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BMC Oral Health Sep 2022Evaluating the diagnostic efficiency of deep learning models to diagnose vertical root fracture in vivo on cone-beam CT (CBCT) images.
OBJECTIVES
Evaluating the diagnostic efficiency of deep learning models to diagnose vertical root fracture in vivo on cone-beam CT (CBCT) images.
MATERIALS AND METHODS
The CBCT images of 276 teeth (138 VRF teeth and 138 non-VRF teeth) were enrolled and analyzed retrospectively. The diagnostic results of these teeth were confirmed by two chief radiologists. There were two experimental groups: auto-selection group and manual selection group. A total of 552 regions of interest of teeth were cropped in manual selection group and 1118 regions of interest of teeth were cropped in auto-selection group. Three deep learning networks (ResNet50, VGG19 and DenseNet169) were used for diagnosis (3:1 for training and testing). The diagnostic efficiencies (accuracy, sensitivity, specificity, and area under the curve (AUC)) of three networks were calculated in two experiment groups. Meanwhile, 552 teeth images in manual selection group were diagnosed by a radiologist. The diagnostic efficiencies of the three deep learning network models in two experiment groups and the radiologist were calculated.
RESULTS
In manual selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth. The accuracy, sensitivity, specificity and AUC was 97.8%, 97.0%, 98.5%, and 0.99, the radiologist presented accuracy, sensitivity, and specificity as 95.3%, 96.4 and 94.2%. In auto-selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth, the accuracy, sensitivity, specificity and AUC was 91.4%, 92.1%, 90.7% and 0.96.
CONCLUSION
In manual selection group, ResNet50 presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19, DensenNet169 and radiologist with 2 years of experience. In auto-selection group, Resnet50 also presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19 and DensenNet169. This makes it a promising auxiliary diagnostic technique to screen for VRF teeth.
Topics: Cone-Beam Computed Tomography; Deep Learning; Humans; Retrospective Studies; Tooth Fractures; Tooth Root
PubMed: 36064682
DOI: 10.1186/s12903-022-02422-9 -
Journal of Neuroimaging : Official... Jan 2023Alzheimer's disease (AD) is currently diagnosed using a mixture of psychological tests and clinical observations. However, these diagnoses are not perfect, and... (Review)
Review
Alzheimer's disease (AD) is currently diagnosed using a mixture of psychological tests and clinical observations. However, these diagnoses are not perfect, and additional diagnostic tools (e.g., MRI) can help improve our understanding of AD as well as our ability to detect the disease. Accordingly, a large amount of research has been invested into innovative diagnostic methods for AD. Functional MRI (fMRI) is a form of neuroimaging technology that has been used to diagnose AD; however, fMRI is incredibly noisy, complex, and thus lacks clinical use. Nonetheless, recent innovations in deep learning technology could enable the simplified and streamlined analysis of fMRI. Deep learning is a form of artificial intelligence that uses computer algorithms based on human neural networks to solve complex problems. For example, in fMRI research, deep learning models can automatically denoise images and classify AD by detecting patterns in participants' brain scans. In this systematic review, we investigate how fMRI (specifically resting-state fMRI) and deep learning methods are used to diagnose AD. In turn, we outline the common deep neural network, preprocessing, and classification methods used in the literature. We also discuss the accuracy, strengths, limitations, and future direction of fMRI deep learning methods. In turn, we aim to summarize the current field for new researchers, suggest specific areas for future research, and highlight the potential of fMRI to aid AD diagnoses.
Topics: Humans; Alzheimer Disease; Deep Learning; Artificial Intelligence; Magnetic Resonance Imaging; Neuroimaging; Brain
PubMed: 36257926
DOI: 10.1111/jon.13063 -
The Pan African Medical Journal 2019Self-diagnosis and pain management is a worldwide practice. The current study aims to determine the percentage of dental students and interns who self-diagnose and...
INTRODUCTION
Self-diagnosis and pain management is a worldwide practice. The current study aims to determine the percentage of dental students and interns who self-diagnose and manage their dental pain and further establish the proportion of students who depend on various resources for diagnosing and treating their condition.
METHODS
A cross-sectional, self-administered questionnaire-based study was conducted among the dental students in and around Riyadh. The questionnaire consisted of three parts including: part 1-demographic data; part 2-pain and self-diagnosis; part 3-visiting the dentist and managing the pain. The data were analyzed using the Statistical Package for Social Sciences (SPSS version 22.0).
RESULTS
Fifty four percent of the participants were involved in self-diagnosis and managed the pain by themselves. Seventy three percent of the respondents experienced teeth/gum discomfort or any symptoms of an oral health problem, of which 57% searched the symptoms they faced on the internet to arrive at a diagnosis. Besides, 35% of the interns considered internet to be a helpful tool for diagnosing their pain. 16% admitted that they have never visited a dentist.
CONCLUSION
We found that a significant proportion of the participants self-diagnosed by using their background or resorting to the internet, at times consulting a dentist to confirm their diagnosis. The students from the health sciences background should refrain from this practice. Efforts should be made to make the population mindful of the potential risks linked to self-medication and diagnosis. Further research should be done with a larger sample size by including the students and interns from different institutions.
Topics: Cross-Sectional Studies; Diagnostic Self Evaluation; Facial Pain; Female; Humans; Male; Saudi Arabia; Students, Dental; Surveys and Questionnaires; Toothache
PubMed: 32180872
DOI: 10.11604/pamj.2019.34.198.18347 -
Urology Dec 2022To analyze the accuracy of the 4 most commonly used online symptom checkers (OSCs) in diagnosing erectile dysfunction (ED), scrotal pain (SP), Peyronie's disease (PD),...
OBJECTIVE
To analyze the accuracy of the 4 most commonly used online symptom checkers (OSCs) in diagnosing erectile dysfunction (ED), scrotal pain (SP), Peyronie's disease (PD), and low testosterone (LT).
METHODS AND OUTCOMES
One-hundred and sixty artificial vignettes were created by de-identifying recent initial outpatient consults presenting to discuss ED (40), SP (40), PD (40), and LT (40). The vignettes were entered into the 4 most frequently used OSCs (WebMD, MedicineNet, EverydayHealth, and SutterHealth) as determined by web traffic analysis tools. The top 5 conditions listed in the OSC differential diagnosis were recorded and scored.
RESULTS
WebMD's accuracy for ED, SP, PD, and LT vignettes was 0%, 22.5%, 0%, and 95%, respectively. EverydayHealth was only able to diagnose SP 20% of the time, and failed to diagnose ED, PD, or LT on all occasions. MedicineNet diagnosed ED, PD, SP, and LT in 100%, 98%, 27.5%, and 0% of vignettes, respectively. SutterHealth correctly diagnosed ED, SP, and LT in 100%, 20%, and 80% of patients, respectively. Cumulatively, the OSCs were most accurate in diagnosing ED and least accurate in diagnosing SP when using the Top 1 (37.5% vs 6.9%) and Top 5 (50% vs 24.5%) of the suggested conditions.
CONCLUSION
No OSC could accurately diagnose all the conditions tested. The OSCs, on average, were poor at suggesting precise diagnoses for ED, PD, LT, SP. Patients and practitioners should be cautioned regarding the accuracy of OSCs.
Topics: Male; Humans; Men's Health; Penile Induration; Erectile Dysfunction; Diagnosis, Differential; Data Collection
PubMed: 36115428
DOI: 10.1016/j.urology.2022.08.032 -
Immunologic Research Oct 2021Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a rare and chronic progressive clinical entity, characterized by elevated serum IgG4 along with tissue infiltration... (Review)
Review
Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a rare and chronic progressive clinical entity, characterized by elevated serum IgG4 along with tissue infiltration by IgG4 + plasma cells. It is an immune-mediated fibro-inflammatory condition that can affect virtually any organ and tissue. IgG4-related lung disease (IgG4-RLD) occupies 14% of all IgG4-RD, with nonspecific symptoms and various abnormal radiographic patterns. Published data on IgG4-related hypertrophic pachymeningitis (IgG4-RHP), an increasingly recognized central nervous system manifestation of IgG4-RD, is also limited. Both lung and cranial dura involvement have not yet been reported until now. We further entail a review of the literature on the clinicopathologic features and differential diagnosis of this uncommon disease. We herein report an interesting case of a 70-year-old male patient admitted due to headache and fever. A magnetic resonance imaging (MRI) of the brain revealed extensive dural thickening with marked enhancement. Chest computed tomography (CT) scan showed nodular or mass-like consolidation and focal interstitial change. Thoracoscopic lung biopsy and lumbar puncture were conducted. After careful histopathological observation and consideration of alternative differential diagnoses, he was diagnosed with IgG4-related disease with lung and cranial dural involvement based upon significant elevation of serum and cerebrospinal fluid (CSF) IgG4 concentration. The patient was started on oral prednisolone 60 mg/day (1.0 mg/kg/day) for 14 days, and a tapering dose of 5 mg every 2 weeks followed by maintenance therapy at low dose for 3 months. His clinical manifestations, and serologic and imaging findings improved with steroid treatment. Currently, the patient remains well without disease progression. IgG4-RD should be considered as a differential when diagnosing other similar multisystemic lesions. Clinical examination, careful histological observation, and immunostaining for appropriate markers are essential in establishing the diagnosis. Clinicians should become familiar with this alternative differential diagnosis.
Topics: Aged; Biomarkers; Biopsy; Brain; Disease Management; Disease Susceptibility; Humans; Immunoglobulin G4-Related Disease; Immunohistochemistry; Immunosuppressive Agents; Lung; Magnetic Resonance Imaging; Male; Symptom Assessment; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34374950
DOI: 10.1007/s12026-021-09215-2 -
Japanese Journal of Radiology Jan 2021Lesions in the middle and posterior mediastinum are relatively rare, but there are some useful radiological clues that can be used to diagnose them precisely. It is... (Review)
Review
Lesions in the middle and posterior mediastinum are relatively rare, but there are some useful radiological clues that can be used to diagnose them precisely. It is useful to determine the affected mediastinal compartment and the locations of the main thoracic nerves on medical images for diagnosing such mediastinal lesions. Neurogenic tumors can occur in the middle mediastinum, although they generally arise as posterior mediastinal tumors. Based on the above considerations, we review various characteristic imaging findings of middle and posterior mediastinal lesions, and their differential diagnoses.
Topics: Diagnosis, Differential; Diagnostic Imaging; Female; Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Mediastinum; Middle Aged; Radiography; Tomography, X-Ray Computed
PubMed: 32740793
DOI: 10.1007/s11604-020-01025-0 -
Journal of Voice : Official Journal of... Jul 2020To determine the consistency and accuracy of preoperative diagnosis in the voice clinic with intraoperative diagnosis and to suggest a standardized laryngeal examination... (Comparative Study)
Comparative Study
INTRODUCTION
To determine the consistency and accuracy of preoperative diagnosis in the voice clinic with intraoperative diagnosis and to suggest a standardized laryngeal examination protocol in the UK that is supported by evidence-based findings.
METHOD
From January 2011-September 2014, 164 patients were referred to the Multidisciplinary Team voice clinic and diagnosed with laryngeal pathology that required phonosurgery. The visualization (videostrobolaryngoscopy) in clinic was performed using either rigid laryngoscope or a video-naso-laryngoscope. Intraoperatively, laryngeal visualization and surgical procedure was conducted using Storz Aida HD system, 10-mm rigid laryngoscope 0° or 5-mm rigid laryngoscope 0°/30° and a Zeiss S7 microscope.
RESULTS
Of the 164 patients seen in the multidisciplinary voice clinic, 86 clinic diagnoses were confirmed intraoperatively (52.4%), 15 patients had the diagnosis confirmed intraoperatively with additional lesion found (9.1%). The clinic diagnosis changed intraoperatively in 63 cases (38.4%). 61 (37.2%) patients seen in the voice clinic were diagnosed with cyst, in 39.3% the diagnosis was confirmed intraoperatively with 5 cases (8.2%) having an additional diagnosis. Twenty (12.2%) patients were diagnosed with polyps, with 80% confirmation intraoperatively; 3 patients (10%) had an additional diagnosis.
CONCLUSION
Videolaryngostroboscopy imaging of the larynx provides an outpatient tool for accurately diagnosing more than 50% of laryngeal pathologies when interpreted by multidisciplinary voice clinicians. However direct laryngeal examination under general anesthesia remains the gold standard when obtaining accurate diagnoses of laryngeal pathology. Patients diagnosed with nonorganic voice disorders should be considered for direct laryngoscopy under general anesthetic should they fail to respond to conservative management.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Care; Child; Child, Preschool; Clinical Decision-Making; Diagnostic Errors; Female; Humans; Intraoperative Care; Laryngeal Diseases; Laryngoscopes; Laryngoscopy; London; Male; Middle Aged; Observer Variation; Operating Rooms; Predictive Value of Tests; Reproducibility of Results; Stroboscopy; Voice Disorders; Young Adult
PubMed: 30660339
DOI: 10.1016/j.jvoice.2018.12.016 -
Ultrasound in Medicine & Biology May 2022We investigated the diagnostic performance of qualitative and quantitative ultrasound criteria for anterosuperior acetabular labral tears (ALTs). In all, 118 people with...
We investigated the diagnostic performance of qualitative and quantitative ultrasound criteria for anterosuperior acetabular labral tears (ALTs). In all, 118 people with ALTs (120 hips; case group) and 31 asymptomatic volunteers (42 hips; control group) at Peking University Third Hospital between August 2018 and November 2019 were consecutively included. The labral cleft, labral heterogeneous echogenicity, labral plump morphology, paralabral cyst and labral focal hyperechoic area were used as the qualitative criteria. The anterosuperior labral cross-section area (CSA) was measured as the quantitative criterion. The diagnostic utility of the quantitative and qualitative criteria were explored with magnetic resonance imaging as the diagnostic gold standard. Labral heterogeneous echogenicity was the most sensitive criterion for diagnosing ALTs (up to 80.00%), and the specificity of diagnosing ALTs with paralabral cysts, labral focal hyperechoic area and subcortical cysts of the femoral head and neck was as high as 90.48%-100%. The labral CSA in the case group was 0.27 cm (0.21-0.39 cm), which was significantly larger compared with the control group (0.18 cm [0.14-0.23 cm]; p < 0.001). The area under the receiver operating characteristic curve was 0.802 for diagnosing ALTs according to the labral CSA. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the combined qualitative criteria for diagnosing ALTs were 90.00%, 71.43%, 90.00%, 71.43% and 85.19%, respectively. Labral heterogeneous echogenicity is a sensitive criterion for diagnosing ALTs, and paralabral cysts, labral focal hyperechoic, area and subcortical cysts of the femoral head and neck are specific criteria. The CSA of the anterosuperior acetabular labrum measured by ultrasound can be used as a quantitative criterion to diagnose ALTs. The combination of labral qualitative criteria provides higher sensitivity and accuracy in diagnosing ALTs.
Topics: Acetabulum; Arthroscopy; Cartilage, Articular; Humans; Magnetic Resonance Imaging; Retrospective Studies; Sensitivity and Specificity; Ultrasonography
PubMed: 35256224
DOI: 10.1016/j.ultrasmedbio.2022.01.016 -
European Radiology Aug 2022To evaluate the feasibility and accuracy of diagnosing acute heart failure (HF) with CT pulmonary angiography (CTPA) in emergency department patients.
OBJECTIVES
To evaluate the feasibility and accuracy of diagnosing acute heart failure (HF) with CT pulmonary angiography (CTPA) in emergency department patients.
METHODS
In this retrospective single-center study, we evaluated 150 emergency department patients (mean age 65 ± 17 years) undergoing CTPA with a fixed scan (100 kVp) and contrast media protocol (60 mL, 4 mL/s) who had no pulmonary embolism (PE). Patients were subdivided into training cohort (n = 100) and test cohort (n = 50). Three independent, blinded readers measured the attenuation in the right ventricle (RV) and left ventricle (LV) on axial images. The ratio (HU) and difference (HU) between RV and LV attenuation were calculated. Diagnosis of acute HF was made on the basis of clinical, laboratory, and echocardiography data. Optimal thresholds, sensitivity, and specificity were calculated using the area under the curve (AUC) from receiver operating characteristics analysis.
RESULTS
Fifty-nine of the 150 patients (40%) were diagnosed with acute HF. Attenuation measurements showed an almost perfect interobserver agreement (intraclass correlation coefficient: 0.986, 95%CI: 0.980-0.991). NT-pro BNP exhibited moderate correlations with HU (r = 0.50, p < 0.001) and HU (r = 0.50, p < 0.001). In the training cohort, HU (AUC: 0.89, 95%CI: 0.82-0.95) and HU (AUC: 0.88, 95%CI: 0.81-0.95) showed a very good performance to diagnose HF. Optimal cutoff values were 1.42 for HU (sensitivity 93%; specificity 75%) and 113 for HU (sensitivity 93%; specificity 73%). Applying these thresholds to the test cohort yielded a sensitivity of 89% and 89% and a specificity of 69% and 63% for HU and HU, respectively.
CONCLUSION
In emergency department patients undergoing CTPA and showing no PE, both HU and HU have a high sensitivity for diagnosing acute HF.
KEY POINTS
• Heart failure is a common differential diagnosis in patients undergoing CT pulmonary angiography. • In emergency department patients undergoing CT pulmonary angiography and showing no pulmonary embolism, attenuation differences of the left and right ventricle have a high sensitivity for diagnosing acute heart failure.
Topics: Aged; Aged, 80 and over; Angiography; Computed Tomography Angiography; Feasibility Studies; Heart Failure; Humans; Middle Aged; Pulmonary Embolism; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 35294585
DOI: 10.1007/s00330-022-08676-9 -
Clinical Dysmorphology Jul 2022Mosaicism refers to the coexistence of two or more genetically distinct cell populations in an individual from a single fertilized egg. We performed a retrospective... (Review)
Review
Mosaicism refers to the coexistence of two or more genetically distinct cell populations in an individual from a single fertilized egg. We performed a retrospective analysis of all patients diagnosed with mosaic disorders between 2010 and 2021 in a university-affiliated genetics clinic, which attends to territory-wide genetic consultations. All patients with confirmed mosaic diagnoses through reproductive (n = 6), prenatal (n = 24), and postnatal (n = 53) testing were examined. We observed that mosaic 45, X (n = 31) and PIK3CA-related overgrowth spectrum (n = 16) disorders were among the most prevalent diagnoses in the clinic, and the total percentage of patients with mosaicism in our cohort was 2.0% (83/4157). A review of the diagnostic journey highlights the challenge in diagnosing mosaic disorders, whereby 38% of the subjects required more than one test sample, and 52% of the cases required more than one orthogonal method of detection to reach the correct diagnosis. While detection of mosaicism is passive through routine clinical testing, for example karyotyping in reproductive and prenatal care, in postnatal care, clinicians can more actively drive the detection of mosaicism. Therefore, we recommend a low threshold for additional genetic testing in suspected mosaicism for more accurate diagnosis and counselling.
Topics: Female; Genetic Testing; Humans; Karyotyping; Mosaicism; Pregnancy; Retrospective Studies; Universities
PubMed: 35256561
DOI: 10.1097/MCD.0000000000000418