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Diagnostics
Volume 14
Issue 24
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Diagnostics, Volume 14, Issue 24 (December-2 2024) – 128 articles

Cover Story (view full-size image): Nodular thyroid disease is very common in the general population. Most nodules are benign with malignancy found in around 10% of cases. The majority of thyroid nodules are detected as incidental findings as a result of greater imaging volumes and the use of modern imaging technologies. The purpose of this study was to evaluate the effectiveness of ACR TI-RADS in predicting the cancer risk in thyroid nodules. The analysis involved over 1000 consecutive FNA biopsies in a single Canadian institution over a three-year period. Variables examined included gender, age, history of thyroid cancer or neck irradiation, nodule size and location, TR level, and sonographic features such as punctate echogenic foci (PEF), a very hypoechoic appearance, taller-than-wide shape, and suspected extrathyroidal extension. View this paper
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29 pages, 2570 KiB  
Systematic Review
The Challenge of Deep Learning for the Prevention and Automatic Diagnosis of Breast Cancer: A Systematic Review
by Jhelly-Reynaluz Pérez-Núñez, Ciro Rodríguez, Luis-Javier Vásquez-Serpa and Carlos Navarro
Diagnostics 2024, 14(24), 2896; https://doi.org/10.3390/diagnostics14242896 - 23 Dec 2024
Viewed by 753
Abstract
Objectives: This review aims to evaluate several convolutional neural network (CNN) models applied to breast cancer detection, to identify and categorize CNN variants in recent studies, and to analyze their specific strengths, limitations, and challenges. Methods: Using PRISMA methodology, this review examines studies [...] Read more.
Objectives: This review aims to evaluate several convolutional neural network (CNN) models applied to breast cancer detection, to identify and categorize CNN variants in recent studies, and to analyze their specific strengths, limitations, and challenges. Methods: Using PRISMA methodology, this review examines studies that focus on deep learning techniques, specifically CNN, for breast cancer detection. Inclusion criteria encompassed studies from the past five years, with duplicates and those unrelated to breast cancer excluded. A total of 62 articles from the IEEE, SCOPUS, and PubMed databases were analyzed, exploring CNN architectures and their applicability in detecting this pathology. Results: The review found that CNN models with advanced architecture and greater depth exhibit high accuracy and sensitivity in image processing and feature extraction for breast cancer detection. CNN variants that integrate transfer learning proved particularly effective, allowing the use of pre-trained models with less training data required. However, challenges include the need for large, labeled datasets and significant computational resources. Conclusions: CNNs represent a promising tool in breast cancer detection, although future research should aim to create models that are more resource-efficient and maintain accuracy while reducing data requirements, thus improving clinical applicability. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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13 pages, 708 KiB  
Article
Health and Liver Diagnostic Markers Influencing Glycemia in Subjects with Prediabetes: Preview Study
by Omar Ramos-Lopez, Diego Martinez-Urbistondo, Santiago Navas-Carretero, Ruixin Zhu, Maija Huttunen-Lenz, Gareth Stratton, Teodora Handjieva-Darlenska, Svetoslav Handjiev, Jouko Ensio Sundvall, Marta P. Silvestre, Elli Jalo, Kirsi H. Pietiläinen, Tanja C. Adam, Margriet Westerterp-Plantenga, Elizabeth Simpson, Ian MacDonald, Moira A. Taylor, Sally D. Poppitt, Wolfgang Schlicht, Jennie Brand-Miller, Mikael Fogelholm, Anne Raben and J. Alfredo Martinezadd Show full author list remove Hide full author list
Diagnostics 2024, 14(24), 2895; https://doi.org/10.3390/diagnostics14242895 - 23 Dec 2024
Viewed by 571
Abstract
Introduction: Glucose homeostasis may be dependent on liver conditions and influence health-related markers and quality of life (QoL) objective measurements. This study aimed to analyze the interactions of glycemia with liver and health status in a prediabetic population. Subjects and methods: This study [...] Read more.
Introduction: Glucose homeostasis may be dependent on liver conditions and influence health-related markers and quality of life (QoL) objective measurements. This study aimed to analyze the interactions of glycemia with liver and health status in a prediabetic population. Subjects and methods: This study included 2220 overweight/obese prediabetics from the multinational PREVIEW project. Anthropometrics; clinical, metabolic and other health-related markers; and QoL variables were analyzed. Univariate and multilinear-adjusted regression models were run to explain the interrelationships and effect modification between glycemia, health-related QoL (applying SF-12) and metabolic/liver health (using the HSI, a putative marker of fatty liver). Results: Relevant age/sex interactions were found concerning the levels of insulin, HOMA-IR, C peptide and transaminases in this prediabetic population. Multivariate models identified age, sex, glucose, WC and QoL as important predictors of HSI variability (adj. R value = 0.1393, p < 0.001), whereas the QoL status was statistically related to age, sex, HOMA-IR and HSI (adj. R value = 0.1130, p < 0.001) in this glycemia-impaired group. Furthermore, the QoL values declined with increased HSI scores, where a significant interaction was found (p = 0.011) when the data were analyzed when comparing lower glycemia vs. higher glycemia in prediabetics. Indeed, an effect modification was featured depending on the glycemia levels concerning the QoL and HSI worsening. Conclusion: Glycemia associations with the QoL status and liver metabolism markers were evidenced, with clinical implications for diabetes and liver disease precision management given the modification of the QoL outcomes depending on the liver status and glycemia concentrations. Notably, independent associations of circulating glucose with age, sex, adiposity, inflammation and C peptide levels were found. Full article
(This article belongs to the Special Issue Diagnosis, Biomarkers, and Treatment of Metabolic Disorders)
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13 pages, 2191 KiB  
Article
Assessment of a Bioimpedance-Based Method for the Diagnosis of Oral Cancer
by Kristina Horvat Šikonja, Ivica Richter, Marko Velimir Grgić, Krešimir Gršić, Dinko Leović, Lovorka Batelja Vuletić and Vlaho Brailo
Diagnostics 2024, 14(24), 2894; https://doi.org/10.3390/diagnostics14242894 - 23 Dec 2024
Viewed by 511
Abstract
Background/Objectives: Oral cancer (OC) is a disease with poor prognosis mainly due to late diagnosis. There is considerable interest in the use and development of rapid, point of care (POC) non-invasive methods that can accelerate the diagnostic process. Bioimpedance (BI) is resistance to [...] Read more.
Background/Objectives: Oral cancer (OC) is a disease with poor prognosis mainly due to late diagnosis. There is considerable interest in the use and development of rapid, point of care (POC) non-invasive methods that can accelerate the diagnostic process. Bioimpedance (BI) is resistance to the passage of electric currents through tissue that reflects structural changes in the tissue. The aim of this study was to determine the spectrum of BI values in patients with oral cancer, to compare them with other oral lesions and healthy controls, and to determine the diagnostic value of the BI-based method for diagnosis of OC. Methods: Ninety-three participants divided into three groups participated in this study. The first group (31 participants) consisted of patients with histologically confirmed OC, the second group (31 participants) consisted of patients with an active reticular form of oral lichen planus (positive controls; OLP) and the third group (31 participants) consisted of healthy controls. In OC and OLP patients, BI was measured at three points (non-ulcerated lesional mucosa, clinically unaffected perilesional mucosa and unaffected mucosa on the contralateral side). In healthy controls, BI was measured on a healthy mucosa in the corresponding anatomical region. Measurements were performed at nine frequencies (1, 2, 5, 7, 10, 20, 70 and 100 kHz). Results: In OC patients, BI values in the lesion were significantly lower than BI values in clinically intact perilesional mucosa and the unaffected contralateral side at all frequencies. Furthermore, BI values of the clinically intact perilesional mucosa were significantly lower than the BI values of the healthy contralateral mucosa at frequencies of 1 kHz, 2 kHz, 5 kHz, 7 kHz and 10 kHz. Patients with OC had significantly lower BI values compared to patients with OLP and individuals with healthy oral mucosa at all frequencies. Conclusions: This study demonstrated the very good to excellent ability of this method to detect OC lesions, which needs to be confirmed by further studies on a larger number of participants. Full article
(This article belongs to the Special Issue Advances in Oral Diseases Diagnosis and Management: 2nd Edition)
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16 pages, 3889 KiB  
Article
The Comparison of Accuracy of Post Space Digital Impressions Made by Three Different Intraoral Scanners: An In Vitro Study
by Abdullah A. Meshni, Saurabh Jain, Hanan Nasser Marie Osaysi, Khadijah Nasser Hezam and Samar Samir Gomaan Adlan
Diagnostics 2024, 14(24), 2893; https://doi.org/10.3390/diagnostics14242893 - 23 Dec 2024
Viewed by 472
Abstract
Background and Objectives: The present study aims to assess and compare the accuracy of post-space impressions captured by three different intraoral scanners (IOS) using various canal diameters. Methods: Three extracted natural maxillary central incisors were selected and prepared for a 1 mm wide [...] Read more.
Background and Objectives: The present study aims to assess and compare the accuracy of post-space impressions captured by three different intraoral scanners (IOS) using various canal diameters. Methods: Three extracted natural maxillary central incisors were selected and prepared for a 1 mm wide margin and a 3 mm ferrule. All steps required for the endodontic procedure were performed, and the post space was prepared using post drills. The post length was kept constant at 12 mm, whereas the width was varied (Group 1: 1.4 mm, Group 2: 1.6 mm, and Group 3: 1.8 mm). Three IOSs (Trios3, iTero2, and Medit i700) were used to acquire a digital impression of the prepared post space. Each tooth was scanned 10 times by each scanner. So, in the end, 90 digital images were recorded, and the STL files were stored. GC Pattern resin was used to fabricate resin post and core patterns, which were scanned using an extraoral scanner (EOS). The STL file obtained was used as the reference file. To evaluate the trueness of the tested IOSs, each three-dimensional scan from an IOS was superimposed on the reference scan with the help of the Medit Design software 2.1.4. The software generates color plots and gives numerical values as deviations in the Root mean square (RMS) for the variance between the two superimposed scans. The data collected was tabulated for statistical analysis. One Way ANOVA was used to test the significance difference between three different IOSs, followed by Bonferroni Post-hoc test pairwise test to identify the differences between every two different IOS. Statistical significance was set at p < 0.05. Results: The mean deviation for trueness in post space impression values recorded by the Medit i700 was highest among groups 1, 2, and 3 [0.825 (±0.071), 0.673 (±0.042) and 0.516 (±0.039), respectively], followed by iTero2 [0.738 (±0.081), 0.569 (±0.043) and 0.470 (±0.037), respectively] and Trios3 [0.714 (±0.062), 0.530 (±0.040) and 0.418 (±0.024), respectively]. Significant differences were found between the groups for all three IOSs (Trios3: p-value < 0.0001; iTero2: p-value < 0.0001; Medit i700: p-value < 0.0001). Conclusions: Within the limitations of this study, it can be concluded that Trios3 IOS has higher accuracy (as it exhibited minimal deviation for trueness) in recording post space, followed by iTero2 and Mediti700 IOS. As the diameter of the post space is increased, the accuracy of recording by IOS increases. For all the tested IOSs (except for Trios3 and iTero2, when used to record post space with 1.8 mm canal diameter), the deviations in trueness were higher than the clinically acceptable limits. Thus, IOSs should be used cautiously when recording impressions of post spaces. Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
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20 pages, 8559 KiB  
Review
Diagnostic and Therapeutic Aspects of Monoclonal Gammopathies of Renal Significance (MGRS): An Update
by Giuseppe Stefano Netti, Dario Troise, Michele Rossini, Valeria Catalano, Federica De Luca, Javeria Khalid, Valentina Camporeale, Fabiana Ritrovato, Barbara Infante, Francesca Sanguedolce, Giovanni Stallone and Elena Ranieri
Diagnostics 2024, 14(24), 2892; https://doi.org/10.3390/diagnostics14242892 - 23 Dec 2024
Viewed by 530
Abstract
Monoclonal gammopathy of renal significance (MGRS) refers to a group of renal disorders caused by a monoclonal immunoglobulin (MIg), secreted by a non-malignant B-cell clone. Unlike overt multiple myeloma or B-cell proliferation, MGRS does not meet those diagnostic criteria. However, it is associated [...] Read more.
Monoclonal gammopathy of renal significance (MGRS) refers to a group of renal disorders caused by a monoclonal immunoglobulin (MIg), secreted by a non-malignant B-cell clone. Unlike overt multiple myeloma or B-cell proliferation, MGRS does not meet those diagnostic criteria. However, it is associated with significant morbidity, due to severe renal, and sometimes systemic, lesions induced by the MIg. Early recognition is crucial, as chemotherapy to suppress MIg secretion often improves outcomes. The spectrum of renal diseases in MGRS is broad, including both well-known conditions like AL amyloidosis and newly described lesions. Kidney biopsy is essential to determine the specific lesion associated with MGRS and assess its severity. Diagnosis involves integrating morphologic alterations using techniques such as light microscopy, immunofluorescence (IF), electron microscopy, and, in some cases, IF staining for Ig isotypes, immunoelectron microscopy, and proteomic analysis. Additionally, a complete hematologic evaluation, including serum and urine protein electrophoresis, immunofixation, and a serum-free light-chain assay, is necessary. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Kidney Disease)
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25 pages, 1685 KiB  
Article
Federated Learning with Privacy Preserving for Multi- Institutional Three-Dimensional Brain Tumor Segmentation
by Mohammed Elbachir Yahiaoui, Makhlouf Derdour, Rawad Abdulghafor, Sherzod Turaev, Mohamed Gasmi, Akram Bennour, Abdulaziz Aborujilah and Mohamed Al Sarem
Diagnostics 2024, 14(24), 2891; https://doi.org/10.3390/diagnostics14242891 - 23 Dec 2024
Viewed by 683
Abstract
Background and Objectives: Brain tumors are complex diseases that require careful diagnosis and treatment. A minor error in the diagnosis may easily lead to significant consequences. Thus, one must place a premium on accurately identifying brain tumors. However, deep learning (DL) models often [...] Read more.
Background and Objectives: Brain tumors are complex diseases that require careful diagnosis and treatment. A minor error in the diagnosis may easily lead to significant consequences. Thus, one must place a premium on accurately identifying brain tumors. However, deep learning (DL) models often face challenges in obtaining sufficient medical imaging data due to legal, privacy, and technical barriers hindering data sharing between institutions. This study aims to implement a federated learning (FL) approach with privacy-preserving techniques (PPTs) directed toward segmenting brain tumor lesions in a distributed and privacy-aware manner.Methods: The suggested approach employs a model of 3D U-Net, which is trained using federated learning on the BraTS 2020 dataset. PPTs, such as differential privacy, are included to ensure data confidentiality while managing privacy and heterogeneity challenges with minimal communication overhead. The efficiency of the model is measured in terms of Dice similarity coefficients (DSCs) and 95% Hausdorff distances (HD95) concerning the target areas concerned by tumors, which include the whole tumor (WT), tumor core (TC), and enhancing tumor core (ET). Results: In the validation phase, the partial federated model achieved DSCs of 86.1%, 83.3%, and 79.8%, corresponding to 95% values of 25.3 mm, 8.61 mm, and 9.16 mm for WT, TC, and ET, respectively. On the final test set, the model demonstrated improved performance, achieving DSCs of 89.85%, 87.55%, and 86.6%, with HD95 values of 22.95 mm, 8.68 mm, and 8.32 mm for WT, TC, and ET, respectively, which indicates the effectiveness of the segmentation approach, and its privacy preservation.Conclusion: This study presents a highly competitive, collaborative federated learning model with PPTs that can successfully segment brain tumor lesions without compromising patient data confidentiality. Future work will improve model generalizability and extend the framework to other medical imaging tasks. Full article
(This article belongs to the Special Issue A New Era in Diagnosis: From Biomarkers to Artificial Intelligence)
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18 pages, 1205 KiB  
Systematic Review
Dimensional Accuracy of Intraoral Scanners in Recording Digital Impressions of Post and Core Preparations: A Systematic Review
by Saeed M. Alqahtani, Mohammed Salman Almalki, Mai Almarzouki, Saad Saleh AlResayes, Nisreen Nabiel Hassan, Arwa Jaber I. Mohana, Majed S. Altoman and Mohammed E. Sayed
Diagnostics 2024, 14(24), 2890; https://doi.org/10.3390/diagnostics14242890 - 23 Dec 2024
Viewed by 445
Abstract
Background: This study aims to perform a review by selecting, analyzing, and evaluating articles that discuss the accuracy of intraoral scanners (IOSs) in recording post space compared to conventional impression-making techniques. Methods: The review question framed using the PITR framework (participant, index test, [...] Read more.
Background: This study aims to perform a review by selecting, analyzing, and evaluating articles that discuss the accuracy of intraoral scanners (IOSs) in recording post space compared to conventional impression-making techniques. Methods: The review question framed using the PITR framework (participant, index test, targeted condition, and reference standard) is as follows: What is the dimensional accuracy (T) of impressions made using intraoral scanners (I) for post space (P) compared to impressions made using conventional techniques and digitalized using extraoral scanners (R)? Four electronic databases were searched using pre-set keywords. The guidelines and strategies recommended by PRISMA formed the basis for planning, executing, and documenting this systematic review. QUADAS-2 was used to critically analyze the quality of all the selected articles. Results: After excluding ineligible articles, the end synthesis has nine studies (n = 9) for qualitative analysis. All nine evaluated studies were found to be at risk of bias, with high or unclear risk in one or more domains. Three out of nine evaluated studies had unclear concerns regarding the applicability, and the remaining six had low concerns. In all the included studies, the IOSs were reported to have deviations in accuracy compared to the conventional techniques for making digital impressions of post space. Conclusions: The accuracy of IOSs was found to be inversely proportional to the length of post space and directly proportional to the diameter of post space. IOSs, when used adequately in short post spaces, can be an alternative to conventional impression-making for making custom posts and cores. Full article
(This article belongs to the Special Issue New Possibilities for Digital Diagnosis and Planning in Dentistry)
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12 pages, 6235 KiB  
Article
Hepatic Steatosis Analysis in Metabolic Dysfunction-Associated Steatotic Liver Disease Based on Artificial Intelligence
by Xiao-Xiao Wang, Yu-Yun Song, Rui Jin, Zi-Long Wang, Xiao-He Li, Qiang Yang, Xiao Teng, Fang-Fang Liu, Nan Wu, Yan-Di Xie, Hui-Ying Rao and Feng Liu
Diagnostics 2024, 14(24), 2889; https://doi.org/10.3390/diagnostics14242889 - 23 Dec 2024
Viewed by 613
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the accumulation of fat in the liver, excluding excessive alcohol consumption and other known causes of liver injury. Animal models are often used to explore different pathogenic mechanisms and therapeutic targets of MASLD. [...] Read more.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the accumulation of fat in the liver, excluding excessive alcohol consumption and other known causes of liver injury. Animal models are often used to explore different pathogenic mechanisms and therapeutic targets of MASLD. The aim of this study is to apply an artificial intelligence (AI) system based on second-harmonic generation (SHG)/two-photon-excited fluorescence (TPEF) technology to automatically assess the dynamic patterns of hepatic steatosis in MASLD mouse models. Methods: We evaluated the characteristics of hepatic steatosis in mouse models of MASLD using AI analysis based on SHG/TPEF images. Six different models of MASLD were induced in C57BL/6 mice by feeding with a western or high-fat diet, with or without fructose in their drinking water, and/or by weekly injections of carbon tetrachloride. Results: Body weight, serum lipids, and liver enzyme markers increased at 8 and 16 weeks in each model compared to baseline. Steatosis grade showed a steady upward trend. However, the non-alcoholic steatohepatitis (NASH) Clinical Research Network (CRN) histological scoring method detected no significant difference between 8 and 16 weeks. In contrast, AI analysis was able to quantify dynamic changes in the area, number, and size of hepatic steatosis automatically and objectively, making it more suitable for preclinical MASLD animal experiments. Conclusions: AI recognition technology may be a new tool for the accurate diagnosis of steatosis in MASLD, providing a more precise and objective method for evaluating steatosis in preclinical murine MASLD models under various experimental and treatment conditions. Full article
(This article belongs to the Special Issue Artificial Intelligence in Metabolic Diseases)
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12 pages, 3076 KiB  
Article
Three-Dimensional Measurements of Sphenoid Sinus Size by Sex in a Korean Population: An Exploratory Study
by Jeong-Hyun Lee and Jong-Tae Park
Diagnostics 2024, 14(24), 2888; https://doi.org/10.3390/diagnostics14242888 - 23 Dec 2024
Viewed by 508
Abstract
Background/Objectives: This study aims to investigate the three-dimensional morphological differences of the sphenoid sinus according to sex in the Korean adult population and conduct an exploratory study based on the findings. The sphenoid sinus, located deep within the skull, plays a crucial role [...] Read more.
Background/Objectives: This study aims to investigate the three-dimensional morphological differences of the sphenoid sinus according to sex in the Korean adult population and conduct an exploratory study based on the findings. The sphenoid sinus, located deep within the skull, plays a crucial role in forensic identification due to its relative protection from external damage and its unique anatomical characteristics. Methods: Using cone-beam computed tomography (CBCT) data from 120 patients (60 males and 60 females) aged 20–29, the sphenoid sinus was visualized and measured in three dimensions using Mimics software (version 22.0). Measurements included the volume of the sphenoid sinus, as well as its dimensions in the X, Y, and Z axes. The measured data were analyzed using SPSS (version 23.0) with a t-test and linear regression analysis. Results: The results showed that the sphenoid sinus volume was significantly larger in males compared to females (p < 0.05), with an average male sinus volume of 16,957.9 mm3 and a female volume of 13,517.7 mm3. Additionally, the X-width, Y-width, and Z-width were all larger in males, with significant differences (p < 0.001) across all dimensions. Further regression analysis revealed that the volume of the sphenoid sinus was primarily influenced by the Z-axis height (measured from the coronal view) and the Y-axis width (measured from the sagittal view), while the X-axis width had a negligible effect on the overall volume. Conclusions: These findings suggest that sex-specific differences in the sphenoid sinus may provide important insights for clinical diagnoses and forensic personal identification. This study highlights the need for further research on different age groups and ethnic populations to enhance the understanding of anatomical variations in the sphenoid sinus and their potential applications in both medical and forensic fields. Full article
(This article belongs to the Special Issue Advances in Human Anatomy)
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20 pages, 2326 KiB  
Article
The Role of Metabolic Syndrome in Psoriasis Treatment Response: A One-Year Comparative Analysis of PASI Progression
by Maria-Lorena Mustață, Mihaela Ionescu, Lucrețiu Radu, Carmen-Daniela Neagoe, Roxana-Viorela Ahrițculesei, Radu-Cristian Cîmpeanu, Daniela Matei, Anca-Maria Amzolini, Maria-Cristina Predoi and Simona-Laura Ianoși
Diagnostics 2024, 14(24), 2887; https://doi.org/10.3390/diagnostics14242887 - 23 Dec 2024
Viewed by 648
Abstract
Background/Objectives: Psoriasis is a chronic dermatological condition with systemic implications, especially with metabolic syndrome (MS). This study evaluated the vicious cycle where obesity and MS exacerbate systemic inflammation that complicates the efficacy of psoriasis therapies by examining the PASI score over a one-year [...] Read more.
Background/Objectives: Psoriasis is a chronic dermatological condition with systemic implications, especially with metabolic syndrome (MS). This study evaluated the vicious cycle where obesity and MS exacerbate systemic inflammation that complicates the efficacy of psoriasis therapies by examining the PASI score over a one-year period. Patients were classified into two subgroups: those with psoriasis alone (PSO) and those with both psoriasis and metabolic syndrome (PSO-MS). Methods: A total of 150 patients, half of whom also concomitantly presented with metabolic syndrome, received biologic therapies comprising anti-IL-17, anti-IL-23, and anti-TNF-a, or methotrexate, with PASI scores assessed at baseline and at 3, 6, and 12 months. Results: All treatments showed significant reductions in PASI; however, patients with PSO showed more marked reductions in PASI score than those in the PSO-MS group. Anti-IL-17 treatments produced the greatest sustained long-term improvements, whereas anti-IL-23 produced prompt early improvements. Increases in BMI and leptin concentrations were associated with a modest rate of reduction in PASI score, underlining the impact of obesity and metabolic dysfunction on treatment efficacy. Conclusions: This study highlights the importance of managing comorbidities such as MS in the treatment of psoriasis, as the interplay between systemic inflammation and metabolic health further complicates therapeutic outcomes. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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29 pages, 3202 KiB  
Article
Gait-Based AI Models for Detecting Sarcopenia and Cognitive Decline Using Sensor Fusion
by Rocío Aznar-Gimeno, Jose Luis Perez-Lasierra, Pablo Pérez-Lázaro, Irene Bosque-López, Marina Azpíroz-Puente, Pilar Salvo-Ibáñez, Martin Morita-Hernandez, Ana Caren Hernández-Ruiz, Antonio Gómez-Bernal, María de la Vega Rodrigalvarez-Chamarro, José-Víctor Alfaro-Santafé, Rafael del Hoyo-Alonso and Javier Alfaro-Santafé
Diagnostics 2024, 14(24), 2886; https://doi.org/10.3390/diagnostics14242886 - 22 Dec 2024
Viewed by 811
Abstract
Background/Objectives: Sarcopenia and cognitive decline (CD) are prevalent in aging populations, impacting functionality and quality of life. The early detection of these diseases is challenging, often relying on in-person screening, which is difficult to implement regularly. This study aims to develop artificial [...] Read more.
Background/Objectives: Sarcopenia and cognitive decline (CD) are prevalent in aging populations, impacting functionality and quality of life. The early detection of these diseases is challenging, often relying on in-person screening, which is difficult to implement regularly. This study aims to develop artificial intelligence algorithms based on gait analysis, integrating sensor and computer vision (CV) data, to detect sarcopenia and CD. Methods: A cross-sectional case-control study was conducted involving 42 individuals aged 60 years or older. Participants were classified as having sarcopenia if they met the criteria established by the European Working Group on Sarcopenia in Older People and as having CD if their score in the Mini-Mental State Examination was ≤24 points. Gait patterns were assessed at usual walking speeds using sensors attached to the feet and lumbar region, and CV data were captured using a camera. Several key variables related to gait dynamics were extracted. Finally, machine learning models were developed using these variables to predict sarcopenia and CD. Results: Models based on sensor data, CV data, and a combination of both technologies achieved high predictive accuracy, particularly for CD. The best model for CD achieved an F1-score of 0.914, with a 95% sensitivity and 92% specificity. The combined technologies model for sarcopenia also demonstrated high performance, yielding an F1-score of 0.748 with a 100% sensitivity and 83% specificity. Conclusions: The study demonstrates that gait analysis through sensor and CV fusion can effectively screen for sarcopenia and CD. The multimodal approach enhances model accuracy, potentially supporting early disease detection and intervention in home settings. Full article
(This article belongs to the Special Issue Artificial Intelligence and Pattern Recognition Methods for the Automatic Detection and Evaluation of Neurological Disorders, 2nd Edition)
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22 pages, 576 KiB  
Article
Exploring the Relationship Between Ejection Fraction, Arterial Stiffness, NT-proBNP, and Hospitalization Risk in Heart Failure Patients
by Gyongyi Osser, Brigitte Osser, Csongor Toth, Caius Calin Miuța, Gabriel Roberto Marconi and Laura Ioana Bondar
Diagnostics 2024, 14(24), 2885; https://doi.org/10.3390/diagnostics14242885 - 22 Dec 2024
Viewed by 490
Abstract
Background/Objectives: Heart failure (HF) remains a leading cause of hospitalization and morbidity. Arterial stiffness, measured by pulse wave velocity (PWV) and the augmentation index (AIx), has been linked to HF severity and prognosis. This study investigates the relationship between clinical parameters, biochemical indicators, [...] Read more.
Background/Objectives: Heart failure (HF) remains a leading cause of hospitalization and morbidity. Arterial stiffness, measured by pulse wave velocity (PWV) and the augmentation index (AIx), has been linked to HF severity and prognosis. This study investigates the relationship between clinical parameters, biochemical indicators, and arterial stiffness in hospitalized patients with HF, aiming to identify predictors of hospitalization and improve patient management. Methods: This cross-sectional study included 98 patients admitted with HF: 53 with acutely decompensated HF (sudden worsening of symptoms) and 45 with chronic HF (stable symptoms of HF). Clinical and biochemical parameters, including ejection fraction (EF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, and arterial stiffness indicators (PWV and AIx), were measured at admission. During follow-up, 59 patients required re-hospitalization due to acutely decompensated HF, while 39 remained outpatients without further hospitalization. The relationship between these parameters was analyzed using Pearson correlation coefficients, and multiple Cox regression analysis was conducted to identify independent predictors of re-hospitalization. Results: A significant negative correlation between EF and PWV was found (r = −0.853, 95% CI [−0.910, −0.764]), suggesting an association between improved heart function (higher EF) and reduced arterial stiffness (lower PWV). A moderate positive correlation between EF and AIx (r = 0.626, 95% CI [0.473, 0.805]) suggests that, while higher EF is associated with increased AIx, the relationship is weaker compared to EF and PWV. This may reflect differing contributions of vascular and myocardial factors to HF severity. Hospitalized patients exhibited significantly poorer clinical and biochemical profiles, including higher NT-proBNP levels (p < 0.001) and worse blood pressure (BP) measurements (systolic and diastolic, p < 0.01). Multiple Cox regression analysis identified PWV, Aix, and NT-proBNP as independent predictors of re-hospitalization in HF patients, with significant hazard ratios: PWV (HR = 1.15, p = 0.02), AIx (HR = 1.03, p = 0.02), and NT-proBNP (HR = 1.0001, p < 0.01). Conclusions: Arterial stiffness indices (PWV and AIx), EF, and NT-proBNP were identified as significant predictors of re-hospitalization in HF patients. These findings suggest that integrating arterial stiffness measurements into routine clinical assessments may enhance the risk stratification and inform targeted interventions to reduce hospitalizations and improve outcomes. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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16 pages, 2169 KiB  
Article
Fully Automated Assessment of Cardiac Chamber Volumes and Myocardial Mass on Non-Contrast Chest CT with a Deep Learning Model: Validation Against Cardiac MR
by Ramona Schmitt, Christopher L. Schlett, Jonathan I. Sperl, Saikiran Rapaka, Athira J. Jacob, Manuel Hein, Muhammad Taha Hagar, Philipp Ruile, Dirk Westermann, Martin Soschynski, Fabian Bamberg and Christopher Schuppert
Diagnostics 2024, 14(24), 2884; https://doi.org/10.3390/diagnostics14242884 - 21 Dec 2024
Viewed by 640
Abstract
Background: To validate the automated quantification of cardiac chamber volumes and myocardial mass on non-contrast chest CT using cardiac MR (CMR) as a reference. Methods: We retrospectively included 53 consecutive patients who received non-contrast chest CT and CMR within three weeks. [...] Read more.
Background: To validate the automated quantification of cardiac chamber volumes and myocardial mass on non-contrast chest CT using cardiac MR (CMR) as a reference. Methods: We retrospectively included 53 consecutive patients who received non-contrast chest CT and CMR within three weeks. A deep learning model created cardiac segmentations on axial soft-tissue reconstructions from CT, covering all four cardiac chambers and the left ventricular myocardium. Segmentations on CMR cine short-axis and long-axis images served as a reference. Standard estimates of diagnostic accuracy were calculated for ventricular volumes at end-diastole and end-systole (LVEDV, LVESV, RVEDV, RVESV), left ventricular mass (LVM), and atrial volumes (LA, RA) at ventricular end-diastole. A qualitative assessment noted segmentation issues. Results: The deep learning model generated CT measurements for 52 of the 53 patients (98%). Based on CMR measurements, the average LVEDV was 166 ± 64 mL, RVEDV was 144 ± 51 mL, and LVM was 115 ± 39 g. The CT measurements correlated well with CMR measurements for LVEDV, LVESV, and LVM (ICC = 0.85, ICC = 0.84, and ICC = 0.91; all p < 0.001) and RVEDV and RVESV (ICC = 0.79 and ICC= 0.78; both p < 0.001), and moderately well with LA and RA (ICC = 0.74 and ICC = 0.61; both p < 0.001). Absolute agreements likewise favored LVEDV, LVM, and RVEDV. ECG-gating did not relevantly influence the results. The CT results correctly identified 7/15 LV and 1/1 RV as dilated (one and six false positives, respectively). Major qualitative issues were found in three cases (6%). Conclusions: Automated cardiac chamber volume and myocardial mass quantification on non-contrast chest CT produced viable measurements in this retrospective sample. Relevance Statement: An automated cardiac assessment on non-contrast chest CT provides quantitative morphological data on the heart, enabling a preliminary organ evaluation that aids in incidentally identifying at-risk patients who may benefit from a more targeted diagnostic workup. Full article
(This article belongs to the Special Issue Cardiothoracic Imaging: Diagnostics and Modern Techniques—2nd Edition)
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14 pages, 1953 KiB  
Article
Artificial Intelligence Unveils the Unseen: Mapping Novel Lung Patterns in Bronchiectasis via Texture Analysis
by Athira Nair, Rakesh Mohan, Mandya Venkateshmurthy Greeshma, Deepak Benny, Vikram Patil, SubbaRao V. Madhunapantula, Biligere Siddaiah Jayaraj, Sindaghatta Krishnarao Chaya, Suhail Azam Khan, Komarla Sundararaja Lokesh, Muhlisa Muhammaed Ali Laila, Vadde Vijayalakshmi, Sivasubramaniam Karunakaran, Shreya Sathish and Padukudru Anand Mahesh
Diagnostics 2024, 14(24), 2883; https://doi.org/10.3390/diagnostics14242883 - 21 Dec 2024
Viewed by 635
Abstract
Background and Objectives: Thin-section CT (TSCT) is currently the most sensitive imaging modality for detecting bronchiectasis. However, conventional TSCT or HRCT may overlook subtle lung involvement such as alveolar and interstitial changes. Artificial Intelligence (AI)-based analysis offers the potential to identify novel information [...] Read more.
Background and Objectives: Thin-section CT (TSCT) is currently the most sensitive imaging modality for detecting bronchiectasis. However, conventional TSCT or HRCT may overlook subtle lung involvement such as alveolar and interstitial changes. Artificial Intelligence (AI)-based analysis offers the potential to identify novel information on lung parenchymal involvement that is not easily detectable with traditional imaging techniques. This study aimed to assess lung involvement in patients with bronchiectasis using the Bronchiectasis Radiologically Indexed CT Score (BRICS) and AI-based quantitative lung texture analysis software (IMBIO, Version 2.2.0). Methods: A cross-sectional study was conducted on 45 subjects diagnosed with bronchiectasis. The BRICS severity score was used to classify the severity of bronchiectasis into four categories: Mild, Moderate, Severe, and tractional bronchiectasis. Lung texture mapping using the IMBIO AI software tool was performed to identify abnormal lung textures, specifically focusing on detecting alveolar and interstitial involvement. Results: Based on the Bronchiectasis Radiologically Indexed CT Score (BRICS), the severity of bronchiectasis was classified as Mild in 4 (8.9%) participants, Moderate in 14 (31.1%), Severe in 11 (24.4%), and tractional in 16 (35.6%). AI-based lung texture analysis using IMBIO identified significant alveolar and interstitial abnormalities, offering insights beyond conventional HRCT findings. This study revealed trends in lung hyperlucency, ground-glass opacity, reticular changes, and honeycombing across severity levels, with advanced disease stages showing more pronounced structural and vascular alterations. Elevated pulmonary vascular volume (PVV) was noted in cases with higher BRICSs, suggesting increased vascular remodeling in severe and tractional types. Conclusions: AI-based lung texture analysis provides valuable insights into lung parenchymal involvement in bronchiectasis that may not be detectable through conventional HRCT. Identifying significant alveolar and interstitial abnormalities underscores the potential impact of AI on improving the understanding of disease pathology and disease progression, and guiding future therapeutic strategies. Full article
(This article belongs to the Special Issue Machine Learning and Deep Learning for Healthcare Data Processing and Analyzing)
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10 pages, 204 KiB  
Article
Establishment of Local Diagnostic Reference Levels for Head CT Imaging in the Madina Region, Saudi Arabia
by Sultan F. Alhujaili, Abdulaziz S. Alshabibi, Feras Alafer, Ziyad Alrowaili, Hasan Salah, Abdelmoneim Sulieman, Mahmoud Subahi, Khaled Al-Raddadi and Mohamed Abuzaid
Diagnostics 2024, 14(24), 2882; https://doi.org/10.3390/diagnostics14242882 - 21 Dec 2024
Viewed by 652
Abstract
Background: Computed Tomography (CT) is crucial in medical diagnosis, particularly for head examinations. Diagnostic Reference Levels (DRLs) are pivotal in balancing diagnostic efficacy with radiation safety. International organizations such as the International Atomic Energy Agency (IAEA) and the International Commission on Radiological [...] Read more.
Background: Computed Tomography (CT) is crucial in medical diagnosis, particularly for head examinations. Diagnostic Reference Levels (DRLs) are pivotal in balancing diagnostic efficacy with radiation safety. International organizations such as the International Atomic Energy Agency (IAEA) and the International Commission on Radiological Protection (ICRP) provide guidelines for establishing DRLs, emphasizing their importance in optimizing radiation doses. Aim: This study aimed to establish and standardize DRLs for head CT imaging in institutional and regional settings, emphasizing the need for tailored reference levels specific to each region’s practices and standards. Method: Data collection included patient demographics, imaging parameters, and radiation dose indices, namely volume-weighted CT dose index (CTDIvol) and dose-length product (DLP). Statistical analyses were conducted to determine the median and 3rd quartile values for establishing DRLs. The results were compared with national and international benchmarks to assess variations in radiation doses across regions. Results: Demographic profiles detailed gender distributions and ages across hospitals. Imaging parameters exhibited variability in tube voltage, milliampere-seconds (mAs), pitch, scan length, and field of view (FOV). For CTDIvol, the 3rd quartile value was 65.8 mGy (range: 24.8–85.9 mGy), and for DLP, it was 1230.95 mGy·cm (range: 382.3–1189.0 mGy·cm). These values were slightly higher than the national DRLs for Saudi Arabia in 2021 and other international benchmarks, underscoring the need for further optimization and alignment of protocols. Conclusion: Optimizing and standardizing DRLs for head CT imaging is crucial for effectively managing radiation doses while ensuring diagnostic accuracy. Comparison with national and international benchmarks highlighted the importance of tailoring reference levels to regional practices and standards, ensuring patient safety without compromising diagnostic efficacy. Full article
(This article belongs to the Special Issue Advances in Image-Guided Diagnosis and Treatment of Head and Neck Diseases)
14 pages, 2828 KiB  
Article
Impact of Neurodynamic Sequencing on the Mechanical Behaviour of the Median Nerve and Brachial Plexus: An Ultrasound Shear Wave Elastography Study
by Gianluca Ciuffreda, Elena Estébanez-de-Miguel, Isabel Albarova-Corral, Miguel Malo-Urriés, Michael Shacklock, Alberto Montaner-Cuello and Elena Bueno-Gracia
Diagnostics 2024, 14(24), 2881; https://doi.org/10.3390/diagnostics14242881 - 21 Dec 2024
Viewed by 530
Abstract
Background: When performing the Upper Limb Neurodynamic Test 1 (ULNT1), the order of joint movement can be varied to place more stress onto certain nerve segments. However, the mechanisms underlying this phenomenon are still unclear. This study aimed to analyze the differences in [...] Read more.
Background: When performing the Upper Limb Neurodynamic Test 1 (ULNT1), the order of joint movement can be varied to place more stress onto certain nerve segments. However, the mechanisms underlying this phenomenon are still unclear. This study aimed to analyze the differences in the stiffness of the median nerve (MN) and the brachial plexus (BP) using ultrasound shear wave elastography during three sequences of the ULNT1: standard (ULNT1-STD), distal-to-proximal (ULNT1-DIST), and proximal-to-distal (ULNT1-PROX). Methods: Shear wave velocity (SWV) was measured at the initial and final position of each sequence at the MN (wrist) and at the C5 and C6 nerve roots (interscalene level) in 31 healthy subjects. Results: A significant interaction was found between ULNT1 sequence and location (p < 0.001). The ULNT1-STD and ULNT1-DIST induced a greater stiffness increase in the MN (5.67 ± 0.91 m/s, +113.94%; 5.65 ± 0.98 m/s, +115.95%) compared to C5 and C6 (p < 0.001). The ULNT1-PROX resulted in a significantly smaller increase in stiffness at the MN (4.13 ± 0.86 m/s, +54.17%, p < 0.001), but a greater increase at C5 (4.88 ± 1.23 m/s, +53.39%, p < 0.001) and at C6 (4.87 ± 0.81 m/s, +31.55%). The differences for the ULNT1-PROX at C6 were only significant compared to the ULNT1-STD (p < 0.001), but not the ULNT1-DIST (p = 0.066). Conclusions: BP and MN stiffness vary depending on the joint movement sequence during neurodynamic testing. However, the influence of the surrounding tissues may have affected SWV measurements; consequently, these results should be interpreted with caution. Full article
(This article belongs to the Special Issue Advances in Ultrasound)
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13 pages, 691 KiB  
Article
Impact of Neutrophil-to-Lymphocyte Ratio on Stroke Severity and Clinical Outcome in Anterior Circulation Large Vessel Occlusion Stroke
by Zülfikar Memiş, Erdem Gürkaş, Atilla Özcan Özdemir, Bilgehan Atılgan Acar, Muhammed Nur Ögün, Emrah Aytaç, Çetin Kürşad Akpınar, Eşref Akıl, Murat Çabalar, Ayça Özkul, Ümit Görgülü, Hasan Bayındır, Zaur Mehdiyev, Şennur Delibaş Katı, Recep Baydemir, Ahmet Yabalak, Ayşenur Önalan, Türkan Acar, Özlem Aykaç, Zehra Uysal Kocabaş, Serhan Yıldırım, Hasan Doğan, Mehmet Semih Arı, Mustafa Çetiner, Ferhat Balgetir, Fettah Eren, Alper Eren, Nazım Kızıldağ, Utku Cenikli, Aysel Büşra Şişman Bayar, Ebru Temel, Alihan Abdullah Akbaş, Emine Saygın Uysal, Hamza Gültekin, Cebrail Durmaz, Sena Boncuk Ulaş and Talip Asiladd Show full author list remove Hide full author list
Diagnostics 2024, 14(24), 2880; https://doi.org/10.3390/diagnostics14242880 - 21 Dec 2024
Viewed by 701
Abstract
Background: The prognostic value of the neutrophil–lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel [...] Read more.
Background: The prognostic value of the neutrophil–lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline (p = 0.018) and 24 h (p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context. Full article
(This article belongs to the Special Issue Grand Challenges in the Diagnosis and Management of Cardiovascular and Cerebrovascular Diseases)
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12 pages, 1500 KiB  
Article
A New Method of Predicting Final Mandibular Length Based on the Morphology of Cervical Vertebrae
by Manami Yamaguchi, Yong-Il Kim, Heetae Park and Tetsutaro Yamaguchi
Diagnostics 2024, 14(24), 2879; https://doi.org/10.3390/diagnostics14242879 - 21 Dec 2024
Viewed by 400
Abstract
Background/Objectives: Methods for predicting final mandibular length have been studied for many years. We aimed to estimate the final mandibular length at the end of the growth period by analyzing changes in cervical vertebral morphology using longitudinal lateral cephalograms. Methods: Longitudinal lateral cephalograms [...] Read more.
Background/Objectives: Methods for predicting final mandibular length have been studied for many years. We aimed to estimate the final mandibular length at the end of the growth period by analyzing changes in cervical vertebral morphology using longitudinal lateral cephalograms. Methods: Longitudinal lateral cephalograms of elementary school students aged 6–15 who did not undergo orthodontic treatment, collected between 1965 and 1973, were used. For this analysis, 370 images from 44 female individuals were selected, and cervical vertebral morphology was assessed using the semi-landmark method. Generalized Procrustes analysis and principal component analysis were performed, and changes in maxillofacial skeletal and cervical vertebral morphology were analyzed using a linear mixed model with repeated measures. A predictive formula for estimating final mandibular length was developed based on morphological changes in the fourth cervical vertebra. Results: The difference between the predicted and actual final mandibular lengths using the semi-landmark method was 0.17 ± 0.08 mm. The marginal R2 value of the prediction formula was 0.957, and the conditional R2 was 0.990, demonstrating very high accuracy. The annual increase in mandibular length remained consistent each year but slowed after 14 years of age. Geometric morphometric analysis revealed significant morphological changes in the fourth cervical vertebra at 14 years of age, coinciding with a deceleration in mandibular growth. Conclusions: A highly accurate formula was developed to predict final mandibular length based on morphological changes in the fourth cervical vertebra. Cervical vertebral morphology may provide valuable information related to mandibular growth during adolescence. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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13 pages, 698 KiB  
Review
Periodontitis, Metabolic Syndrome and Diabetes: Identifying Patients at Risk for Three Common Diseases Using the aMMP-8 Rapid Test at the Dentist’s Office
by Taija Kristiina Hopealaakso, Julie Toby Thomas, Tommi Pätilä, Miika Penttala, Dimitra Sakellari, Andreas Grigoriadis, Shipra Gupta, Timo Sorsa and Ismo T. Räisänen
Diagnostics 2024, 14(24), 2878; https://doi.org/10.3390/diagnostics14242878 - 21 Dec 2024
Viewed by 603
Abstract
Background/Objectives: This narrative review paper highlights the multifaceted influence of dysbiotic biofilm, genetic background, host response, and environmental factors on periodontitis. It explores the roles of type I and II diabetes mellitus, gestational diabetes, and metabolic syndrome in the progression of periodontitis, drawing [...] Read more.
Background/Objectives: This narrative review paper highlights the multifaceted influence of dysbiotic biofilm, genetic background, host response, and environmental factors on periodontitis. It explores the roles of type I and II diabetes mellitus, gestational diabetes, and metabolic syndrome in the progression of periodontitis, drawing insights from various empirical studies and theoretical perspectives. Methods: Relevant articles were sourced using keywords in databases like PubMed/Medline, Science Direct, Scopus, and Google Scholar. Additionally, this review examines the relationship between aMMP-8 levels and increased glycemic states, as well as varying degrees of periodontitis severity. Results: The biomarker active-matrix metalloproteinase-8 (aMMP-8), produced by polymorphonuclear leukocytes (PMN), is highlighted as a reliable indicator of ongoing connective tissue degradation. Dysfunctions in PMN activity, accumulation of advanced glycation end products (AGE), and oxidative stress aggravate the periodontal inflammatory response and complications of diabetes. Traditional diagnostics of periodontitis do not provide sufficient information about the current or future disease initiation or activity of periodontitis. Conclusions: The implications of this review point to the need for monitoring periodontal health by utilizing innovative strategies like aMMP-8 point-of-care testing, using oral rinse for screening and treatment monitoring, and harnessing the potential of supportive treatments like low-dose doxycycline and light-activated mouth rinses for restoring periodontal health. Its expression in oral fluids is a promising diagnostic tool to differentiate periodontitis from gingivitis and healthy periodontium, especially when associated with systemic diseases, fostering greater collaboration among healthcare professionals. Full article
(This article belongs to the Special Issue Periodontal Disease: Diagnosis and Management)
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16 pages, 2500 KiB  
Article
Computer-Aided Diagnosis in Spontaneous Abortion: A Histopathology Dataset and Benchmark for Products of Conception
by Tahir Mahmood, Zeeshan Ullah, Atif Latif, Binish Arif Sultan, Muhammad Zubair, Zahid Ullah, AbuZar Ansari, Talat Zehra, Shahzad Ahmed and Naqqash Dilshad
Diagnostics 2024, 14(24), 2877; https://doi.org/10.3390/diagnostics14242877 - 21 Dec 2024
Viewed by 625
Abstract
Spontaneous abortion, commonly known as miscarriage, is a significant concern during early pregnancy. Histopathological examination of tissue samples is a widely used method to diagnose and classify tissue phenotypes found in products of conception (POC) after spontaneous abortion. Background: Histopathological examination is subjective [...] Read more.
Spontaneous abortion, commonly known as miscarriage, is a significant concern during early pregnancy. Histopathological examination of tissue samples is a widely used method to diagnose and classify tissue phenotypes found in products of conception (POC) after spontaneous abortion. Background: Histopathological examination is subjective and dependent on the skill and experience of the examiner. In recent years, artificial intelligence (AI)-based techniques have emerged as a promising tool in medical imaging, offering the potential to revolutionize tissue phenotyping and improve the accuracy and reliability of the histopathological examination process. The goal of this study was to investigate the use of AI techniques for the detection of various tissue phenotypes in POC after spontaneous abortion and evaluate the accuracy and reliability of these techniques compared to traditional manual methods. Methods: We present a novel publicly available dataset named HistoPoC, which is believed to be the first of its kind, focusing on spontaneous abortion (miscarriage) in early pregnancy. A diverse dataset of 5666 annotated images was prepared from previously diagnosed cases of POC from Atia General Hospital, Karachi, Pakistan, for this purpose. The digital images were prepared at 10× through a camera-connected microscope by a consultant histopathologist. Results: The dataset’s effectiveness was validated using several deep learning-based models, demonstrating its applicability and supporting its use in intelligent diagnostic systems. Conclusions: The insights gained from this study could illuminate the causes of spontaneous abortion and guide the development of novel treatments. Additionally, this study could contribute to advancements in the field of tissue phenotyping and the wider application of deep learning techniques in medical diagnostics and treatment. Full article
(This article belongs to the Special Issue Latest News in Digital Pathology)
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24 pages, 1373 KiB  
Review
From Tradition to Innovation: Diverse Molecular Techniques in the Fight Against Infectious Diseases
by Ahmed Nouri Alsharksi, Serhat Sirekbasan, Tuğba Gürkök-Tan and Adam Mustapha
Diagnostics 2024, 14(24), 2876; https://doi.org/10.3390/diagnostics14242876 - 21 Dec 2024
Viewed by 1644
Abstract
Infectious diseases impose a significant burden on global health systems due to high morbidity and mortality rates. According to the World Health Organization, millions die from infectious diseases annually, often due to delays in accurate diagnosis. Traditional diagnostic methods in clinical microbiology, primarily [...] Read more.
Infectious diseases impose a significant burden on global health systems due to high morbidity and mortality rates. According to the World Health Organization, millions die from infectious diseases annually, often due to delays in accurate diagnosis. Traditional diagnostic methods in clinical microbiology, primarily culture-based techniques, are time-consuming and may fail with hard-to-culture pathogens. Molecular biology advancements, notably the polymerase chain reaction (PCR), have revolutionized infectious disease diagnostics by allowing rapid and sensitive detection of pathogens’ genetic material. PCR has become the gold standard for many infections, particularly highlighted during the COVID-19 pandemic. Following PCR, next-generation sequencing (NGS) has emerged, enabling comprehensive genomic analysis of pathogens, thus facilitating the detection of new strains and antibiotic resistance tracking. Innovative approaches like CRISPR technology are also enhancing diagnostic precision by identifying specific DNA/RNA sequences. However, the implementation of these methods faces challenges, particularly in low- and middle-income countries due to infrastructural and financial constraints. This review will explore the role of molecular diagnostic methods in infectious disease diagnosis, comparing their advantages and limitations, with a focus on PCR and NGS technologies and their future potential. Full article
(This article belongs to the Special Issue New Diagnostic and Testing Strategies for Infectious Diseases)
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16 pages, 3275 KiB  
Article
Enhancing Microcalcification Detection in Mammography with YOLO-v8 Performance and Clinical Implications
by Wei-Chung Shia and Tien-Hsiung Ku
Diagnostics 2024, 14(24), 2875; https://doi.org/10.3390/diagnostics14242875 - 20 Dec 2024
Viewed by 472
Abstract
Background: Microcalcifications in the breast are often an early warning sign of breast cancer, and their accurate detection is crucial for the early discovery and management of the disease. In recent years, deep learning technology, particularly models based on object detection, has [...] Read more.
Background: Microcalcifications in the breast are often an early warning sign of breast cancer, and their accurate detection is crucial for the early discovery and management of the disease. In recent years, deep learning technology, particularly models based on object detection, has significantly improved the ability to detect microcalcifications. This study aims to use the advanced YOLO-v8 object detection algorithm to identify breast microcalcifications and explore its advantages in terms of performance and clinical application. Methods: This study collected mammograms from 7615 female participants, with a dataset including 10,323 breast images containing microcalcifications. We used the YOLO-v8 model for microcalcification detection and trained and validated the model using five-fold cross-validation. The model’s performance was evaluated through metrics such as accuracy, recall, F1 score, mAP50, and mAP50-95. Additionally, this study explored the potential applications of this technology in clinical practice. Results: The YOLO-v8 model achieved an mAP50 of 0.921, an mAP50-95 of 0.709, an F1 score of 0.82, a detection accuracy of 0.842, and a recall rate of 0.796 in breast microcalcification detection. Compared to previous similar deep learning object detection techniques like Mask R-CNN, YOLO-v8 has shown improvements in both speed and accuracy. Conclusions: YOLO-v8 outperforms traditional detection methods in detecting breast microcalcifications. Its multi-scale detection capability significantly enhances both speed and accuracy, making it more clinically practical for large-scale screenings. Future research should further explore the model’s potential in benign and malignant classification to promote its application in clinical settings, assisting radiologists in diagnosing breast cancer more efficiently. Full article
(This article belongs to the Special Issue Advances in Breast Imaging and Analytics)
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11 pages, 741 KiB  
Article
Clinical Versus Pathological Staging in Patients with Resected Ground Glass Pulmonary Lesions
by Dan Levy Faber, Abed Agbarya, Andrew Lee, Yael Tsenter, Sonia Schneer, Yulia Robitsky Gelis and Ronen Galili
Diagnostics 2024, 14(24), 2874; https://doi.org/10.3390/diagnostics14242874 - 20 Dec 2024
Viewed by 663
Abstract
Background: A ground glass nodule (GGN) is a radiologically descriptive term for a lung parenchymal area with increased attenuation and preserved bronchial and vascular structures. GGNs are further divided into pure versus subsolid lesions. The differential diagnosis for GGNs is wide and contains [...] Read more.
Background: A ground glass nodule (GGN) is a radiologically descriptive term for a lung parenchymal area with increased attenuation and preserved bronchial and vascular structures. GGNs are further divided into pure versus subsolid lesions. The differential diagnosis for GGNs is wide and contains a malignant possibility for a lung adenocarcinoma precursor or tumor. Clinical and pathological staging of GGNs is based on the lesions’ solid component and falls into a specific classification including T0 for TIS, T1mi for minimally invasive adenocarcinoma (MIA) and T1abc for lepidic predominant adenocarcinoma (LPA) according to the eighth edition of the TNM classification of lung cancer. Correlation between solid parts seen on a CT scan and the tumor pathological invasive component is not absolute. Methods: This retrospective study collected the data of 68 GGNs that were operated upon in Carmel Medical Center. A comparison between preoperative clinical staging and post-surgery pathological staging was conducted. Results: Over a third of the lesions, twenty-four (35.3%), were upstaged while only four (5.9%) lesions were downstaged. Another third of the lesions, twenty-three (33.8%), kept their stage. In three (4.4%) cases, premalignant lesion atypical adenomatous hyperplasia (AAH) was diagnosed. Ten (14.7%) cases were diagnosed as non-malignant on final pathology. These findings show an overall low agreement between the clinical and pathological stages of GGNs. Conclusions: The relatively high percentage of upstaging tumors detected in this study and the overall safe and short surgical procedure advocate for surgical resection even in the presence of a significant number of non-malignant lesions that retrospectively do not mandate intervention at all. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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8 pages, 807 KiB  
Brief Report
Oscillometry Assesses Small Airway Disease and Reveals Peripheral Lung Pathology in Early Pulmonary Fibrosis: A Cross-Sectional Study
by Athena Gogali, Georgia Gkrepi, Christos Kyriakopoulos, Konstantinos Tatsis, Konstantinos Katsoulis, Chara Tselepi and Konstantinos Kostikas
Diagnostics 2024, 14(24), 2873; https://doi.org/10.3390/diagnostics14242873 - 20 Dec 2024
Viewed by 786
Abstract
Background/Objectives: Small airway disease/dysfunction (SAD) is crucial in obstructive airway diseases but is less investigated in interstitial lung disease (ILD). There are only a few physiological studies investigating SAD in the context of pulmonary fibrosis. Oscillometry is a simple technique that assesses SAD [...] Read more.
Background/Objectives: Small airway disease/dysfunction (SAD) is crucial in obstructive airway diseases but is less investigated in interstitial lung disease (ILD). There are only a few physiological studies investigating SAD in the context of pulmonary fibrosis. Oscillometry is a simple technique that assesses SAD with minimal patient effort. In this study, we investigated the role of oscillometry in patients with mild pulmonary fibrosis without evident obstructive disorder, focusing on small airways. Methods: Oscillometry and pulmonary function test (PFT) data of consecutive patients newly diagnosed with pulmonary fibrosis of unknown etiology in a university hospital ILD clinic were collected and analyzed. Results: Data from 34 patients with mild pulmonary fibrosis were collected in 6 months. Disease severity, as evaluated by FVC, presented strong correlations with the oscillometry parameters: resistance (R5: r = −0.588, p < 0.001), reactance (X5: r = 0.671, p < 0.001), resonant frequency (Fres: r = −0.562, p = 0.001), and the area of reactance (AX: r = −0.515, p = 0.002). The oscillometry parameter R5-19-expressing was abnormal in 27% of patients, correlated with FEF25-75% (r = −0.370, p = 0.021) and was a predictor of a FEF25-75% < 60% pred. with AUC 0.738 (95%Cl 0.519–0.956). R5-19 correlated with FVC (r = −0.481, p = 0.004) and was the only SAD parameter that correlated with the composite physiologic index (CPI, r = 0.338, p = 0.04), while FEF 25-75% and RV/TLC% did not. Conclusions: Oscillometry is an easy to perform technique that may reveal early mechanical alterations caused by pulmonary fibrosis. Peripheral resistance, as expressed by R5-19, which identifies small airway dysfunction as a marker of peripheral lung pathology, may be complementary to pulmonary function testing and may also have prognostic implications for ILD patients. Full article
(This article belongs to the Special Issue Diagnosis, Classification, and Monitoring of Pulmonary Diseases)
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14 pages, 1552 KiB  
Article
PCOS Influences the Expression of AMHRII in the Endometrium of AEH During the Reproductive Age
by Yingsha Yao, Shulan Zhu and Xiaoming Zhu
Diagnostics 2024, 14(24), 2872; https://doi.org/10.3390/diagnostics14242872 - 20 Dec 2024
Viewed by 491
Abstract
Background: Endometrial proliferative lesions (EPLs) encompass endometrial hyperplasia (EH) and endometrial carcinoma (EC). Atypical endometrial hyperplasia (AEH) is associated with an elevated risk of progression to EC. Patients with polycystic ovarian syndrome (PCOS) exhibit higher serum levels of anti-Müllerian hormone (AMH) and a [...] Read more.
Background: Endometrial proliferative lesions (EPLs) encompass endometrial hyperplasia (EH) and endometrial carcinoma (EC). Atypical endometrial hyperplasia (AEH) is associated with an elevated risk of progression to EC. Patients with polycystic ovarian syndrome (PCOS) exhibit higher serum levels of anti-Müllerian hormone (AMH) and a correspondingly increased incidence of EPLs. AMH has the capacity to inhibit the cell proliferation of EPLs derived from Müllerian duct tissue through the AMH-AMH receptor (AMHR) signaling pathway. Methods: Pairs of samples matched by preference scores were randomly selected. Immunohistochemistry was employed to assess the expression levels of AMHR type II (AMHR2) in endometrial tissue. A comparative analysis was performed between tissues from individuals with PCOS and those without, as well as between a normal endometrium and endometrial tissue from individuals with EPLs. This study aimed to elucidate differences in AMHR2 expression among these tissue types. By focusing on AMHR2 expression, the impact of the PCOS-related background on the endometrial AMH-AMHR cascade signaling pathway was initially investigated. Results: The AMHR2 protein was expressed in the endometrium of both the PCOS group and the non-PCOS group during the reproductive age (20–39 years). The expression of the AMHR2 protein in the AEH endometrium of PCOS patients did not differ significantly from that in the normal endometrium of PCOS patients; however, it was significantly higher than in the AEH endometrium of non-PCOS patients (p = 0.011). Conversely, the expression of the AMHR2 protein in the AEH endometrium of non-PCOS patients was significantly lower than that in the normal endometrium of non-PCOS patients (p = 0.021). Notably, there was no significant difference in AMHR2 protein expression in a normal endometrium between PCOS and non-PCOS patients. Conclusions: The involvement of the endometrial AMH-AMHR cascade signaling pathway and its biological effects in the pathogenesis of AEH are evident. The pathophysiological conditions associated with PCOS, such as elevated serum AMH levels and other pathological states, may directly or indirectly influence the AMH-AMHR cascade signaling pathway in the endometrium. This influence could contribute to the progression of AEH. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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7 pages, 5304 KiB  
Case Report
Molecular Identification of Dibothriocephalus nihonkaiense Infection Using Nanopore Sequencing: A Case Report and Literature Review
by Hin-Fung Tsang, Stanley W.M. Leung, Tin-Nok Hung, Icy Law, Ka-Wai Lam, Loiston Chan and Sze-Chuen Cesar Wong
Diagnostics 2024, 14(24), 2871; https://doi.org/10.3390/diagnostics14242871 - 20 Dec 2024
Viewed by 458
Abstract
Background: Dibothriocephalus nihonkaiense (previously known as Diphyllobothrium nihonkaiense) infection is not common in Hong Kong. D. nihonkaiense is a fish-borne cestode parasite that infects humans after consuming raw or insufficiently cooked fish containing plerocercoids. Case presentation: We reported a case of D. [...] Read more.
Background: Dibothriocephalus nihonkaiense (previously known as Diphyllobothrium nihonkaiense) infection is not common in Hong Kong. D. nihonkaiense is a fish-borne cestode parasite that infects humans after consuming raw or insufficiently cooked fish containing plerocercoids. Case presentation: We reported a case of D. nihonkaiense infection in a 40-year-old woman who presented with a complaint of epigastric pain and diarrhea. A curvilinear opacity was seen at the upper quadrant of the abdomen via abdominal X-ray. An incomplete 80 cm long strobila of D. nihonkaiense without a scolex and neck was found in her feces. A grayish-brown oval egg with an inconspicuous operculum and small knob at the abopercular end was also found. Species-level identification was performed using Nanopore sequencing. Complete blood count and serum vitamin B12 level were tested to check for megaloblastic anemia and vitamin B12 deficiency, respectively. Laboratory investigations demonstrated an elevated percentage of monocytes in peripheral blood. A single oral dose of praziquantel (25 mg/kg) was prescribed to the patient. There was no evidence of relapse after the treatment. Conclusions: We reported a case of D. nihonkaiense infection using Oxford Nanopore NGS as a tool for accurate parasite identification. Full article
(This article belongs to the Special Issue Clinical Diagnosis, Prognosis and Data Analysis of Medical Parasites and Arthropods)
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11 pages, 2091 KiB  
Article
Local Myoelectric Sensing During Human Colonic Tissue Perfusion
by Matan Ben-David, Raj Makwana, Tal Yered, Gareth J. Sanger, Charles H. Knowles, Nir Wasserberg and Erez Shor
Diagnostics 2024, 14(24), 2870; https://doi.org/10.3390/diagnostics14242870 - 20 Dec 2024
Viewed by 434
Abstract
Objectives: Anastomotic leakage (AL) is one of the most devastating complications after colorectal surgery. The verification of the adequate perfusion of the anastomosis is essential to ensuring anastomosis integrity following colonic resections. This study aimed to evaluate the efficacy of measuring the electrical [...] Read more.
Objectives: Anastomotic leakage (AL) is one of the most devastating complications after colorectal surgery. The verification of the adequate perfusion of the anastomosis is essential to ensuring anastomosis integrity following colonic resections. This study aimed to evaluate the efficacy of measuring the electrical activity of the colonic muscularis externa at an anastomosis site for perfusion analysis following colorectal surgery. Methods: Strips of human isolated colon were maintained in a horizontal tissue bath to record spontaneous contractions and myoelectric activity and spike potentials (using a bipolar electrode array for the wireless transmission of myoelectric data—the xBar system) from the circular muscle. Intraoperative myoelectric signal assessment was performed by placing the electrode array on the colon prior to and following mesenteric artery ligation, just prior to colonic resection. Results: In human isolated colon, the amplitude, duration, and frequency of contractions were inhibited during hypoxia by >80% for each measurement, compared to control values and time-matched oxygenated muscle. Intraoperative (N = 5; mean age, 64.8 years; range, 54–74 years; 60% females) myoelectric signal assessment revealed a decline in spike rate following arterial ligation, with a mean reduction of 112.64 to 51.13 spikes/min (p < 0.0008). No adverse events were observed during the study, and the device did not substantially alter the surgical procedure. Conclusions: The electrical and contraction force of the human colon was reduced by ischemia, both in vitro and in vivo. These preliminary findings also suggest the potential of the xBar system to measure such changes during intraoperative and possibly postoperative periods to predict the risk of anastomotic viability as a surrogate of evolving dehiscence. Full article
(This article belongs to the Special Issue Gastrointestinal Motility Disorders: Diagnosis and Management)
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8 pages, 911 KiB  
Article
Biomarker Insights: Evaluation of Presepsin, Apelin, and Irisin Levels in Cutaneous Leishmaniasis
by Revsa Evin Canpolat-Erkan, Recep Tekin and Bilal Sula
Diagnostics 2024, 14(24), 2869; https://doi.org/10.3390/diagnostics14242869 - 20 Dec 2024
Viewed by 602
Abstract
Background/Objectives: Cutaneous leishmaniasis (CL) is a skin disease caused by Leishmania parasites. Presepsin, irisin, and apelin are biomarkers that are involved in the inflammatory response. The aim of this study was to investigate the association between serum levels of specific biomarkers, such [...] Read more.
Background/Objectives: Cutaneous leishmaniasis (CL) is a skin disease caused by Leishmania parasites. Presepsin, irisin, and apelin are biomarkers that are involved in the inflammatory response. The aim of this study was to investigate the association between serum levels of specific biomarkers, such as presepsin, apelin, and irisin, and the clinical features, location, number, and size of lesions in patients with CL. Methods: This study is a single-centre, prospective cohort study involving a total of 30 patients with skin lesions compatible with CL and 30 healthy matched controls. Age, sex, type of skin lesion, location of skin lesion, number of skin lesions, and diameter of skin lesions were recorded. The levels of presepsin, irisin, and apelin measured in the blood samples of the patient group were analysed in comparison to those in the healthy control group. Results: The findings revealed that presepsin levels were significantly elevated in the patient group compared to the controls (p = 0.000). However, no statistically significant differences were observed between the groups for irisin and apelin levels (p-values 0.096 and 0.836, respectively). A negative correlation was identified between presepsin levels and the number of skin lesions, the diameter of the largest lesion, and the total diameter of the lesions (p = 0.000). Conclusions: It appears that measuring presepsin levels in patients with CL may be beneficial. Presepsin has the potential to serve as a prognostic marker in CL, offering significant benefits in guiding clinicians in assessing disease progression and response to treatment. Full article
(This article belongs to the Special Issue Laboratory Diagnosis in Microbial Diseases, 2nd Edition)
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12 pages, 2736 KiB  
Article
Ultra-Wide-Field OCT Measurements in Patients with Age-Related Macular Degeneration in Relation to Their Visual Function
by Maciej Gawęcki, Krzysztof Kiciński, Jan Kucharczuk, Sławomir Teper, Magdalena Hubert and Tomasz Kuc
Diagnostics 2024, 14(24), 2868; https://doi.org/10.3390/diagnostics14242868 - 20 Dec 2024
Viewed by 454
Abstract
Background: Ultra-wide-field optical coherence tomography (UWF-OCT) devices have recently been introduced to clinical practice. The goal of this study was to compare choroidal and retinal thickness (CT and RT) in age-related macular degeneration (AMD) with a healthy control group using UWF-OCT Xephilio S1. [...] Read more.
Background: Ultra-wide-field optical coherence tomography (UWF-OCT) devices have recently been introduced to clinical practice. The goal of this study was to compare choroidal and retinal thickness (CT and RT) in age-related macular degeneration (AMD) with a healthy control group using UWF-OCT Xephilio S1. Additionally, we sought to determine the relationship between the RT and CT of patients with AMD, measured in different sectors, and their visual acuity. Methods: The study included 104 eyes from 74 participants with dry AMD, 119 eyes from 86 participants with wet AMD, and 85 eyes from 53 healthy controls. Of the participants with wet AMD, 87 eyes received anti-VEGF treatment, 13 were treatment naïve, and 19 had incomplete data. The analyzed measurements were taken in the central area of 3 mm in diameter and two peripheral rings located between 3–9 mm and 9–18 mm diameters. Results. There was no significant variation in the RT in any sector between the three study groups. CT in dry and wet AMD cohorts was significantly lower compared to controls in every sector. Patients with treatment-naïve wet AMD did not demonstrate significant CT loss but had a tendency for lower CT values. Visual impairment in patients with AMD correlated with older age in both subgroups and with smaller RT in the dry AMD subgroup. Conclusions: Values of RT and CT obtained at the mid- and far-periphery with UWF-OCT generally reflect the alterations observed in AMD in the central part of the posterior pole. Intravitreal anti-VEGF treatment might contribute to loss of choroidal tissue observed in AMD in every sector. Full article
(This article belongs to the Special Issue Images in the Diagnosis and Treatment of Macular Edema)
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12 pages, 702 KiB  
Article
The Role of Liver Stiffness Measurement and Spleen Stiffness Measurement in Predicting the Risk of Developing HCC
by Rui Gaspar, Joana Mota, Maria João Almeida, Marco Silva and Guilherme Macedo
Diagnostics 2024, 14(24), 2867; https://doi.org/10.3390/diagnostics14242867 - 20 Dec 2024
Viewed by 530
Abstract
Background/Objectives: Hepatocellular carcinoma (HCC) is the sixth most common cause of cancer worldwide. More than 90% of cases occur in cirrhotic patients, with the degree of fibrosis being the main risk factor for the development of HCC. Liver biopsy is the gold-standard for [...] Read more.
Background/Objectives: Hepatocellular carcinoma (HCC) is the sixth most common cause of cancer worldwide. More than 90% of cases occur in cirrhotic patients, with the degree of fibrosis being the main risk factor for the development of HCC. Liver biopsy is the gold-standard for fibrosis assessment, but it is an invasive procedure. Liver stiffness measurement (LSM) has shown high accuracy for diagnosing liver cirrhosis, as well as for predicting decompensation and HCC development. More recently, spleen stiffness measurement (SSM) has presented excellent results for ruling in/out high-risk varices and the presence of clinical significant portal hypertension. The aim of our study was to evaluate the relationship between LSM and SSM and the risk of hepatocellular carcinoma. Methods: A prospective study on cirrhotic patients was performed in a tertiary center from January 2020 to May 2024. All patients were submitted to liver and spleen elastography (with a new probe of 100 Hz) by the same blinded operator and were treated in the same institution for the development of hepatocellular carcinoma. Results: We included 299 cirrhotic patients, 75.9% male, with a mean age of 61.8 years (±10.0). The median value of LSM was 25.7 kPa [4.5–75.0] and that of SSM was 44.6 kPa [7.9–100.0]. The median follow-up time was 505 days [114.0–1541.0]. During this period, 18 patients developed HCC, with a median time to HCC diagnosis after LSM and SSM of 321 days [63.0–1227.0]. LSM was the only factor associated with the development of HCC (p = 0.002) with an AUC of 0.715. On the other hand, SSM was not associated with the development of HCC. Conclusions: We found that the risk of developing HCC is associated with liver fibrosis but not with portal hypertension (assessed using SSM). Full article
(This article belongs to the Special Issue Diagnosis and Management of Liver Diseases—2nd Edition)
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