Iodine uptake of adrenal glands: A novel and reliable spectral dual-layer computed tomographic-derived biomarker for acute septic shock

OBJECTIVES

Septic shock is a potentially fatal condition. This study aims to assess whether iodine uptake and iodine density of abdominal organs on dual-layer spectral detector computed tomography (SDCT) could serve as a new imaging biomarker for patients in septic shock.

METHODS

Here, 95 patients who received contrast-enhanced abdominal CT examinations were included and separated into two groups: group A - septic shock; group B - no shock condition. Preselected abdominal (right and left adrenal gland, right and left kidney, infrarenal inferior vena cava (IVC), pancreas, spleen, and liver) localizations were independently evaluated by two radiologists, who measured iodine concentrations (mg/ml) and Hounsfield units (HU).

RESULTS

In all, 1520 measurements of iodine concentrations in mg/ml and HU were performed, with 27 patients in group A and 68 in group B. Iodine concentrations in mg/ml and HU correlated significantly in all organs measured. The corresponding correlation coefficient (r) ranged from 0.809 (pancreas) to 0.963 (right kidney). Inter-rater reliability (IRR) was very good for mg/ml (κ = 0.8; p < 0.01) and good for HU (κ = 0.773; p < 0.01) measurements. The mean iodine concentration and HU of the adrenal glands in septic and nonseptic patients was 4.88 ± 1.16 mg/ml/153 ± 36 HU and 2.67 ± 1.07 mg/ml/112 ± 41 HU, respectively. Iodine concentrations in the adrenal glands were significantly higher in group A than in group B patients (p < 0.01). The other organs remained unaffected and no significant difference was observed between patients in group A and B. Patients in group A presented significantly more often with an iodine uptake of >3.5 mg/ml of one adrenal gland (sensitivity = 0.926, specificity = 0.849, AUC = 0.951) or/and a combined concentration of >7 mg/ml of both adrenal glands (sensitivity = 0.889, specificity = 0.836, AUC = 0.928).

CONCLUSION

SDCT-derived iodine concentration of the adrenal glands could serve as a novel imaging biomarker for patients in acute septic shock. Our data suggest that an iodine uptake of >3.5 mg/ml of at least one adrenal gland or a combined iodine uptake of >7 mg/ml in both adrenal glands identifies patients in this condition.

Highly efficient removal of methylene blue by a synthesized TiO2/montmorillonite-albumin nanocomposite: kinetic and isothermal analysis in water

Color removal from industrial effluents, especially in the textile and dyeing industries, is of great interest nowadays.

Bacterial colonization and occurrence of Legionella pneumophila in warm and cold water, in faucet aerators, and in drains of hospitals

Warm and cold water as well as water from wash basin drains and faucet aerators was examined to determine the number of viable and dead bacteria by culture and by staining and to establish the spectrum of species with special consideration of Legionella pneumophila. The relation between the number of Legionella pneumophila, the temperature, and the iron content of the water was determined in three separate warm water systems. High colony counts (up to 8.9 X 10(5) colony-forming units), were detected in both warm and cold water at certain sampling sites. The most prevalent genera were Pseudomonas, Bacillus, Flavobacterium, Acinetobacter, and Moraxella. Legionella pneumophila was found in every building in 35 of 150 warm samples and in 1 of 43 cold water samples. The highest water temperature of a sample containing Legionella pneumophila was 64 degrees C. The correlation between high colony counts and the occurrence of Legionella pneumophila in the samples was not significant. High iron concentrations, however, appear to have a positive effect on the growth of Legionella pneumophila.