology, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Matthias A Fink
- Section of Emergency Radiology, Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Levester Kirksey
- Department of Vascular Surgery, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Sameer Gadani
- Department of Interventional Radiology, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | | | - Claudius Melzig
- Section of Emergency Radiology, Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dustin Thompson
- Department of Interventional Radiology, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Giuseppe D'Amico
- Department of Transplant Surgery, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Fabian Rengier
- Section of Emergency Radiology, Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Sasan Partovi
- Department of Interventional Radiology, Cleveland Clinic Main Campus, Cleveland, OH, USA.
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22
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Kvåle Løvmo M, Pressl B, Thalhammer G, Ritsch-Marte M. Controlled orientation and sustained rotation of biological samples in a sono-optical microfluidic device. LAB ON A CHIP 2021; 21:1563-1578. [PMID: 33634305 DOI: 10.1039/d0lc01261k] [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
In cell biology, recently developed technologies for studying suspended cell clusters, such as organoids or cancer spheroids, hold great promise relative to traditional 2D cell cultures. There is, however, growing awareness that sample confinement, such as fixation on a surface or embedding in a gel, has substantial impact on cell clusters. This creates a need for contact-less tools for 3D manipulation and inspection. This work addresses this demand by presenting a reconfigurable, hybrid sono-optical system for contact-free 3D manipulation and imaging, which is suitable for biological samples up to a few hundreds of micrometers in liquid suspension. In our sono-optical device, three independently addressable MHz transducers, an optically transparent top-transducer for levitation and two side-transducers, provide ultrasound excitation from three orthogonal directions. Steerable holographic optical tweezers give us an additional means of manipulation of the acoustically trapped specimen with high spatial resolution. We demonstrate how to control the reorientation or the spinning of complex samples, for instance for 3D visual inspection or for volumetric reconstruction. Whether continuous rotation or transient reorientation takes place depends on the strength of the acoustic radiation torque, arising from pressure gradients, compared to the acoustic viscous torque, arising from the shear forces at the viscous boundary layer around the particle. Based on numerical simulations and experimental insights, we develop a strategy to achieve a desired alignment or continuous rotation around a chosen axis, by tuning the relative strengths of the transducers and thus adjusting the relative contributions of viscous and radiation torques. The approach is widely applicable, as we discuss in several generic examples, with limitations dictated by size and shape asymmetry of the samples.
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Affiliation(s)
- Mia Kvåle Løvmo
- Institut für Biomedizinische Physik, Medizinische Universität Innsbruck, Müllerstraße 44, 6020 Innsbruck, Austria.
| | - Benedikt Pressl
- Institut für Biomedizinische Physik, Medizinische Universität Innsbruck, Müllerstraße 44, 6020 Innsbruck, Austria.
| | - Gregor Thalhammer
- Institut für Biomedizinische Physik, Medizinische Universität Innsbruck, Müllerstraße 44, 6020 Innsbruck, Austria.
| | - Monika Ritsch-Marte
- Institut für Biomedizinische Physik, Medizinische Universität Innsbruck, Müllerstraße 44, 6020 Innsbruck, Austria.
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23
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Bueno MR, Estrela C, Granjeiro JM, Estrela MRDA, Azevedo BC, Diogenes A. Cone-beam computed tomography cinematic rendering: clinical, teaching and research applications. Braz Oral Res 2021; 35:e024. [PMID: 33624709 DOI: 10.1590/1807-3107bor-2021.vol35.0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/22/2020] [Indexed: 02/08/2023] Open
Abstract
Cone-beam computed tomography (CBCT) is an essential imaging method that increases the accuracy of diagnoses, planning and follow-up of endodontic complex cases. Image postprocessing and subsequent visualization relies on software for three-dimensional navigation, and application of indexation tools to provide clinically useful information according to a set of volumetric data. Image postprocessing has a crucial impact on diagnostic quality and various techniques have been employed on computed tomography (CT) and magnetic resonance imaging (MRI) data sets. These include: multiplanar reformations (MPR), maximum intensity projection (MIP) and volume rendering (VR). A recent advance in 3D data visualization is the new cinematic rendering reconstruction method, a technique that generates photorealistic 3D images from conventional CT and MRI data. This review discusses the importance of CBCT cinematic rendering for clinical decision-making, teaching, and research in Endodontics, and a presents series of cases that illustrate the diagnostic value of 3D cinematic rendering in clinical care.
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Affiliation(s)
| | - Carlos Estrela
- Universidade Federal de Goiás - UFGO, School of Dentistry, Stomatologic Science Department, Goiânia, GO, Brazil
| | - José Mauro Granjeiro
- Instituto Nacional de Metrologia, Qualidade e Tecnologia - Inmetro, Duque de Caxias, RJ, Brazil
| | | | - Bruno Correa Azevedo
- University of Louisville, School of Dentistry, Oral Radiology Department, Louisville, KY, USA
| | - Anibal Diogenes
- University of Texas Health at San Antonio, School of Dentistry, Endodontics Department, San Antonio, TX, USA
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24
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Van der Cruyssen F, Croonenborghs TM, Renton T, Hermans R, Politis C, Jacobs R, Casselman J. Magnetic resonance neurography of the head and neck: state of the art, anatomy, pathology and future perspectives. Br J Radiol 2021; 94:20200798. [PMID: 33513024 PMCID: PMC8011265 DOI: 10.1259/bjr.20200798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Magnetic resonance neurography allows for the selective visualization of peripheral nerves and is increasingly being investigated. Whereas in the past, the imaging of the extracranial cranial and occipital nerve branches was inadequate, more and more techniques are now available that do allow nerve imaging. This basic review provides an overview of the literature with current state of the art, anatomical landmarks and future perspectives. Furthermore, we illustrate the possibilities of the three-dimensional CRAnial Nerve Imaging (3D CRANI) MR-sequence by means of a few case studies.
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Affiliation(s)
- Fréderic Van der Cruyssen
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Tomas-Marijn Croonenborghs
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Tara Renton
- Department of Oral Surgery, King's College London Dental Institute, London, UK
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, University Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven and Department of Dentistry, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Casselman
- Department of Radiology, AZ St-Jan Brugge-Oostende, Bruges, Belgium.,Department of Radiology, AZ St-Augustinus, Antwerp, Belgium.,Department of Radiology, UZ Gent, Gent, Belgium
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25
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Regmi PR, Amatya I, Kayastha P, Paudel S, Suwal S, Ghimire RK. Normal Anatomy and Variants of Renal Vasculature with Multidetector Computed Tomography in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2020; 58:911-914. [PMID: 34506406 PMCID: PMC7775024 DOI: 10.31729/jnma.5615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction: Preoperative multisection computed tomography evaluation can provide necessary anatomic information in minimally invasive surgeries. This study was done to estimate the prevalence and pattern of variations of renal vasculature through contrast-enhanced computed tomography in patients referred to the radiology department of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted from 6th April 2016 to 6th April 2017. Ethical approval was taken. The triple-phase contrast-enhanced computed tomography was performed on 188 patients enrolled through convenient sampling. The images were evaluated in unenhanced, arterial, and venous phases for the vascular variants. Data were analyzed based on the anatomical types of variations and descriptive statistics such as frequency and percentage using the Statistical Package for the Social Sciences. Results: Out of the 188 patients, 60 (31.9%) had accessory renal arteries. The most common variant was hilar arteries which comprised 38 cases (20.2%) whereas polar arteries were present in 21 (11.1%) cases and the capsular artery was present in one (0.5%) case. Early bifurcation of the renal artery was noted in 15 (8%) cases with 10 (5.3%) on the right and 5 (2.7%) on the left side. Twelve (6.3%) cases of the double right renal vein were noted whereas retroaortic left renal vein was noted in only 4(2.1%) cases. Conclusions: Based on our study, almost one in three patients had accessory renal arteries and eighty-five out of a thousand patients had variants of renal veins.
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Affiliation(s)
- Pradeep Raj Regmi
- Department of Radiology and Imaging, University Hospital of Ioannina, Ioannina, Greece
| | - Isha Amatya
- Department of Community Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Prakash Kayastha
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Sharma Paudel
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Sundar Suwal
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Ram Kumar Ghimire
- Department of Radiology and Imaging, Nepal Mediciti Hospital,Karyabinayak,Lalitpur, Nepal
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26
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Hansen K, Machin R, James J, Coats T, Rutty GN. A look inside cardiopulmonary resuscitation: A 4D computed tomography model of simulated closed chest compression. A proof of concept. Resuscitation 2020; 153:149-153. [PMID: 32526250 DOI: 10.1016/j.resuscitation.2020.05.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/30/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
AIM To mimic chest compression during cardiopulmonary resuscitation (CPR), this study aimed to produce time-resolved 3D (volumetric) reformats of thoracic and upper abdominal tissue movement during incremental closed chest compression/decompression from 0 to 8 to 0 cm. METHODS Sequential angiography enhanced computed tomography (CT) scans were acquired from a recently deceased, consented adult cadaver with 1 cm incremental closed chest compression/decompression. Three compression/decompression sequences from 0 to 3 cm, 0 to 5 cm, and 0 to 8 cm, respectively, were scanned using a radio-opaque, manually operated, chest compression device. The multiphase volumetric data sets were compiled into 4D models that allowed for multiplanar reformatted and volume rendered image manipulation. RESULTS Time-resolved volumetric (4D) models were produced using freeware to post-process the static CT scans. The 4D models allowed the study of simulated thoracic and upper abdominal content movement during closed chest compression. CONCLUSIONS The method described could assist CPR researchers and educators in the development and demonstration of effective CPR protocols.
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Affiliation(s)
- Kasper Hansen
- Department of Forensic Medicine, Aarhus University, DK-8200 Aarhus N, Denmark; Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark; Zoophysiology, Department of Biology, Aarhus University, C. F. Møllers Allé 3, DK-8000 Aarhus C, Denmark; University of Leicester, East Midlands Forensic Pathology Unit, Robert Kilpatrick Building, Level, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - Ruth Machin
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - Jonathon James
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - Timothy Coats
- University of Leicester, Cardiovascular Sciences, Jarvis Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK
| | - Guy N Rutty
- University of Leicester, East Midlands Forensic Pathology Unit, Robert Kilpatrick Building, Level, Leicester Royal Infirmary, Leicester LE2 7LX, UK.
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27
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Kacmaz IE, Topkaya Y, Basa CD, Zhamilov V, Er A, Reisoglu A, Ekizoglu O. Posterior tibial slope of the knee measured on X-rays in a Turkish population. Surg Radiol Anat 2020; 42:673-679. [PMID: 32052159 DOI: 10.1007/s00276-020-02430-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/31/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Posterior tibial inclination of the knee joint should be considered during anterior cruciate ligament reconstruction and total knee replacement surgery. This inclination is called the posterior tibial slope (PTS) angle. The PTS differs among populations and the aim of this study was to determine the mean PTS in a Turkish population. METHODS PTS was measured retrospectively on lateral knee X-rays (n = 1024). The angle between the line connecting the anterior and posterior points of the lateral tibial plateau and the tibial longitudinal axis was taken as the PTS angle. Intra- and inter-observer agreement regarding the measurements on 20 X-rays were checked. RESULTS The mean PTS angle for the entire cohort was 8.36 ± 3.3° (range: 2.1-18.7°); it was 8.57 ± 3.4° (range: 2.3-17.4°) in men and 8.16 ± 3.2° (range: 2.1-18.7°) in women. Although no significant correlation was detected between PTS and age, PTS was higher in men than in women. CONCLUSION The increasing number of total knee replacement surgeries has increased the need for studies on implant mismatch. In this study, reference PTS values were determined for a Turkish population. It may be beneficial to use patient-specific implants in some cases.
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Affiliation(s)
- Ismail Eralp Kacmaz
- Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35180, Izmir, Turkey.
| | - Yuksel Topkaya
- Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35180, Izmir, Turkey
| | - Can Doruk Basa
- Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35180, Izmir, Turkey
| | - Vadym Zhamilov
- Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35180, Izmir, Turkey
| | - Ali Er
- Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Reisoglu
- Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35180, Izmir, Turkey
| | - Oguzhan Ekizoglu
- Department of Forensic Medicine, Tepecik Training and Research Hospital, Izmir, Turkey
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28
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Delhaas EM, Harhangi BS, Frankema SPG, Huygen FJPM, van der Lugt A. Catheter Access Port (Computed Tomography) Myelography in Intrathecal Drug Delivery Troubleshooting: A Case Series of 70 Procedures. Neuromodulation 2020; 23:949-960. [PMID: 32267597 PMCID: PMC7687167 DOI: 10.1111/ner.13153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/13/2022]
Abstract
Objectives Intrathecal drug delivery is used for the treatment of intractable spasticity, dystonia, and pain. When the symptomatology fails to respond to therapy, the cause could be failure of the medication infusion. The purpose of this study is to assess pump catheter access port (CAP)‐myelography and CAP‐CT‐myelography as advanced imaging methods in treatment failure. Materials and Methods We analyzed observational routinely collected data of 70 CAP procedures with 2D/3D reconstructions and additional imaging of 53 adult patients where the cause of treatment was unclear between November 2013 and November 2018. CAP‐myelography and CAP‐CT myelography were performed with postprocessing 2D/3D reconstructions. When myelography could not be obtained or when the result did not reveal the cause of the treatment failure, additional procedures, such as noncontrast CT, MRI, lumbar puncture CT, and 111Indium‐DTPA SPECT‐CT, were performed. Results CAP fluid aspiration prior to contrast medium injection was not possible (N = 17). In one case, contrast was injected into the pump pocket unintentionally (N = 1). Of 70 procedures, 24% were unaspiratable. The remaining CAP myelography examinations (N = 52) had limited value for the diagnosis. CAP‐CT myelography (N = 50) was normal (N = 31). The abnormal results (N = 19) were dorsal dural leak (N = 5), subdural catheter position (N = 2), limited rostral flow of contrast material (N = 4), limited and abnormal contrast distribution (N = 3), obstruction of rostral flow (N = 2), a leak at the pump‐catheter connection (N = 1), and a sheared catheter localized in the pump pocket (N = 2). Limited contrast distributions were found to be false positive findings (N = 2). Four normal CT‐CAP myelographic procedures were false negatives, as the reference tests revealed a cause of intrathecal drug delivery (ITDD) failure. The CAP‐CT procedures resulted in a sensitivity of 81% (17/21) and a specificity of 93% (27/29). Conclusions CAP‐CT myelography with 2D/3D reconstructions is an essential step in the diagnostic algorithm for cases involving ITDD failure.
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Affiliation(s)
- Elmar M Delhaas
- Center for Pain Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Biswadjiet S Harhangi
- Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sander P G Frankema
- Center for Pain Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank J P M Huygen
- Center for Pain Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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29
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Gupta V, Demirer M, Bigelow M, Little KJ, Candemir S, Prevedello LM, White RD, O'Donnell TP, Wels M, Erdal BS. Performance of a Deep Neural Network Algorithm Based on a Small Medical Image Dataset: Incremental Impact of 3D-to-2D Reformation Combined with Novel Data Augmentation, Photometric Conversion, or Transfer Learning. J Digit Imaging 2020; 33:431-438. [PMID: 31625028 PMCID: PMC7165215 DOI: 10.1007/s10278-019-00267-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Collecting and curating large medical-image datasets for deep neural network (DNN) algorithm development is typically difficult and resource-intensive. While transfer learning (TL) decreases reliance on large data collections, current TL implementations are tailored to two-dimensional (2D) datasets, limiting applicability to volumetric imaging (e.g., computed tomography). Targeting performance enhancement of a DNN algorithm based on a small image dataset, we assessed incremental impact of 3D-to-2D projection methods, one supporting novel data augmentation (DA); photometric grayscale-to-color conversion (GCC); and/or TL on training of an algorithm from a small coronary computed tomography angiography (CCTA) dataset (200 examinations, 50% with atherosclerosis and 50% atherosclerosis-free) producing 245 diseased and 1127 normal coronary arteries/branches. Volumetric CCTA data was converted to a 2D format creating both an Aggregate Projection View (APV) and a Mosaic Projection View (MPV), supporting DA per vessel; both grayscale and color-mapped versions of each view were also obtained. Training was performed both without and with TL, and algorithm performance of all permutations was compared using area under the receiver operating characteristics curve. Without TL, APV performance was 0.74 and 0.87 on grayscale and color images, respectively, compared to 0.90 and 0.87 for MPV. With TL, APV performance was 0.78 and 0.88 on grayscale and color images, respectively, compared with 0.93 and 0.91 for MPV. In conclusion, TL enhances performance of a DNN algorithm from a small volumetric dataset after proposed 3D-to-2D reformatting, but additive gain is achieved with application of either GCC to APV or the proposed novel MPV technique for DA.
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Affiliation(s)
- Vikash Gupta
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Mutlu Demirer
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Matthew Bigelow
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Kevin J Little
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Sema Candemir
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Luciano M Prevedello
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | - Richard D White
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA
| | | | | | - Barbaros S Erdal
- Laboratory for Augmented Intelligence in Imaging-Division of Medical Imaging Informatics, Department of Radiology, Ohio State University College of Medicine, 395 West 12th Avenue, Columbus, OH, 43210, USA.
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30
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Putnam AJ, Kebed K, Mor-Avi V, Rashedi N, Sun D, Patel B, Balkhy H, Lang RM, Patel AR. Prevalence of mitral annular disjunction in patients with mitral valve prolapse and severe regurgitation. Int J Cardiovasc Imaging 2020; 36:1363-1370. [PMID: 32221771 DOI: 10.1007/s10554-020-01818-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/17/2020] [Indexed: 11/26/2022]
Abstract
Mitral annular disjunction (MAD) is routinely diagnosed by cardiac imaging, mostly by echocardiography, and shown to be a risk factor for ventricular arrhythmias. While MAD is associated with mitral valve (MV) prolapse (MVP), it is unknown which patients with MAD are at higher risk and which additional imaging features may help identify them. The value of cardiac computed tomography (CCT) for the diagnosis of MAD is unknown. Accordingly, we aimed to: (1) develop a standardized CCT approach to identify MAD in patients with MVP and severe mitral regurgitation (MR); (2) determine its prevalence and identify features that are associated with MAD in this population. We retrospectively studied 90 patients (age 63 ± 12 years) with MVP and severe MR, who had pre-operative CCT (256-slice scanner) of sufficient quality for analysis. The presence and degree of MAD was assessed by rotating the view plane around the MV center to visualize disjunction along the annulus. Additionally, detailed measurements of MV apparatus and left heart chambers were performed. Univariate logistic regression analysis was performed to determine which parameters were associated with MAD. MAD was identified in 18 patients (20%), and it was typically located adjacent to a prolapsed or flail mitral leaflet scallop. Of these patients, 75% had maximum MAD distance > 4.8 mm and 90% > 3.8 mm. Female gender was most strongly associated with MAD (p = 0.04). Additionally, smaller end-diastolic mitral annulus area (p = 0.045) and longer posterior leaflet (p = 0.03) were associated with greater MAD. No association was seen between MAD and left ventricular size and function, left atrial size, and papillary muscle geometry. CCT can be used to readily detect MAD, by taking advantage of the 3D nature of this modality. A significant portion of MVP patients referred for mitral valve repair have MAD. The presence of MAD is associated with female gender, smaller annulus size and greater posterior leaflet length.
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Affiliation(s)
- Andrew J Putnam
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Kalie Kebed
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Victor Mor-Avi
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Nina Rashedi
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Deyu Sun
- Philips Healthcare, Andover, MA, USA
| | - Brooke Patel
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Husam Balkhy
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Roberto M Lang
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA
| | - Amit R Patel
- Biological Sciences Division, University of Chicago Medicine, Chicago, IL, USA.
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Abu Mughli R, Wu T, Li J, Moghimi S, Alem Z, Nasir MU, Abdellatif W, Nicolaou S. An Update in Imaging of Blunt Vascular Neck Injury. Can Assoc Radiol J 2020; 71:281-292. [PMID: 32174162 DOI: 10.1177/0846537120909468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Traumatic injuries of the cervical carotid and vertebral arteries, collectively referred to as blunt cerebrovascular injury (BCVI), can result in significant patient morbidity and mortality, with one of the most feared outcomes being cerebrovascular ischemia. Systematic imaging-guided screening for BCVI aims for early detection to guide timely management. In particular, accurate detection of the severity and grade of BCVI is paramount in guiding initial management. Furthermore, follow-up imaging is required to decide the duration of antithrombotic therapy. In this article, classification of the grades of BCVI and associated imaging findings will be outlined and diagnostic pitfalls and mimickers that can confound diagnosis will be described. In addition, updates to existing screening guidelines and recent efforts of criteria modification to improve detection of BCVI cases will be reviewed. The advent of postprocessing tools applied to conventional computed tomography (CT) angiograms and new diagnostic tools in dual energy CT for improved detection will also be discussed.
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Affiliation(s)
- Rawan Abu Mughli
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Tong Wu
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Jessica Li
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Saba Moghimi
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Zersenay Alem
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Muhammad Umer Nasir
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Waleed Abdellatif
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - Savvas Nicolaou
- Radiology Department, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
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A simple and software-independent protocol for the measurement of post-cranial bones in anthropological contexts using thin slab maximum intensity projection. FORENSIC IMAGING 2020. [DOI: 10.1016/j.fri.2020.200354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Park BJ, Hunt SJ, Martin C, Nadolski GJ, Wood BJ, Gade TP. Augmented and Mixed Reality: Technologies for Enhancing the Future of IR. J Vasc Interv Radiol 2020; 31:1074-1082. [PMID: 32061520 DOI: 10.1016/j.jvir.2019.09.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/01/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022] Open
Abstract
Augmented and mixed reality are emerging interactive and display technologies. These technologies are able to merge virtual objects, in either 2 or 3 dimensions, with the real world. Image guidance is the cornerstone of interventional radiology. With augmented or mixed reality, medical imaging can be more readily accessible or displayed in actual 3-dimensional space during procedures to enhance guidance, at times when this information is most needed. In this review, the current state of these technologies is addressed followed by a fundamental overview of their inner workings and challenges with 3-dimensional visualization. Finally, current and potential future applications in interventional radiology are highlighted.
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Affiliation(s)
- Brian J Park
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
| | - Stephen J Hunt
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Charles Martin
- Department of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio
| | - Gregory J Nadolski
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
| | - Bradford J Wood
- Interventional Radiology, National Institutes of Health, Bethesda, Maryland
| | - Terence P Gade
- Department of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104
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Suzuki S. [4. Development of the Partial Enhanced Ray-summation Algorithm for the Planning and Guidance of Interventional Radiology]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:855-862. [PMID: 32814742 DOI: 10.6009/jjrt.2020_jsrt_76.8.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Shogo Suzuki
- Department of Radiological Technology, KARIYA TOYOTA General Hospital
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Cheng K, Cassidy F, Aganovic L, Taddonio M, Vahdat N. CT urography: how to optimize the technique. Abdom Radiol (NY) 2019; 44:3786-3799. [PMID: 31317210 DOI: 10.1007/s00261-019-02111-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Computed tomography urography (CTU) has emerged as the modality of choice for imaging the urinary tract within the past few decades. It is a powerful tool that enables detailed anatomic evaluation of the urinary tract in order to identify primary urothelial malignancies, benign urinary tract conditions, and associated abdominopelvic pathologies. As such, there have been extensive efforts to optimize CTU protocol. METHODS This article reviews the published literature on CTU protocol optimization, including contrast bolus timing, dose reduction, reconstruction algorithms, and ancillary practices. CONCLUSION There have been many advances in CTU techniques, which allow for imaging diagnosis of a wide spectrum of diseases while minimizing radiation dose and maximizing urinary tract distension and opacification.
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Affiliation(s)
- Karen Cheng
- Department of Radiology, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA, 92103, USA
| | - Fiona Cassidy
- Department of Radiology, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA, 92103, USA
| | - Lejla Aganovic
- Department of Radiology, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA, 92103, USA
| | - Michael Taddonio
- Department of Radiology, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA, 92103, USA
| | - Noushin Vahdat
- Department of Radiology, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA, 92103, USA.
- Department of Radiology, VA Medical Center, San Diego, 3350 La Jolla Village Drive, Mail Code: 114, San Diego, CA, 92161, USA.
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Avasarala SK, Freitag L, Mehta AC. Metallic Endobronchial Stents. Chest 2019; 155:1246-1259. [DOI: 10.1016/j.chest.2018.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 02/07/2023] Open
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Delhaas EM, van der Lugt A. Low-Dose Computed Tomography With Two- and Three-Dimensional Postprocessing as an Alternative to Plain Radiography for Intrathecal Catheter Visualization: A Phantom Pilot Study. Neuromodulation 2019; 22:818-822. [PMID: 31087726 PMCID: PMC6852017 DOI: 10.1111/ner.12966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 12/02/2022]
Abstract
Objectives In intrathecal drug delivery, visualization of the device has been performed with plain radiography. However, the visibility of the related structures can be problematic. In troubleshooting, after the contrast material injection via the catheter access port, a computed tomography (CT) scan has been used. In troubleshooting, we also used a non‐contrast CT scan with 2D and 3D reconstructions. With the current phantom study, we aimed to obtain high‐resolution imaging of a poor opaque catheter with the use of a low‐dose single‐energy 2D and 3D CT scan with limited radiation exposure as a substitute for plain radiography. Materials and Methods The catheter was placed into a fatty substance and mounted on an anthropomorphic abdomen phantom followed by CT with varying kVp settings and with added tin beam filtering. Dose levels corrected based on the spinal catheter tip on T8 would result in a calculated effective dose in the range of the mSv's calculated for the plain x‐ray examination. Results Ultimately, Sn100 kVp has the best trade‐off between visibility, artifacts, and noise for a fixed dose. Although 3D VRT imaging was challenging at this low dose level, we could make a full evaluation possible with complementary 2D projections. Conclusions We could correctly identify the catheter and related structures, which supports the investigation of this in vivo and side‐by‐side evaluation with plain radiography. If found superior, then this technique may be able to replace plain radiography, while providing better visualization and acceptable radiation exposure. Conflict of Interest Dr. Delhaas reports personal fees from Medtronic Inc., as a previous consultant, outside the submitted work; Prof. van der Lugt reports grants from GE Healthcare, Siemens, Stryker, Medtronic, and Penumbra outside the submitted work.
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Affiliation(s)
- Elmar M Delhaas
- Center for Pain Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Deb S, Lu Z, Kuganesan A, Lau KK. Ray sum image: its efficacy in renal tract calculus detection. Clin Radiol 2019; 74:650.e7-650.e12. [PMID: 31036313 DOI: 10.1016/j.crad.2019.03.022] [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: 09/05/2018] [Accepted: 03/28/2019] [Indexed: 11/19/2022]
Abstract
AIM To determine the efficacy of a ray sum image derived from computed tomography of the kidneys, ureters and bladder (CT KUB) in detecting renal tract calculi and whether this can replace the baseline abdominal radiograph (AXR). MATERIALS AND METHODS This is a retrospective study performed at a tertiary referral centre examining adult patients referred for urolithiasis who had undergone AXR within 24 hours of the diagnostic CT KUB. AXR and ray sum image for calculus visibility were reviewed blindly by two readers. Anteroposterior thickness of the patient, presence of excess gas/faecal material, calculus size, location, and mean attenuation were analysed to determine effect on the AXR and ray sum sensitivity. RESULTS One hundred and fifty-two calculi were examined with ray sum image sensitivity of 44% (95% confidence interval [CI]: 36-52) and AXR 30% (95% CI: 22-38). Calculus size and mean attenuation significantly affected sensitivities of both ray sum and AXR. There was substantial agreement between the two techniques with κ(Kappa)=0.70 (95% CI: 0.58-0.81, p<0.001). CONCLUSION Ray sum image as a post-processed image derived from CT KUB dataset may be a viable alternative to the baseline AXR in patients with CT proven urolithiasis. This would reduce patient radiation dose and streamline workflow in busy radiology and emergency departments.
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Affiliation(s)
- S Deb
- Department of Diagnostic Imaging, Monash Health, Victoria, Australia.
| | - Z Lu
- Monash Pathology, Monash Health, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - A Kuganesan
- Department of Diagnostic Imaging, Monash Health, Victoria, Australia
| | - K K Lau
- Department of Diagnostic Imaging, Monash Health, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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Alsaikhan N, Alshehri W, Cassidy F, Aganovic L, Vahdat N. Renal tumor structured reporting including nephrometry score and beyond: what the urologist and interventional radiologist need to know. Abdom Radiol (NY) 2019; 44:190-200. [PMID: 29980830 DOI: 10.1007/s00261-018-1691-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of this paper is to describe cross-sectional imaging anatomic and morphologic parameters of solid renal tumors that urologists and interventional radiologists need for precise management, review the commonly used terms and descriptors of those parameters, and suggest a comprehensive reporting system for detected masses.
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Affiliation(s)
- Naif Alsaikhan
- Department of Radiology, University of California, San Diego, USA
| | - Wael Alshehri
- Department of Radiology, University of California, San Diego, USA.
| | - Fiona Cassidy
- Department of Radiology, University of California, San Diego, USA
- Division of Body Imaging, Department of Radiology, VA Healthcare System, San Diego, USA
| | - Lejla Aganovic
- Department of Radiology, University of California, San Diego, USA
- Division of Body Imaging, Department of Radiology, VA Healthcare System, San Diego, USA
| | - Noushin Vahdat
- Department of Radiology, University of California, San Diego, USA
- Division of Body Imaging, Department of Radiology, VA Healthcare System, San Diego, USA
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40
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Cook TS, Steingall SJ, Steingall SR, Boonn WW. Establishing and Running a Three-dimensional and Advanced Imaging Laboratory. Radiographics 2018; 38:1799-1809. [DOI: 10.1148/rg.2018180058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Tessa S. Cook
- From the Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, 1 Silverstein Radiology, Philadelphia, PA 19104 (T.S.C., W.W.B.); Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.S.); Siemens Healthineers, Cary, NC (S.R.S.); and Nuance Communications, Burlington, Mass (W.W.B.)
| | - Samantha J. Steingall
- From the Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, 1 Silverstein Radiology, Philadelphia, PA 19104 (T.S.C., W.W.B.); Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.S.); Siemens Healthineers, Cary, NC (S.R.S.); and Nuance Communications, Burlington, Mass (W.W.B.)
| | - Scott R. Steingall
- From the Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, 1 Silverstein Radiology, Philadelphia, PA 19104 (T.S.C., W.W.B.); Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.S.); Siemens Healthineers, Cary, NC (S.R.S.); and Nuance Communications, Burlington, Mass (W.W.B.)
| | - William W. Boonn
- From the Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, 1 Silverstein Radiology, Philadelphia, PA 19104 (T.S.C., W.W.B.); Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.S.); Siemens Healthineers, Cary, NC (S.R.S.); and Nuance Communications, Burlington, Mass (W.W.B.)
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Abstract
Non-invasive cross-sectional imaging techniques play a crucial role in the assessment of the varied manifestations of vascular disease. Vascular imaging encompasses a wide variety of pathology. Designing vascular imaging protocols can be challenging owing to the non-uniform velocity of blood in the aorta, differences in cardiac output between patients, and the effect of different disease states on blood flow. In this review, we provide the rationale behind—and a practical guide to—designing and implementing straightforward vascular computed tomography (CT) and magnetic resonance imaging (MRI) protocols. Teaching Points • There is a wide range of vascular pathologies requiring bespoke imaging protocols. • Variations in cardiac output and non-uniform blood velocity complicate vascular imaging. • Contrast media dose, injection rate and duration affect arterial enhancement in CTA. • Iterative CT reconstruction can improve image quality and reduce radiation dose. • MRA is of particular value when imaging small arteries and venous studies.
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Hubig M, Schenkl S, Muggenthaler H, Güttler F, Heinrich A, Teichgräber U, Mall G. Fully automatic CT-histogram-based fat estimation in dead bodies. Int J Legal Med 2018; 132:563-577. [DOI: 10.1007/s00414-017-1757-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/12/2017] [Indexed: 02/02/2023]
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Ghonge NP, Chowdhury V. Minimum-intensity projection images in high-resolution computed tomography lung: Technology update. Lung India 2018; 35:439-440. [PMID: 30168468 PMCID: PMC6120307 DOI: 10.4103/lungindia.lungindia_489_17] [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] [Indexed: 11/16/2022] Open
Abstract
Chest physicians need to be aware about MinIP images, as these are increasingly being used for the evaluation of a wide range of lung diseases in HRCT study of lungs. MinIP images highlight the areas with reduced CT attenuation in the lung parenchyma. This allows prompt and early diagnosis of cystic lung diseases or airway, vascular or parenchymal disorders, which manifest with hypoattenuation, mosaic attenuation or air trapping. MiniP images are therefore useful for accurate pre-operative planning and disease monitoring.
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Affiliation(s)
- Nitin P Ghonge
- Department of Radiology, Indraprastha Apollo Hospital, New Delhi, India
| | - Veena Chowdhury
- Department of Radiology, Indraprastha Apollo Hospital, New Delhi, India
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Alabsi H, Alreshoodi S, Low E, Sultan N, Murray N, Mallinson P, Munk PL, Ouellette HA. Advancements in Dual-Energy CT Applications for Musculoskeletal Imaging. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0249-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mallinson PI, Coupal TM, McLaughlin PD, Nicolaou S, Munk PL, Ouellette HA. Dual-Energy CT for the Musculoskeletal System. Radiology 2017; 281:690-707. [PMID: 27870622 DOI: 10.1148/radiol.2016151109] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The principal advantages of dual-energy computed tomography (CT) over conventional CT in the musculoskeletal setting relate to the additional information provided regarding tissue composition, artifact reduction, and image optimization. This article discusses the manifestations of these in clinical practice-urate and bone marrow edema detection, metal artifact reduction, and tendon analysis, with potential in arthrography, bone densitometry, and metastases surveillance. The basic principles of dual-energy CT physics and scanner design will also be discussed. © RSNA, 2016.
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Affiliation(s)
- Paul I Mallinson
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Tyler M Coupal
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Patrick D McLaughlin
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Savvas Nicolaou
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Peter L Munk
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
| | - Hugue A Ouellette
- From the Department of Radiology, Vancouver General Hospital/University of British Columbia, Jim Pattison Pavilion, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1M9
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Abstract
With advances in both medical imaging and computer programming, two-dimensional axial images can be processed into other reformatted views (sagittal and coronal) and three-dimensional (3D) virtual models that represent a patients’ own anatomy. This processed digital information can be analyzed in detail by orthopedic surgeons to perform patient-specific orthopedic procedures. The use of 3D printing is rising and has become more prevalent in medical applications over the last decade as surgeons and researchers are increasingly utilizing the technology’s flexibility in manufacturing objects. 3D printing is a type of manufacturing process in which materials such as plastic or metal are deposited in layers to create a 3D object from a digital model. This additive manufacturing method has the advantage of fabricating objects with complex freeform geometry, which is impossible using traditional subtractive manufacturing methods. Specifically in surgical applications, the 3D printing techniques can not only generate models that give a better understanding of the complex anatomy and pathology of the patients and aid in education and surgical training, but can also produce patient-specific surgical guides or even custom implants that are tailor-made to the surgical requirements. As the clinical workflow of the 3D printing technology continues to evolve, orthopedic surgeons should embrace the latest knowledge of the technology and incorporate it into their clinical practice for patient-specific orthopedic applications. This paper is written to help orthopedic surgeons stay up-to-date on the emerging 3D technology, starting from the acquisition of clinical imaging to 3D printing for patient-specific applications in orthopedics. It 1) presents the necessary steps to prepare the medical images that are required for 3D printing, 2) reviews the current applications of 3D printing in patient-specific orthopedic procedures, 3) discusses the potential advantages and limitations of 3D-printed custom orthopedic implants, and 4) suggests the directions for future development. The 3D printing technology has been reported to be beneficial in patient-specific orthopedics, such as in the creation of anatomic models for surgical planning, education and surgical training, patient-specific instruments, and 3D-printed custom implants. Besides being anatomically conformed to a patient’s surgical requirement, 3D-printed implants can be fabricated with scaffold lattices that may facilitate osteointegration and reduce implant stiffness. However, limitations including high cost of the implants, the lead time in manufacturing, and lack of intraoperative flexibility need to be addressed. New biomimetic materials have been investigated for use in 3D printing. To increase utilization of 3D printing technology in orthopedics, an all-in-one computer platform should be developed for easy planning and seamless communications among different care providers. Further studies are needed to investigate the real clinical efficacy of 3D printings in orthopedic applications.
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Affiliation(s)
- Kwok Chuen Wong
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong,
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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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A case of fatal sigmoid volvulus visualized on postmortem radiography: The importance of image optimization with multidetector computed tomography. Leg Med (Tokyo) 2016; 19:32-4. [DOI: 10.1016/j.legalmed.2016.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/23/2022]
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50
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Li CH, Arzamendi D, Carreras F. Role of Imaging Techniques in Percutaneous Treatment of Mitral Regurgitation. ACTA ACUST UNITED AC 2016; 69:421-36. [PMID: 26926991 DOI: 10.1016/j.rec.2015.12.009] [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: 11/01/2015] [Accepted: 12/09/2015] [Indexed: 11/30/2022]
Abstract
Mitral regurgitation is the most prevalent valvular heart disease in the United States and the second most prevalent in Europe. Patients with severe mitral regurgitation have a poor prognosis with medical therapy once they become symptomatic or develop signs of significant cardiac dysfunction. However, as many as half of these patients are inoperable because of advanced age, ventricular dysfunction, or other comorbidities. Studies have shown that surgery increases survival in patients with organic mitral regurgitation due to valve prolapse but has no clinical benefit in those with functional mitral regurgitation. In this scenario, percutaneous repair for mitral regurgitation in native valves provides alternative management of valvular heart disease in patients at high surgical risk. Percutaneous repair for mitral regurgitation is a growing field that relies heavily on imaging techniques to diagnose functional anatomy and guide repair procedures.
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Affiliation(s)
- Chi-Hion Li
- Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Unidad de Hemodinámica, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Dabit Arzamendi
- Unidad de Hemodinámica, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Francesc Carreras
- Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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