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Journal of Digital Imaging Jun 2022The National Health Systems have been severely stressed out by the COVID-19 pandemic because 14% of patients require hospitalization and oxygen support, and 5% require...
The National Health Systems have been severely stressed out by the COVID-19 pandemic because 14% of patients require hospitalization and oxygen support, and 5% require admission to an Intensive Care Unit (ICU). Relationship between COVID-19 prognosis and the extent of alterations on chest CT obtained by both visual and software-based quantification that expresses objective evaluations of the percentage of ventilated lung parenchyma compared to the affected one has been proven. While commercial applications for automatic medical image computing and visualization are expensive and limited in their spread, the open-source systems are characterized by not enough standardization and time-consuming troubles. We analyzed chest CT exams on 246 patients suspected of COVID-19 performed in the Emergency Department CT room. The lung parenchyma segmentation was obtained by a threshold-based method using the open-source 3D Slicer software and software tools called "Segment Editor" and "Segment Quantification." For the three main characteristics analyzed on lungs affected by COVID-19 pneumonia, a specifical densitometry value range was defined: from - 950 to - 700 HU for well-aerated parenchyma; from - 700 to - 250 HU for interstitial lung disease; from - 250 to 250 HU for parenchymal consolidation. For the well-aerated parenchyma and the interstitial alterations, the procedure was semi-automatic with low time consumption, whereas consolidations' analysis needed manual interventions by the operator. After the chest CT, 13% of the sample was admitted to intensive care, while 34% of them to the sub-intensive care. In patients moved to intensive care, the parenchyma analysis reported a higher crazy paving presentation. The quantitative analysis of the alterations affecting the lung parenchyma of patients with COVID-19 pneumonia can be performed by threshold method segmentation on 3D Slicer. The segmentation could have an important role in the quantification in different COVID-19 pneumonia presentations, allowing to help the clinician in the correct management of patients.
Topics: COVID-19; Humans; Lung; Pandemics; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 35091874
DOI: 10.1007/s10278-022-00593-z -
Schweizer Archiv Fur Tierheilkunde Dec 2021The sonographic findings of the udder parenchyma and udder lymph nodes in 30 lactating sheep after experimental infection with Mycoplasma agalactiae are described. The...
The sonographic findings of the udder parenchyma and udder lymph nodes in 30 lactating sheep after experimental infection with Mycoplasma agalactiae are described. The objective of the study was to describe infection related changes in the udder parenchyma and udder lymph nodes using physical, sonographic, and histological examination and to detect associations between sonographic and histological changes of the tissues. Animals were intramammarily infected with different mutant cocktails and the wild type PG2. One group served as a negative control. A 15 MHz linear transducer (Esaote MyLab 30 CV, Esaote, Florence, Italy) was used for sonographic examinations. Compared with the uninfected control group with homogeneously granular parenchyma, the udder lymph nodes were larger and the udder parenchyma was more inhomogeneous and partially hyperechoic. The corresponding histological findings in infected mammary glands comprised proliferation of interstitial connective tissue, non-purulent interstitial mastitis, and purulent galactophoritis. The infected udder lymph nodes showed reactive hyperplasia. The findings obtained in this study may improve the diagnosis of Mycoplasma mastitis in sheep.
Topics: Animals; Female; Lactation; Mammary Glands, Animal; Mastitis; Milk; Mycoplasma Infections; Mycoplasma agalactiae; Sheep
PubMed: 34881717
DOI: 10.17236/sat00331 -
Respiratory Research Aug 2017Diffuse alveolar damage (DAD), which is the histological surrogate for acute respiratory distress syndrome (ARDS), has a multifactorial aetiology. Therefore it is...
BACKGROUND
Diffuse alveolar damage (DAD), which is the histological surrogate for acute respiratory distress syndrome (ARDS), has a multifactorial aetiology. Therefore it is possible that the immunopathology differs among the various presentations of DAD. The aim of this study is to compare lung immunopathology of viral (influenza A(H1N1)pdm09) to non-viral, extrapulmonary aetiologies in autopsy cases with DAD.
METHODS
The lung tissue of 44 patients, was divided in the H1N1 group (n = 15) characterized by severe pulmonary injury due to influenza A(H1N1)pdm09 infection; the ARDS group (n = 13), characterized by patients with DAD due to non-pulmonary causes; and the Control group (n = 16), consisting of patients with non-pulmonary causes of death. Immunohistochemistry and image analysis were used to quantify, in the parenchyma and small airways, several immune cell markers.
RESULTS
Both DAD groups had higher expression of neutrophils and macrophages in parenchyma and small airways. However, there was a higher expression of CD4+ and CD8+ T lymphocytes, CD83+ dendritic cells, granzyme A+ and natural killer + cell density in the lung parenchyma of the H1N1 group (p < 0.05). In the small airways, there was a lower cell density of tryptase + mast cells and dendritic + cells and an increase of IL-17 in both DAD groups (p < 0.05).
CONCLUSION
DAD due to viral A(H1N1)pdm09 is associated with a cytotoxic inflammatory phenotype, with partially divergent responses in the parenchyma relative to the small airways. In non-viral DAD, main immune cell alterations were found at the small airway level, reinforcing the role of the small airways in the pathogenesis of the exudative phase of DAD.
Topics: Adult; Aged; Dendritic Cells; Female; Humans; Immunity, Cellular; Influenza A Virus, H1N1 Subtype; Influenza, Human; Male; Middle Aged; Pulmonary Alveoli; Respiratory Distress Syndrome; Retrospective Studies; T-Lymphocytes
PubMed: 28774302
DOI: 10.1186/s12931-017-0630-x -
Tomography (Ann Arbor, Mich.) Jun 2022Our aim was to compare the image quality and patient dose of contrast-enhanced oncologic chest-CT of a first-generation photon-counting detector (PCD-CT) and a...
Image Quality and Radiation Dose of Contrast-Enhanced Chest-CT Acquired on a Clinical Photon-Counting Detector CT vs. Second-Generation Dual-Source CT in an Oncologic Cohort: Preliminary Results.
Our aim was to compare the image quality and patient dose of contrast-enhanced oncologic chest-CT of a first-generation photon-counting detector (PCD-CT) and a second-generation dual-source dual-energy CT (DSCT). For this reason, one hundred consecutive oncologic patients (63 male, 65 ± 11 years, BMI: 16−42 kg/m2) were prospectively enrolled and evaluated. Clinically indicated contrast-enhanced chest-CT were obtained with PCD-CT and compared to previously obtained chest-DSCT in the same individuals. The median time interval between the scans was three months. The same contrast media protocol was used for both scans. PCD-CT was performed in QuantumPlus mode (obtaining full spectral information) at 120 kVp. DSCT was performed using 100 kV for Tube A and 140 kV for Tube B. “T3D” PCD-CT images were evaluated, which emulate conventional 120 keV polychromatic images. For DSCT, the convolution algorithm was set at I31f with class 1 iterative reconstruction, whereas comparable Br40 kernel and iterative reconstruction strengths (Q1 and Q3) were applied for PCD-CT. Two radiologists assessed image quality using a five-point Likert scale and performed measurements of vessels and lung parenchyma for signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and in the case of pulmonary metastases tumor-to-lung parenchyma contrast ratio. PCD-CT CNRvessel was significantly higher than DSCT CNRvessel (all, p < 0.05). Readers rated image contrast of mediastinum, vessels, and lung parenchyma significantly higher in PCD-CT than DSCT images (p < 0.001). Q3 PCD-CT CNRlung_parenchyma was significantly higher than DSCT CNRlung_parenchyma and Q1 PCD-CT CNRlung_parenchyma (p < 0.01). The tumor-to-lung parenchyma contrast ratio was significantly higher on PCD-CT than DSCT images (0.08 ± 0.04 vs. 0.03 ± 0.02, p < 0.001). CTDI, DLP, SSDE mean values for PCD-CT and DSCT were 4.17 ± 1.29 mGy vs. 7.21 ± 0.49 mGy, 151.01 ± 48.56 mGy * cm vs. 288.64 ± 31.17 mGy * cm and 4.23 ± 0.97 vs. 7.48 ± 1.09, respectively. PCD-CT enables oncologic chest-CT with a significantly reduced dose while maintaining image quality similar to a second-generation DSCT for comparable protocol settings.
Topics: Algorithms; Humans; Male; Radiation Dosage; Signal-To-Noise Ratio; Thorax; Tomography, X-Ray Computed
PubMed: 35736867
DOI: 10.3390/tomography8030119 -
Frontiers in Plant Science 2014
PubMed: 25505481
DOI: 10.3389/fpls.2014.00672 -
Acta Clinica Croatica Oct 2022In prostate adenocarcinoma, both tumorous stroma and epithelium have important role in tumor progression. Transforming growth factor beta (TGF- β) is a promotor in...
In prostate adenocarcinoma, both tumorous stroma and epithelium have important role in tumor progression. Transforming growth factor beta (TGF- β) is a promotor in advanced stages of prostate cancer. Matrix Metalloproteinase 2 (MMP2), the endopeptidase that degrades extracellular matrix is considered to be overexpressed in prostatic carcinoma related to its growth and aggressiveness. Therefore, the aim was to analyze the expression of proteins TGF- β and MMP2 between both epithelium and stroma of prostatic adenocarcinoma and adjacent unaffected parenchyma. The intensity of TGF- β and MMP2 expression in epithelium, tumorous stroma and adjacent unaffected parenchyma was analyzed in 62 specimens of prostatic adenocarcinoma by microarray-based immunohistochemistry. TGF- β was more expressed in tumorous than in prostate stroma (p =0.000), while no statistical significance in case of MMP2 (p = 0.097) was found. MMP2 was more expressed in tumorous than in prostate epithelium (p =0.000), while no statistical significance in case of TGF- β (p = 0.096) was observed. The study results indicate that both tumorous stroma and epithelium have a role in tumor progression and support potential role of TGF- β and MMP2 in prostatic adenocarcinoma progression.
Topics: Humans; Male; Adenocarcinoma; Matrix Metalloproteinase 2; Prostate; Prostatic Neoplasms; Transforming Growth Factor beta
PubMed: 36938549
DOI: 10.20471/acc.2022.61.s3.1 -
PloS One 2019Osteoporotic vertebral compression fractures (OVCFs) have a serious impact on people's health and quality of life. The purpose of this study was to analyze brain volume...
PURPOSE
Osteoporotic vertebral compression fractures (OVCFs) have a serious impact on people's health and quality of life. The purpose of this study was to analyze brain volume in patients with osteoporosis using brain magnetic resonance imaging (MRI) and to investigate the relationship with osteoporotic vertebral compression fractures.
MATERIALS AND METHODS
We included 246 patients with osteoporosis who underwent thoracolumbar radiographs and brain MRI at our hospital. Clinical data on age, sex, bone mineral density, height, weight, osteoporosis medication, hypertension, diabetes, alcohol drinking, and smoking were collected. Intracranial cavity, brain parenchyma, and lateral ventricles volumes were measured using brain MRI with a semiautomated tool.
RESULTS
We founded an independent correlation between age and volume percentages of the brain parenchyma and lateral ventricles. We observed a statistically significant decrease in volume percentage of the brain parenchyma and an increase in volume percentage of the lateral ventricles with increasing age. In addition, we confirmed that patients with OVCF showed a significantly lower volume percentage of brain parenchyma than patients without OVCF.
CONCLUSION
We observed a significant association between OVCF and volume percentage of brain parenchyma. Degeneration of the brain may lead to a high incidence of falls, and OVCF may occur more frequently in patients with osteoporosis.
Topics: Absorptiometry, Photon; Accidental Falls; Age Factors; Aged; Aged, 80 and over; Atrophy; Bone Density; Brain; Female; Fractures, Compression; Humans; Incidence; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Osteoporotic Fractures; Quality of Life; Retrospective Studies; Risk Factors; Spinal Fractures; Thoracic Vertebrae
PubMed: 31689324
DOI: 10.1371/journal.pone.0224439 -
Dual-Energy Lung Perfusion in Portal Venous Phase CT-A Comparison with the Pulmonary Arterial Phase.Diagnostics (Basel, Switzerland) Oct 2021Pulmonary arterial dual-energy (aDE) CT is an established technique for evaluating pulmonary perfusion blood volume (PBV). As DECT protocols are increasingly used for...
Pulmonary arterial dual-energy (aDE) CT is an established technique for evaluating pulmonary perfusion blood volume (PBV). As DECT protocols are increasingly used for thoraco-abdominal CT, this study assessed image quality and clinical findings in portal-venous phase dual-energy (vDE) CT and compared it to aDE. In 95 patients, vDE-CT was performed using a dual-source scanner (70/Sn150 kV, 560/140 ref.mAs). Pulmonary triggered aDE-CT served as reference ( = 94). PBV was reconstructed using a dedicated algorithm. Mean relative attenuation was measured in the pulmonary trunk, aorta, and segmented lung parenchyma. A distribution ratio (DL) between vessels and parenchyma was calculated to assess the iodine uptake of the lung parenchyma. Subjective overall diagnostic image quality was assessed for PBV images on a five-point Likert scale. Image artifacts were classified into five groups based on scale rating and compared between vDE and aDE. Pathological findings were correlated with the anatomical image datasets. Mean relative attenuation of the lung parenchyma was comparable in both groups (vDE: 23 ± 6 HU and aDE: 22 ± 7 HU), but significantly lower in the vessels of vDE. Therefore, iodine uptake of the lung parenchyma was significantly higher in vDE (DL: 10% vs. 8%, < 0.01). The subjective overall image quality of the PBV images was comparable ( = 0.5). Rotation and streak artifacts were found in most of the patients (>86%, both > 0.6). Dual-source artifacts were found in only a few patients in both groups (vDE 5%, aDE 7%, = 0.5). Recess and subpleural artifacts were increased in vDE (vDE 53/27%, aDE 24/7%, both < 0.001). Pathological findings were found in 19% of the vDE patients and 59% of the aDE patients. Comparable objective and subjective image quality of lung perfusion can be obtained in vDE and aDE. Iodine uptake of the lung parenchyma is increased in vDE compared to aDE, suggesting an interstitial pooling effect. Knowledge of the different appearances of artifacts will aid in the interpretation of the images. Additional clinical information about the lung parenchyma can be provided by PBV evaluation in vDE.
PubMed: 34829336
DOI: 10.3390/diagnostics11111989 -
Journal of Cancer Research and... 2019To present the ultrasound (US), shear-wave elastography (SWE), and contrast-enhanced ultrasonography (CEUS) features of breast hamartomas.
AIMS
To present the ultrasound (US), shear-wave elastography (SWE), and contrast-enhanced ultrasonography (CEUS) features of breast hamartomas.
SUBJECTS AND METHODS
In this retrospective analysis, we included 36 breast hamartomas of 36 female patients who had been scheduled for US-guided vacuum-assisted biopsy (VAB) or surgical excision between May 2013 and October 2016. In the 36 patients, US, CEUS, and SWE were performed, and the pathology results from surgical or VAB were obtained. The US, SWE, and CEUS features of the lesions were analyzed.
RESULTS
All breast hamartomas had an oval-shaped and a circumscribed margin. Of the 36 hamartomas, 30 (83.3%) had heterogeneous echogenicity and 28 (77.8%) displayed no changes in posterior echogenicity. There were no significant differences in the maximum, mean, and minimum elasticity between the hamartomas and peripheral parenchyma (P = 0.885, 0.683, and 0.451, respectively). All hamartomas appeared with a clear edge on CEUS, and none showed lesion diameter expansion after the injection of contrast. Compared with the peripheral parenchyma, 10 hamartomas (27.8%) showed rapid perfusion mode, 23 (63.9%) showed equal perfusion mode, 24 (66.7%) showed equal enhancement, and 9 (25.0%) showed hyperenhancement. The mean peak intensity and area under the curve of hamartomas were significantly higher than those of peripheral parenchyma (P = 0.013 and P = 0.011, respectively). The peak time and increasing-start time were not significantly different between hamartomas and peripheral parenchyma (P = 0.321 and P = 0.215, respectively).
CONCLUSIONS
Hamartomas have typical features on US, SWE, and CEUS. Applying multiple ultrasound techniques would be helpful for their diagnosis.
Topics: Adult; Aged; Breast Diseases; Contrast Media; Elasticity Imaging Techniques; Female; Follow-Up Studies; Hamartoma; Humans; Middle Aged; Prognosis; Retrospective Studies; Ultrasonography, Mammary; Young Adult
PubMed: 31436244
DOI: 10.4103/jcrt.JCRT_711_18 -
Pancreatology : Official Journal of the... Apr 2021The subtypes of intraductal papillary mucinous neoplasms (IPMNs) are closely associated with the clinicopathological behavior and recurrence after surgical resection....
BACKGROUND AND AIMS
The subtypes of intraductal papillary mucinous neoplasms (IPMNs) are closely associated with the clinicopathological behavior and recurrence after surgical resection. However, there are no established non-invasive methods to confirm the subtypes of IPMNs without surgery. The aim of this study is to predict the subtypes of IPMNs using the findings of endoscopic ultrasonography (EUS).
METHODS
Sixty-two consecutive patients with IPMNs who underwent EUS before surgery were retrospectively reviewed. The following EUS findings were analyzed and their relationship with the subtypes was evaluated: diameter of the main pancreatic duct, cyst size, number of cysts, height of mural nodule, early chronic pancreatitis (CP) finding, fatty parenchyma and atrophic parenchyma.
RESULTS
The subtypes of IPMNs were as follows: gastric (G)-type 38 (61%), intestinal (I) -type 14 (23%) and pancreatobiliary (PB) -type 10 (16%). Fatty parenchyma was significantly associated with G-type (P < 0.0001). Early CP findings ≥2 and atrophic parenchyma were significantly correlated with I-type (P < 0.0001). PB-type was significantly associated with pancreatic parenchyma without early CP findings or fatty degeneration in comparison to the other subtypes (P < 0.0001). Using the above characteristic EUS findings, the sensitivity, specificity, and accuracy were as follows: 63%, 92% and 74%, respectively, in G-type, 57%, 96% and 87% in I-type, and 90%, 94% and 94% in PB-type.
CONCLUSIONS
The evaluation of EUS findings, especially focused on the pancreatic parenchyma, has the potential to predict the subtypes of IPMN.
Topics: Adult; Aged; Aged, 80 and over; Endosonography; Female; Humans; Male; Middle Aged; Pancreas; Pancreatic Intraductal Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 33640249
DOI: 10.1016/j.pan.2021.01.026