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Rybczynska DN, Markiet KE, Pienkowska JM, Szurowska E, Frydrychowski A. To assess the quantitative features of focal liver lesions in gadoxetic acid enhanced MRI and to determine whether these features can accurately differentiate benign form malignant lesions. Eur J Radiol 2024; 171:111288. [PMID: 38194844 DOI: 10.1016/j.ejrad.2024.111288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/07/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
PURPOSE The study aims at assessing the quantitative features which distinguish focal liver lesions (FLLs) in gadoxetic acid (GA) enhanced liver MRI and at determining whether these features can accurately differentiate benign from malignant lesions. MATERIAL AND METHODS 107 patients with 180 unequivocal FLLs in previous examinations were included in a single-center retrospective study. All patients underwent a MRI test of the liver with GA. 99 benign and 74 malignant lesions were included. The group of benign lesions consisted of 60 focal nodular hyperplasias (FNH), 22 hemangiomas (HMG), 6 hepatic adenomas (HA), and 11 other benign lesions (1 angiomyolipioma, 6 lesions histopathology diagnoses as benign without further specification, or ones lacking features of malignancy, and 4 lesions radiologically diagnosed as benign which remained stable in the follow-up studies). The group of malignant lesions consisted of primary 51 hepatocellular carcinomas, 12 metastases, and 11 metastases from melanoma malignum (MM meta). 7 FLLs were excluded (4 cases of uncertain histopathological diagnosis, 2 cholangiocarcinomas, and 1 regenerative nodule). For the included lesions ROI (region of interest) measurements were taken by two observers in the T2-w, ADC (apparent diffusion coefficient) and in the T1-w sequence in the hepatobiliary phase (HBP). The interobserver agreement was evaluated with the Wilcoxon test. The Kruskal - Wallis, Mann - Whitney U and post hoc Dunn's tests were applied to assess if there were any significant differences in the ROI values between individual lesions. The variables with the p values of < 0.05 were considered statistically significant. RESULTS We found significant differences in the ROI values between lesions with p < 0.0001. Strikingly high ROI values in the T2-w sequence were found for HMG. The lowest ADC values were encountered for metastases and MM metastases. The highest ROI values in the HBP were found for FNH, and the lowest for metastases. We also found statistically significant differences in the ROI values between benign and malignant lesions with benign lesions presenting statistically higher ROI values compared to malignant lesions. CONCLUSIONS There were significant differences in the ROI values among different types of FLLs. The predominant quantitative feature in the T2-w sequence was a strikingly high ROI value for HMG. Benign lesions presented statistically higher ROI values in the T2-w, ADC, and HBP sequences compared to malignant lesions. This was true for all lesions except for HA.
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Affiliation(s)
- Dorota N Rybczynska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland; Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland.
| | - Karolina E Markiet
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
| | - Joanna M Pienkowska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
| | - Edyta Szurowska
- 2(nd) Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
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Wołoszyn-Durkiewicz A, Iwaszkiewicz-Grześ D, Świętoń D, Kujawa MJ, Jankowska A, Durawa A, Glasner P, Trzonkowski P, Glasner L, Szurowska E, Myśliwiec M. The Complex Network of Cytokines and Chemokines in Pediatric Patients with Long-Standing Type 1 Diabetes. Int J Mol Sci 2024; 25:1565. [PMID: 38338843 PMCID: PMC10855710 DOI: 10.3390/ijms25031565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Type 1 diabetes (T1D) is a progressive disorder leading to the development of microangiopathies and macroangiopathies. Numerous cytokines and chemokines are involved in the pathogenesis of T1D complications. The study aimed to assess the presence of complications in patients with long-standing T1D and its relationship with serum biomarker concentrations. We examined 52 T1D subjects, with a disease duration ≥4 years and 39 healthy controls. The group of T1D patients was further divided into subgroups based on the duration of the disease (<7 years and ≥7 years) and the metabolic control assessed by the HbAlc level (<8% and ≥8%). We used Luminex Technology to assess a wide range of biomarker concentrations. A 24 h urine test was done to evaluate the rate of albuminuria. Optical coherence tomography (OCT) was conducted to detect early retinopathic changes. Subclinical atherosclerosis was assessed by measuring the carotid intima-media thickness (IMT). T1D patients showed remarkably higher concentrations of EGF, eotaxin/CCL11, MDC/CCL22, sCD40L, TGF-α, and TNF-α. Moreover, we reported statistically significant correlations between cytokines and IMT. Biomarker concentrations depend on numerous factors such as disease duration, metabolic control, and the presence of complications. Although the majority of pediatric T1D patients do not present signs of overt complications, it is indispensable to conduct the screening for angiopathies already in childhood, as its early recognition may attenuate the further progression of complications.
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Affiliation(s)
- Anna Wołoszyn-Durkiewicz
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Dorota Iwaszkiewicz-Grześ
- Department of Medical Immunology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.I.-G.); (P.T.)
| | - Dominik Świętoń
- 2nd Department of Radiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.Ś.); (A.J.); (A.D.); (E.S.)
| | - Mariusz J. Kujawa
- 2nd Department of Radiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.Ś.); (A.J.); (A.D.); (E.S.)
| | - Anna Jankowska
- 2nd Department of Radiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.Ś.); (A.J.); (A.D.); (E.S.)
| | - Agata Durawa
- 2nd Department of Radiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.Ś.); (A.J.); (A.D.); (E.S.)
| | - Paulina Glasner
- Department of Ophthalmology, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (P.G.); (L.G.)
- Department of Anesthesiology and Intensive Care, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.I.-G.); (P.T.)
| | - Leopold Glasner
- Department of Ophthalmology, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (P.G.); (L.G.)
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (D.Ś.); (A.J.); (A.D.); (E.S.)
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
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Kasprzyk P, Undrunas A, Dziadziuszko K, Dziedzic R, Kuziemski K, Szurowska E, Rzyman W, Zdrojewski T. Evaluation of Conventional Cardiovascular Risk Factors and Ordinal Coronary Artery Calcium Scoring in a Lung Cancer Screening Cohort. J Cardiovasc Dev Dis 2024; 11:16. [PMID: 38248886 PMCID: PMC10816916 DOI: 10.3390/jcdd11010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
(1) Background: Lung cancer screening (LCS) consists of low-dose computed tomography (LDCT) results to reduce lung cancer-related mortality. The LCS program has a unique opportunity to impact CVD mortality by providing tools for CVD risk assessment and implementing preventative strategies. In this study, we estimated standardized CVD risk (SCORE) and assessed the prevalence of coronary artery calcium (CAC) in a Polish LCS cohort. (2) Methods: In this observational study, 494 LCS participants aged 50-79 years with a cigarette smoking history of at least 30 pack-years were included. Medical history, anthropometric measurements, blood pressure measurements, serum glucose, and cholesterol levels were assessed in one visit. CVD risk assessment using SCORE tables was performed. The results were compared to the general population (NATPOL 2011 study). On LDCT scans, CAC was classified using an Ordinal Score ranging from 0 to 12. (3) Results: The prevalence of classic cardiovascular risk factors was very high. Among study participants, 83.7% of men and 40.7% of women were classified with a very high CVD SCORE risk (>10%). CAC was reported in 190 (47%) participants. Calcification was categorized as severe (CAC ≥ 4) in 84 (21%) participants. (4) Conclusions: Due to the high cardiovascular risk, intensive preventive strategies are recommended for LCS participants.
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Affiliation(s)
- Piotr Kasprzyk
- First Department of Cardiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Department of Preventive Medicine and Education, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.U.); (T.Z.)
| | - Aleksandra Undrunas
- Department of Preventive Medicine and Education, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.U.); (T.Z.)
| | - Katarzyna Dziadziuszko
- II Department of Radiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (K.D.); (E.S.)
| | - Robert Dziedzic
- Department of Thoracic Surgery, Medical University of Gdańsk, 80-210 Gdańsk, Poland (W.R.)
| | - Krzysztof Kuziemski
- Department of Allergology and Pneumonology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Edyta Szurowska
- II Department of Radiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (K.D.); (E.S.)
| | - Witold Rzyman
- Department of Thoracic Surgery, Medical University of Gdańsk, 80-210 Gdańsk, Poland (W.R.)
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (A.U.); (T.Z.)
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Zyla J, Marczyk M, Prazuch W, Sitkiewicz M, Durawa A, Jelitto M, Dziadziuszko K, Jelonek K, Kurczyk A, Szurowska E, Rzyman W, Widłak P, Polanska J. Combining Low-Dose Computer-Tomography-Based Radiomics and Serum Metabolomics for Diagnosis of Malignant Nodules in Participants of Lung Cancer Screening Studies. Biomolecules 2023; 14:44. [PMID: 38254644 PMCID: PMC10813699 DOI: 10.3390/biom14010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
Radiomics is an emerging approach to support the diagnosis of pulmonary nodules detected via low-dose computed tomography lung cancer screening. Serum metabolome is a promising source of auxiliary biomarkers that could help enhance the precision of lung cancer diagnosis in CT-based screening. Thus, we aimed to verify whether the combination of these two techniques, which provides local/morphological and systemic/molecular features of disease at the same time, increases the performance of lung cancer classification models. The collected cohort consists of 1086 patients with radiomic and 246 patients with serum metabolomic evaluations. Different machine learning techniques, i.e., random forest and logistic regression were applied for each omics. Next, model predictions were combined with various integration methods to create a final model. The best single omics models were characterized by an AUC of 83% in radiomics and 60% in serum metabolomics. The model integration only slightly increased the performance of the combined model (AUC equal to 85%), which was not statistically significant. We concluded that radiomics itself has a good ability to discriminate lung cancer from benign lesions. However, additional research is needed to test whether its combination with other molecular assessments would further improve the diagnosis of screening-detected lung nodules.
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Affiliation(s)
- Joanna Zyla
- Department of Data Science and Engineering, Silesian University of Technology, 44-100 Gliwice, Poland; (J.Z.); (W.P.); (J.P.)
| | - Michal Marczyk
- Department of Data Science and Engineering, Silesian University of Technology, 44-100 Gliwice, Poland; (J.Z.); (W.P.); (J.P.)
- Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA
| | - Wojciech Prazuch
- Department of Data Science and Engineering, Silesian University of Technology, 44-100 Gliwice, Poland; (J.Z.); (W.P.); (J.P.)
| | - Magdalena Sitkiewicz
- Department of Thoracic Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.S.); (A.D.); (W.R.)
| | - Agata Durawa
- Department of Thoracic Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.S.); (A.D.); (W.R.)
| | - Malgorzata Jelitto
- 2nd Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.J.); (K.D.); (E.S.); (P.W.)
| | - Katarzyna Dziadziuszko
- 2nd Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.J.); (K.D.); (E.S.); (P.W.)
| | - Karol Jelonek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-100 Gliwice, Poland;
| | - Agata Kurczyk
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-100 Gliwice, Poland;
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.J.); (K.D.); (E.S.); (P.W.)
| | - Witold Rzyman
- Department of Thoracic Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.S.); (A.D.); (W.R.)
| | - Piotr Widłak
- 2nd Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.J.); (K.D.); (E.S.); (P.W.)
| | - Joanna Polanska
- Department of Data Science and Engineering, Silesian University of Technology, 44-100 Gliwice, Poland; (J.Z.); (W.P.); (J.P.)
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Jankowska A, Chwojnicki K, Szurowska E. The diagnosis of multiple sclerosis: what has changed in diagnostic criteria? Pol J Radiol 2023; 88:e574-e581. [PMID: 38362016 PMCID: PMC10867947 DOI: 10.5114/pjr.2023.133677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/14/2023] [Indexed: 02/17/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic, demyelinating disease affecting the central nervous system. Diagnosis of MS is based on the proof of disease dissemination in time (DIT) and dissemination in space (DIS) and excluding other disorders that can mimic multiple sclerosis in laboratory tests and clinical manifestation. Over the years the diagnostic criteria have evolved; the introduction of magnetic resonance in the McDonald's 2001 criteria was revolutionary. Since then, the criteria have been modified up to the currently used McDonald 2017. The aim of this review is to analyse the 2017 McDonald criteria, assess what has changed from the 2010 criteria, and present the impact of revised criteria on rapid and accurate diagnosis of MS. The main differences are as follows: inclusion of oligoclonal bands in cerebrospinal fluid as a DIT criterion, and symptomatic and cortical lesions in magnetic resonance imaging are counted in the determination of DIS and DIT. We present also the newest recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology and international group of North American Imaging in Multiple Sclerosis and Consortium of Multiple Sclerosis Centers, as well as future directions for further investigations. A proper diagnosis is crucial for the patient's quality of life, to give the possibility of early treatment, and to help avoid misdiagnosis and unnecessary therapy.
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Affiliation(s)
- Anna Jankowska
- 2 Department of Radiology, Medical University of Gdańsk, Poland
| | - Kamil Chwojnicki
- Department of Anaesthesiology and Intensive Care, Medical University of Gdańsk, Poland
| | - Edyta Szurowska
- 2 Department of Radiology, Medical University of Gdańsk, Poland
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Urbanik A, Guz W, Gołębiowski M, Szurowska E, Majos A, Sąsiadek M, Stajgis M, Ostrogórska M. Assessment of the corpus callosum size in male individuals with high intelligence quotient (members of Mensa International). Radiologie (Heidelb) 2023; 63:49-54. [PMID: 37160478 PMCID: PMC10689507 DOI: 10.1007/s00117-023-01146-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES The aim of this study was to assess the size of the corpus callosum in members of Mensa International, which is the world's largest and oldest high-intelligence quotient (IQ) society. METHODS We performed T2-weighted magnetic resonance imaging (Repetition Time, TR = 3200 ms, Time of Echo, TE = 409 ms) to examine the brain of members of Mensa International (Polish national group) in order to assess the size of the corpus callosum. Results from 113 male MENSA members and 96 controls in the age range of 21-40 years were analyzed. RESULTS The comparative analysis showed that the mean length of the corpus callosum and the thickness of the isthmus were significantly greater in the Mensa members compared to the control groups. A statistically significant difference was also identified in the largest linear dimension of the brain from the frontal lobe to the occipital lobe. The mean corpus callosum cross-sectional area and its ratio to the brain area were significantly greater in the Mensa members. CONCLUSIONS The results show that the dimensions (linear measures and midsagittal cross-sectional surface area) of the corpus callosum were significantly greater in the group of Mensa members than in the controls.
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Affiliation(s)
- Andrzej Urbanik
- Department of Radiology, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501, Krakow, Poland
| | - Wiesław Guz
- Department of Electroradiology, University of Rzeszów, Rzeszów, Poland
| | - Marek Gołębiowski
- I-st Department of Clinical Radiology, Medical University of Warsaw, Warszawa, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Agata Majos
- Chair of Radiology and Imaging Diagnostics, Medical University of Łódź, Łódź, Poland
| | - Marek Sąsiadek
- Department of Radiology, Wroclaw Medical University, Wrocław, Poland
| | - Marek Stajgis
- Department of General Radiology and Neuroradiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Monika Ostrogórska
- Department of Radiology, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501, Krakow, Poland.
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Socha M, Prażuch W, Suwalska A, Foszner P, Tobiasz J, Jaroszewicz J, Gruszczynska K, Sliwinska M, Nowak M, Gizycka B, Zapolska G, Popiela T, Przybylski G, Fiedor P, Pawlowska M, Flisiak R, Simon K, Walecki J, Cieszanowski A, Szurowska E, Marczyk M, Polanska J. Pathological changes or technical artefacts? The problem of the heterogenous databases in COVID-19 CXR image analysis. Comput Methods Programs Biomed 2023; 240:107684. [PMID: 37356354 PMCID: PMC10278898 DOI: 10.1016/j.cmpb.2023.107684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/11/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND When the COVID-19 pandemic commenced in 2020, scientists assisted medical specialists with diagnostic algorithm development. One scientific research area related to COVID-19 diagnosis was medical imaging and its potential to support molecular tests. Unfortunately, several systems reported high accuracy in development but did not fare well in clinical application. The reason was poor generalization, a long-standing issue in AI development. Researchers found many causes of this issue and decided to refer to them as confounders, meaning a set of artefacts and methodological errors associated with the method. We aim to contribute to this steed by highlighting an undiscussed confounder related to image resolution. METHODS 20 216 chest X-ray images (CXR) from worldwide centres were analyzed. The CXRs were bijectively projected into the 2D domain by performing Uniform Manifold Approximation and Projection (UMAP) embedding on the radiomic features (rUMAP) or CNN-based neural features (nUMAP) from the pre-last layer of the pre-trained classification neural network. Additional 44 339 thorax CXRs were used for validation. The comprehensive analysis of the multimodality of the density distribution in rUMAP/nUMAP domains and its relation to the original image properties was used to identify the main confounders. RESULTS nUMAP revealed a hidden bias of neural networks towards the image resolution, which the regular up-sampling procedure cannot compensate for. The issue appears regardless of the network architecture and is not observed in a high-resolution dataset. The impact of the resolution heterogeneity can be partially diminished by applying advanced deep-learning-based super-resolution networks. CONCLUSIONS rUMAP and nUMAP are great tools for image homogeneity analysis and bias discovery, as demonstrated by applying them to COVID-19 image data. Nonetheless, nUMAP could be applied to any type of data for which a deep neural network could be constructed. Advanced image super-resolution solutions are needed to reduce the impact of the resolution diversity on the classification network decision.
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Affiliation(s)
- Marek Socha
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Wojciech Prażuch
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Aleksandra Suwalska
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Paweł Foszner
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland; Department of Computer Graphics, Vision and Digital Systems, Silesian University of Technology, Gliwice, Poland
| | - Joanna Tobiasz
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland; Department of Computer Graphics, Vision and Digital Systems, Silesian University of Technology, Gliwice, Poland
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Gruszczynska
- Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland
| | - Magdalena Sliwinska
- Department of Diagnostic Imaging, Voivodship Specialist Hospital, Wroclaw, Poland
| | - Mateusz Nowak
- Department of Radiology, Silesian Hospital, Cieszyn, Poland
| | - Barbara Gizycka
- Department of Imaging Diagnostics, MEGREZ Hospital, Tychy, Poland
| | | | - Tadeusz Popiela
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Grzegorz Przybylski
- Department of Lung Diseases, Cancer and Tuberculosis, Kujawsko-Pomorskie Pulmonology Center, Bydgoszcz, Poland
| | - Piotr Fiedor
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Pawlowska
- Department of Infectious Diseases and Hepatology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Simon
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Walecki
- Department of Radiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior in Warsaw, Poland
| | - Andrzej Cieszanowski
- Department of Radiology I, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Poland
| | - Michal Marczyk
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland; Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Joanna Polanska
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland.
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Chylińska M, Karaszewski B, Komendziński J, Wyszomirski A, Hałas M, Szurowska E, Sabisz A. The association between white matter tract structural connectivity and information processing speed in relapsing-remitting multiple sclerosis. Neurol Sci 2023; 44:3221-3232. [PMID: 37103603 PMCID: PMC10415523 DOI: 10.1007/s10072-023-06817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Information processing speed (IPS) deterioration is common in relapsing-remitting multiple sclerosis (RRMS) patients [1] and might severely affect quality of life and occupational activity. However, understanding of its neural substrate is not fully elucidated. We aimed to investigate the associations between MRI-derived metrics of neuroanatomical structures, including the tracts, and IPS. METHODS Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Color Trails Test (CTT) were used to evaluate IPS in 73 RRMS consecutive patients, all undergoing only interferon beta (IFN-β) therapy during the study. At the same time, 1.5T MRI including diffusion tensor imaging (DTI) data was acquired for each recruited subject. We analyzed volumetric and diffusion MRI measures (FreeSurfer 6.0) including normalized brain volume (NBV), cortical thickness (thk), white matter hypointensities (WMH), volume (vol), diffusion parameters: mean (MD), radial (RD), axial (AD) diffusivities, and fractional anisotropy (FA) of 18 major white-matter (WM) tracts. Multiple linear regression model with interaction resulted in distinguishing the neural substrate of IPS deficit in the IPS impaired subgroup of patients. RESULTS The most significant tract abnormalities contributing to IPS deficit were right inferior longitudinal fasciculus (R ILF) FA, forceps major (FMAJ) FA, forceps minor (FMIN) FA, R uncinate fasciculus (UNC) AD, R corticospinal tract (CST) FA, and left superior longitudinal fasciculus FA (L SLFT). Among volumetric MRI metrics, IPS deficit was associated with L and R thalamic vol. and cortical thickness of insular regions. CONCLUSION In this study, we showed that disconnection of the selected WM tracts, in addition to cortical and deep gray matter (GM) atrophy, might underlie IPS deficit in RRMS patients but more extensive studies are needed for precise associations.
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Affiliation(s)
- Magdalena Chylińska
- Department of Adult Neurology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
| | - Bartosz Karaszewski
- Department of Adult Neurology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
| | - Jakub Komendziński
- Department of Adult Neurology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Adam Wyszomirski
- Department of Adult Neurology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Marek Hałas
- Department of Adult Neurology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Sabisz
- Second Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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9
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Jankowska A, Chwojnicki K, Grzywińska M, Trzonkowski P, Szurowska E. Choroid Plexus Volume Change-A Candidate for a New Radiological Marker of MS Progression. Diagnostics (Basel) 2023; 13:2668. [PMID: 37627928 PMCID: PMC10453931 DOI: 10.3390/diagnostics13162668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: Multiple sclerosis (MS) is an auto-immune, chronic, neuroinflammatory, demyelinating disease that affects mainly young patients. This progressive inflammatory process causes the chronic loss of brain tissue and results in a deterioration in quality of life. To monitor neuroinflammatory process activity and predict the further development of disease, it is necessary to find a suitable biomarker that could easily be used. In this research, we verify the usability of choroid plexus (CP) volume, a new MS biomarker, in the monitoring of the progression of multiple sclerosis disease. (2) Methods: A single-center, prospective study with three groups of patients was conducted based on the following groups: MS patients who received experimental cellular therapy (Treg), treatment-naïve MS patients and healthy controls. (3) Results: This study concludes that there is a correlation between the CPV/TIV (choroid plexus/total intracranial volume) ratio and the progress of multiple sclerosis disease-patients with MS (MS + Treg) had larger volumes of choroid plexuses. CPV/TIV ratios in MS groups were constantly and significantly growing. In the Treg group, patients with relapses had larger plexuses in comparison to the group with no relapses of MS. A similar correlation was observed for the GD+ group (patients with postcontrast enhancing plaques) compared against the non-GD group (patients without postcontrast enhancing plaques). (4) Conclusion: Choroid plexus volume, due to its immunological function, correlates with the inflammatory process in the central nervous system. We consider it to become a valuable radiological biomarker of MS activity.
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Affiliation(s)
- Anna Jankowska
- 2nd Department of Radiology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Kamil Chwojnicki
- Department of Anesthesiology and Intensive Care, Medical University of Gdańsk, Debinki 7, 80-210 Gdańsk, Poland;
| | - Małgorzata Grzywińska
- Neuroinformatics and Artificial Intelligence Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdańsk, Debinki 7, 80-210 Gdańsk, Poland;
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdańsk, Debinki 7, 80-210 Gdańsk, Poland;
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
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10
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Żurowska A, Pęksa R, Bieńkowski M, Skrobisz K, Sowa M, Matuszewski M, Biernat W, Szurowska E. Prostate Cancer and Its Mimics-A Pictorial Review. Cancers (Basel) 2023; 15:3682. [PMID: 37509343 PMCID: PMC10378330 DOI: 10.3390/cancers15143682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/24/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Multiparametric prostate MRI (mpMRI) is gaining wider recommendations for diagnosing and following up on prostate cancer. However, despite the high accuracy of mpMRI, false positive and false negative results are reported. Some of these may be related to normal anatomic structures, benign lesions that may mimic cancer, or poor-quality images that hamper interpretation. The aim of this review is to discuss common potential pitfalls in the interpretation of mpMRI. METHODS mpMRI of the prostates was performed on 3T MRI scanners (Philips Achieva or Siemens Magnetom Vida) according to European Society of Urogenital Radiology (ESUR) guidelines and technical requirements. RESULTS This pictorial review discusses normal anatomical structures such as the anterior fibromuscular stroma, periprostatic venous plexus, central zone, and benign conditions such as benign prostate hyperplasia (BPH), post-biopsy hemorrhage, prostatitis, and abscess that may imitate prostate cancer, as well as the appearance of prostate cancer occurring in these locations. Furthermore, suggestions on how to avoid these pitfalls are provided, and the impact of image quality is also discussed. CONCLUSIONS In an era of accelerating prostate mpMRI and high demand for high-quality interpretation of the scans, radiologists should be aware of these potential pitfalls to improve their diagnostic accuracy.
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Affiliation(s)
- Anna Żurowska
- Second Department of Radiology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Michał Bieńkowski
- Department of Pathomorphology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Katarzyna Skrobisz
- Department of Radiology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Marek Sowa
- Department of Urology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Marcin Matuszewski
- Department of Urology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
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11
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Fijalkowska J, Glinska A, Fijalkowski M, Sienkiewicz K, Kulawiak-Galaska D, Szurowska E, Pienkowska J, Dorniak K. Cardiac Magnetic Resonance Relaxometry Parameters, Late Gadolinium Enhancement, and Feature-Tracking Myocardial Longitudinal Strain in Patients Recovered from COVID-19. J Cardiovasc Dev Dis 2023; 10:278. [PMID: 37504534 PMCID: PMC10380498 DOI: 10.3390/jcdd10070278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
COVID-19 infection is associated with myocarditis, and cardiovascular magnetic resonance (CMR) is the reference non-invasive imaging modality for myocardial tissue characterization. Quantitative CMR techniques, such as feature tracking (FT) and left ventricular global longitudinal strain (GLS) analysis, have been introduced as promising diagnostic tools to improve the diagnostic accuracy of suspected myocarditis. The aim of this study was to analyze the left ventricular global longitudinal strain (GLS) and the influence of T1 and T2 relaxation times, ECV, and LGE appearance on GLS parameters in a multiparametric imaging protocol in patients who recovered from COVID-19. The 86 consecutive patients enrolled in the study had all recovered from mild or moderate COVID-19 infections; none required hospitalization. Their persistent symptoms and suspected myocarditis led to cardiac magnetic resonance imaging within 3 months of the diagnosis of the SARS-CoV-2 infection. Results: Patients with GLS less negative than -15% had significantly lower LVEF (53.6% ± 8.9 vs. 61.6% ± 4.8; <0.001) and were significantly more likely to have prolonged T1 (28.6% vs. 7.5%; p = 0.019). Left ventricular GLS correlated significantly with T1 (r = 0.303; p = 0.006) and LVEF (r = -0.732; p < 0.001). Left ventricular GLS less negative than -15% was 7.5 times more likely in patients with prolonged T1 (HR 7.62; 95% CI 1.25-46.64). The reduced basal inferolateral longitudinal strain had a significant impact on the global left ventricular longitudinal strain. ROC results suggested that a GLS of 14.5% predicted prolonged T1 relaxation time with the best sensitivity and specificity. Conclusions: CMR abnormalities, including a myocarditis pattern, are common in patients who have recovered from COVID-19. The CMR feature-tracking left ventricular GLS is related to T1 relaxation time and may serve as a novel parameter to detect global and regional myocardial injury and dysfunction in patients with suspected myocardial involvement after recovery from COVID-19.
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Affiliation(s)
- Jadwiga Fijalkowska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Anna Glinska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Marcin Fijalkowski
- First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | | | | | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Joanna Pienkowska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, 80-211 Gdansk, Poland
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12
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Łyźniak P, Świętoń D, Serafin Z, Szurowska E. Lung ultrasound in a nutshell. Lines, signs, some applications, and misconceptions from a radiologist's point of view. Pol J Radiol 2023; 88:e294-e310. [PMID: 37404548 PMCID: PMC10317011 DOI: 10.5114/pjr.2023.128866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/29/2023] [Indexed: 07/06/2023] Open
Abstract
In recent years, lung ultrasound (LUS) has developed rapidly, and it is growing in popularity in various scenarios. It has become especially popular among clinicians. There are constant attempts to introduce it in new fields, with quite a strong resistance in the radiological community. In addition, knowledge regarding lung and LUS has been augmented by the recent COVID-19 pandemic. Unfortunately, this has led to many misconceptions. The aim of this review is to discuss lines, signs, and phenomena that can be seen in LUS in order to create a single, easily available compendium for radiologists and promote consistency in LUS nomenclature. Some simplified suggestions are presented.
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Affiliation(s)
- Piotr Łyźniak
- 2 Department of Radiology, University Clinical Centre in Gdańsk, Gdańsk, Poland
| | - Dominik Świętoń
- 2 Department of Radiology, University Clinical Centre in Gdańsk, Gdańsk, Poland
| | - Zbigniew Serafin
- Department and Chair of Radiology and Imaging Diagnostics, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Edyta Szurowska
- 2 Department of Radiology, University Clinical Centre in Gdańsk, Gdańsk, Poland
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13
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Kujawa MJ, Marcinkowska AB, Grzywińska M, Waśkow M, Romanowski A, Szurowska E, Winklewski PJ, Szarmach A. Physical activity and the brain myelin content in humans. Front Cell Neurosci 2023; 17:1198657. [PMID: 37342769 PMCID: PMC10277468 DOI: 10.3389/fncel.2023.1198657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023] Open
Abstract
New imaging sequences and biophysical models allow adopting magnetic resonance imaging (MRI) for in vivo myelin mapping in humans. Understanding myelination and remyelination processes in the brain is fundamental from the perspective of proper design of physical exercise and rehabilitation schemes that aim to slow down demyelination in the aging population and to induce remyelination in patients with neurodegenerative diseases. Therefore, in this review we strive to provide a state-of-the art summary of the existing MRI studies in humans focused on the effects of physical activity on myelination/remyelination. We present and discuss four cross-sectional and four longitudinal studies and one case report. Physical activity and an active lifestyle have a beneficial effect on the myelin content in humans. Myelin expansion can be induced in humans throughout the entire lifespan by intensive aerobic exercise. Additional research is needed to determine (1) what exercise intensity (and cognitive novelty, which is embedded in the exercise scheme) is the most beneficial for patients with neurodegenerative diseases, (2) the relationship between cardiorespiratory fitness and myelination, and (3) how exercise-induced myelination affect cognitive abilities.
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Affiliation(s)
- Mariusz J. Kujawa
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna B. Marcinkowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
- Applied Cognitive Neuroscience Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Grzywińska
- Neuroinformatics and Artificial Intelligence Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdańsk, Gdańsk, Poland
| | - Monika Waśkow
- Institute of Health Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | | | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Paweł J. Winklewski
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
- Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdańsk, Gdańsk, Poland
| | - Arkadiusz Szarmach
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
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14
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Suwalska A, Tobiasz J, Prazuch W, Socha M, Foszner P, Piotrowski D, Gruszczynska K, Sliwinska M, Walecki J, Popiela T, Przybylski G, Nowak M, Fiedor P, Pawlowska M, Flisiak R, Simon K, Zapolska G, Gizycka B, Szurowska E, Marczyk M, Cieszanowski A, Polanska J. POLCOVID: a multicenter multiclass chest X-ray database (Poland, 2020-2021). Sci Data 2023; 10:348. [PMID: 37268643 DOI: 10.1038/s41597-023-02229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/11/2023] [Indexed: 06/04/2023] Open
Abstract
The outbreak of the SARS-CoV-2 pandemic has put healthcare systems worldwide to their limits, resulting in increased waiting time for diagnosis and required medical assistance. With chest radiographs (CXR) being one of the most common COVID-19 diagnosis methods, many artificial intelligence tools for image-based COVID-19 detection have been developed, often trained on a small number of images from COVID-19-positive patients. Thus, the need for high-quality and well-annotated CXR image databases increased. This paper introduces POLCOVID dataset, containing chest X-ray (CXR) images of patients with COVID-19 or other-type pneumonia, and healthy individuals gathered from 15 Polish hospitals. The original radiographs are accompanied by the preprocessed images limited to the lung area and the corresponding lung masks obtained with the segmentation model. Moreover, the manually created lung masks are provided for a part of POLCOVID dataset and the other four publicly available CXR image collections. POLCOVID dataset can help in pneumonia or COVID-19 diagnosis, while the set of matched images and lung masks may serve for the development of lung segmentation solutions.
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Affiliation(s)
- Aleksandra Suwalska
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Joanna Tobiasz
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
- Department of Computer Graphics, Vision and Digital Systems, Silesian University of Technology, Gliwice, Poland
| | - Wojciech Prazuch
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Marek Socha
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Pawel Foszner
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
- Department of Computer Graphics, Vision and Digital Systems, Silesian University of Technology, Gliwice, Poland
| | - Damian Piotrowski
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Gruszczynska
- Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland
| | - Magdalena Sliwinska
- Department of Diagnostic Imaging, Voivodship Specialist Hospital, Wroclaw, Poland
| | - Jerzy Walecki
- Department of Diagnostic Radiology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - Tadeusz Popiela
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Grzegorz Przybylski
- Department of Lung Diseases, Cancer and Tuberculosis, Kujawsko-Pomorskie Pulmonology Center, Bydgoszcz, Poland
| | - Mateusz Nowak
- Department of Radiology, Silesian Hospital, Cieszyn, Poland
| | - Piotr Fiedor
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Pawlowska
- Department of Infectious Diseases and Hepatology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Simon
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Barbara Gizycka
- Department of Imaging Diagnostics, MEGREZ Hospital, Tychy, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Michal Marczyk
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland.
- Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA.
| | - Andrzej Cieszanowski
- Department of Radiology I, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
| | - Joanna Polanska
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
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15
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Bobowicz M, Rygusik M, Buler J, Buler R, Ferlin M, Kwasigroch A, Szurowska E, Grochowski M. Attention-Based Deep Learning System for Classification of Breast Lesions-Multimodal, Weakly Supervised Approach. Cancers (Basel) 2023; 15:2704. [PMID: 37345041 DOI: 10.3390/cancers15102704] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 06/23/2023] Open
Abstract
Breast cancer is the most frequent female cancer, with a considerable disease burden and high mortality. Early diagnosis with screening mammography might be facilitated by automated systems supported by deep learning artificial intelligence. We propose a model based on a weakly supervised Clustering-constrained Attention Multiple Instance Learning (CLAM) classifier able to train under data scarcity effectively. We used a private dataset with 1174 non-cancer and 794 cancer images labelled at the image level with pathological ground truth confirmation. We used feature extractors (ResNet-18, ResNet-34, ResNet-50 and EfficientNet-B0) pre-trained on ImageNet. The best results were achieved with multimodal-view classification using both CC and MLO images simultaneously, resized by half, with a patch size of 224 px and an overlap of 0.25. It resulted in AUC-ROC = 0.896 ± 0.017, F1-score 81.8 ± 3.2, accuracy 81.6 ± 3.2, precision 82.4 ± 3.3, and recall 81.6 ± 3.2. Evaluation with the Chinese Mammography Database, with 5-fold cross-validation, patient-wise breakdowns, and transfer learning, resulted in AUC-ROC 0.848 ± 0.015, F1-score 78.6 ± 2.0, accuracy 78.4 ± 1.9, precision 78.8 ± 2.0, and recall 78.4 ± 1.9. The CLAM algorithm's attentional maps indicate the features most relevant to the algorithm in the images. Our approach was more effective than in many other studies, allowing for some explainability and identifying erroneous predictions based on the wrong premises.
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Affiliation(s)
- Maciej Bobowicz
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland
| | - Marlena Rygusik
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland
| | - Jakub Buler
- Department of Intelligent Control Systems and Decision Support, Faculty of Electrical and Control Engineering, Gdansk University of Technology, 80-233 Gdansk, Poland
| | - Rafał Buler
- Department of Intelligent Control Systems and Decision Support, Faculty of Electrical and Control Engineering, Gdansk University of Technology, 80-233 Gdansk, Poland
| | - Maria Ferlin
- Department of Intelligent Control Systems and Decision Support, Faculty of Electrical and Control Engineering, Gdansk University of Technology, 80-233 Gdansk, Poland
| | - Arkadiusz Kwasigroch
- Department of Intelligent Control Systems and Decision Support, Faculty of Electrical and Control Engineering, Gdansk University of Technology, 80-233 Gdansk, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland
| | - Michał Grochowski
- Department of Intelligent Control Systems and Decision Support, Faculty of Electrical and Control Engineering, Gdansk University of Technology, 80-233 Gdansk, Poland
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16
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Pilarska E, Kopyta I, Szurowska E, Radoń-Proskura J, Irga-Jaworska N, Kozera G, Sabiniewicz R, Emich-Widera E, Wojczal J. Polish recommendations for diagnosis and therapy of paediatric stroke. Neurol Neurochir Pol 2023:VM/OJS/J/92767. [PMID: 37144904 DOI: 10.5603/pjnns.a2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/05/2023] [Accepted: 01/24/2023] [Indexed: 05/06/2023]
Abstract
Stroke remains one of the greatest health challenges worldwide, due to a high mortality rate and, despite great progress in its treatment, the significant disability that it causes. Studies conducted around the world show that the diagnosis of stroke in children is often significantly delayed. Paediatric ischaemic arterial stroke (PAIS) is not only a problem that varies greatly in frequency compared to the adult population, it is also completely different in terms of its risk factors, clinical course and outcome. The main reason for the lack of a rapid diagnosis of PAIS is a lack of access to neuroimaging under general anaesthesia. The insufficient knowledge regarding PAIS in society as a whole is also of great importance. Parents and carers of children should always bear in mind that paediatric age is not a factor that excludes a diagnosis of stroke. The aim of this article was to develop recommendations for the management of children with acute neurological symptoms suspected of ischaemic stroke and further treatment after confirmation of the ischaemic aetiology of the problem. These recommendations are based on current global recommendations for the management of children with stroke, but our goal was also to match them as closely as possible to the needs and technical diagnostic and therapeutic possibilities encountered in Poland. Due to the multifactorial problem of stroke in children, not only paediatric neurologists but also a neurologist, a paediatric cardiologist, a paediatric haematologist and a radiologist took part in the preparation of these recommendations.
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Affiliation(s)
- Ewa Pilarska
- Department of Developmental Neurology, Department of Neurology, Medical University of Gdansk, Gdansk, Poland.
| | - Ilona Kopyta
- Department of Paediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Julia Radoń-Proskura
- Department of Paediatric Hematology and Oncology , Medical University of Gdansk, Gdansk, Poland
| | - Ninela Irga-Jaworska
- Department of Paediatric Hematology and Oncology , Medical University of Gdansk, Gdansk, Poland
| | - Grzegorz Kozera
- Medical Simulation Centre, Faculty of Medicine, Medical University of Gdansk, Poland and Department of Neurology, Copernicus Hospital, Gdansk, Poland
| | - Robert Sabiniewicz
- Department of Paediatric Cardiology and Congenital Heart Disease, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Emich-Widera
- Department of Paediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Wojczal
- Department of Neurology, Medical University of Lublin, Lublin, Poland
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Haberka M, Rajewska-Tabor J, Wojtowicz D, Jankowska A, Miszalski-Jamka K, Janus M, Dorniak K, Kulawiak-Gałąska D, Stasiow B, Rozmiarek S, Szurowska E, Elikowski W, Ławrynowicz M, Śpiewak M, Koziński M, Pyda M. A distinct septal pattern of late gadolinium enhancement specific for COVID-induced myocarditis: A multicenter cardiovascular magnetic resonance study. Kardiol Pol 2023:VM/OJS/J/93708. [PMID: 36871296 DOI: 10.33963/kp.a2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/15/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Coronavirus disease-19 (COVID-19) is a great medical challenge provoking acute respiratory distress, pulmonary manifestations, and cardiovascular (CV) consequences. AIMS This study compares cardiac injury in COVID-19 myocarditis patients with non-COVID myocarditis patients. METHODS Patients who recovered from COVID-19 were scheduled for cardiovascular magnetic resonance (CMR) owing to clinical myocarditis suspicion. The retrospective non-COVID-19 myocarditis (2018-2019) group was enrolled (n=221 patients). All patients underwent a contrast-enhanced CMR, conventional myocarditis protocol, and late gadolinium enhancement (LGE). The COVID study group included 552 patients with a mean (standard deviation [SD]) age 45.9 (12.6) years old. RESULTS CMR assessment confirmed a myocarditis-like LGE in 46% of the cases (68.5% of the segments with LGE <25% transmural extent), left ventricular (LV) dilatation in 10%, and systolic dysfunction in 16%. The COVID-myocarditis group showed a smaller median (interquartile range [IQR]) LV LGE (4.4% [2.9%-8.1%] vs. 5.9% [4.4%-11.8%]; P <0.001), lower LVEDV (144.6 [125.5-178] ml vs. 162.8 [136.6-194] ml; P <0.001), limited functional consequence (LVEF, 59% [54.1%-65%] vs. 58% [52%-63%]; P = 0.01), and a higher rate of pericarditis (13.6% vs. 6%; P = 0.03) compared to non-COVID myocarditis. The COVID-induced injury was more frequent in septal segments (2, 3, 14), and non-COVID myocarditis showed higher affinity to lateral wall segments (P <0.01). Neither obesity nor age was associated with LV injury or remodeling in subjects with COVID-myocarditis. CONCLUSIONS COVID-19-induced myocarditis is associated with minor LV injury with a significantly more frequent septal pattern and a higher pericarditis rate than non-COVID-19 myocarditis.
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Affiliation(s)
- Maciej Haberka
- Department of Cardiology, SHS, Medical University of Silesia, Katowice, Poland. .,Department of Cardiovascular Imaging, CMR unit, Upper Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland.
| | - Justyna Rajewska-Tabor
- 1st Department of Cardiology, CMR unit, Poznan University of Medical Sciences, Poznań, Poland
| | - Dagmara Wojtowicz
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Anna Jankowska
- Department of Cardiology, Cardinal Wyszynski Specialist Hospital, Lublin, Poland
| | | | - Magdalena Janus
- 1st Department of Cardiology, CMR unit, Poznan University of Medical Sciences, Poznań, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Bartłomiej Stasiow
- Department of Cardiovascular Imaging, CMR unit, Upper Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland
| | - Szymon Rozmiarek
- 1st Department of Cardiology, CMR unit, Poznan University of Medical Sciences, Poznań, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Waldemar Elikowski
- Infectious diseases hospital for COVID-19, Józef Strus Municipal Hospital, Poznań, Poland
| | - Marzena Ławrynowicz
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Mateusz Śpiewak
- Magnetic Resonance Unit, Department of Radiology, National Institute of Cardiology, Warszawa, Poland
| | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Małgorzata Pyda
- 1st Department of Cardiology, CMR unit, Poznan University of Medical Sciences, Poznań, Poland
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Sawicka AK, Jaworska J, Brzeska B, Sabisz A, Samborowska E, Radkiewicz M, Szurowska E, Winklewski PJ, Szarmach A, Olek RA. Erratum to: L-Carnitine Combined with Leucine Supplementation Does Not Improve the Effectiveness of Progressive Resistance Training in Healthy Aged Women. J Nutr Health Aging 2023. [DOI: 10.1007/s12603-022-1878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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19
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Abstract
A lot has happened in the field of lung cancer screening in recent months. The ongoing discussion and documentation published by the scientific community and policymakers are of great importance to the entire European community and perhaps beyond. Lung cancer is the main worldwide killer. Low-dose computed tomography-based screening, together with smoking cessation, is the only tool to fight lung cancer, as it has already been proven in the United States of America but also European randomized controlled trials. Screening requires a lot of well-organized specialized work, but it can be supported by artificial intelligence (AI). Here we discuss whether and how to use AI for patients, radiologists, pulmonologists, thoracic surgeons, and all hospital staff supporting screening process benefits.
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20
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Hu L, Fu C, Song X, Grimm R, von Busch H, Benkert T, Kamen A, Lou B, Huisman H, Tong A, Penzkofer T, Choi MH, Shabunin I, Winkel D, Xing P, Szolar D, Coakley F, Shea S, Szurowska E, Guo JY, Li L, Li YH, Zhao JG. Automated deep-learning system in the assessment of MRI-visible prostate cancer: comparison of advanced zoomed diffusion-weighted imaging and conventional technique. Cancer Imaging 2023; 23:6. [PMID: 36647150 PMCID: PMC9843860 DOI: 10.1186/s40644-023-00527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Deep-learning-based computer-aided diagnosis (DL-CAD) systems using MRI for prostate cancer (PCa) detection have demonstrated good performance. Nevertheless, DL-CAD systems are vulnerable to high heterogeneities in DWI, which can interfere with DL-CAD assessments and impair performance. This study aims to compare PCa detection of DL-CAD between zoomed-field-of-view echo-planar DWI (z-DWI) and full-field-of-view DWI (f-DWI) and find the risk factors affecting DL-CAD diagnostic efficiency. METHODS This retrospective study enrolled 354 consecutive participants who underwent MRI including T2WI, f-DWI, and z-DWI because of clinically suspected PCa. A DL-CAD was used to compare the performance of f-DWI and z-DWI both on a patient level and lesion level. We used the area under the curve (AUC) of receiver operating characteristics analysis and alternative free-response receiver operating characteristics analysis to compare the performances of DL-CAD using f- DWI and z-DWI. The risk factors affecting the DL-CAD were analyzed using logistic regression analyses. P values less than 0.05 were considered statistically significant. RESULTS DL-CAD with z-DWI had a significantly better overall accuracy than that with f-DWI both on patient level and lesion level (AUCpatient: 0.89 vs. 0.86; AUClesion: 0.86 vs. 0.76; P < .001). The contrast-to-noise ratio (CNR) of lesions in DWI was an independent risk factor of false positives (odds ratio [OR] = 1.12; P < .001). Rectal susceptibility artifacts, lesion diameter, and apparent diffusion coefficients (ADC) were independent risk factors of both false positives (ORrectal susceptibility artifact = 5.46; ORdiameter, = 1.12; ORADC = 0.998; all P < .001) and false negatives (ORrectal susceptibility artifact = 3.31; ORdiameter = 0.82; ORADC = 1.007; all P ≤ .03) of DL-CAD. CONCLUSIONS Z-DWI has potential to improve the detection performance of a prostate MRI based DL-CAD. TRIAL REGISTRATION ChiCTR, NO. ChiCTR2100041834 . Registered 7 January 2021.
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Affiliation(s)
- Lei Hu
- grid.16821.3c0000 0004 0368 8293Department of Diagnostic and Interventional Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, 200233 China
| | - Caixia Fu
- MR Application Development, Siemens Shenzhen magnetic Resonance Ltd., Shenzhen, China
| | - Xinyang Song
- grid.443573.20000 0004 1799 2448Department of Radiology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, 441000 China
| | - Robert Grimm
- grid.5406.7000000012178835XMR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Heinrich von Busch
- grid.5406.7000000012178835XInnovation Owner Artificial Intelligence for Oncology, Siemens Healthcare GmbH, Erlangen, Germany
| | - Thomas Benkert
- grid.5406.7000000012178835XMR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Ali Kamen
- grid.415886.60000 0004 0546 1113Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ USA
| | - Bin Lou
- grid.415886.60000 0004 0546 1113Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ USA
| | - Henkjan Huisman
- grid.10417.330000 0004 0444 9382Radboud University Medical Center, Nijmegen, Netherlands
| | - Angela Tong
- grid.137628.90000 0004 1936 8753New York University, New York City, NY USA
| | - Tobias Penzkofer
- grid.6363.00000 0001 2218 4662Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Moon Hyung Choi
- grid.411947.e0000 0004 0470 4224Eunpyeong St. Mary’s Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | | | - David Winkel
- grid.410567.1Universitätsspital Basel, Basel, Switzerland
| | - Pengyi Xing
- grid.411525.60000 0004 0369 1599Changhai Hospital, Shanghai, China
| | | | - Fergus Coakley
- grid.5288.70000 0000 9758 5690Oregon Health and Science University, Portland, OR USA
| | - Steven Shea
- grid.411451.40000 0001 2215 0876Loyola University Medical Center, Maywood, IL USA
| | - Edyta Szurowska
- grid.11451.300000 0001 0531 3426Medical University of Gdansk, Gdansk, Poland
| | - Jing-yi Guo
- grid.16821.3c0000 0004 0368 8293Clinical Research Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233 China
| | - Liang Li
- grid.412632.00000 0004 1758 2270Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060 China
| | - Yue-hua Li
- grid.16821.3c0000 0004 0368 8293Department of Diagnostic and Interventional Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, 200233 China
| | - Jun-gong Zhao
- grid.16821.3c0000 0004 0368 8293Department of Diagnostic and Interventional Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, 200233 China
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Klein-Awerjanow K, Rzyman W, Dziedzic R, Fijalkowska J, Spychalski P, Szurowska E, Fijalkowski M. Assessment of Calcium Score Cutoff Point for Clinically Significant Aortic Stenosis on Lung Cancer Screening Program Low-Dose Computed Tomography-A Cross-Sectional Analysis. Diagnostics (Basel) 2023; 13:diagnostics13020246. [PMID: 36673055 PMCID: PMC9858230 DOI: 10.3390/diagnostics13020246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Low-dose computed tomography (LDCT) is predominantly applied in lung cancer screening programs. Tobacco smoking is the main risk factor for developing lung cancer but is also common for cardiovascular diseases, including aortic stenosis (AS). Consequently, an increased prevalence of cardiovascular diseases is expected in lung cancer screenees. Therefore, initial aortic valve calcification evaluation should be additionally performed on LDCT. The aim of this study was to estimate a calcium score (CS) cutoff point for clinically significant AS diagnosis based on LDCT, confirmed by echocardiographic examination. The study included 6631 heavy smokers who participated in a lung cancer screening program (MOLTEST BIS). LDCTs were performed on all individuals and were additionally assessed for aortic valve calcification with the use of CS according to the Agatston method. Patients with CS ≥ 900 were referred for echocardiography to confirm the diagnosis of AS and to evaluate its severity. Of 6631 individuals, 54 met the inclusion criteria and underwent echocardiography for confirmation and assessment of AS. Based on that data, receiver operating characteristic (ROC) curves of CS were plotted, and cutoff points for clinically significant AS diagnosis were established: A CS of 1758 for at least moderate AS had 85.71% (CI 65.36-95.02%) sensitivity and 75.76% (CI 58.98-87.17%) specificity; a CS of 2665 for severe AS had 87.5% (CI 73.89-94.54%) sensitivity and 76.92% (CI 49.74-91.82%) specificity. This is the first study to assess possible CS cutoff points for diagnosing clinically significant AS detected by LDCT in lung cancer screening participants. LDCT with CS assessment could enable early detection of patients with clinically significant AS and therefore identify patients who require appropriate treatment.
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Affiliation(s)
- Kaja Klein-Awerjanow
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
- Correspondence: ; Tel.: +48-58-349-2504; Fax: +48-58-346-1201
| | - Witold Rzyman
- Department of Thoracic Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Robert Dziedzic
- Department of Thoracic Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Jadwiga Fijalkowska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Marcin Fijalkowski
- First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland
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22
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Bidzińska J, Szurowska E. Awaiting the support of artificial intelligence in lung cancer. Transl Lung Cancer Res 2023; 12:395-397. [PMID: 37057120 PMCID: PMC10087998 DOI: 10.21037/tlcr-23-76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Joanna Bidzińska
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
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23
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Wojtowicz D, Dorniak K, Ławrynowicz M, Wąż P, Fijałkowska J, Kulawiak-Gałąska D, Rejszel-Baranowska J, Knut R, Haberka M, Szurowska E, Koziński M. Cardiac Magnetic Resonance Findings in Patients Recovered from COVID-19 Pneumonia and Presenting with Persistent Cardiac Symptoms: The TRICITY-CMR Trial. Biology (Basel) 2022; 11:biology11121848. [PMID: 36552357 PMCID: PMC9775441 DOI: 10.3390/biology11121848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/03/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
The prevalence and clinical consequences of coronavirus disease 2019 (COVID-19)-related non-ischemic cardiac injury are under investigation. The main purpose of this study was to determine the occurrence of non-ischemic cardiac injury using cardiac magnetic resonance (CMR) imaging in patients with persistent cardiac symptoms following recovery from COVID-19 pneumonia. We conducted a single-center, cross-sectional study. Between January 2021 and May 2021, we enrolled 121 patients with a recent COVID-19 infection and persistent cardiac symptoms. Study participants were divided into those who required hospitalization during the acute phase of SARS-CoV-2 infection (n = 58; 47.9%) and those non-hospitalized (n = 63; 52.1%). Non-ischemic cardiac injury (defined as the presence of late gadolinium enhancement (LGE) lesion and/or active myocarditis in CMR) was detected in over half of post-COVID-19 patients (n = 64; 52.9%). LGE lesions were present in 63 (52.1%) and active myocarditis in 10 (8.3%) post-COVID-19 study participants. The majority of LGE lesions were located in the left ventricle at inferior and inferolateral segments at the base. There were no significant differences in the occurrence of LGE lesions (35 (60.3%) vs. 28 (44.4%); p = 0.117) or active myocarditis (6 (10.3%) vs. 4 (6.3%); p = 0.517) between hospitalized and non-hospitalized post-COVID-19 patients. However, CMR imaging revealed lower right ventricular ejection fraction (RVEF; 49.5 (44; 54) vs. 53 (50; 58) %; p = 0.001) and more frequent presence of reduced RVEF (60.3% vs. 33.3%; p = 0.005) in the former subgroup. In conclusion, more than half of our patients presenting with cardiac symptoms after a recent recovery from COVID-19 pneumonia had CMR imaging abnormalities indicating non-ischemic cardiac injury. The most common finding was LGE, while active myocarditis was detected in the minority of patients. CMR imaging abnormalities were observed both in previously hospitalized and non-hospitalized post-COVID-19 patients. Further research is needed to determine the long-term cardiovascular consequences of COVID-19 infection and the optimal management of patients with suspected post-COVID-19 non-ischemic cardiac injury.
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Affiliation(s)
- Dagmara Wojtowicz
- Department of Cardiology and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Marzena Ławrynowicz
- Department of Cardiology and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland
| | - Piotr Wąż
- Department of Nuclear Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Jadwiga Fijałkowska
- Second Department of Radiology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | | | - Joanna Rejszel-Baranowska
- Department of Cardiology and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland
| | - Robert Knut
- Department of Cardiology and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland
| | - Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Marek Koziński
- Department of Cardiology and Internal Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 81-519 Gdynia, Poland
- Correspondence: ; Tel.: +48-58-699-84-06
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Kasprzyk P, Undrunas A, Dziedzic R, Szurowska E, Gruchala M, Gierlotka M, Jaguszewski M, Rzyman W, Zdrojewski T. Ordinal scoring of coronary artery calcification in low dose computed tomography is predictive factor of all-cause death and cardiovascular events. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lung cancer and cardiovascular disease (CVD) are leading worldwide mortality causes firmly related to smoking. Lung cancer screening (LCS) consisted in performing low-dose computed tomography (LDCT) offers an opportunity for simultaneous coronary artery calcification (CAC) assessment.
Purpose
The study aimed to determine the usefulness of the visual assessment of CAC in the prediction of all-cause death and non-fatal cardiovascular outcomes including myocardial infarction and stroke.
Methods
The study involved 6580 participants aged 50–79 years, current or former smokers with a cigarette smoking history of at least 30 pack-years, who were qualified for lung cancer screening program performed between April 2016 and May 2018. CAC was visually scored on ungated LDCT scans in the range of 0–12 based on the length of calcification involvement in four main coronary arteries. CAC severity was categorized into groups of 0, 1–3, 4–12. The primary outcome was all-cause mortality. The secondary outcome was major adverse cardiovascular events (composite of CVD death, nonfatal myocardiaI infarction, nonfatal stroke). The outcomes data were obtained by using the National Health Care Provider Registry of death and hospitalizations. The mean time of follow-up was 41.1 months (SD 8.3). Logistic regression analysis was used to determine the risk of mortality according to the CAC category adjusted for age, pack-years of cigarette smoking, and sex.
Results
The rate of all-cause death substantially increased in groups of higher CAC and it was consecutively 2.7% (89 of 3288 subjects) for a score of 0, 4.2% (66 of 1582 subjects) for a score of 1–3 and 8.3% (145 of 1742 subjects) for a score of 4–12. With the use of subjects with a CAC score of 0 as the reference group, adjusted for sex, age, and pack-years of smoking, a CAC score of at least 4 was a significant predictor of all-cause death (hazard ratio [HR], 1.89; 95% CI: 1.42; 2.52; P<0.05). Similar results were observed for the composite of CVD death, nonfatal myocardial infarction, nonfatal stroke with even greater significance. The rate of secondary outcames was 1.6% (51/3276) in a 0 score cohort, 3.0% (47/1570) in a 1–3 score cohort and 7.5% (130/1732) in a 4–12 score cohort. Both CAC score in the range 1–3 ([HR], 1.57; 95% CI: 1.05; 1.2.35; P<0.05), and 4–12 ([HR], 3.55; 95% CI: 2.50; 5.04; P<0.05) were a significant predictors of major adverse cardiovascular event incidence.
Conclusions
Visual assessment of CAC provides solid evidence of all-cause death and cardiovascular incidents independently of traditional coronary risk factors. Therefore evaluation of CAC in LDCT scans offers a unique opportunity for instituting CVD risk assessment in lung cancer screening program.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development of Poland.
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Affiliation(s)
- P Kasprzyk
- Medical University of Gdansk , Gdansk , Poland
| | - A Undrunas
- Medical University of Gdansk , Gdansk , Poland
| | - R Dziedzic
- Medical University of Gdansk , Gdansk , Poland
| | - E Szurowska
- Medical University of Gdansk , Gdansk , Poland
| | - M Gruchala
- Medical University of Gdansk , Gdansk , Poland
| | | | | | - W Rzyman
- Medical University of Gdansk , Gdansk , Poland
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Chylińska M, Karaszewski B, Komendziński J, Wyszomirski A, Sabisz A, Halas M, Szurowska E. Skeletonized mean diffusivity and neuropsychological performance in relapsing-remitting multiple sclerosis. Brain Behav 2022; 12:e2591. [PMID: 35560868 PMCID: PMC9226842 DOI: 10.1002/brb3.2591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 01/18/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Peak width of Skeletonized Mean Diffusivity (PSMD), as a novel marker of white matter (WM) microstructure damage, is associated with cognitive decline in several WM pathologies (i.e., small vessel disorders). We hypothesized that markers combining alterations in whole WM could be associated with cognitive dysfunction in relapsing-remitting multiple sclerosis (RRMS) patients. METHODS We used PSMD based on tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) magnetic resonance (MR) scans. We investigated RRMS patients (n = 73) undergoing interferon beta (IFN-β) therapy. In this cross-sectional study, we investigated the association between neuropsychological data and clinical and MRI variables: PSMD, WM hypointensities, and normalized brain volume (NBV). RESULTS In our cohort, 37 (50.7%) patients were recognized as cognitively impaired (CI) and 36 (49.3%) patients were cognitively normal (CN). In regression analysis, PSMD was a statistically significant contributor in the California Verbal Learning Test (CVLT) list A (p = 0.04) and semantic fluency (p = 0.036). PSMD (p < 0.001, r2 = 0.35), NBV (p = 0.002, r2 = 2.6) and WM hypointensities (p < 0.001, r2 = 0.40) were major contributors to upper extremity disability (9HPT) in the CN subgroup. A significant contributor in the majority of neuropsychological measures was education attainment. CONCLUSION We investigated PSMD as a new parameter of WM microstructure damage that is a contributor in complex cognitive tasks, CVLT performance, and semantic fluency. PSMD was a statistically significant contributor to upper extremity disability (9HPT) together with WM hypointensities and NBV. Education attainment proved to be relevant in the majority of cognitive domains. Further studies are needed to estimate PSMD relevance as a marker of CI in MS.
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Affiliation(s)
- Magdalena Chylińska
- Department of Adult NeurologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Bartosz Karaszewski
- Department of Adult NeurologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Jakub Komendziński
- Department of Adult NeurologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Adam Wyszomirski
- Department of Adult NeurologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Agnieszka Sabisz
- 2nd Department of RadiologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Marek Halas
- Department of Adult NeurologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
| | - Edyta Szurowska
- 2nd Department of RadiologyMedical University of Gdańsk, Faculty of MedicineGdańskPoland
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26
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Marcinkowska AB, Tarasewicz A, Jóźwiak S, Dębska-Ślizień A, Szurowska E. Tuberous sclerosis complex-associated neuropsychiatric disorders. Psychiatr Pol 2022; 57:1-20. [PMID: 36370437 DOI: 10.12740/pp/onlinefirst/146265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The aim of the study was to provide a state-of-the-art review with regard to neuropsychiatric disorders associated with tuberous sclerosis complex (TSC). TSC is a rare genetic disease classified as a phacomatosis. Due to the wide spectrum of clinical symptoms of the disease, many cases remain undiagnosed. The vast majority of people with a mutation in the TSC1 or TSC2 genes develop some of the neuropsychiatric symptoms during their lifetime. Diagnostic criteria, neuroanatomical pathology and pathophysiology of psychiatric, neuropsychological, developmental and psychosocial symptoms present in TSC are described. The specificity of epilepsy in TSC and its role in neuropsychiatric and neuropsychological development are presented. All levels (intellectual, developmental, behavioral, psychiatric, school, neuropsychological and psychosocial) of tuberous sclerosis complex-associated neuropsychiatric disorders (TAND) are discussed in detail. The TAND Checklist - a tool for assessing all potentially disturbed aspects of functioning - was presented. The importance of proper diagnosis of neuropsychiatric disorders and multidisciplinary patient care was emphasized.
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Affiliation(s)
- Anna B Marcinkowska
- Gdański Uniwersytet Medyczny, Zakład Fizjologii Człowieka, Pracownia Stosowanych Neuronauk Poznawczych
- Gdański Uniwersytet Medyczny, Drugi Zakład Radiologii
| | - Agnieszka Tarasewicz
- Gdański Uniwersytet Medyczny, Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych
| | | | - Alicja Dębska-Ślizień
- Gdański Uniwersytet Medyczny, Klinika Nefrologii, Transplantologii i Chorób Wewnętrznych
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Tao G, Shi D, Yu L, Chen C, Zhang Z, Park CM, Szurowska E, Chen Y, Wang R, Yu H. Longitudinal prediction of lung nodule invasiveness by sequential modelling with common clinical computed tomography (CT) measurements: a prediction accuracy study. Transl Lung Cancer Res 2022; 11:845-857. [PMID: 35693275 PMCID: PMC9186168 DOI: 10.21037/tlcr-22-319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
Background Accurate preoperative prediction of the invasiveness of lung nodules on computed tomography (CT) can avoid unnecessary invasive procedures and costs for low-risk patients. While previous studies approached this task using cross-sectional data, this study aimed to utilize the commonly available longitudinal data of lung nodules through sequential modelling based on long short-term memory (LSTM) networks. Methods We retrospectively included 171 patients with lung nodules that were followed-up at least once and pathologically diagnosed with adenocarcinoma for model development. Pathological diagnosis was the gold standard for deciding lung nodule invasiveness. For each nodule, a handful of semantic features, including size intensity and interval since first discovery, were obtained from an arbitrary number of CT scans available to individual patients and used as input variables to pre-operatively predict nodule invasiveness. The LSTM-based classifier was optimized by extensive experiments and compared to logistic regression (LR) as baseline with five-fold cross-validation. Results The best LSTM-based classifier, capable of receiving data from an arbitrary number of time points, achieved better preoperative prediction of lung nodule invasiveness [area under the curve (AUC), 0.982; accuracy, 0.924; sensitivity, 0.946; specificity, 0.881] than the best LR (AUC, 0.947; accuracy, 0.906; sensitivity, 0.938; specificity, 0.847) classifier. Conclusions The longitudinal data of lung nodules, though unevenly spaced and varying in length, can be well modeled by the LSTM, allowing for the accurate prediction of nodule invasiveness. Given that the input variables of the sequential modelling consist of a few semantic features that are easily obtained and interpreted by clinicians, our approach is worthy further investigation for the optimal management of lung nodules.
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Affiliation(s)
- Guangyu Tao
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Dejun Shi
- Keya Medical Technology Co. Ltd., Beijing, China
| | - Lingming Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chunji Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Zhang
- School of Biological Science & Medical Engineering, Southeast University, Nanjing, China
| | - Chang Min Park
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University, Seoul, Korea
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Yinan Chen
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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Skotarczak M, Dzierżanowski J, Kaszubowski M, Winklewski PJ, Romanowski A, Szurowska E, Szarmach A. Diagnostic value of diffusion tensor imaging in patients with clinical signs of cervical spondylotic myelopathy. Neurol Neurochir Pol 2022; 56:341-348. [PMID: 35471632 DOI: 10.5603/pjnns.a2022.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY The aim of this study was to assess the diagnostic value of diffusion tensor imaging (DTI) in patients with symptoms of cervical myelopathy. Detailed goals included determining the diagnostic effectiveness of quantitative parameters, i.e. fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in the diagnosis of cervical myelopathy, and the correlation between these parameters and clinical symptoms. CLINICAL RATIONALE FOR THE STUDY The demonstration of an ischaemic focus in the spinal cord by standard magnetic resonance imaging (MRI) methods is associated with already accomplished spinal cord damage, and of course limited treatment options. Therefore, finding a new examination protocol that allows early diagnosis of myelopathic focus, before the onset of full neurological symptoms, has become a priority in the diagnosis and treatment of spine diseases. Such an examination increases the chances of correctly qualifying the patient for conservative vs. surgical treatment. MATERIAL AND METHODS Between 2013 and 2017, 128 adults with clinical signs of cervical myelopathy were examined, and were divided into four symptomatic subgroups. A control group consisted of 37 healthy volunteers. DTI values were measured at the level of C2/C3, and at the most severe stenosis of the spine. RESULTS In patients with cervical spondylotic myelopathy (CSM), the ADC values were significantly higher (p < 0.001), and FA values were significantly lower (p < 0.001), than in healthy volunteers at the stenotic level. There were significant differences in DTI parameters between the clinical subgroups (p < 0.001). CONCLUSIONS AND CLINICAL IMPLICATIONS Changes in DTI parameters indicate a microstructural disorder of the core which is not visible in a structural MRI. FA and ADC values measured at the level of the most severe stenosis of the spinal canal allow the differentiation of patients with myelopathy of varying degrees of clinical severity. Extending standard MRI to include assessment of FA and ADC may be helpful in deciding treatment modalities (conservative vs. surgical) for patients with visible canal stenosis without full neurological symptoms. This may be useful in selecting patients for urgent rehabilitative treatment. This study is a starting point for further research, i.e. an evaluation of the extent of FA and ADC lesion withdrawal after surgical treatment.
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Affiliation(s)
- Monika Skotarczak
- 2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | | | - Mariusz Kaszubowski
- Department of Economic Sciences, Faculty of Management and Economics, Gdansk University of Technology, Gdansk, Poland
| | - Paweł J Winklewski
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.,Department of Clinical Anatomy and Physiology, Faculty of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland
| | | | - Edyta Szurowska
- 2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Arkadiusz Szarmach
- 2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.
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Dorniak K, Sabisz A, Szurowska E, Gorczewski K, Pawlaczyk R, Żarczyńska-Buchowiecka M. Unusual cardiac magnetic resonance findings in a young patient, years after the diagnosis of hypertrophic cardiomyopathy. Kardiol Pol 2022; 80:505-506. [PMID: 35344587 DOI: 10.33963/kp.a2022.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland.
| | - Agnieszka Sabisz
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
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Jabłoński B, Gójska-Grymajło A, Ossowska D, Szurowska E, Wyszomirski A, Rojek B, Karaszewski B. New Remote Cerebral Microbleeds on T2 *-Weighted Echo Planar MRI After Intravenous Thrombolysis for Acute Ischemic Stroke. Front Neurol 2022; 12:744701. [PMID: 35242092 PMCID: PMC8886895 DOI: 10.3389/fneur.2021.744701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The main and well-defined complication of intravenous administration of recombinant tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS) is symptomatic intracranial hemorrhage (sICH). However, rtPA might also be connected with the formation of cerebral microbleeds (CMBs), located remotely from the ischemic lesions, that may remain clinically silent. This association might be important because the load of CMBs has been associated with cognitive impairment. We investigated whether administration of rtPA in AIS results in the appearance of new CMBs and if the initial load of CMBs is associated with hemorrhagic transformation. Methods A total of fifty-nine consecutive patients with AIS treated with rtPA underwent MRI including T2*-weighted Echo Planar Imaging (T2*-EPI) shortly before and 7–9 days after rtPA administration. We calculated the load of new CMBs located outside the MR diffusion restriction area in the follow-up imaging and assessed hemorrhagic transformation with ECASS-II scoring. Results A total of forty-nine patients were included for the final analysis. On initial T2*-EPI-GRE, 37 baseline microbleeds (CMBs) were observed in 14 patients (28.6%). On follow-up T2*-EPI-GRE amount of CMBs increased to a total number of 103. New CMBs were found in 5 (14.3%) of 35 patients without and in 9 (64.3%) of 14 with any baseline CMBs. Multiple logistic regression analysis indicated that presence of baseline CMBs (risk ratio [RR] 5.95, 95% CI 2.69–13.20, p < 0.001) and lower platelets level (risk ratio [RR] 0.992, 95% CI 0.986–0.998, p = 0.007) were independently associated with new CMBs. The baseline load of CMBs was not associated with the risk of hemorrhagic transformation. Conclusion In this study, new CMBs were found in nearly 30% of patients with AIS on the 7–9 days after rtPA treatment. Baseline CMBs correlated with a higher risk of new CMBs appearing after the rtPA treatment, independently of other factors. At the same time, in our sample, baseline CMBs did not correlate with an increased risk of hemorrhagic transformation. Since the associations between the CMBs load and cognitive impairment have already been proved, further studies are warranted to investigate possible associations between the thrombolytic treatment of patients with AIS, mainly those with baseline CMBs, and the risk of earlier cognitive decline.
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Affiliation(s)
- Bartosz Jabłoński
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Gójska-Grymajło
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
| | - Daria Ossowska
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland.,II Department of Radiology, Medical University of Gdańsk, Department of Radiology, University Clinical Centre, Gdańsk, Poland
| | - Edyta Szurowska
- II Department of Radiology, Medical University of Gdańsk, Department of Radiology, University Clinical Centre, Gdańsk, Poland
| | - Adam Wyszomirski
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
| | - Bartłomiej Rojek
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
| | - Bartosz Karaszewski
- Department of Adult Neurology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
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Markiet K, Glinska A, Nowicki T, Szurowska E, Mikaszewski B. Feasibility of Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in Differentiation of Benign Parotid Gland Tumors. Biology (Basel) 2022; 11:biology11030399. [PMID: 35336773 PMCID: PMC8945348 DOI: 10.3390/biology11030399] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 01/18/2023]
Abstract
Aim: The aim of this prospective study is to identify quantitative intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging parameters of the most frequent benign parotid tumors, compare their utility and diagnostic accuracy. Methods: The study group consisted of 52 patients with 64 histopathologically confirmed parotid focal lesions. Parametric maps representing apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (FP) and transfer constant (Ktrans), reflux constant (Kep), extra-vascular extra-cellular volume fraction (Ve), and initial area under curve in 60 s (iAUC) have been obtained from multiparametric MRI. Results: Statistically significant (p < 0.001) inter-group differences were found between pleomorphic adenomas (PA) and Warthin tumors (WT) in all tested parameters but iAUC. Receiver operating characteristic curves were constructed to determine the optimal cut-off levels of the most significant parameters allowing differentiation between WT and PA. The Area Under the Curve (AUC) values and thresholds were for ADC: 0.931 and 1.05, D: 0.896 and 0.9, Kep: 0.964 and 1.1 and Ve: 0.939 and 0.299, respectively. Lesions presenting with a combination of ADC, D, and Ve values superior to the cut-off and Kep values inferior to the cut-off are classified as pleomorphic adenomas. Lesions presenting with combination of ADC, D, and Ve values inferior to the cut-off and Kep values superior to the cut-off are classified as Warthin tumors. Conclusions: DWI, IVIM and quantitative analysis of DCE-MRI derived parameters demonstrated distinctive features of PAs and WT and as such they seem feasible in differentiation of benign parotid gland tumors.
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Affiliation(s)
- Karolina Markiet
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland; (A.G.); (T.N.); (E.S.)
- Correspondence: ; Tel.: +48-58-349-36-80
| | - Anna Glinska
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland; (A.G.); (T.N.); (E.S.)
| | - Tomasz Nowicki
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland; (A.G.); (T.N.); (E.S.)
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, 80-214 Gdansk, Poland; (A.G.); (T.N.); (E.S.)
| | - Boguslaw Mikaszewski
- Department of Otolaryngology, Medical University of Gdansk, 80-214 Gdansk, Poland;
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Sawicka AK, Jaworska J, Brzeska B, Sabisz A, Samborowska E, Radkiewicz M, Szurowska E, Winklewski PJ, Szarmach A, Olek RA. L-Carnitine Combined with Leucine Supplementation Does Not Improve the Effectiveness of Progressive Resistance Training in Healthy Aged Women. J Nutr Health Aging 2022; 26:945-953. [PMID: 36259583 DOI: 10.1007/s12603-022-1848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate the effect of L-carnitine (LC) in combination with leucine supplementation on muscle strength and muscle hypertrophy in aged women participating in a resistance exercise training (RET) program. DESIGN/SETTING/PARTICIPANTS Thirty-seven out of sixty (38.3% dropout) healthy women aged 60-75 years (mean 67.6 ± 0.7 years) completed the intervention in one of three groups. One of the supplemented groups received 1 g of L-carnitine-L-tartrate in combination with 3 g of L-leucine per day (LC+L group; n = 12), and the second supplemented group received 4 g of L-leucine per day (L group; n = 13). The control group (CON group; n = 12) received no supplementation. INTERVENTION All three groups completed the same RET protocol involving exercise sessions twice per week for 24 weeks. MEASUREMENTS Before and after the experiment, participants performed isometric and isokinetic muscle strength testing on the Biodex dynamometer. The cross-sectional areas of the major knee extensors and total thigh muscles were assessed using magnetic resonance imaging. Fasting serum levels of insulin-like growth factor-1 (IGF-1), myostatin and decorin, and plasma levels of total carnitine (TC) and trimethylamine-N-oxide (TMAO) levels were measured. RESULTS The 24-week RET significantly increased muscle strength and muscle volume, but the group and time interactions were not significant for the muscle variables analyzed. Plasma total carnitine increased only in the LC+L group (p = 0.009). LC supplementation also caused a significant increase in plasma TMAO, which was higher after the intervention in the LC+L group than in the L (p < 0.001), and CON (p = 0.005) groups. The intervention did not change plasma TMAO concentration in the L (p = 0.959) and CON (p = 0.866) groups. After the intervention serum decorin level was higher than before in both supplemented groups combined (p = 0.012), still not significantly different to post intervention CON (p = 0.231). No changes in serum IGF-1 and myostatin concentrations and no links between the changes in blood markers and muscle function or muscle volume were observed. CONCLUSIONS LC combined with leucine or leucine alone does not appear to improve the effectiveness of RET.
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Affiliation(s)
- A K Sawicka
- Robert A. Olek, Department of Athletics, Strength, and Conditioning, Poznan University of Physical Education, Krolowej Jadwigi 27/39; 61-871 Poznan, Poland, e-mail: , ORCID: 0000-0002-3714-7386
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Haberka M, Rajewska-Tabor J, Wojtowicz D, Jankowska A, Miszalski-Jamka K, Janus M, Dorniak K, Kulawiak-Gałąska D, Stasiow B, Rozmiarek S, Szurowska E, Elikowski W, Ławrynowicz M, Śpiewak M, Koziński M, Pyda M. Perimyocardial Injury Specific for SARS-CoV-2-Induced Myocarditis in Comparison With Non-COVID-19 Myocarditis: A Multicenter CMR Study. JACC Cardiovasc Imaging 2021; 15:705-707. [PMID: 34922867 PMCID: PMC8673438 DOI: 10.1016/j.jcmg.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022]
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Wojtowicz D, Dorniak K, Ławrynowicz M, Rejszel-Baranowska J, Fijałkowska J, Kulawiak-Gałąska D, Szurowska E, Koziński M. Spectrum of lesions visualized in cardiac magnetic resonance imaging in COVID-19-related myocarditis: Findings from a pilot study of the TRICITY-CMR trial. Cardiol J 2021; 28:976-978. [PMID: 34708861 PMCID: PMC8747819 DOI: 10.5603/cj.a2021.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/01/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Dagmara Wojtowicz
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland.
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, University Clinical Centre in Gdańsk, Dębinki 7, 80-952 Gdańsk, Poland
| | - Marzena Ławrynowicz
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland
| | - Joanna Rejszel-Baranowska
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland
| | - Jadwiga Fijałkowska
- Department of Radiology II, Medical University of Gdańsk, University Clinical Centre in Gdańsk, Mariana Smoluchowskiego 17, 80-214 Gdańsk, Poland
| | - Dorota Kulawiak-Gałąska
- Department of Radiology II, Medical University of Gdańsk, University Clinical Centre in Gdańsk, Mariana Smoluchowskiego 17, 80-214 Gdańsk, Poland
| | - Edyta Szurowska
- Department of Radiology II, Medical University of Gdańsk, University Clinical Centre in Gdańsk, Mariana Smoluchowskiego 17, 80-214 Gdańsk, Poland
| | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland
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Dorniak K, Di Sopra L, Sabisz A, Glinska A, Roy CW, Gorczewski K, Piccini D, Yerly J, Jankowska H, Fijałkowska J, Szurowska E, Stuber M, van Heeswijk RB. Respiratory Motion-Registered Isotropic Whole-Heart T 2 Mapping in Patients With Acute Non-ischemic Myocardial Injury. Front Cardiovasc Med 2021; 8:712383. [PMID: 34660714 PMCID: PMC8511642 DOI: 10.3389/fcvm.2021.712383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: T2 mapping is a magnetic resonance imaging technique that can be used to detect myocardial edema and inflammation. However, the focal nature of myocardial inflammation may render conventional 2D approaches suboptimal and make whole-heart isotropic 3D mapping desirable. While self-navigated 3D radial T2 mapping has been demonstrated to work well at a magnetic field strength of 3T, it results in too noisy maps at 1.5T. We therefore implemented a novel respiratory motion-resolved compressed-sensing reconstruction in order to improve the 3D T2 mapping precision and accuracy at 1.5T, and tested this in a heterogeneous patient cohort. Materials and Methods: Nine healthy volunteers and 25 consecutive patients with suspected acute non-ischemic myocardial injury (sarcoidosis, n = 19; systemic sclerosis, n = 2; acute graft rejection, n = 2, and myocarditis, n = 2) were included. The free-breathing T2 maps were acquired as three ECG-triggered T2-prepared 3D radial volumes. A respiratory motion-resolved reconstruction was followed by image registration of the respiratory states and pixel-wise T2 mapping. The resulting 3D maps were compared to routine 2D T2 maps. The T2 values of segments with and without late gadolinium enhancement (LGE) were compared in patients. Results: In the healthy volunteers, the myocardial T2 values obtained with the 2D and 3D techniques were similar (45.8 ± 1.8 vs. 46.8 ± 2.9 ms, respectively; P = 0.33). Conversely, in patients, T2 values did differ between 2D (46.7 ± 3.6 ms) and 3D techniques (50.1 ± 4.2 ms, P = 0.004). Moreover, with the 2D technique, T2 values of the LGE-positive segments were similar to those of the LGE-negative segments (T2LGE-= 46.2 ± 3.7 vs. T2LGE+ = 47.6 ± 4.1 ms; P = 0.49), whereas the 3D technique did show a significant difference (T2LGE- = 49.3 ± 6.7 vs. T2LGE+ = 52.6 ± 8.7 ms, P = 0.006). Conclusion: Respiratory motion-registered 3D radial imaging at 1.5T led to accurate isotropic 3D whole-heart T2 maps, both in the healthy volunteers and in a small patient cohort with suspected non-ischemic myocardial injury. Significantly higher T2 values were found in patients as compared to controls in 3D but not in 2D, suggestive of the technique's potential to increase the sensitivity of CMR at earlier stages of disease. Further study will be needed to demonstrate its accuracy.
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Affiliation(s)
- Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Lorenzo Di Sopra
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Agnieszka Sabisz
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Anna Glinska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Christopher W Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - Davide Piccini
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Jadwiga Fijałkowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Fijałkowska J, Sobolewski J, Glińska A, Pisowodzka I, Nowak R, Żarczynska-Buchowiecka M, Pieńkowska J, Gruchała M, Szurowska E, Dorniak K, Fijałkowski M. Cardiac abnormalities detected by echocardiography and cardiac magnetic resonance in healthcare professionals recovered from non-severe COVID-19. Kardiol Pol 2021; 79:1256-1258. [PMID: 34599499 DOI: 10.33963/kp.a2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jakub Sobolewski
- Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Anna Glińska
- Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Radosław Nowak
- Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Joanna Pieńkowska
- Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Gruchała
- Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Edyta Szurowska
- Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
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Klein-Awerjanow K, Rzyman W, Ostrowski M, Fijalkowska J, Szurowska E, Fijalkowski M. Aortic Stenosis as an Additional Finding in Low-Dose Computed Tomography Lung Cancer Screening: A Cross-Sectional Study. Ann Intern Med 2021; 174:1482-1483. [PMID: 34097430 DOI: 10.7326/m20-5507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Wujtewicz M, Regent B, Marszałek-Ratnicka R, Smugała A, Szurowska E, Owczuk R. The Incidence of Radial Artery Occlusion in Critically Ill Patients after Cannulation with a Long Catheter. J Clin Med 2021; 10:jcm10143172. [PMID: 34300338 PMCID: PMC8303106 DOI: 10.3390/jcm10143172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
Cardiac output monitoring is a common practice in critically ill patients. The PiCCO (pulse index continuous cardiac output) method requires artery cannulation. According to the manufacturer, the cannula in the radial artery should be removed after three days. However, longer monitoring is sometimes necessary. The aim of this study was to assess the incidence of radial artery occlusion (RAO) after three days of cannulation and to check whether five-day cannulation is related to a higher occlusion rate. An additional assessment was made to verify the presence of occlusion three, fourteen and thirty days after decannulation. The PiCCO cannula was inserted into the radial artery after the Barbeau test and Doppler assessment of blood flow. It was left for three or five days. Doppler was performed immediately after its removal and at three, fourteen and thirty days following decannulation. Thirty-seven patients were randomly assigned for three or five days of cannulation, and twenty-three of them were eligible for further analysis. RAO was found in thirteen (56.5%) patients. No statistical difference was found between the RAO rate for three and five day cannulations (p = 0.402). The incidence of RAO was lower when the right radial artery was cannulated (p = 0.022; OR 0.129). Radial artery cannulation with a PiCCO catheter poses a risk of RAO. However, the incidence of prolonged cannulation appeared to not increase the risk of artery occlusion. ClinicalTrials.gov ID NCT02695407.
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Affiliation(s)
- Magdalena Wujtewicz
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland;
- Correspondence:
| | - Bartosz Regent
- Department of Radiology, University Clinical Centre, The Medical University of Gdansk Hospital, 80-214 Gdansk, Poland; (B.R.); (A.S.)
| | - Rozalia Marszałek-Ratnicka
- Department of Anaesthesiology and Intensive Therapy University Clinical Centre, the Medical University of Gdansk Hospital, 80-214 Gdansk, Poland;
| | - Aneta Smugała
- Department of Radiology, University Clinical Centre, The Medical University of Gdansk Hospital, 80-214 Gdansk, Poland; (B.R.); (A.S.)
| | - Edyta Szurowska
- 2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Radosław Owczuk
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland;
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Dorniak K, Stopczyńska I, van Heeswijk RB, Żaczyńska-Buchowiecka M, Fijałkowska J, Glińska A, Gruchała M, Szurowska E, Dudziak M, Sabisz A. Cardiac magnetic resonance imaging with T2 mapping for the monitoring of acute heart transplant rejection in patients with problematic endomyocardial biopsy: in anticipation of new recommendations. Kardiol Pol 2021; 79:339-343. [PMID: 33687863 DOI: 10.33963/kp.15852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Publications of the final results of the two largest randomized lung cancer screening (LCS) trials in the United States and Europe confirmed the reduction in the mortality rate associated with the use of screening with low-dose computed tomography (LDCT). Results of these trials led to widespread acceptance of LCS in properly defined high-risk populations, and its implementation in the clinical practice. Many countries started preparation for national LCS and refreshed still open debate about lung nodule management. Detection of lung cancer in the early stage with a reduction of lung cancer mortality requires dedicated programs with optimized protocols, including a specified pulmonary nodule diagnostic algorithm. The screening protocol should be clear with a precise nodule diameter or volume threshold, based on which a positive screen result is defined. The application of risk-prediction models and the introduction of the semiautomated assessment of detected nodules improves screening accuracy and should be applied in LCS protocols as verified tools to aid radiological diagnosis. In this review, we have summarized recent data about the radiological protocols from the most important LCS programs and pulmonary diagnostic algorithms. These protocols should be taken into consideration in the ongoing and planned LCS programs.
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Affiliation(s)
| | - Edyta Szurowska
- II Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
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Połom W, Cytawa W, Połom A, Szurowska E, Lass P, Matuszewski M. Radionuclide-guided sentinel lymph node mapping in urachal cancer. ADV CLIN EXP MED 2021; 30:203-210. [PMID: 33650332 DOI: 10.17219/acem/130600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Urachal cancer gives metastases through the lymph nodes (LNs). No lymphadenectomy scheme in the case of this cancer exist, yet it is proposed as a staging procedure. An assessment of lymphatic outflow from the tumor site with the use of single-photon emission computed tomography/computed tomography (SPECT/CT) lymphangiography is possible for staging purposes. OBJECTIVES To perform the mapping of the LNs draining the lymph from urachal cancer with the use of radioisotope-based technique and to propose the lymphadenectomy template in case of urachal cancer. MATERIAL AND METHODS A prospective study was conducted in 5 patients with urachal cancer. The 99m-technetium (Tc-99m)-nanocolloid was injected during a cystoscopy prior to the surgery. Lymphangiography was performed using SPECT/CT. A radioactive LNs analysis with the use of a hand-held gamma-ray detection probe was conducted during the surgery and the sentinel lymph node (SLN) biopsy procedure was performed. An additional lymphadenectomy containing the lymphatic basin of identified radioactive LNs was performed. RESULTS In all cases lymphatic outflow from the urachal tumor to the LNs was present. Preoperative SPECT/CT allowed detecting the activity of the radiotracer in the common iliac region in all the studied patients. In 3 cases, bilateral lymphatic outflow, and in 2 cases, unilateral lymphatic outflow was observed. All preoperatively visualized LNs were found and excised with the use of a gamma-ray detection probe during a lymphadenectomy. In all cases, SLNs did not contain metastases. CONCLUSIONS Mapping of the LNs draining the lymph from urachal cancer with the use of radiotracer is possible. Lymphatic outflow in the case of this cancer can be both unilateral and bilateral. No recommendations about the extension of lymphadenectomy are proposed. We recommend individual assessment and treatment based on additional knowledge about lymphatic outflow. This allows for minimally invasive yet targeted treatment as an SLN basin lymphadenectomy.
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Affiliation(s)
- Wojciech Połom
- Department of Urology, Medical University of Gdańsk, Poland
| | - Wojciech Cytawa
- Department of Nuclear Medicine, Medical University of Gdańsk, Poland
| | - Anna Połom
- Department of Radiology, Medical University of Gdańsk, Poland
| | - Edyta Szurowska
- Department of Radiology, Medical University of Gdańsk, Poland
| | - Piotr Lass
- Department of Nuclear Medicine, Medical University of Gdańsk, Poland
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Świętoń D, Bernard W, Grzywińska M, Czarniak P, Durawa A, Kaszubowski M, Piskunowicz M, Szurowska E. A Comparability of Renal Length and Volume Measurements in MRI and Ultrasound in Children. Front Pediatr 2021; 9:778079. [PMID: 34956985 PMCID: PMC8692871 DOI: 10.3389/fped.2021.778079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/08/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction: Despite the significant increase in use of magnetic resonance imaging (MRI) in children, there is still a lack of normal reference values of renal size in this method and reference values are being interpolated from the ultrasound (US) studies. The study provides comparative analysis of agreement in renal length and volume measurements between MRI and ultrasound. Materials and Methods: Ninety-three children with a mean age of 8.0 ± 6.0 years, who had undergone both renal US and MRI exams, were included in the study. Participants were divided into three subgroups; each kidney was considered separately. Group 1 included 106 kidneys without any anomalies. Group 2 comprised 48 kidneys with a dilated collecting system. Group 3 included 32 kidneys with a duplicated collecting system. Measurements were taken in three dimensions, and renal volume was calculated from the ellipsoid formula. Results: We found no significant difference between US and MRI measurements in Group 1 and Group 2. In Group 3, the difference between measurements in both imaging methods was significant. The mean difference varied from 0.05% in Group 1, 2.95% in Group 2, to 4.99% in Group 3. Conclusion: The US and MRI are comparable methods in renal size measurements. The interpolation of sonographic renal length and volume reference values to the MRI in the pediatric population is justified, as there is a strong agreement between both methods. Both methods can be used interchangeably for following up of the renal size changes in the pediatric population.
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Affiliation(s)
- Dominik Świętoń
- Second Radiology Department, Medical University of Gdansk, Gdańsk, Poland
| | - Weronika Bernard
- Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | | | - Piotr Czarniak
- Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdańsk, Poland
| | - Agata Durawa
- Second Radiology Department, Medical University of Gdansk, Gdańsk, Poland
| | - Mariusz Kaszubowski
- Department of Statistics and Econometrics, Faculty of Management and Economics, Gdansk University of Technology, Gdansk, Poland
| | - Maciej Piskunowicz
- First Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Edyta Szurowska
- Second Radiology Department, Medical University of Gdansk, Gdańsk, Poland
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Frankiewicz M, Markiet K, Krukowski J, Szurowska E, Matuszewski M. MRI in patients with urethral stricture: a systematic review. Diagn Interv Radiol 2020; 27:134-146. [PMID: 33226004 DOI: 10.5152/dir.2020.19515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Magnetic resonance imaging (MRI) is gaining acceptance as a diagnostic tool in urethral stricture disease. Numerous publications emphasize on the advantages of MRI including its ability to determine periurethral spongiofibrosis, thus overcoming the main limitation of retrograde urethrography (RUG). It is also becoming an alternative for sonourethrography (SUG), which is a highly subjective examination. Magnetic resonance urethrography (MRU) has become an increasingly appreciated tool for diagnosing patients with urethral stricture disease. Obtained data provides radiologists and urethral reconstructive surgeons with additional information regarding anatomical relationships and periurethral tissue details, facilitating further treatment planning. Considering the great prevalence of urethral stricture disease and necessity of using accurate, and acceptable diagnostic method, this review was designed to provide radiologists and clinicians with a systematic review of the literature on the use of MRI in the urethral stricture disease.
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Affiliation(s)
| | - Karolina Markiet
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Jakub Krukowski
- Department of Urology, Medical University of Gdansk, Gdansk, Poland
| | - Edyta Szurowska
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
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Gołębiewska J, Wolnik B, Hoffmann M, Gorycki T, Śledziński M, Gołąb K, Skowrońska P, Milecka A, Skóra I, Gulczyński J, Żygowska I, Witkowski P, Moszkowska G, Bieniaszewska M, Szurowska E, Śledziński Z, Stefaniak T, Dębska-Ślizień A. Pancreatic islet transplantation in a simultaneous pancreas and kidney transplant recipient — a case report. Clinical Diabetology 2020. [DOI: 10.5603/dk.2020.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Stańska A, Fijałkowska J, Targoński R, Fijałkowski M, Jaguszewski M, Rogowski J, Szurowska E, Jagielak D. Transcatheter aortic valve implantation through a transcarotid approach and cerebral injury. Kardiol Pol 2020; 78:756-758. [PMID: 32238792 DOI: 10.33963/kp.15267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Aleksandra Stańska
- Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland; Department of Quality ofLife Research, Medical University of Gdańsk, Gdańsk, Poland.
| | | | - Radosław Targoński
- Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Fijałkowski
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jan Rogowski
- Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Edyta Szurowska
- Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dariusz Jagielak
- Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland
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Mikaszewski B, Markiet K, Smugała A, Stodulski D, Szurowska E, Stankiewicz C. Clinical and demographic data improve diagnostic accuracy of dynamic contrast-enhanced and diffusion-weighted MRI in differential diagnostics of parotid gland tumors. Oral Oncol 2020; 111:104932. [PMID: 32739792 DOI: 10.1016/j.oraloncology.2020.104932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To verify if differential diagnostic algorithms based on selected parameters of dynamic and diffusion-weighted MRI, clinical and demographic variables are accurate enough to differentiate between parotid malignancies, pleomorphic adenomas and Warthin tumors. MATERIALS AND METHODS The study included 84 patients, among them 19 (23%) with postoperative diagnosis of a parotid malignancy, 37 (44%) with Warthin tumors and 28 (33%) with pleomorphic adenomas. Accuracy of dynamic and diffusion-weighted MRI parameters (Tpeak, Tmax, WR and ADC), clinical parameters of the tumor (location in the superficial or deep parotid lobe, single vs. multiple lesion, concomitant lymphadenopathy) and demographic characteristics of the patient (age, sex) was determined on ROC analysis. RESULTS Compared to Warthin tumors, parotid malignancies showed higher Tpeak, Tmax and ADC, lower WR, were more often located in the deep lobe of the parotid and presented as single lesions with concomitant lymphadenopathy. Consideration of all these variables provided 100% sensitivity and 89.2% specificity of the differential diagnostic algorithm. Compared to pleomorphic adenomas, parotid malignancies presented with lower ADC and Tpeak, higher Tmax, were more often located in the deep lobe of the parotid, associated with concomitant lymphadenopathy, diagnosed in men and individuals older than 66 years. Consideration of all these variables provided 100% sensitivity and 96.4% specificity of the differential diagnostic algorithm. CONCLUSION Combined analysis of clinical data and results of dynamic and diffusion-weighted MRI may provide nearly ideal accuracy in differential diagnostics of parotid malignancies and the two most common histological types of benign tumors.
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Affiliation(s)
- Bogusław Mikaszewski
- Department of Otolaryngology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland.
| | - Karolina Markiet
- Second Department of Radiology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland
| | - Aneta Smugała
- Department of Radiology, University Clinical Center, 17 Smoluchowskiego St., 80-214 Gdansk, Poland
| | - Dominik Stodulski
- Department of Otolaryngology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland
| | - Czesław Stankiewicz
- Department of Otolaryngology, Medical University of Gdansk, 7 Dębinki St., 80-952 Gdansk, Poland
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Rybczynska D, Pienkowska J, Frydrychowski A, Szurowska E, Jankowska A. Understanding the Role of Gadoxetic Acid in MRI. Curr Med Imaging 2020; 16:572-577. [DOI: 10.2174/1573405615666181224125909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/13/2018] [Accepted: 11/28/2018] [Indexed: 11/22/2022]
Abstract
Background:
Radiological imaging methods used at a large scale in the assessment of
hepatic lesions include: Ultrasound, computed tomography and magnetic resonance. To further characterize
these lesions, specific contrast agents may be added, thus revealing the vascularity of the
lesions.
Discussion:
This review focuses on gadoxetic acid, which is a hepatospecific contrast agent used in
MRI. The aim of the review is to briefly explain the mechanism of GA enhancement, describe the
enhancement patterns of some benign and malignant hepatic lesions and discuss possible advantages
of GA over standard contrast agents.
Conclusion:
The role of GA in functional MR cholangiography and the idea of accessing liver function
by measuring parenchymal enhancement will also be explained.
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Affiliation(s)
- Dorota Rybczynska
- 2nd Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, Gdansk 80-214, Poland
| | - Joanna Pienkowska
- 2nd Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, Gdansk 80-214, Poland
| | - Andrzej Frydrychowski
- Institute of Human Physiology, Medical University of Gdansk, Tuwima 15, Gdansk 80-210, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Smoluchowskiego 17, Gdansk 80-214, Poland
| | - Anna Jankowska
- 2nd Department of Radiology, University Clinical Centre in Gdansk, Gdansk, Poland
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Tarasewicz A, Dębska-Ślizień A, Rutkowska B, Szurowska E. Living Donor Preemptive Kidney Transplantation in Tuberous Sclerosis Complex Patient and the Role of Mammalian Target of Rapamycin Inhibitor: A Case Report. Transplant Proc 2020; 52:2520-2523. [PMID: 32448667 DOI: 10.1016/j.transproceed.2020.01.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Kidney transplantation (KT) is the preferred treatment for end-stage kidney disease (ESKD), while preemptive (PE) living donor (LD) KT is associated with better survival, quality of life, and lower costs. Tuberous sclerosis complex (TSC) is a genetic multisystem disorder. Renal involvement (multiple bilateral angiomyolipoma [AMLs], cysts, renal cell carcinoma [RCC]) is related to significant morbidity, including ESKD and KT. Nephrectomy in TSC patients before KT is controversial. Affected kidneys carry a risk of hemorrhage or malignancy, while AMLs may be fat-poor and are often hardly distinguishable from RCC in magnetic resonance (MR)/computed tomography. On the other hand nephrectomy impedes PE KT. Mammalian target of rapamycin inhibitors (mTORi) have proved efficacy in many TSC complications, including AMLs, fat-poor AMLs, TSC-related RCC, and immunosuppressive (IS) treatment. CASE REPORT A 29-year-old female TSC patient was referred for evaluation to the TSC reference center. Her family history was negative for TSC. A clinical evaluation revealed multisystem TSC manifestation (skin, brain, lungs, kidneys). MR disclosed indeterminate fat-poor renal lesions, possibly AMLs, but RCC could not be excluded. A comparison with previous MR did not show any significant progression. Due to ESKD, the patient was qualified for PE LD (mother) KT. mTORi, sirolimus, was used in IS. Creatinine at discharge was 2.1 mg/dL. Sixteen months later, MR showed significant reduction in tumor size. Two years after KT, graft function remained stable (creatinine 1.98 mg/dL). No complications related to renal lesions occurred. CONCLUSIONS mTORi are the therapy of choice in TSC patients after KT, achieving IS effect and improvement in TSC manifestations while avoiding nephrectomy and management of patients with indeterminate renal lesions, especially in the case of PE KT.
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Affiliation(s)
- Agnieszka Tarasewicz
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Beata Rutkowska
- Department of Radiology, University Clinic Center, Gdańsk, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
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Durawa A, Dziadziuszko K, Jelitto-Górska M, Szurowska E. Emphysema - The review of radiological presentation and its clinical impact in the LDCT screening era. Clin Imaging 2020; 64:85-91. [PMID: 32388002 DOI: 10.1016/j.clinimag.2020.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/24/2020] [Accepted: 04/07/2020] [Indexed: 12/17/2022]
Abstract
Emphysema is one of three main lung pathologies in Chronic Obstructive Pulmonary Disease, along with chronic bronchitis and small airway obstruction. The diagnosis is based on detection of low attenuation areas in lung tissue on chest Computed Tomography, either visual by a radiologist, or automatic by the applied Computed Tomography software. Results of the studies on the association between emphysema and lung cancer incidence are mixed. Many studies have demonstrated, that chronic lung diseases, like Chronic Obstructive Pulmonary Disease, are associated with lung cancer morbidity. There is also evidence, that emphysema can be related with worse prognosis in patients with detected lung cancer. In this review article we aim to summarize current knowledge about emphysema detection and evaluation on Computed Tomography, both quantitative and qualitative. We also summarize current data on correlation between emphysema and lung cancer, as well as its potential use in selecting patients, who would most benefit from lung cancer screening.
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Affiliation(s)
- Agata Durawa
- 2nd Department of Radiology, Medical University of Gdansk, ul. Smoluchowskiego 17, 80-001 Gdansk, Poland.
| | - Katarzyna Dziadziuszko
- 2nd Department of Radiology, Medical University of Gdansk, ul. Smoluchowskiego 17, 80-001 Gdansk, Poland
| | - Małgorzata Jelitto-Górska
- 2nd Department of Radiology, Medical University of Gdansk, ul. Smoluchowskiego 17, 80-001 Gdansk, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, ul. Smoluchowskiego 17, 80-001 Gdansk, Poland
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Banach-Ambroziak E, Jankowska M, Grzywińska M, Szurowska E, Dębska-Ślizień A. Application of Total Kidney Volume and Its Predictive Value in Assessment of Kidney Transplant Waitlist Candidates With Autosomal Dominant Polycystic Kidney Disease. Transplant Proc 2020; 52:2273-2277. [PMID: 32312534 DOI: 10.1016/j.transproceed.2020.02.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/15/2020] [Accepted: 02/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is one of the most prevalent causes of kidney transplantation (KTx) worldwide. About 40% of ADPKD patients require peritransplant native kidney nephrectomy (NKN). The decision regarding qualification for NKN usually relies on the surgeon's expertise. Currently used qualification criteria are subjective and incomparable between clinical centers. There is a need to identify the indications for NKN by applying radiologically based methods to the decision-making process. AIM To assess the usefulness of radiologic parameters in the qualification process of ADPKD waitlist candidates for the NKN procedure. METHOD A retrospective, observational study in a cohort of ADPKD patients in a single institution was conducted. The study included the participation of waitlist candidates and kidney transplant recipients with computed tomography (CT) or magnetic resonance imaging (MRI) obtained in the peritransplant period. The correlation of imaging-based measurements with the results of clinical qualification for the NKN procedure was assessed. RESULTS In the years 2012 to 2019, 19 patients completed the inclusion criteria. Total kidney volume (TKV) values were statistically more significant in the NKN group (n = 10) than in the non-NKN group (n = 9), with medians of 3351 mL and 1654 mL, respectively (P = .016). There were no significant differences between the groups in terms of the ratio of complex cyst volume to TKV, with the NKN group having a ratio of 19.2% and the non-NKN group 15.6% (P = .095). Venous compression was found only in the NKN group (n = 2). CONCLUSIONS TKV highly correlates with the results of clinical qualification for NKN. Radiologic assessment enables the detection of complicated cysts or clinically silent states of venous compression. Pretransplant imaging should be routinely obtained.
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Affiliation(s)
| | - Magdalena Jankowska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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