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Korean Journal of Radiology Jun 2023Detection of pneumoperitoneum using abdominal radiography, particularly in the supine position, is often challenging. This study aimed to develop and externally validate...
OBJECTIVE
Detection of pneumoperitoneum using abdominal radiography, particularly in the supine position, is often challenging. This study aimed to develop and externally validate a deep learning model for the detection of pneumoperitoneum using supine and erect abdominal radiography.
MATERIALS AND METHODS
A model that can utilize "pneumoperitoneum" and "non-pneumoperitoneum" classes was developed through knowledge distillation. To train the proposed model with limited training data and weak labels, it was trained using a recently proposed semi-supervised learning method called distillation for self-supervised and self-train learning (DISTL), which leverages the Vision Transformer. The proposed model was first pre-trained with chest radiographs to utilize common knowledge between modalities, fine-tuned, and self-trained on labeled and unlabeled abdominal radiographs. The proposed model was trained using data from supine and erect abdominal radiographs. In total, 191212 chest radiographs (CheXpert data) were used for pre-training, and 5518 labeled and 16671 unlabeled abdominal radiographs were used for fine-tuning and self-supervised learning, respectively. The proposed model was internally validated on 389 abdominal radiographs and externally validated on 475 and 798 abdominal radiographs from the two institutions. We evaluated the performance in diagnosing pneumoperitoneum using the area under the receiver operating characteristic curve (AUC) and compared it with that of radiologists.
RESULTS
In the internal validation, the proposed model had an AUC, sensitivity, and specificity of 0.881, 85.4%, and 73.3% and 0.968, 91.1, and 95.0 for supine and erect positions, respectively. In the external validation at the two institutions, the AUCs were 0.835 and 0.852 for the supine position and 0.909 and 0.944 for the erect position. In the reader study, the readers' performances improved with the assistance of the proposed model.
CONCLUSION
The proposed model trained with the DISTL method can accurately detect pneumoperitoneum on abdominal radiography in both the supine and erect positions.
Topics: Humans; Deep Learning; Retrospective Studies; Radiography, Abdominal; Radiography; Supervised Machine Learning; Radiography, Thoracic
PubMed: 37271208
DOI: 10.3348/kjr.2022.1032 -
American Family Physician Jan 2005Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a... (Review)
Review
Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a valuable role in the early diagnosis and management of this condition. However, the overall diagnostic accuracy achieved by traditional history, physical examination, and laboratory tests has been approximately 80 percent. The ease and accuracy of diagnosis varies by the patient's sex and age, and is more difficult in women of childbearing age, children, and elderly persons. If th diagnosis of acute appendicitis is clear from the history and physical examination, prompt surgical referral is warranted. In atypical cases, ultrasonography and computed tomography (CT) may help lower the rate of false-negative appendicitis diagnoses, reduce morbidity from perforation, and lower hospital expenses. Ultrasonography is safe and readily available, with accuracy rates between 71 and 97 percent, although it is highly operator dependent and difficult in patients with a large body habitus. While there is controversy regarding the use of contrast media and which CT technique is best, the accuracy rate of CT scanning is between 93 and 98 percent. Disadvantages of CT include radiation exposure, cost, and possible complications from contrast media.
Topics: Appendicitis; Clinical Trials as Topic; Humans; Radiography, Abdominal; Tomography, X-Ray Computed; Ultrasonography
PubMed: 15663029
DOI: No ID Found -
The Turkish Journal of Gastroenterology... Jun 2005An internal abdominal herniation is the protrusion of a viscus through a normal or abnormal mesenteric or peritoneal aperture. Internal abdominal herniations can either... (Review)
Review
An internal abdominal herniation is the protrusion of a viscus through a normal or abnormal mesenteric or peritoneal aperture. Internal abdominal herniations can either be acquired through a trauma or surgical procedure, or constitutional and related to congenital peritoneal defects. Paraduodenal hernias are the most common type of internal abdominal hernias, accounting for over one-half of reported cases, and thus are a significant clinical entity. Other internal hernias include pericecal, transmesenteric, transomental, intersigmoid, supravesical hernias and herniation through the foramen of Winslow. Because internal abdominal herniations are rare, their diagnosis remains a challenge for both the clinician and the radiologist. Symptoms of internal abdominal herniations are nonspecific. We present our experience with the radiological evaluation of internal abdominal herniations and review the main radiologic findings on barium as well as computed tomography studies.
Topics: Barium Sulfate; Contrast Media; Diagnosis, Differential; Enema; Hernia, Abdominal; Humans; Radiography, Abdominal; Reproducibility of Results; Tomography, X-Ray Computed
PubMed: 16252193
DOI: No ID Found -
Surgical Infections Aug 2014
Topics: Appendicitis; Female; Humans; Middle Aged; Pelvis; Radiography, Abdominal; Tomography, X-Ray Computed
PubMed: 24821085
DOI: 10.1089/sur.2013.163 -
Canadian Association of Radiologists... Nov 2018Peer review for radiologists plays an important role in identifying contributing factors that can lead to diagnostic errors and patient harm. It is essential that all... (Review)
Review
Peer review for radiologists plays an important role in identifying contributing factors that can lead to diagnostic errors and patient harm. It is essential that all radiologists be aware of the multifactorial causes of diagnostic error in radiology and the methods available to reduce it. This pictorial review provides readers with an overview of common errors that occur in abdominal radiology and strategies to reduce them. This review aims to make readers more aware of pitfalls in abdominal imaging so that these errors can be avoided in the future. This essay also provides a systematic approach to classifying abdominal imaging errors that will be of value to all radiologists participating in peer review.
Topics: Diagnostic Errors; Digestive System Diseases; Humans; Radiography, Abdominal; Radiologists; Tomography, X-Ray Computed
PubMed: 30318459
DOI: 10.1016/j.carj.2018.06.006 -
The New England Journal of Medicine Feb 2018
Topics: Adult; Cesarean Section; Female; Foreign Bodies; Humans; Radiography, Abdominal; Tomography, X-Ray Computed
PubMed: 29466155
DOI: 10.1056/NEJMicm1708836 -
Diagnostic and Interventional Radiology... Mar 2020When compared with chest radiographs, medical devices of the abdomen and pelvis are less frequently seen. However, with recent advances in technology the interpreting... (Review)
Review
When compared with chest radiographs, medical devices of the abdomen and pelvis are less frequently seen. However, with recent advances in technology the interpreting radiologists are seeing more medical objects on these radiographs. The identification of these devices and materials are crucial for not only enabling the radiologist to understand the underlying background pathology but also for evaluating any related complications. An online survey of literature showed our review article to be the most detailed. In this first part of our two-part series, we discuss about the various gastrointestinal and vascular devices and materials seen on abdominal and pelvic radiographs.
Topics: Abdomen; Equipment and Supplies; Gastrointestinal Tract; Humans; Pelvis; Prostheses and Implants; Radiography, Abdominal
PubMed: 32071024
DOI: 10.5152/dir.2019.19390 -
The Ulster Medical Journal Sep 2013
Review
Topics: Algorithms; Appendicitis; Bone Diseases; Colitis; Gallstones; Gases; Humans; Intestinal Obstruction; Intestinal Volvulus; Intestines; Radiography, Abdominal; Urinary Calculi; Vascular Calcification
PubMed: 24505155
DOI: No ID Found -
Clinical Imaging Jan 2023To provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center.
OBJECTIVES
To provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center.
METHODS
The portal venous phase abdomen-pelvis acquisition was assessed for image noise and radiation dose in 13,320 contrast-enhanced CT examinations. Patient size (effective diameter) and radiation dose (CTDI) were recorded using a commercial software system, and image noise (Global Noise metric) was quantified using a custom processing system. The reference level and range for dose and noise were calculated for the full dataset, and for examinations grouped by CT scanner model. Dose and noise reference levels were also calculated for exams grouped by five different patient size categories.
RESULTS
The noise reference level was 11.25 HU with a reference range of 10.25-12.25 HU. The dose reference level at a median effective diameter of 30.7 cm was 26.7 mGy with a reference range of 19.6-37.0 mGy. Dose increased with patient size; however, image noise remained approximately constant within the noise reference range. The doses were 2.1-2.5 times than the doses in the ACR DIR registry for corresponding patient sizes. The image noise was 0.63-0.75 times the previously published reference level in abdominal-pelvic CT examinations.
CONCLUSIONS
Our oncology-specific abdominal-pelvic CT dose reference levels are higher than in the ACR dose index registry and our oncology-specific image noise reference levels are lower than previously proposed image noise reference levels.
ADVANCES IN KNOWLEDGE
This study reports reference image noise and radiation dose levels appropriate for the indication of abdomen-pelvis CT examination for cancer diagnosis and staging. The difference in these reference levels from non-oncology-specific CT examinations highlight a need for indication-specific, dose index and image quality reference registries.
Topics: Adult; Humans; Radiography, Abdominal; Radiation Dosage; Pelvis; Abdomen; Tomography, X-Ray Computed
PubMed: 36375364
DOI: 10.1016/j.clinimag.2022.10.016 -
Journal of Medical Radiation Sciences Dec 2018This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal...
This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus.
Topics: Emergency Service, Hospital; Humans; Radiation Dosage; Radiography, Abdominal
PubMed: 30506851
DOI: 10.1002/jmrs.307