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Diagnostics, Volume 15, Issue 10 (May-2 2025) – 6 articles

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12 pages, 443 KiB

Open AccessArticle

Inflammatory Indices and Preterm Delivery: A New Horizon in Obstetric Risk Assessment

by Samet Kırat

Diagnostics 2025, 15(10), 1188; https://doi.org/10.3390/diagnostics15101188 (registering DOI) - 8 May 2025

Abstract

Objective: Preterm delivery is a leading cause of neonatal morbidity and mortality globally, with inflammation playing a crucial role in its pathophysiology. This study aimed to evaluate the predictive value of systemic inflammatory response indices in identifying pregnant women at risk of preterm delivery. Methods: This retrospective study analyzed data from 1128 pregnant women admitted to a tertiary care hospital between 2020 and 2025. Patients were classified into two groups: preterm delivery (n = 528) and term delivery (n = 600). Demographic characteristics, obstetric history, neonatal outcomes, and inflammatory indices were compared. Results: The preterm delivery group showed a significantly higher systemic inflammatory response index (SIRI) (p < 0.001), systemic immune-inflammation index (SII) (p < 0.001), neutrophil/lymphocyte ratio (NLR) (p < 0.001), and monocyte/lymphocyte ratio (MLR) (p < 0.001) than the term delivery group, while platelet/lymphocyte ratio (PLR) levels were significantly lower (p = 0.002). Inflammatory indices were higher in early preterm delivery cases (p < 0.001) than in middle and late preterm cases. Multivariate logistic regression identified the SIRI (p = 0.015) and NLR (p < 0.001) as independent predictors of preterm delivery, while the PLR showed an inverse association (p = 0.002). Higher inflammatory indices correlated with lower 1st and 5th minute APGAR scores (p < 0.001) and increased neonatal intensive care unit (NICU) admission rates (p < 0.001). NICU stay was prolonged in neonates born to mothers with elevated SIRI and NLR levels (p < 0.001). Conclusions: Integrating these inflammatory indices into obstetric risk assessment may enhance early detection and intervention strategies, potentially improving maternal and neonatal prognosis. Full article

(This article belongs to the Section Clinical Diagnosis and Prognosis)

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9 pages, 1138 KiB

Open AccessArticle

Impact of Delayed Centrifugation on Interleukin 6 Determination in Human Blood

by Hannah L. Sauerwein, Derik F. Hermsen, Detlef Kindgen-Milles, Erik Michael, Johannes C. Fischer and Fritz Boege

Diagnostics 2025, 15(10), 1187; https://doi.org/10.3390/diagnostics15101187 (registering DOI) - 8 May 2025

Abstract

Background/Objectives: Clinical experience indicates that the determination of interleukin 6 (IL-6) in human blood can vary depending on time span between sample collection and centrifugation. Here, we evaluated confounding effects in various blood specimens. Methods: The blood of healthy individuals and critically ill patients was collected in EDTA-, heparin-, and serum collection tubes. Tubes were facultatively incubated (20 °C, 24–48 h) before centrifugation, and IL-6 was measured in the supernatant. Results: The preincubation of the blood collection tubes increased the IL-6 values in heparin plasma (in 17/20 samples up to 50-fold) and serum (in 17/20 samples up to 12-fold). These changes were relevant since the normal values were thereby lifted above the upper confidence limit in 12/20 heparin plasma samples and 4/20 serum samples. These IL-6 increases were probably due to in vitro synthesis as opposed to the release of preformed IL-6 from blood cells because subjecting uncentrifuged collection tubes to mechanical cell lyses had negligible effects on IL-6, while incubation with microbial stimulators dramatically increased these values. In the case of EDTA blood, collection tube preincubation induced IL-6 decreases in 17/20 samples from healthy individuals and 20/23 samples from critically ill patients. Conclusions: IL-6 determination in heparin plasma and serum is compromised by delayed centrifugation. This effect is relevant for normal values. It increased the number of false high results by >50%. The delayed centrifugation of EDTA blood decreased the IL-6 values, which caused a single false-negative result in 1/43 healthy and critically ill people. The false-negative rate is possibly higher in EDTA blood from non-critically ill out-patients, exhibiting moderately increased IL-6 levels. Full article

(This article belongs to the Section Clinical Laboratory Medicine)

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26 pages, 5404 KiB

Open AccessArticle

Real-Time Coronary Artery Dominance Classification from Angiographic Images Using Advanced Deep Video Architectures

by Hasan Ali Akyürek

Diagnostics 2025, 15(10), 1186; https://doi.org/10.3390/diagnostics15101186 (registering DOI) - 8 May 2025

Abstract

Background/Objectives: The automatic identification of coronary artery dominance holds critical importance for clinical decision-making in cardiovascular medicine, influencing diagnosis, treatment planning, and risk stratification. Traditional classification methods rely on the manual visual interpretation of coronary angiograms. However, current deep learning approaches typically classify right and left coronary artery angiograms separately. This study aims to develop and evaluate an integrated video-based deep learning framework for classifying coronary dominance without distinguishing between RCA and LCA angiograms. Methods: Three advanced video-based deep learning models—Temporal Segment Networks (TSNs), Video Swin Transformer (VST), and VideoMAEv2—were implemented using the MMAction2 framework. These models were trained and evaluated on a large dataset derived from a publicly available source. The integrated approach processes entire angiographic video sequences, eliminating the need for separate RCA and LCA identification during preprocessing. Results: The proposed framework demonstrated strong performance in classifying coronary dominance. The best test accuracies achieved using TSNs, Video Swin Transformer, and VideoMAEv2 were 87.86%, 92.12%, and 92.89%, respectively. Transformer-based models showed superior accuracy compared to convolution-based methods, highlighting their effectiveness in capturing spatial–temporal patterns in angiographic videos. Conclusions: This study introduces a unified video-based deep learning approach for coronary dominance classification, eliminating manual arterial branch separation and reducing preprocessing complexity. The results indicate that transformer-based models, particularly VideoMAEv2, offer highly accurate and clinically feasible solutions, contributing to the development of objective and automated diagnostic tools in cardiovascular imaging. Full article

(This article belongs to the Special Issue Cardiovascular Imaging)

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13 pages, 1852 KiB

Open AccessArticle

The Impact of Automatic Exposure Control Technology on the In Vivo Radiation Dose in Digital Mammography: A Comparison Between Different Systems and Target/Filter Combinations

by Ahmad A. Alhulail, Salman M. Albeshan, Mohammed S. Alshuhri, Essam M. Alkhybari, Mansour A. Almanaa, Haitham Alahmad, Khaled Alenazi, Abdulaziz S. Alshabibi, Mohammed Alsufayan, Saleh A. Alsulaiman, Maha M. Almuqbil, Mahmoud M. Elsharkawi and Sultan Alghamdi

Diagnostics 2025, 15(10), 1185; https://doi.org/10.3390/diagnostics15101185 - 8 May 2025

Abstract

Background/Objectives: Digital mammography is widely used for breast cancer screening; however, variations in system design and automatic exposure control (AEC) strategies can lead to significant differences in radiation dose, potentially affecting the diagnostic quality and patient safety. In this study, we aimed to determine the effect of various mammographic technologies on the in vivo mean glandular doses (MGDs) that are received in clinical settings. Methods: The MGDs and applied acquisition parameters from 194,608 mammograms, acquired employing AEC using different digital mammography systems (GE, Siemens, and two different models of Hologic), were retrospectively collected. The potential variation in MGD resulting from different technologies (system and target/filter combination) was assessed employing the Kruskal–Wallis test, followed by Dunn’s post hoc. The AEC optimization of acquisition parameters (kVp, mAs) within each system was investigated through a multi-regression analysis as a function of the compressed breast thickness (CBT). The trend line of these parameters in addition to the MGD and source-to-breast distance were also plotted and compared. Results: There were significant variations in delivered doses per CBT based on which technology was used (p < 0.001). The regression analyses revealed system-specific differences in AEC adjustments of mAs and kVp in response to CBT changes. As the CBT increases, the MGD increases with different degrees, rates, and patterns across systems due to differences in AEC strategies. Conclusions: The MGD is affected by the applied technology, which is different between systems. Clinicians need to be aware of these variations and how they affect the MGD. Additionally, manufacturers may need to consider standardizing the implemented technology effects on the MGDs. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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29 pages, 9984 KiB

Open AccessReview

Osteotomies: Indications, Imaging Appearance, Surgical Techniques, and Complications

by Arash Azhideh, Nastaran Hosseini, Sara Haseli, Chankue Park, Nitin Venugopal, Ali Abadi, Zahra Masroori, Eric Chen, Zachary Miller, David Camacho and Majid Chalian

Diagnostics 2025, 15(10), 1184; https://doi.org/10.3390/diagnostics15101184 - 8 May 2025

Abstract

Osteotomies can be performed on almost every bone and are commonly encountered indications for imaging studies. These procedures are employed to correct congenital, degenerative, and traumatic osseous deformities, ultimately improving both function and cosmetic appearance. It is crucial for radiologists to be aware of the wide range of surgical osteotomies and to be familiar with reporting clinically relevant imaging findings during surgical planning and post-operative follow-up. In this review, we discuss the indications, techniques, post-operative imaging appearance, and key reporting elements of commonly performed osteotomies, supported by comprehensive illustrative cases. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Bone Diseases in 2025)

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13 pages, 1020 KiB

Open AccessArticle

Real-World Data: Implementation and Outcomes of Next-Generation Sequencing in the MENA Region

by Rami Mahfouz, Reine Abou Zeidane, Tasnim Diab, Ali Tarhini, Eman Sbaity, Houry Kazarian, Yomna El Zibaoui, Nour Sabiha Naji, Mounir Barake and Hazem I. Assi

Diagnostics 2025, 15(10), 1183; https://doi.org/10.3390/diagnostics15101183 - 8 May 2025

Abstract

Background: In the era of precision medicine, Next-Generation Sequencing (NGS) has emerged as an important tool for identifying targetable mutations and tailoring treatment options. Yet the Middle East and North Africa (MENA) lags behind in adopting this technology. This study aims to demonstrate the transformative potential of molecular profiling in the region. Methods: This retrospective study reviewed cancer patients at the American University of Beirut Medical Centre, comparing outcomes between those who received NGS-based treatment adjustments (NBTAs) and those who did not. Results: The study enrolled 180 patients, including those with non-small-cell lung cancer (21.2%), sarcomas (20%), gastrointestinal malignancies (23.3%), breast cancer (10.6%), and other cancers (24.9%); 58.3% had stage 4 cancer at diagnosis. Before molecular profiling, 20.6% had stable disease, 21.7% showed partial response, and 57.8% had progressive disease. Most (96%) had received treatment, mainly systemic (90%), with chemotherapy (89%) being the most common. Forty patients (22.2%) underwent NGS-based treatment adjustments (NBTAs). Post-NGS, targeted therapies increased from 35% to 43% and immunotherapies from 14% to 18%. Mutations were detected in 98% of patients, with a median of four mutations per patient. NBTA patients had a median overall survival of 59 months, compared to 23 months for non-NBTA patients (p = 0.096), and significantly improved progression-free survival (5.32 vs. 3.28 months, p = 0.023). Conclusions: The use of large-scale molecular profiling to guide treatment adjustments promises advancements in patient care. Integrating NGS into clinical practice correlates with improved PFS, calling for a broader adoption of its use in the MENA region. Full article

(This article belongs to the Special Issue Advances in Cancer Pathology and Diagnosis)

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