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Cahalane AM, Habibollahi S, Staffa SJ, Yang K, Fintelmann FJ, Chang CY. Helical CT versus intermittent CT fluoroscopic guidance for musculoskeletal needle biopsies: impact on radiation exposure, procedure time, diagnostic yield, and adverse events. Skeletal Radiol 2022. [PMID: 36355218 DOI: 10.1007/s00256-022-04226-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Image-guided percutaneous needle biopsies are essential in the workup of musculoskeletal (MSK) lesions. While helical CT (HCT) is well established, intermittent CT fluoroscopy (iCTF) is an increasingly used alternative. The purpose of this study is to establish whether differences in subject radiation exposure, procedure time, yield, or adverse events exist between HCT and iCTF guidance. MATERIALS AND METHODS This retrospective cohort study included consecutive MSK needle biopsies performed on a single-CT scanner over a 12-month period at a tertiary academic center. Subject demographics, radiation dose, and outcomes were abstracted from the medical record. Comparisons between the two cohorts were performed using Student's t-test for continuous data and using Fisher's exact test for categorical data and a two-tailed p value less than 0.05 was considered significant. RESULTS Two hundred sixteen adults (115 (53.2%) females) with a mean age of 58.8 ± 18.4 years, underwent 216 biopsies (109 (50.5%) HCT guided, 107 (49.5%) iCTF guided) between June 2017 and June 2018. Dose-length product (DLP) and volume CT dose index (CTDIvol) were significantly higher for the HCT cohort (HCT 698.9 ± 400.8 mGycm vs iCTF 312.8 ± 170.8 mGycm; p < 0.005 and HCT 19.1 mGy ± 8.8 vs iCTF 6.9 mGy ± 1.5, p < 0.001). No significant difference in diagnostic yield, procedure time, or adverse event rate was identified. CONCLUSION For CT-guided MSK needle biopsies, iCTF decreases subject radiation dose compared to HCT without negatively affecting outcomes. iCTF should be strongly considered by radiologists performing MSK biopsies given the reduced patient radiation exposure.
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Alkulaibi MM, Suleiman AM. A Proposed Method for Cervical Lymph Node Evaluation in Head and Neck Cancer Patients: A Radiological Study. J Maxillofac Oral Surg 2022; 21:156-162. [PMID: 35400901 PMCID: PMC8934800 DOI: 10.1007/s12663-020-01341-y] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 02/20/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives To present a new method to assess the cervical lymph nodes status in head and neck cancer patients. Methods Twenty-five oral and maxillofacial cancer patients underwent preoperative CT imaging. The cervical lymph node features on CT scan were examined. Each parameter was given a score, and the total scores in each case was calculated and referred to as metastatic score (MS). Then, patients underwent neck dissection, and all dissected lymph nodes were sent for histopathology. Results All cases with MS ≥ 6 were histopathologically positive, and all cases with MS ≤ 3 were histopathologically negative. All cases of nodal sizes > 3 cm were histopathologically positive, 82% of cases of nodal sizes between 2.1 and 3 cm were histopathologically positive, 40% of cases of nodal sizes between 1 and 2 cm were histopathologically positive, and all cases of lymph nodes sizes < 1 cm were histopathologically negative. Seventy-seven percent of cases which had a group of lymph nodes ≥ 3 nodes/region were histopathologically positive, while 79% of cases with rounded nodes were histopathologically positive, and all cases with necrotic lymph nodes were positive for malignancy. Conclusion The proposed formula is a good assessment tool for cervical lymph nodes evaluation using helical CT scan in head and neck cancer patients.
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Affiliation(s)
- Mohammed Musid Alkulaibi
- grid.9763.b0000 0001 0674 6207Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan ,grid.412413.10000 0001 2299 4112Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sana’a University, Sana’a, Yemen
| | - Ahmed Mohamed Suleiman
- grid.9763.b0000 0001 0674 6207Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Wang R, Jiao Z, Yang L, Choi JW, Xiong Z, Halsey K, Tran TML, Pan I, Collins SA, Feng X, Wu J, Chang K, Shi LB, Yang S, Yu QZ, Liu J, Fu FX, Jiang XL, Wang DC, Zhu LP, Yi XP, Healey TT, Zeng QH, Liu T, Hu PF, Huang RY, Li YH, Sebro RA, Zhang PJL, Wang J, Atalay MK, Liao WH, Fan Y, Bai HX. Artificial intelligence for prediction of COVID-19 progression using CT imaging and clinical data. Eur Radiol 2021; 32:205-212. [PMID: 34223954 PMCID: PMC8256200 DOI: 10.1007/s00330-021-08049-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 11/20/2020] [Revised: 02/11/2021] [Accepted: 05/05/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Early recognition of coronavirus disease 2019 (COVID-19) severity can guide patient management. However, it is challenging to predict when COVID-19 patients will progress to critical illness. This study aimed to develop an artificial intelligence system to predict future deterioration to critical illness in COVID-19 patients. METHODS An artificial intelligence (AI) system in a time-to-event analysis framework was developed to integrate chest CT and clinical data for risk prediction of future deterioration to critical illness in patients with COVID-19. RESULTS A multi-institutional international cohort of 1,051 patients with RT-PCR confirmed COVID-19 and chest CT was included in this study. Of them, 282 patients developed critical illness, which was defined as requiring ICU admission and/or mechanical ventilation and/or reaching death during their hospital stay. The AI system achieved a C-index of 0.80 for predicting individual COVID-19 patients' to critical illness. The AI system successfully stratified the patients into high-risk and low-risk groups with distinct progression risks (p < 0.0001). CONCLUSIONS Using CT imaging and clinical data, the AI system successfully predicted time to critical illness for individual patients and identified patients with high risk. AI has the potential to accurately triage patients and facilitate personalized treatment. KEY POINT • AI system can predict time to critical illness for patients with COVID-19 by using CT imaging and clinical data.
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Affiliation(s)
- Robin Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Center for Biomedical Image Computation and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Zhicheng Jiao
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Center for Biomedical Image Computation and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Li Yang
- Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ji Whae Choi
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA.,Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Zeng Xiong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Kasey Halsey
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA.,Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Thi My Linh Tran
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA.,Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Ian Pan
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA
| | - Scott A Collins
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA
| | - Xue Feng
- Carina Medical, Carina, Australia
| | - Jing Wu
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ken Chang
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lin-Bo Shi
- Department of Radiology, Yongzhou Central Hospital, Yongzhou, China
| | - Shuai Yang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Qi-Zhi Yu
- Department of Radiology, The First Hospital of Changsha, Changsha, China
| | - Jie Liu
- Department of Radiology, Changde Second People's Hospital, Changde, China
| | - Fei-Xian Fu
- Department of Radiology, Yiyang City Center Hospital, Yiyang, China
| | - Xiao-Long Jiang
- Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, China
| | - Dong-Cui Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Li-Ping Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Ping Yi
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Terrance T Healey
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA
| | - Qiu-Hua Zeng
- Department of Radiology, Loudi Central Hospital, Loudi, China
| | - Tao Liu
- Brown University School of Public Health, Providence, RI, USA
| | - Ping-Feng Hu
- Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, China
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Yi-Hui Li
- Department of Radiology, Zhuzhou Central Hospital, Zhuzhou, China
| | - Ronnie A Sebro
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Center for Biomedical Image Computation and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Paul J L Zhang
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Center for Biomedical Image Computation and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jianxin Wang
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Michael K Atalay
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA
| | - Wei-Hua Liao
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
| | - Yong Fan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Center for Biomedical Image Computation and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Harrison X Bai
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, 02903, USA. .,Warren Alpert Medical School at Brown University, Providence, RI, USA.
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Dar G, Goldberg SN, Hiller N, Caplan N, Sosna J, Appelbaum L, Lev-Cohain N. CT severity indices derived from low monoenergetic images at dual-energy CT may improve prediction of outcome in acute pancreatitis. Eur Radiol 2021; 31:4710-9. [PMID: 33404695 DOI: 10.1007/s00330-020-07477-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/14/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine whether imaging features and severity indices using low monoenergetic DECT images improve diagnostic conspicuity and outcome prediction in acute pancreatitis compared to conventional images. METHODS A retrospective study of patients with clinical and radiographic signs of acute pancreatitis who underwent 50 contrast-enhanced CT exams conducted on a single-source DECT was performed. Representative conventional and 50 keV-monoenergetic images were randomized and presented to four abdominal radiologists to determine preferred imaging for detecting fat stranding and parenchymal inflammation. Contrast and signal-to-noise ratios were constructed for necrotic, hypoattenuated, inflamed, and healthy parenchyma. These parameters and the CT severity index (CTSI) were compared between conventional and low monoenergetic images using paired t tests and correlated to clinical outcome. RESULTS Although preference for conventional images was noted for subtle peri-pancreatic fat stranding (169/200 (85%) reads), there was clear preference for low monoenergetic images among all readers for pancreatic inflammation evaluation (188/200 (94%) reads). Moreover, identification of small, hypoattenuating inflammatory foci on monoenergetic images alone in 13/50 (26%) cases resulted in upstaged CTSI from mild to moderate in 7/50 (14%), associated with longer hospitalization (16 ± 17 days vs. 5 ± 2 days; p < 0.05), ICU admission, and drainage. Quantitatively, a twofold difference between normal and inflamed parenchyma attenuation was identified for monoenergetic (44.8 ± 27.6) vs. conventional (25.1 ± 14.7) images (p < 0.05). Significant increases were seen in the monoenergetic SNR and CNR compared to the conventional images (p < 0.05). CONCLUSIONS DECT low monoenergetic images afford better tissue assessment and demarcation of inflamed pancreatic parenchyma. Additionally, they provide improved characterization of the extent parenchymal necrosis, enabling better classification that may better predict severe clinical outcomes. KEY POINTS • DECT low monoenergetic images afford better tissue assessment and demarcation of inflamed pancreatic parenchyma and provide improved characterization of the extent parenchymal necrosis. • Qualitatively, low monoenergetic images were preferred over conventional DECT images for the evaluation of pancreatic inflammation; and quantitatively, there is a twofold difference between normal and inflamed parenchyma attenuation, SNR, and CNR between monoenergetic vs. conventional images. • Monoenergetic imaging identified additional small, hypoattenuating inflammatory foci in 26% resulting in an upstaged CT severity index in 14% associated with longer hospitalization, ICU admission, and drainage, thereby enabling better classification and better prediction of severe clinical outcomes.
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Perisinakis K, Ntoufas N, Velivassaki M, Tzedakis A, Myronakis M, Hatzidakis A, Damilakis J. Effect of scan projection radiography coverage on tube current modulation in pediatric and adult chest CT. Z Med Phys 2020; 30:259-270. [PMID: 32513526 DOI: 10.1016/j.zemedi.2020.05.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/22/2020] [Accepted: 05/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the effect of scan projection radiography (SPR) coverage on tube current modulation in pediatric and adult thoracic CT examinations. METHODS Sixty pediatric and 60 adult chest CT examinations were retrospectively studied to determine the incidence rate of examinations involving SPRs that did not include the entire image volume (IV) or the entire primarily exposed body volume (PEBV). The routine chest CT acquisition procedure on a modern 64-slice CT system was imitated on five anthropomorphic phantoms of different size. SPRs of varying length were successively acquired. The same IV was prescribed each time and the computed tube current modulation plan was recorded. The SPR boundaries were altered symmetrically by several steps of ±10mm with respect to the IV boundaries. RESULTS The upper IV boundary was found to be excluded from SPR in 52% of pediatric and 40% adult chest CT examinations. The corresponding values for the lower boundary were 15% and 20%, respectively. The computed tube current modulation was found to be considerably affected when the SPR did not encompass the entire IV. SPR deficit of 3cm was found to induce up to 46% increase in the computed tube current value to be applied during the first tube rotations over lung apex. CONCLUSIONS The tube current modulation mechanism functions properly only if the IV set by the operator is entirely included in the localizing SPR image. Operators should cautiously set the SPR boundaries to avoid partial exclusion of prescribed IV from SPRs and thus achieve optimum tube current modulation.
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Affiliation(s)
- Kostas Perisinakis
- University of Crete, Medical School, Department of Medical Physics, 71003 Heraklion, Crete, Greece; University Hospital of Heraklion, Department of Medical Physics, P.O. Box 1352, 71110 Heraklion, Crete, Greece.
| | - Nikos Ntoufas
- University of Crete, Medical School, Department of Medical Physics, 71003 Heraklion, Crete, Greece
| | - Mary Velivassaki
- University Hospital of Heraklion, Department of Medical Physics, P.O. Box 1352, 71110 Heraklion, Crete, Greece
| | - Antonis Tzedakis
- University Hospital of Heraklion, Department of Medical Physics, P.O. Box 1352, 71110 Heraklion, Crete, Greece
| | - Marios Myronakis
- University of Crete, Medical School, Department of Medical Physics, 71003 Heraklion, Crete, Greece; Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School
| | - Adam Hatzidakis
- University of Crete, Medical School, Department of Radiology, Heraklion, Crete, Greece
| | - John Damilakis
- University of Crete, Medical School, Department of Medical Physics, 71003 Heraklion, Crete, Greece; University Hospital of Heraklion, Department of Medical Physics, P.O. Box 1352, 71110 Heraklion, Crete, Greece
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Andersen MB, Ebbesen D, Thygesen J, Kruis M, Rasmussen F. Impact of spectral body imaging in patients suspected for occult cancer: a prospective study of 503 patients. Eur Radiol 2020; 30:5539-5550. [PMID: 32367416 PMCID: PMC7476920 DOI: 10.1007/s00330-020-06878-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 02/07/2023]
Abstract
Objectives To investigate the diagnostic impact and performance of spectral dual-layer detector CT in the detection and characterization of cancer compared to conventional CE-CT. Methods In a national workup program for occult cancer, 503 patients (286 females and 217 males) were prospectively enrolled for a contrast-enhanced spectral CT scan. The readings were performed with and without spectral data available. A minimum of 3 months between interpretations was implemented to minimize recall bias. The sequence of reads for the individual patient was randomized. Readers were blinded for patient identifiers and clinical outcome. Two radiologists with 9 and 33 years of experience performed the readings in consensus. If disagreement, a third radiologist with 11 years of experience determined the outcome of the reading Results Significantly more cancer findings were identified on the spectral reading. In 73 cases of proven cancer, we found a sensitivity of 89% vs 77% and a specificity of 77% vs 83% on spectral CT compared to conventional CT. A slight increase in reading time in spectral images of 82 s was found (382 vs 300, p < 0.001). For all cystic lesions, the perceived diagnostic certainty increased from 30% being completely certain to 96% most pronounced in the kidney, liver, thyroid, and ovaries. And adding the spectral information to the reading gave a decrease in follow-up examination for diagnostic certainty (0.25 vs 0.81 per reading, p < 0.001). Conclusion The use of contrast-enhanced spectral CT increases the confidence of the radiologists in correct characterization of various lesions and minimizes the need for supplementary examinations. Key Points • Spectral CT is associated with a higher sensitivity, but a slightly lower specificity compared to conventional CT. • Spectral CT increases the confidence of the radiologists. • The need for supplementary examinations is decreased, with only a slight increase in reading times. Electronic supplementary material The online version of this article (10.1007/s00330-020-06878-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Brun Andersen
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark.
- Department of Radiology, Zealand University Hospital Roskilde, Sygehusvej 10, Roskilde, 4000, Denmark.
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 161, Aarhus, 8200, Denmark.
| | - Dyveke Ebbesen
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 161, Aarhus, 8200, Denmark
| | - Jesper Thygesen
- Department of Clinical Engineering, Central Denmark Region, Nørrebrogade 44, Building 2A, Aarhus, 8000, Denmark
| | - Matthijs Kruis
- Philips Medical Systems, Clinical Science, CT, Veenpluis 4-6, Best, 5684, The Netherlands
| | - Finn Rasmussen
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 161, Aarhus, 8200, Denmark
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Velasco Gonzalez A, Buerke B, Görlich D, Fobker M, Rusche T, Sauerland C, Meier N, Jeibmann A, McCarthy R, Kugel H, Sporns P, Faldum A, Paulus W, Heindel W. Clot Analog Attenuation in Non-contrast CT Predicts Histology: an Experimental Study Using Machine Learning. Transl Stroke Res 2020; 11:940-949. [PMID: 31933117 DOI: 10.1007/s12975-019-00766-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/14/2019] [Revised: 12/01/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
Exact histological clot composition remains unknown. The purpose of this study was to identify the best imaging variables to be extrapolated on clot composition and clarify variability in the imaging of thrombi by non-contrast CT. Using a CT-phantom and covering a wide range of histologies, we analyzed 80 clot analogs with respect to X-ray attenuation at 24 and 48 h after production. The mean, maximum, and minimum HU values for the axial and coronal reconstructions were recorded. Each thrombus underwent a corresponding histological analysis, together with a laboratory analysis of water and iron contents. Decision trees, a type of supervised machine learning, were used to select the primary variable altering attenuation and the best parameter for predicting histology. The decision trees selected red blood cells (RBCs) for correlation with all attenuation parameters (p < 0.001). Conversely, maximum attenuation on axial CT offered the greatest accuracy for discriminating up to four groups of clot histology (p < 0.001). Similar RBC-rich thrombi displayed variable imaging associated with different iron (p = 0.023) and white blood cell contents (p = 0.019). Water content varied among the different histologies but did not in itself account for the differences in attenuation. Independent factors determining clot attenuation were the RBCs (β = 0.33, CI = 0.219-0.441, p < 0.001) followed by the iron content (β = 0.005, CI = 0.0002-0.009, p = 0.042). Our findings suggest that it is possible to extract more and valuable information from NCCT that can be extrapolated to provide insights into clot histological and chemical composition.
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Affiliation(s)
- Aglae Velasco Gonzalez
- Department of Clinical Radiology, Neuroradiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany.
| | - Boris Buerke
- Department of Clinical Radiology, Neuroradiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstraße 56, 48149, Muenster, Germany
| | - Manfred Fobker
- Center for Laboratory Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Thilo Rusche
- Department of Clinical Radiology, Neuroradiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Cristina Sauerland
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstraße 56, 48149, Muenster, Germany
| | - Norbert Meier
- Department of Clinical Radiology, Medical Physics, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Astrid Jeibmann
- Institute of Neuropathology, University Hospital Muenster, Pottkamp 2, 48149, Muenster, Germany
| | - Ray McCarthy
- Cerenovus, Galway Neuro Technology Centre, Mervue Business Park, Galway, Ireland
| | - Harald Kugel
- Department of Clinical Radiology, Medical Physics, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Peter Sporns
- Department of Clinical Radiology, Neuroradiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
| | - Andreas Faldum
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstraße 56, 48149, Muenster, Germany
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Muenster, Pottkamp 2, 48149, Muenster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, Neuroradiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany
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Sato H, Okada F, Matsumoto S, Mori H, Kashiwagi J, Komatsu E, Maeda T, Nishida H, Daa T, Ohtani S, Umeki K, Ando M, Kadota J. The scab-like sign: A CT finding indicative of haemoptysis in patients with chronic pulmonary aspergillosis? Eur Radiol 2018; 28:4053-61. [PMID: 29725831 DOI: 10.1007/s00330-018-5434-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/18/2018] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aim of this study was to assess the CT findings that characterise haemoptysis in patients with chronic pulmonary aspergillosis (CPA). METHODS We retrospectively identified 120 consecutive patients with CPA (84 men and 36 women, 17-89 years of age, mean age 68.4 years) who had undergone a total of 829 CT examinations between January 2007 and February 2017. In the 11 patients who underwent surgical resection, CT images were compared with the pathological results. RESULTS The scab-like sign was seen on 142 of the 829 CT scans, specifically, in 87 of the 90 CT scans for haemoptysis and in 55 of the 739 CT scans obtained during therapy evaluation. In 48 of those 55 patients, haemoptysis occurred within 55 days (mean 12.0 days) after the CT scan. In the 687 CT scans with no scab-like sign, there were only three instances of subsequent haemoptysis in the respective patients over the following 6 months. Patients with and without scab-like sign differed significantly in the frequency of haemoptysis occurring after a CT scan (p<0.0001). Pathologically, the scab-like sign corresponded to a fibrinopurulent mass or blood crust. CONCLUSIONS The scab-like sign should be considered as a CT finding indicative of haemoptysis. KEY POINTS • Haemoptysis is commonly found in patients with CPA. • A CT finding indicative of haemoptysis in CPA patients is described. • Scab-like sign may identify CPA patients at higher risk of haemoptysis.
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Ono S, Niwa T, Yanagimachi N, Yamashita T, Okazaki T, Nomura T, Hashimoto J, Imai Y. Improved image quality of helical computed tomography of the head in children by iterative reconstruction. J Neuroradiol 2015; 43:31-6. [PMID: 26519982 DOI: 10.1016/j.neurad.2015.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 07/15/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Iterative reconstruction (IR) offers noise reduction and improved image quality of computed tomography (CT). Our aim was to assess the imaging quality of non-contrast helical CT of the head in children using IR. MATERIALS AND METHODS This study recruited 78 consecutive children aged ≤5 years (range: from 3 months to 5 years; mean: 1.7 years) who underwent an emergent non-enhanced helical CT of the head with no abnormal findings. The acquired data were reconstructed using filtered back projection (FBP) and sinogram-affirmed IR (SAFIRE) with strength levels of 2 (IR2) and 4 (IR4). The imaging quality of FBP, IR2 and IR4 was scored by two experienced neuroradiologists in terms of the contrast between the gray-white matter junction and artifacts from the skull at the level of the semioval center, basal ganglia and fourth ventricle. FBP, IR2 and IR4 scores were compared at each slice level. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for FBP, IR2 and IR4 and were compared among the three reconstruction algorithms. RESULTS The score of IR2 and IR4 was significantly higher than that of FBP in terms of both the contrast between the gray-white matter junction and artifacts from the skull at each slice level (P<0.001). SNR and CNR on IR4 were the highest followed by those on IR2 and FBP (P<0.001). CONCLUSIONS IR may improve the image quality of helical CT of the head in children.
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Affiliation(s)
- Shun Ono
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
| | - Tetsu Niwa
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan.
| | - Noriharu Yanagimachi
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
| | - Tomohiro Yamashita
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan; Department of Radiology, Isehara Kyodo Hospital, 345, Tanaka, Isehara 259-1132, Japan
| | - Takashi Okazaki
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
| | - Takakiyo Nomura
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
| | - Jun Hashimoto
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine, 143, Shimokasuya, Isehara 259-1193, Japan
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Turmezei TD, Treece GM, Gee AH, Fotiadou AF, Poole KE. Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography. Eur Radiol 2016; 26:2047-54. [PMID: 26443603 DOI: 10.1007/s00330-015-4048-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 09/11/2015] [Accepted: 09/24/2015] [Indexed: 12/03/2022]
Abstract
Objective To assess the relationship between proximal femoral cortical bone thickness and radiological hip osteoarthritis using quantitative 3D analysis of clinical computed tomography (CT) data. Methods Image analysis was performed on clinical CT imaging data from 203 female volunteers with a technique called cortical bone mapping (CBM). Colour thickness maps were created for each proximal femur. Statistical parametric mapping was performed to identify statistically significant differences in cortical bone thickness that corresponded with the severity of radiological hip osteoarthritis. Kellgren and Lawrence (K&L) grade, minimum joint space width (JSW) and a novel CT-based osteophyte score were also blindly assessed from the CT data. Results For each increase in K&L grade, cortical thickness increased by up to 25 % in distinct areas of the superolateral femoral head–neck junction and superior subchondral bone plate. For increasing severity of CT osteophytes, the increase in cortical thickness was more circumferential, involving a wider portion of the head–neck junction, with up to a 7 % increase in cortical thickness per increment in score. Results were not significant for minimum JSW. Conclusions These findings indicate that quantitative 3D analysis of the proximal femur can identify changes in cortical bone thickness relevant to structural hip osteoarthritis. Key Points • CT is being increasingly used to assess bony involvement in osteoarthritis • CBM provides accurate and reliable quantitative analysis of cortical bone thickness • Cortical bone is thicker at the superior femoral head–neck with worse osteoarthritis • Regions of increased thickness co-locate with impingement and osteophyte formation • Quantitative 3D bone analysis could enable clinical disease prediction and therapy development Electronic supplementary material The online version of this article (doi:10.1007/s00330-015-4048-x) contains supplementary material, which is available to authorized users.
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Wang Y, Zhang FX, Chang ZH, Liu X, Deng SX, Zhao HX. EUS versus CT for preoperative TN staging of adenocarcinoma of the esophagogastric junction. Shijie Huaren Xiaohua Zazhi 2013; 21:1977-1981. [DOI: 10.11569/wcjd.v21.i20.1977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the accuracy of endoscopic ultrasonography (EUS) versus computed tomography (CT) in TN staging of the adenocarcinoma of the esophagogastric Junction (AEG).
METHODS: Ninety-one patients with pathologically proven AEG who received preoperative EUS and helical CT and surgical resection from February 2007 to December 2012 and had complete clinical data were included in this study. The accuracy of EUS versus CT in TN staging of AEG was compared.
RESULTS: The overall accuracy rates of preoperative T staging and N staging by EUS were 81.3% and 86.8%, respectively, significantly higher than those by helical CT (58.2% and 58.3%, respectively).
CONCLUSION: Compared with helical CT, EUS is associated with a higher accuracy in preoperative TN staging of AEG.
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Soyer P, Dohan A, Eveno C, Naneix AL, Pocard M, Pautrat K, Hamzi L, Duteil C, Lavergne-Slove A, Boudiaf M. Pitfalls and mimickers at 64-section helical CT that cause negative appendectomy: an analysis from 1057 appendectomies. Clin Imaging 2013; 37:895-901. [PMID: 23845254 DOI: 10.1016/j.clinimag.2013.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 03/04/2013] [Revised: 04/13/2013] [Accepted: 05/09/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE To determine the rate of negative appendectomy and clarify the causes of negative appendectomy in patients with clinically suspected acute appendicitis who had surgery after 64-section helical computed tomography (CT). MATERIAL AND METHODS A retrospective analysis of 1057 patients who had appendectomy after 64-section helical CT was performed to determine the rate of negative appendectomy. The 64-section helical CT examinations obtained with submillimeter and isotropic voxels in the patients with negative appendectomy were analyzed by two readers and compared to clinical, operative and histopathological reports, discharge summaries and original radiology reports. RESULTS The negative appendectomy rate was 1.7% (18/1057). Appendix enlargement (>6 mm) and fat stranding were present in 17 (17/18; 94%) and 6 patients (6/18; 33%), respectively. In 13 patients (13/18; 72%) 64-section helical CT findings were consistent with acute appendicitis. Interpretive errors in original imaging reports were identified in five patients (5/18; 28%). CONCLUSION The preoperative use of 64-section helical CT results in a very low rate of negative appendectomy. Patients with negative appendectomy have 64-section helical CT findings consistent with a diagnosis of acute appendicitis in the majority of cases. Interpretive errors are less frequent.
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Affiliation(s)
- Philippe Soyer
- Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10 rue de Verdun, 75010 Paris, France; INSERM, U 965, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
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Saberi H, Hashemi M, Habibi Z, Tayebi Meybodi A, Fakhr Tabatabai SA, Saberi H, Saboori S. Diagnostic accuracy of early computed tomographic angiography for visualizing medium sized inferior and posterior projecting carotid system aneurysms. Iran J Radiol 2011; 8:139-44. [PMID: 23329930 PMCID: PMC3522323 DOI: 10.5812/kmp.iranjradiol.17351065.3135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/21/2010] [Revised: 07/10/2011] [Accepted: 07/15/2011] [Indexed: 11/16/2022]
Abstract
Background Conventional angiography, generally referred to as intra-arterial digital subtraction angiography, still remains the gold standard reference method for the diagnosis of intracranial aneurysms, helical computed tomography angiography (CTA) is a new non-invasive volumetric imaging method. Objectives This study was conducted to screen patients presenting with subarachnoidhemorrhage by CTA before conventional digital subtraction angiography (DSA) and subsequently comparing the results for various aneurysm projections. Patients and Methods In a prospective study, 99 consecutive patients with an initial diagnosis of subarachnoid hemorrhage were screened for aneurysms with CTA followed by conventional DSA. There were 17 cases with negative angiograms in whom repeat angiograms, three months later were negative for 15 cases, while two cases were found to bear aneurysm on the repeat examination. Eighty two patients had at least one proven aneurysm on initial DSA and two on the repeat angiogram. Out of 84 patients, five underwent endovascular treatment and 79 patients who underwent surgical clipping were considered for projection evaluation. Results Sensitivity of CTA was 98.78% (95% confidence interval [CI], 93.4-99.7%), while the specificity was 100% (95% CI, 81.57-100%) and the kappa coefficient of agreement between CTA and DSA was 96.5%. The most significant discrepancies with DSA findings were for visualizing the projection of inferior and posterior projecting proximal anterior circulation aneurysms. Conclusions Helical CTA was in good concordance with DSA for screening of cerebral aneurysms; however, for exact visualization of the aneurysm neck and its projection, especially if it is inferior or posterior, DSA remains the gold standard.
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Affiliation(s)
- Hooshang Saberi
- Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Hooshang Saberi, Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Blvd, P O. Box: 14197, Tehran, Iran. Tel.: +98-2166939330, Fax: +98-2166939330, E-mail:
| | - Mohammad Hashemi
- Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Habibi
- Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Tayebi Meybodi
- Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fakhr Tabatabai
- Department of Neurosurgery, Brain and Spinal Cord Injuries Repair Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hazhir Saberi
- Department of Radiology, Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Xiao L, Xu K. Clinical application of normal saline flush in multi-detector CT photography on portal vein. Shijie Huaren Xiaohua Zazhi 2005; 13:2343-2348. [DOI: 10.11569/wcjd.v13.i19.2343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the clinical application of normal saline flush technique in improving the three-dimensional image quality of multi-detector helical CT-photography obtained by maximum intensity projection (MIP).
METHODS: Fifty-eight patients were randomly divided into two groups. Patients in the two groups were both injected with 2.0 mL/kg contrast material (300 gI/L), and patients in group A were also treated with 30 mL saline flush (3 mL/s). The injection of the contrast material lasted 33 s in both groups. The scanning was performed 45 s after injection. The scanning started at the level of the diaphragm and covered the entire liver and spleen. The acquired raw data were reconstructed at an interval of 1 mm. The CT values of the right hepatic lobe (RHL), main portal vein (MPV), right portal vein (RPV), and abdominal aorta were assessed. MIP images of 3D-CTP were visually graded by the four point-scoring system.
RESULTS: The mean CT attenuation values of MPV, RPV, and RPV-RHL were higher in group A. The differences between the two groups were 25.0, 19.7, and 17.6 Hu (P = 0.006, 0.047, and 0.042, respectively). The rates of the excellent or good MIP images were 60.7% (17/28) in group A, and 33.3% (10/30) in group B. The mean score of the differences was 0.59, which was significant between the two groups (P = 0.040).
CONCLUSION: The saline flush technique can increase the CT attenuation value of portal vein as well as improve the quality of its MIP images.
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