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The British Journal of Radiology Nov 2023To assess the repeatability of quantitative multiparametric whole-body MRI (mpWB-MRI) parameters in advanced prostate cancer (APC) bone metastases.
OBJECTIVES
To assess the repeatability of quantitative multiparametric whole-body MRI (mpWB-MRI) parameters in advanced prostate cancer (APC) bone metastases.
METHODS
1.5T MRI was performed twice on the same day in 10 APC patients. MpWB-MRI-included diffusion weighted imaging (DWI) and -weighted gradient-echo 2-point Dixon sequences. ADC and relative fat-fraction percentage (rFF%) maps were calculated, respectively. A radiologist delineated up to 10 target bone metastases per study. Means of ADC, b900 signal intensity(SI), normalised b900 SI, rFF% and maximum diameter (MD) for each target lesion and overall parameter averages across all targets per patient were recorded. The total disease volume (tDV in ml) was manually delineated on b900 images and mean global (g)ADC was derived. Bland-Altman analyses were performed with calculation of 95% repeatability coefficients (RC).
RESULTS
Seventy-three individual targets (median MD 26 mm) were included. Lesion mean ADC RC was 12.5%, mean b900 SI RC 137%, normalised mean b900 SI RC 110%, rFF% RC 3.2 and target MD RC 5.5 mm (16.3%). Patient target lesion average mean ADC RC was 6.4%, b900 SI RC 104% and normalised mean b900 SI RC 39.6%. Target average rFF% RC was 1.8, average MD RC 1.3 mm (4.8%). tDV segmentation RC was 6.4% and mean gADC RC 5.3%.
CONCLUSIONS
APC bone metastases' ADC, rFF% and maximum diameter, tDV and gADC show good repeatability.
ADVANCES IN KNOWLEDGE
APC bone metastases' mean ADC and rFF% measurements of single lesions and global disease volumes are repeatable, supporting their potential role as quantitative biomarkers in metastatic bone disease.
Topics: Male; Humans; Magnetic Resonance Imaging; Diffusion Magnetic Resonance Imaging; Prostatic Neoplasms; Multiparametric Magnetic Resonance Imaging; Bone Neoplasms
PubMed: 37660399
DOI: 10.1259/bjr.20230378 -
CT measurements of the proximal femoral medullary cavity in healthy adults: a cross-sectional study.JPMA. the Journal of the Pakistan... Dec 2023To analyse the proximal femoral morphology on three-dimensional reconstructed imagery to explore the factors influencing the relevant parameters.
OBJECTIVES
To analyse the proximal femoral morphology on three-dimensional reconstructed imagery to explore the factors influencing the relevant parameters.
METHODS
The cross-sectional study was conducted at Peking University Third Hospital in northern China from January 2019 to August 2020, and comprised healthy adults who underwent computed tomography scanning. Three-dimensional computed tomography reconstruction of the proximal femoral medullary cavity was performed using Mimics 22. The anatomical parameters related to total hip arthroplasty were measured to examine the relationship among gender, age and femoral length. Data was analysed using SPSS 20.
RESULTS
Of the 63 adults, meaning 126 hips, 21(33.3%) were males, meaning 42 (33.3%) hips, and 42(66.6%) were females, meaning 84(66.6%) hips. The overall mean age was 51.5±23.1 years (range: 23-68 years). The inflection point of the medullary cavity curved at 5-10mm distal to the lesser trochanteric line. Most horizontal plane parameters significantly differed between men and women (p<0.05), with the mean medullary cavity being wider in men than women. There was a significant difference between the genders in the sagittal anterior-posterior diameter of the canal flare index (p<0.05). Age was negatively correlated with the coronal medial-lateral diameter and coronal lateral diameter of canal flare index. In the coronal and sagittal planes, there was a positive correlation between the metaphysis and diaphysis, and the coronal and sagittal planes were positively correlated with the orthogonal plane.
CONCLUSIONS
Femoral morphology could be influenced by gender and age. Morphological changes of the proximal femoral medullary cavity were not present in a single plane, but were affected by multiple planes. When the diameter of one plane became larger, its orthogonal plane concomitantly increased.
Topics: Adult; Humans; Female; Male; Middle Aged; Aged; Cross-Sectional Studies; Femur; Arthroplasty, Replacement, Hip; Tomography, X-Ray Computed; Diaphyses
PubMed: 38083913
DOI: 10.47391/JPMA.7538 -
Beyoglu Eye Journal 2023We aimed to investigate the short- and long-term static and dynamic pupillary responses of patients recovered from coronavirus disease-19 (COVID-19) using quantitative...
OBJECTIVES
We aimed to investigate the short- and long-term static and dynamic pupillary responses of patients recovered from coronavirus disease-19 (COVID-19) using quantitative infrared pupillography.
METHODS
This study included patients who recovered from COVID-19 (Group 1) and age- and gender-matched controls (Group 2). A detailed ophthalmic examination was performed at 1 month and 6 months after the diagnosis of COVID-19. Photopic, mesopic, and scotopic pupil diameters (PDs) were measured using a quantitative infrared pupillography which was integrated into Scheimpflug/Placido photography-based topography system. PDs at 0, 2, 4, and 6 seconds, and average pupil dilation speeds at 2, 4, 6, and 8 seconds were recorded.
RESULTS
Eighty-six eyes of 86 patients (Group 1: n=42; Group 2: n=44) were included. While the mean photopic, mesopic, and scotopic PDs were significantly larger in the COVID-19 group than the control group in the 1 month (p=0.035, p=0.017, p=0.018, respectively), no statistically significant difference was found in the 6 month. Besides, average pupil dilation speeds and PDs at the 0, 2, 4, and 6 seconds were not statistically significantly different between the two groups in the 1 month and 6 month.
CONCLUSION
PDs were significantly larger in COVID-19 patients in all light intensities in the 1 month after COVID-19. However, pupillary dilation was transient, and no significant difference was found in the 6 month. We suggest that the transient pupillary dilation may be secondary to the autonomic nervous system dysfunction and/or optic nerve and visual pathways alterations following COVID-19.
PubMed: 37766761
DOI: 10.14744/bej.2023.30592 -
JB & JS Open Access 2023Graft choice for anterior cruciate ligament reconstruction (ACLR) has been evolving. The peroneus longus tendon (PLT) has been seen as a suitable choice for ACLR,...
BACKGROUND
Graft choice for anterior cruciate ligament reconstruction (ACLR) has been evolving. The peroneus longus tendon (PLT) has been seen as a suitable choice for ACLR, providing comparable results to those of hamstring tendon (HT) autograft, but its clinical relevance in terms of return to sports, to our knowledge, has not been studied.
METHODS
Two hundred and thirty-two patients who sustained an isolated ACL injury were enrolled and underwent ACLR using doubled PLT autograft or quadrupled HT autograft; 158 were followed for 24 months. Functional scores (International Knee Documentation Committee [IKDC] and Tegner-Lysholm scores) were assessed preoperatively and at 3,6, 12, and 24 months postoperatively. Graft diameter and graft harvesting time were measured intraoperatively. Donor-site morbidity was evaluated using subjective evaluation. Time to return to sports in both groups was compared.
RESULTS
The mean diameter of PLT autograft was significantly larger than that of HT autograft, and the mean graft-harvesting time was less (p < 0.001). Patients in the PLT group returned to sports a mean of 34 days earlier than those in the HT group (p < 0.001) and had a lower rate of donor-site morbidity and, at 6 months, better patient-reported outcomes at the knee (p < 0.001). There were no significant differences between the groups in the rate of graft rupture or in IKDC and Tegner-Lysholm scores at the 24-month follow-up.
CONCLUSIONS
PLT is a suitable autograft for ACLR in terms of graft diameter and graft-harvesting time and may offer athletes an earlier return to sports related to better outcomes at 6 months of follow-up. HT autograft was associated with increased thigh weakness. Both grafts, however, performed similarly at 24 months postoperatively.
LEVEL OF EVIDENCE
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
PubMed: 38058511
DOI: 10.2106/JBJS.OA.23.00051 -
La Clinica Terapeutica 2023To evaluate the anatomical factors affecting stress urinary incontinence (SUI) in female patients via dynamic pelvic floor magnetic resonance imaging (DP-MRI). (Observational Study)
Observational Study
OBJECTIVE
To evaluate the anatomical factors affecting stress urinary incontinence (SUI) in female patients via dynamic pelvic floor magnetic resonance imaging (DP-MRI).
METHODS
This prospective study was conducted on 43 female patients, including 22 patients with SUI (disease group) and 21 patients without SUI (control group). All patients underwent DP-MRI. The length, volume, transverse/anteroposterior diameter, and outer/inner layer thickness of the urethra were measured on static (T2W) pulse sequences. Urethral angle, posterior urethro-vesical angle (PUVA), bladder neck-pubococcygeal angle, and position of the bladder neck and cervix relative to the pubococcygeal line were measured on dynamic (Cine) pulse sequences at rest and during evacuation phase. These parameters were compared between the groups to evaluate which anatomical factors affected SUI. The area under the ROC curve (AUC) and threshold of the sensitivity and specificity of these parameters for the diagnosis of SUI were calculated.
RESULTS
The mean age of the patients was 57.3±13.8 years (disease group: 53.9±12.6 years; control group: 60.8±14.4 years). The mean number of childbirths was 2.2±0.65, and vaginal delivery accounted for 73% in each group. There was no significant difference between the two groups in terms of length, transverse diameter, outer layer thickness of the urethra, urethral angle, bladder neck-pubococcygeal angle, position of bladder neck relative to the pubococcygeal line in both resting and evacuation phases (p>0.05). There was a significant difference between the two groups regarding volume (p=0.014), anteroposterior diameter (p=0.01), inner layer thickness of the urethra (p=0.04), and PUVA (p<0.001) at rest and evacuation phases and cervix position at evacuation phase (p=0.001). The AUC of the PUVA for SUI diagnosis was 0.9 at rest and 0.98 during evacuation phases. For the threshold 133.5° at rest phase and 153.5° at evacuation phase, the sensitivity and specificity of PUVA were 0.86 and 0.86 at rest phase and 0.91 and 0.95 at evacuation phase, respectively.
CONCLUSIONS
PUVA was the anatomical factor that had the greatest effect on SUI and provided high sensitivity and specificity for SUI diag-nosis.
Topics: Humans; Female; Pregnancy; Adult; Middle Aged; Aged; Urinary Incontinence, Stress; Pelvic Floor; Prospective Studies; Magnetic Resonance Imaging; Parturition
PubMed: 38048111
DOI: 10.7417/CT.2023.5015 -
Scientific Reports Dec 2023Previous studies have demonstrated prolonged occlusion flow-mediated dilatation (PO-FMD) could reduce cannulation failure rates and decrease radial artery pulsation loss... (Observational Study)
Observational Study
Previous studies have demonstrated prolonged occlusion flow-mediated dilatation (PO-FMD) could reduce cannulation failure rates and decrease radial artery pulsation loss during trans-radial coronary angiography. However, the time and degree of radial artery dilatation induced after PO-FMD were unclear. This study aimed to evaluate the degree and duration of the radial artery dilation after PO-FMD, and the time point at which the radial artery diameter is expanded to the maximum. This was a prospective observational study. According to the Chinese guideline on the primary prevention of cardiovascular diseases, 142 patients awaking from general anesthesia were divided into two groups: low-risk (LR) group and high-risk (HR) group. Firstly, the baseline radial artery diameter was measured on the left wrist using ultrasound in both groups. Subsequently, the radial artery diameters were obtained continuously at the same location for 5 min after PO-FMD. The baseline radial artery diameter, the maximum radial artery diameter, and the duration of radial artery dilation in the two groups were recorded. The time point at which the radial artery diameter is expanded to the maximum in the LR group and HR group was 26.49 ± 11.69 s and 46.27 ± 12.03 s, respectively (P < 0.01). The time of radial artery dilation and the percentage changes in arterial diameter in HR group were significantly lower than LR group (duration time: mean [mean ± standard]: 136.65 ± 31.55 s vs. 168.98 ± 33.27 s; percentage changes: median [interquartile range] 10.5 [8.6, 12.9] % vs. 15.2 [12.4, 19.0] %). In this study, the optimal puncture time point of PO-FMD in the LR group was 26 s, and in the HR group was 46 s. It would be helpful to guide the time point in radial artery catheterization after PO-FMD.Chinese Clinical Trial Registry identifier: ChiCTR2200066214.
Topics: Humans; Catheterization; Coronary Angiography; Dilatation; Punctures; Radial Artery; Prospective Studies
PubMed: 38066251
DOI: 10.1038/s41598-023-49122-0 -
Journal of Neurological Surgery. Part... Oct 2023This study aimed to investigate the morphometric features of the stylomastoid foramen (SMF) and the facial canal in the Turkish population using cone-beam computed...
This study aimed to investigate the morphometric features of the stylomastoid foramen (SMF) and the facial canal in the Turkish population using cone-beam computed tomography (CBCT) retrospectively. The randomly selected 479 patients aged from 8 to 87 years were examined, and a total of 958 CBCT images of the SMF and facial canal (FC) were analyzed. The diameter of the SMF and FC at the mastoid segment and their relation to age, gender, and side were evaluated. Statistical analyses were performed using Kolmogorov-Smirnov, one-way analysis of variance, Student's -test, chi-squared test, Tukey's honestly significant difference, and Fisher-Freeman-Halton exact test. -Values < 0.05 were accepted as statistically significant at the 95% confidence interval. The mean age of the patients was 40.49 ± 19.73 years. The mean diameter of the right SMF was 2.24 ± 0.58 and 2.50 ± 0.63 mm in females and males. The mean diameter of the left SMF was 2.25 ± 0.56 and 2.44 ± 0.62 mm in females and males. The mean diameter of the right FC was 1.60 ± 0.35 and 1.70 ± 0.34 mm in females and males. The mean diameter of left FC was 1.55 ± 0.35 and 1.66 ± 0.33 mm in females and males. A statistically significant difference was found between the age groups in terms of the mean SMF and FC diameter on both sides ( < 0.05). Information obtained from this study regarding the morphometric features of the SMF and thereby FC may assist surgeons in treatment plans and reduce the risk of neurosurgical complications.
PubMed: 37671299
DOI: 10.1055/a-1993-7468 -
Frontiers in Neuroanatomy 2023G-ratio is crucial for understanding the nervous system's health and function as it measures the relative myelin thickness around an axon. However, manual measurement is...
G-ratio is crucial for understanding the nervous system's health and function as it measures the relative myelin thickness around an axon. However, manual measurement is biased and variable, emphasizing the need for an automated and standardized technique. Although deep learning holds promise, current implementations lack clinical relevance and generalizability. This study aimed to develop an automated pipeline for selecting nerve fibers and calculating relevant g-ratio using quality parameters in optical microscopy. Histological sections from the sciatic nerves of 16 female mice were prepared and stained with either p-phenylenediamine (PPD) or toluidine blue (TB). A custom UNet model was trained on a mix of both types of staining to segment the sections based on 7,694 manually delineated nerve fibers. Post-processing excluded non-relevant nerves. Axon diameter, myelin thickness, and g-ratio were computed from the segmentation results and its reliability was assessed using the intraclass correlation coefficient (ICC). Validation was performed on adjacent cuts of the same nerve. Then, morphometrical analyses of both staining techniques were performed. High agreement with the ground truth was shown by the model, with dice scores of 0.86 (axon) and 0.80 (myelin) and pixel-wise accuracy of 0.98 (axon) and 0.94 (myelin). Good inter-device reliability was observed with ICC at 0.87 (g-ratio) and 0.83 (myelin thickness), and an excellent ICC of 0.99 for axon diameter. Although axon diameter significantly differed from the ground truth ( = 0.006), g-ratio ( = 0.098) and myelin thickness ( = 0.877) showed no significant differences. No statistical differences in morphological parameters (g-ratio, myelin thickness, and axon diameter) were found in adjacent cuts of the same nerve (ANOVA -values: 0.34, 0.34, and 0.39, respectively). Comparing all animals, staining techniques yielded significant differences in mean g-ratio (PPD: 0.48 ± 0.04, TB: 0.50 ± 0.04), myelin thickness (PPD: 0.83 ± 0.28 μm, TB: 0.60 ± 0.20 μm), and axon diameter (PPD: 1.80 ± 0.63 μm, TB: 1.78 ± 0.63 μm). The proposed pipeline automatically selects relevant nerve fibers for g-ratio calculation in optical microscopy. This provides a reliable measurement method and serves as a potential pre-selection approach for large datasets in the context of healthy tissue. It remains to be demonstrated whether this method is applicable to measure g-ratio related with neurological disorders by comparing healthy and pathological tissue. Additionally, our findings emphasize the need for careful interpretation of inter-staining morphological parameters.
PubMed: 38074449
DOI: 10.3389/fnana.2023.1260186 -
Assessment of patient characteristics influencing the complexity of leadless pacemaker implantation.Heart Rhythm O2 Feb 2024The complexity of leadless pacemaker (LP) implantation varies widely. However, the predictive factors determining this difficulty are poorly understood.
BACKGROUND
The complexity of leadless pacemaker (LP) implantation varies widely. However, the predictive factors determining this difficulty are poorly understood.
OBJECTIVE
The purpose of this study was to evaluate the factors influencing LP implantation difficulty, specifically procedural time during right atrial (RA) and right ventricular (RV) manipulation, based on patient background, cardiac function, and anatomic characteristics.
METHODS
Analysis included LP implantation cases between 2017 and 2023, excluding the initial 3 implants performed by each operator. The relevance of patient background, cardiac function, and anatomic features on procedural and fluoroscopy times was evaluated.
RESULTS
Fifty-four patients (mean age 82.2 ± 10.0 years; 57.4% male) were included in the study. Median procedural and fluoroscopy time was 45.8 minutes and 16.0 minutes, respectively, with an average of 2.0 ± 1.4 device deployments. Univariate analysis showed associations between procedural time and older age, RA and RV diameter, and severity of tricuspid regurgitation (TR). After adjustment for physician and potential contributing factors, RV dilation (midventricular diameter ≥35 mm) and severe TR were identified as independent predictors of prolonged procedural time. Medical history exhibited no association with procedural time. Consistent results were observed in analyses using fluoroscopy time as the outcome.
CONCLUSION
RV dilation and severe TR were associated with prolonged procedural time for LP implantation. Anatomic features obtained from preprocedural echocardiography could provide valuable insights into both the safety and efficiency of LP implantation, thereby enhancing tailored treatment strategies for patients undergoing pacemaker implantation.
PubMed: 38545320
DOI: 10.1016/j.hroo.2023.12.004 -
BMC Medical Imaging Nov 2023Due to the lack of corresponding clinical symptoms, small calcified gastric gastrointestinal stromal tumors (GISTs) are often overlooked in clinical practice. Therefore,...
BACKGROUND
Due to the lack of corresponding clinical symptoms, small calcified gastric gastrointestinal stromal tumors (GISTs) are often overlooked in clinical practice. Therefore, there is an unmet need to define the imaging features of calcified micro-gastric GISTs to facilitate diagnosis. This study retrospectively analyzed the computed tomography (CT) features of pathologically confirmed calcified micro-gastric GISTs.
METHODS
The medical records (gastroscopy, pre-treatment gastric CT imaging [pre- and post-contrast scans], pathology) of patients with calcified gastric GISTs < 1 cm in diameter confirmed pathologically after endoscopic submucosal dissection, endoscopic submucosal excavation, or endoscopic full-thickness resection were retrospectively reviewed.
RESULTS
Seven patients had 8 calcified gastric GISTs < 1 cm in diameter. Six patients hadsingle lesions, and 1patients had multiple lesions. Six patients had lesions in the gastric fundus, 1 patient had a lesion in the body of the stomach. Lesions had a mean diameter of 5.2 mm (range, 1.3 mm ~ 7 mm). Unenhanced CT scans showed spots and high-density nodular calcifications in 3 submucosal lesions, 2 lesions in the muscularis propria, and 3 subserosal lesions that protruded outside the stomach. Among the 8 lesions, only two had solid soft tissue components surrounding the calcification, with one of these two showing post contrast enhancement of the solid soft tissue component.
CONCLUSIONS
Novel CT features of gastric GISTs included: commonly found in the gastric antrum, small size (< 1 cm in diameter), calcification, few solid soft tissue components, and no abnormal enhancement in most cases.
Topics: Humans; Gastrointestinal Stromal Tumors; Retrospective Studies; Treatment Outcome; Stomach Neoplasms; Tomography, X-Ray Computed; Calcinosis
PubMed: 37986048
DOI: 10.1186/s12880-023-01146-8