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Tomography, Volume 8, Issue 4 (August 2022) – 41 articles

Cover Story (view full-size image): Organ volume measurements are a key metric for managing many diseases, including autosomal dominant polycystic kidney disease (ADPKD), where disease severity is directly correlated with kidney volumes and liver and spleen are also affected. However, measuring organ volumes by manually contouring organ outlines on cross-sectional MRI or CT images is tedious and prone to operator variability. Here, we extend an open-source, 2D U-net deep learning ADPKD kidney segmentation pipeline to also automate measuring liver and spleen using radiologist-labeled T2-weighted images from 273 ADPKD subjects as the reference standard. This deep learning approach reduced radiologist time to perform multiorgan segmentations while also reducing measurement variability without sacrificing precision. View this paper
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14 pages, 30932 KiB  
Article
Investigation of Brain Activation Patterns Related to the Feminization or Masculinization of Body and Face Images across Genders
by Carlo Ceruti, Alessandro Cicerale, Matteo Diano, Mattia Sibona, Caterina Guiot, Giovanna Motta, Chiara Crespi, Anna Gualerzi, Fabio Lanfranco, Mauro Bergui and Federico D’Agata
Tomography 2022, 8(4), 2093-2106; https://doi.org/10.3390/tomography8040176 - 22 Aug 2022
Cited by 1 | Viewed by 1745
Abstract
Previous studies demonstrated sex-related differences in several areas of the human brain, including patterns of brain activation in males and females when observing their own bodies and faces (versus other bodies/faces or morphed versions of themselves), but a complex paradigm touching multiple aspects [...] Read more.
Previous studies demonstrated sex-related differences in several areas of the human brain, including patterns of brain activation in males and females when observing their own bodies and faces (versus other bodies/faces or morphed versions of themselves), but a complex paradigm touching multiple aspects of embodied self-identity is still lacking. We enrolled 24 healthy individuals (12 M, 12 F) in 3 different fMRI experiments: the vision of prototypical body silhouettes, the vision of static images of the face of the participants morphed with prototypical male and female faces, the vision of short videos showing the dynamic transformation of the morphing. We found differential sexual activations in areas linked to self-identity and to the ability to attribute mental states: In Experiment 1, the male group activated more the bilateral thalamus when looking at sex congruent body images, while the female group activated more the middle and inferior temporal gyrus. In Experiment 2, the male group activated more the supplementary motor area when looking at their faces; the female group activated more the dorsomedial prefrontal cortex (dmPFC). In Experiment 3, the female group activated more the dmPFC when observing either the feminization or the masculinization of their face. The defeminization produced more activations in females in the left superior parietal lobule and middle occipital gyrus. The performance of all classifiers built using single ROIs exceeded chance level, reaching an area under the ROC curves > 0.85 in some cases (notably, for Experiment 2 using the V1 ROI). The results of the fMRI tasks showed good agreement with previously published studies, even if our sample size was small. Therefore, our functional MRI protocol showed significantly different patterns of activation in males and females, but further research is needed both to investigate the gender-related differences in activation when observing a morphing of their face/body, and to validate our paradigm using a larger sample. Full article
(This article belongs to the Section Neuroimaging)
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10 pages, 573 KiB  
Review
Can Chest Ultrasound Replace Chest X-ray in Thoracic Surgery?
by Konstantinos Grapatsas, Vasileios Leivaditis, Benjamin Ehle and Anastasia Papaporfyriou
Tomography 2022, 8(4), 2083-2092; https://doi.org/10.3390/tomography8040175 - 20 Aug 2022
Cited by 2 | Viewed by 2012
Abstract
Background: There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications. However, data regarding its use after thoracic surgery are scarce and contradictory. The aim of this study was to [...] Read more.
Background: There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications. However, data regarding its use after thoracic surgery are scarce and contradictory. The aim of this study was to conduct a systematic review to evaluate the accuracy of CUS after thoracic surgery. Methods: An electronic search in MEDLINE (via PubMed), complemented by manual searches in article references, was conducted to identify eligible studies. Results: Six studies with a total of 789 patients were included in this meta-analysis. Performing CXR decreased in up to 61.6% of cases, with the main reasons for performing CXR being massive subcutaneous emphysema or complex hydrothorax. Agreement between CUS and routine-based therapeutic options was, in some studies, up to 97%. Conclusions: The selectively postoperative use of CUS may reduce the number of routinely performed CXR. However, if CUS findings are inconclusive, further radiological examinations are obligatory. Full article
(This article belongs to the Special Issue Radiation Protection Opportunities in Medical Imaging)
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10 pages, 8042 KiB  
Case Report
Stocky/Packed Pancreas: A Case of Focal Drug-Induced Acute Pancreatitis Mimicking Cancer
by Marco Di Serafino, Roberto Ronza, Divina D’Auria, Roberto Fiorentino, Dario Arundine, Annalisa De Leone, Salvatore Picascia, Alberto Martino, Enrico Crolla, Severo Campione, Giovanna Guida, Carlo Molino, Ferdinando Riccardi and Luigia Romano
Tomography 2022, 8(4), 2073-2082; https://doi.org/10.3390/tomography8040174 - 19 Aug 2022
Cited by 1 | Viewed by 2105
Abstract
Drug-induced acute pancreatitis (DIP) is a recognised but underreported entity in the literature. Immunotherapy drugs have been described as one possible emerging cause, although the pathogenic mechanism is still largely unclear. To date, only a few cases have been reported, even if in [...] Read more.
Drug-induced acute pancreatitis (DIP) is a recognised but underreported entity in the literature. Immunotherapy drugs have been described as one possible emerging cause, although the pathogenic mechanism is still largely unclear. To date, only a few cases have been reported, even if in recent times there is an over-increasing awareness of this pathologic entity. The imaging-based diagnosis of DIP can be difficult to establish, representing a real challenge for a radiologist, especially when the inflammatory disease appears as a focal mass suspicious for a malignancy. Case report: We herein report the case of a 71-year-old man with a known history of partially responsive lung adenocarcinoma subtype with high programmed cell death ligand 1 (PD-L1) expression, who underwent positron emission tomography (PET)/computed tomography (CT) imaging follow-up after one year of immunotherapy. The exam revealed a stocky/packed lesion in the pancreatic body, with increased 18F-fluorodeoxyglucose (FDG) accumulation highly suggestive of pancreatic cancer, which finally was proven to be a DIP induced by immunotherapy. Conclusion: Distinguishing between focal DIP and pancreatic neoplasm is, therefore, crucial for timely therapeutic management and prognostic stratification. A deep knowledge of possible imaging pitfalls coupled with a comprehensive clinical and laboratory assessment is pivotal to avoid any delays in diagnosis. Full article
(This article belongs to the Section Abdominal Imaging)
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14 pages, 4362 KiB  
Article
Performance of Machine Learning and Texture Analysis for Predicting Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer with 3T MRI
by Davide Bellini, Iacopo Carbone, Marco Rengo, Simone Vicini, Nicola Panvini, Damiano Caruso, Elsa Iannicelli, Vincenzo Tombolini and Andrea Laghi
Tomography 2022, 8(4), 2059-2072; https://doi.org/10.3390/tomography8040173 - 19 Aug 2022
Cited by 4 | Viewed by 1670
Abstract
Background: To evaluate the diagnostic performance of a Machine Learning (ML) algorithm based on Texture Analysis (TA) parameters in the prediction of Pathological Complete Response (pCR) to Neoadjuvant Chemoradiotherapy (nChRT) in Locally Advanced Rectal Cancer (LARC) patients. Methods: LARC patients were prospectively [...] Read more.
Background: To evaluate the diagnostic performance of a Machine Learning (ML) algorithm based on Texture Analysis (TA) parameters in the prediction of Pathological Complete Response (pCR) to Neoadjuvant Chemoradiotherapy (nChRT) in Locally Advanced Rectal Cancer (LARC) patients. Methods: LARC patients were prospectively enrolled to undergo pre- and post-nChRT 3T MRI for initial loco-regional staging. TA was performed on axial T2-Weighted Images (T2-WI) to extract specific parameters, including skewness, kurtosis, entropy, and mean of positive pixels. For the assessment of TA parameter diagnostic performance, all patients underwent complete surgical resection, which served as a reference standard. ROC curve analysis was carried out to determine the discriminatory accuracy of each quantitative TA parameter to predict pCR. A ML-based decisional tree was implemented combining all TA parameters in order to improve diagnostic accuracy. Results: Forty patients were considered for final study population. Entropy, kurtosis and MPP showed statistically significant differences before and after nChRT in patients with pCR; in particular, when patients with Pathological Partial Response (pPR) and/or Pathological Non-Response (pNR) were considered, entropy and skewness showed significant differences before and after nChRT (all p < 0.05). In terms of absolute value changes, pre- and post-nChRT entropy, and kurtosis showed significant differences (0.31 ± 0.35, in pCR, −0.02 ± 1.28 in pPR/pNR, (p = 0.04); 1.87 ± 2.19, in pCR, −0.06 ± 3.78 in pPR/pNR (p = 0.0005); 107.91 ± 274.40, in pCR, −28.33 ± 202.91 in pPR/pNR, (p = 0.004), respectively). According to ROC curve analysis, pre-treatment kurtosis with an optimal cut-off value of ≤3.29 was defined as the best discriminative parameter, resulting in a sensitivity and specificity in predicting pCR of 81.5% and 61.5%, respectively. Conclusions: TA parameters extracted from T2-WI MRI images could play a key role as imaging biomarkers in the prediction of response to nChRT in LARC patients. ML algorithms can be used to efficiently combine all TA parameters in order to improve diagnostic accuracy. Full article
(This article belongs to the Section Artificial Intelligence in Medical Imaging)
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10 pages, 646 KiB  
Article
Efficacy and Safety of Cone-Beam CT Augmented Electromagnetic Navigation Guided Bronchoscopic Biopsies of Indeterminate Pulmonary Nodules
by Shreya Podder, Sana Chaudry, Harpreet Singh, Elise M. Jondall, Jonathan S. Kurman and Bryan S. Benn
Tomography 2022, 8(4), 2049-2058; https://doi.org/10.3390/tomography8040172 - 18 Aug 2022
Cited by 5 | Viewed by 1962
Abstract
Bronchoscopic biopsy results for indeterminate pulmonary nodules remain suboptimal. Electromagnetic navigation bronchoscopy (ENB) coupled with cone beam computed tomography (CBCT) for confirmation has the potential to improve diagnostic yield. We present our experience using this multimodal approach to biopsy 17 indeterminate nodules in [...] Read more.
Bronchoscopic biopsy results for indeterminate pulmonary nodules remain suboptimal. Electromagnetic navigation bronchoscopy (ENB) coupled with cone beam computed tomography (CBCT) for confirmation has the potential to improve diagnostic yield. We present our experience using this multimodal approach to biopsy 17 indeterminate nodules in 14 consecutive patients from April to August 2021. Demographic information, nodule characteristics, and biopsy results were recorded. Procedures were performed in a hybrid operating room equipped with a Siemens Artis Q bi-plane CBCT (Siemens, Munich, Germany). After ENB using the superDimension version 7.1 (Medtronic, Plymouth, MN, USA) to target the lesion, radial endobronchial ultrasound was used as secondary confirmation. Next, transbronchial needle aspiration was performed prior to CBCT to evaluate placement of the biopsy tool in the lesion. The average nodule size was 21.7+/−15 mm with 59% (10/17) < 2 cm in all dimensions and 35% (6/17) showing a radiographic bronchus sign. The diagnostic yield of CBCT-guided ENB was 76% (13/17). No immediate periprocedural or postprocedural complications were identified. Our experience with CBCT-guided ENB further supports the comparable efficacy and safety of this procedure compared to other mature biopsy modalities. Studies designed to optimize the lung nodule biopsy process and to determine the contributions from different procedural aspects are warranted. Full article
(This article belongs to the Section Cancer Imaging)
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7 pages, 4231 KiB  
Case Report
Quantitative Scintigraphy Imaging of Lingual Raynaud’s Phenomenon Using 3-Dimensional-Ring Cadmium-Zinc-Telluride Single-Photon Emission Computed Tomography/Computed Tomography
by Ik Dong Yoo, In Young Jo, Geum Cheol Jeong, Yong Kyun Won, Du Shin Jeong and Sang Mi Lee
Tomography 2022, 8(4), 2042-2048; https://doi.org/10.3390/tomography8040171 - 17 Aug 2022
Viewed by 1575
Abstract
Perfusion scintigraphy with the acquisition of planar blood flow and pool images of bilateral hands has been used to aid diagnosis and to evaluate treatment response to Raynaud’s phenomenon (decreased blood flow to hand or foot). However, because of the difficulty in imaging [...] Read more.
Perfusion scintigraphy with the acquisition of planar blood flow and pool images of bilateral hands has been used to aid diagnosis and to evaluate treatment response to Raynaud’s phenomenon (decreased blood flow to hand or foot). However, because of the difficulty in imaging the tongue area with a conventional gamma camera, perfusion scintigraphy imaging of patients with lingual Raynaud’s phenomenon has yet to be reported. Here, we report the case of a 59-year-old man with lingual Raynaud’s phenomenon in which blood pool imaging of the tongue was performed using three-dimensional (3D)-ring cadmium-zinc-telluride (CZT) single-photon emission computed tomography/computed tomography (SPECT/CT). During follow-up, the patient’s lingual symptoms had worsened, and follow-up blood pool SPECT/CT images also revealed decreased blood pool uptake of the tongue, showing a decreased blood pool of more than 25% on quantitative analysis. This case suggests that blood pool imaging of the tongue using 3D-ring CZT SPECT/CT has clinical significance in evaluating patients with lingual Raynaud’s phenomenon. Full article
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12 pages, 4991 KiB  
Article
Radiotherapy Target Volume Definition in Newly Diagnosed High-Grade Glioma Using 18F-FET PET Imaging and Multiparametric MRI: An Inter Observer Agreement Study
by Brieg Dissaux, Doria Mazouz Fatmi, Julien Ognard, Bastien Allard, Nathalie Keromnes, Amina Latreche, Amandine Lepeuve, Ulrike Schick, Vincent Bourbonne, Douraied Ben Salem, Gurvan Dissaux and Solène Querellou
Tomography 2022, 8(4), 2030-2041; https://doi.org/10.3390/tomography8040170 - 16 Aug 2022
Cited by 4 | Viewed by 1716
Abstract
Background: The aim of this prospective monocentric study was to assess the inter-observer agreement for tumor volume delineations by multiparametric MRI and 18-F-FET-PET/CT in newly diagnosed, untreated high-grade glioma (HGG) patients. Methods: Thirty patients HGG underwent O-(2-[18F]-fluoroethyl)-l-tyrosine(18F-FET) positron emission tomography [...] Read more.
Background: The aim of this prospective monocentric study was to assess the inter-observer agreement for tumor volume delineations by multiparametric MRI and 18-F-FET-PET/CT in newly diagnosed, untreated high-grade glioma (HGG) patients. Methods: Thirty patients HGG underwent O-(2-[18F]-fluoroethyl)-l-tyrosine(18F-FET) positron emission tomography (PET), and multiparametric MRI with computation of rCBV map and K2 map. Three nuclear physicians and three radiologists with different levels of experience delineated the 18-F-FET-PET/CT and 6 MRI sequences, respectively. Spatial similarity (Dice and Jaccard: DSC and JSC) and overlap (Overlap: OV) coefficients were calculated between the readers for each sequence. Results: DSC, JSC, and OV were high for 18F-FET PET/CT, T1-GD, and T2-FLAIR (>0.67). The Spearman correlation coefficient between readers was ≥0.6 for these sequences. Cross-comparison of similarity and overlap parameters showed significant differences for DSC and JSC between 18F-FET PET/CT and T2-FLAIR and for JSC between 18F-FET PET/CT and T1-GD with higher values for 18F-FET PET/CT. No significant difference was found between T1-GD and T2-FLAIR. rCBV, K2, b1000, and ADC showed correlation coefficients between readers <0.6. Conclusion: The interobserver agreements for tumor volume delineations were high for 18-F-FET-PET/CT, T1-GD, and T2-FLAIR. The DWI (b1000, ADC), rCBV, and K2-based sequences, as performed, did not seem sufficiently reproducible to be used in daily practice. Full article
(This article belongs to the Section Cancer Imaging)
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10 pages, 583 KiB  
Article
Prostate Cancer Detection with mpMRI According to PI-RADS v2 Compared with Systematic MRI/TRUS-Fusion Biopsy: A Prospective Study
by Anja Sauck, Isabelle Keller, Nicolin Hainc, Denis Pfofe, Arash Najafi, Hubert John and Joachim Hohmann
Tomography 2022, 8(4), 2020-2029; https://doi.org/10.3390/tomography8040169 - 16 Aug 2022
Cited by 2 | Viewed by 2078
Abstract
Background: mpMRI assesses prostate lesions through their PI-RADS score. The primary goal of this prospective study was to demonstrate the correlation of PI-RADS v2 score and the volume of a lesion with the presence and clinical significance of prostate cancer (PCa). The secondary [...] Read more.
Background: mpMRI assesses prostate lesions through their PI-RADS score. The primary goal of this prospective study was to demonstrate the correlation of PI-RADS v2 score and the volume of a lesion with the presence and clinical significance of prostate cancer (PCa). The secondary goal was to determine the extent of additionally PCa in inconspicuous areas. Methods: All 157 patients underwent a perineal MRI/TRUS-fusion prostate biopsy. Targeted biopsies as well as a systematic biopsy were performed. The presence of PCa in the probes was specified by the ISUP grading system. Results: In total, 258 lesions were biopsied. Of the PI-RADS 3 lesions, 24% were neoplastic. This was also true for 36.9% of the PI-RADS 4 lesions and for 59.5% of the PI-RADS 5 lesions. Correlation between ISUP grades and lesion volume was significant (p < 0.01). In the non-suspicious mpMRI areas carcinoma was revealed in 19.7% of the patients. Conclusions: The study shows that the PI-RADS v2 score and the lesion volume correlate with the presence and clinical significance of PCa. However, there are two major points to consider: First, there is a high number of false positive findings. Second, inconspicuous mpMRI areas revealed PCa. Full article
(This article belongs to the Special Issue Tumor Diagnosis and Treatment: Imaging Assessment)
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10 pages, 1288 KiB  
Article
Quantib Prostate Compared to an Expert Radiologist for the Diagnosis of Prostate Cancer on mpMRI: A Single-Center Preliminary Study
by Eliodoro Faiella, Daniele Vertulli, Francesco Esperto, Ermanno Cordelli, Paolo Soda, Rosa Maria Muraca, Lorenzo Paolo Moramarco, Rosario Francesco Grasso, Bruno Beomonte Zobel and Domiziana Santucci
Tomography 2022, 8(4), 2010-2019; https://doi.org/10.3390/tomography8040168 - 13 Aug 2022
Cited by 8 | Viewed by 2475
Abstract
Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solution, Quantib Prostate, for prostate cancer (PCa) lesions detection on multiparametric Magnetic Resonance Images (mpMRI). Methods: Prostate mpMRI exams of 108 patients were retrospectively studied. The diagnostic performance of an expert [...] Read more.
Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solution, Quantib Prostate, for prostate cancer (PCa) lesions detection on multiparametric Magnetic Resonance Images (mpMRI). Methods: Prostate mpMRI exams of 108 patients were retrospectively studied. The diagnostic performance of an expert radiologist (>8 years of experience) and of an inexperienced radiologist aided by Quantib software were compared. Three groups of patients were assessed: patients with positive mpMRI, positive target biopsy, and/or at least one positive random biopsy (group A, 73 patients); patients with positive mpMRI and a negative biopsy (group B, 14 patients), and patients with negative mpMRI who did not undergo biopsy (group-C, 21 patients). Results: In group A, the AI-assisted radiologist found new lesions with positive biopsy correlation, increasing the diagnostic PCa performance when compared with the expert radiologist, reaching an SE of 92.3% and a PPV of 90.1% (vs. 71.7% and 84.4%). In group A, the expert radiologist found 96 lesions on 73 mpMRI exams (17.7% PIRADS3, 56.3% PIRADS4, and 26% PIRADS5). The AI-assisted radiologist found 121 lesions (0.8% PIRADS3, 53.7% PIRADS4, and 45.5% PIRADS5). At biopsy, 33.9% of the lesions were ISUP1, 31.4% were ISUP2, 22% were ISUP3, 10.2% were ISUP4, and 2.5% were ISUP5. In group B, where biopsies were negative, the AI-assisted radiologist excluded three lesions but confirmed all the others. In group-C, the AI-assisted radiologist found 37 new lesions, most of them PIRADS 3, with 32.4% localized in the peripherical zone and 67.6% in the transition zone. Conclusions: Quantib software is a very sensitive tool to use specifically in high-risk patients (high PIRADS and high Gleason score). Full article
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13 pages, 3315 KiB  
Article
Supine versus Prone 3D Abus Accuracy in Breast Tumor Size Evaluation
by Anna D’Angelo, Gianluca Gatta, Graziella Di Grezia, Sara Mercogliano, Francesca Ferrara, Charlotte Marguerite Lucille Trombadori, Antonio Franco, Alessandro Cina, Paolo Belli and Riccardo Manfredi
Tomography 2022, 8(4), 1997-2009; https://doi.org/10.3390/tomography8040167 - 12 Aug 2022
Cited by 1 | Viewed by 1529
Abstract
Breast-conserving surgery (BCS) with negative resection margins decreases the locoregional recurrence rate. Breast cancer size is one of the main determinants of Tumor-Node-Metastasis (TNM) staging. Our study aimed to investigate the accuracy of supine 3D automated breast ultrasound (3D ABUS) compared to prone [...] Read more.
Breast-conserving surgery (BCS) with negative resection margins decreases the locoregional recurrence rate. Breast cancer size is one of the main determinants of Tumor-Node-Metastasis (TNM) staging. Our study aimed to investigate the accuracy of supine 3D automated breast ultrasound (3D ABUS) compared to prone 3D ABUS in the evaluation of tumor size in breast cancer patient candidates for BCS. In this prospective two-center study (Groups 1 and 2), we enrolled patients with percutaneous biopsy-proven early-stage breast cancer, in the period between June 2019 and May 2020. Patients underwent hand-held ultrasound (HHUS), contrast-enhanced magnetic resonance imaging (CE-MRI) and 3D ABUS—supine 3D ABUS in Group 1 and prone 3D ABUS in Group 2. Histopathological examination (HE) was considered the reference standard. Bland–Altman analysis and plots were used. Eighty-eight patients were enrolled. Compared to prone, supine 3D ABUS showed better agreement with HE, with a slight tendency toward underestimation (mean difference of −2 mm). Supine 3D ABUS appears to be a useful tool and more accurate than HHUS in the staging of breast cancer. Full article
(This article belongs to the Special Issue New Advances in Breast Imaging)
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10 pages, 2289 KiB  
Article
Peritumoral Brain Edema in Relation to Tumor Size Is a Variable That Influences the Risk of Recurrence in Intracranial Meningiomas
by Alessandro Frati, Daniele Armocida, Umberto Aldo Arcidiacono, Alessandro Pesce, Giancarlo D’Andrea, Fabio Cofano, Diego Garbossa and Antonio Santoro
Tomography 2022, 8(4), 1987-1996; https://doi.org/10.3390/tomography8040166 - 08 Aug 2022
Cited by 3 | Viewed by 2282
Abstract
Peritumoral brain edema (PBE) is common in intracranial meningiomas (IM) and can increase their morbidity. It is not uncommon for a neurosurgeon to confront meningiomas with a large proportion of PBE independently from the site and size of the contrast-enhancing lesion with increased [...] Read more.
Peritumoral brain edema (PBE) is common in intracranial meningiomas (IM) and can increase their morbidity. It is not uncommon for a neurosurgeon to confront meningiomas with a large proportion of PBE independently from the site and size of the contrast-enhancing lesion with increased surgical risks. We performed a retrospective review of 216 surgically-treated patients suffering from IM. We recorded clinical, biological, and radiological data based on the rate of tumor and edema volume and divided the patients into a group with high Edema/Tumor ratio and a group with a low ratio. We investigated how the ratio of edema/lesion may affect the outcome. Multivariate analysis was performed for the two groups. Smokers were found to be more likely to belong to the high-rate group. The edema/tumor ratio did not affect the surgical radicality; however, independently of the biological sub-type, WHO grading, and EOR, a higher frequency of recurrence is shown in patients with a high edema/tumor ratio (70.5% vs. 8.4%. p < 0.01). There is evidence to suggest that the blood-brain barrier (BBB) damage from smoke could play a role in an increased volume of PBE. The present study demonstrates that IMs showing a high PBE ratio to tumor volume at diagnosis are associated with a smoking habit and a higher incidence of recurrence independently of their biological type and grading. Full article
(This article belongs to the Special Issue Clinical and Molecular Analytic in Neuro-Oncology)
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13 pages, 3905 KiB  
Article
B0 Correction for 3T Amide Proton Transfer (APT) MRI Using a Simplified Two-Pool Lorentzian Model of Symmetric Water and Asymmetric Solutes
by Yibing Chen, Xujian Dang, Benqi Zhao, Zhuozhao Zheng, Xiaowei He and Xiaolei Song
Tomography 2022, 8(4), 1974-1986; https://doi.org/10.3390/tomography8040165 - 01 Aug 2022
Cited by 3 | Viewed by 1633
Abstract
Amide proton transfer (APT)-weighted MRI is a promising molecular imaging technique that has been employed in clinic for detection and grading of brain tumors. MTRasym, the quantification method of APT, is easily influenced by B0 inhomogeneity and causes artifacts. Current [...] Read more.
Amide proton transfer (APT)-weighted MRI is a promising molecular imaging technique that has been employed in clinic for detection and grading of brain tumors. MTRasym, the quantification method of APT, is easily influenced by B0 inhomogeneity and causes artifacts. Current model-free interpolation methods have enabled moderate B0 correction for middle offsets, but have performed poorly at limbic offsets. To address this shortcoming, we proposed a practical B0 correction approach that is suitable under time-limited sparse acquisition scenarios and for B1 ≥ 1 μT under 3T. In this study, this approach employed a simplified Lorentzian model containing only two pools of symmetric water and asymmetric solutes, to describe the Z-spectral shape with wide and ‘invisible’ CEST peaks. The B0 correction was then performed on the basis of the fitted two-pool Lorentzian lines, instead of using conventional model-free interpolation. The approach was firstly evaluated on densely sampled Z-spectra data by using the spline interpolation of all acquired 16 offsets as the gold standard. When only six offsets were available for B0 correction, our method outperformed conventional methods. In particular, the errors at limbic offsets were significantly reduced (n = 8, p < 0.01). Secondly, our method was assessed on the six-offset APT data of nine brain tumor patients. Our MTRasym (3.5 ppm), using the two-pool model, displayed a similar contrast to the vendor-provided B0-orrected MTRasym (3.5 ppm). While the vendor failed in correcting B0 at 4.3 and 2.7 ppm for a large portion of voxels, our method enabled well differentiation of B0 artifacts from tumors. In conclusion, the proposed approach could alleviate analysis errors caused by B0 inhomogeneity, which is useful for facilitating the comprehensive metabolic analysis of brain tumors. Full article
(This article belongs to the Section Brain Imaging)
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15 pages, 2205 KiB  
Review
Myocarditis Following COVID-19 Vaccination: Cardiac Imaging Findings in 118 Studies
by Pedram Keshavarz, Fereshteh Yazdanpanah, Maryam Emad, Azadeh Hajati, Seyed Faraz Nejati, Faranak Ebrahimian Sadabad, Tamta Azrumelashvili, Malkhaz Mizandari and Steven S. Raman
Tomography 2022, 8(4), 1959-1973; https://doi.org/10.3390/tomography8040164 - 30 Jul 2022
Cited by 4 | Viewed by 6558
Abstract
We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after [...] Read more.
We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after COVID-19 vaccination were reported (462, 86.8% men and 70, 13.2% women, age range 12 to 80) with the following distribution: Pfizer-BioNTech: 367 (69%), Moderna: 137 (25.8%), AstraZeneca: 12 (2.3%), Janssen/Johnson & Johnson: 6 (1.1%), COVAXIN: 1 (0.1%), and unknown mRNA vaccine: 9 (1.7%). The distribution of patients receiving vaccine dosage was investigated. On cardiac MR Imaging, late intravenous gadolinium enhancement (LGE) was observed mainly in the epicardial/subepicardial segments (90.8%, 318 of 350 enhancing segments), with the dominance of inferolateral segment and inferior walls. Pericardial effusion was reported in 13.1% of cases. The vast majority of patients (94%, 500 of 532) were discharged from the hospital except for 4 (0.7%) cases. Post-COVID-19 myocarditis was most commonly reported in symptomatic men after the second or third dose, with CMRI findings including LGE in 90.8% of inferior and inferolateral epicardial/subepicardial segments. Most cases were self-limited. Full article
(This article belongs to the Section Cardiovascular Imaging)
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12 pages, 2164 KiB  
Systematic Review
Partial Anomalous Left Pulmonary Artery Anterior Versus Posterior Types: A Systematic Review
by Carlos S. Restrepo, Tomas V. Gonzalez, Ameya J. Baxi and Sachin S. Saboo
Tomography 2022, 8(4), 1947-1958; https://doi.org/10.3390/tomography8040163 - 27 Jul 2022
Cited by 1 | Viewed by 1883
Abstract
The aim of this study was to investigate the features of partial anomalous left pulmonary artery (PALPA) and differences between cases with posterior versus anterior a nomalous vessels in relation to the tracheobronchial tree. We hypothesized that statistical significance was dependent on the [...] Read more.
The aim of this study was to investigate the features of partial anomalous left pulmonary artery (PALPA) and differences between cases with posterior versus anterior a nomalous vessels in relation to the tracheobronchial tree. We hypothesized that statistical significance was dependent on the course of the anomalous vessel due to airway compression in the posterior type. This study included cases obtained from the literature (n = 33) and an institution teaching file (n = 2). Information collected: age, sex, medical history, additional anomalies, anomalous vessel course, and respiratory symptoms. Data were analyzed with independent samples t-test and Fisher’s exact test. PALPAs were more commonly anterior than posterior. Mean age: 5.3 years (SD = 12.4) for anterior and 6.8 years (SD = 18.5) for posterior (p = 0.77). Respiratory symptoms: 20% of anterior and 60% of posterior cases (p = 0.032). Tracheobronchial anomalies: 35% of anterior and 60% of posterior cases (p = 0.182). Non-cardiac and non-tracheobronchial anomalies: 30% of anterior and 47% of posterior cases (p = 0.511). Kabuki syndrome: 25% of anterior and 6.7% of posterior cases (p = 0.207). In conclusion, respiratory symptoms were the only significant difference between anterior and posterior PALPA types. Full article
(This article belongs to the Section Cardiovascular Imaging)
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19 pages, 5291 KiB  
Article
A Novel Method for Lung Image Processing Using Complex Networks
by Laura Broască, Ana Adriana Trușculescu, Versavia Maria Ancușa, Horia Ciocârlie, Cristian-Iulian Oancea, Emil-Robert Stoicescu and Diana Luminița Manolescu
Tomography 2022, 8(4), 1928-1946; https://doi.org/10.3390/tomography8040162 - 27 Jul 2022
Cited by 7 | Viewed by 2027
Abstract
The High-Resolution Computed Tomography (HRCT) detection and diagnosis of diffuse lung disease is primarily based on the recognition of a limited number of specific abnormal findings, pattern combinations or their distributions, as well as anamnesis and clinical information. Since texture recognition has a [...] Read more.
The High-Resolution Computed Tomography (HRCT) detection and diagnosis of diffuse lung disease is primarily based on the recognition of a limited number of specific abnormal findings, pattern combinations or their distributions, as well as anamnesis and clinical information. Since texture recognition has a very high accuracy percentage if a complex network approach is used, this paper aims to implement such a technique customized for diffuse interstitial lung diseases (DILD). The proposed procedure translates HRCT lung imaging into complex networks by taking samples containing a secondary lobule, converting them into complex networks and analyzing them in three dimensions: emphysema, ground glass opacity, and consolidation. This method was evaluated on a 60-patient lot and the results showed a clear, quantifiable difference between healthy and affected lungs. By deconstructing the image on three pathological axes, the method offers an objective way to quantify DILD details which, so far, have only been analyzed subjectively. Full article
(This article belongs to the Section Artificial Intelligence in Medical Imaging)
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23 pages, 2664 KiB  
Article
An Efficient Multi-Scale Convolutional Neural Network Based Multi-Class Brain MRI Classification for SaMD
by Syed Ali Yazdan, Rashid Ahmad, Naeem Iqbal, Atif Rizwan, Anam Nawaz Khan and Do-Hyeun Kim
Tomography 2022, 8(4), 1905-1927; https://doi.org/10.3390/tomography8040161 - 26 Jul 2022
Cited by 20 | Viewed by 3895
Abstract
A brain tumor is the growth of abnormal cells in certain brain tissues with a high mortality rate; therefore, it requires high precision in diagnosis, as a minor human judgment can eventually cause severe consequences. Magnetic Resonance Image (MRI) serves as a non-invasive [...] Read more.
A brain tumor is the growth of abnormal cells in certain brain tissues with a high mortality rate; therefore, it requires high precision in diagnosis, as a minor human judgment can eventually cause severe consequences. Magnetic Resonance Image (MRI) serves as a non-invasive tool to detect the presence of a tumor. However, Rician noise is inevitably instilled during the image acquisition process, which leads to poor observation and interferes with the treatment. Computer-Aided Diagnosis (CAD) systems can perform early diagnosis of the disease, potentially increasing the chances of survival, and lessening the need for an expert to analyze the MRIs. Convolutional Neural Networks (CNN) have proven to be very effective in tumor detection in brain MRIs. There have been multiple studies dedicated to brain tumor classification; however, these techniques lack the evaluation of the impact of the Rician noise on state-of-the-art deep learning techniques and the consideration of the scaling impact on the performance of the deep learning as the size and location of tumors vary from image to image with irregular shape and boundaries. Moreover, transfer learning-based pre-trained models such as AlexNet and ResNet have been used for brain tumor detection. However, these architectures have many trainable parameters and hence have a high computational cost. This study proposes a two-fold solution: (a) Multi-Scale CNN (MSCNN) architecture to develop a robust classification model for brain tumor diagnosis, and (b) minimizing the impact of Rician noise on the performance of the MSCNN. The proposed model is a multi-class classification solution that classifies MRIs into glioma, meningioma, pituitary, and non-tumor. The core objective is to develop a robust model for enhancing the performance of the existing tumor detection systems in terms of accuracy and efficiency. Furthermore, MRIs are denoised using a Fuzzy Similarity-based Non-Local Means (FSNLM) filter to improve the classification results. Different evaluation metrics are employed, such as accuracy, precision, recall, specificity, and F1-score, to evaluate and compare the performance of the proposed multi-scale CNN and other state-of-the-art techniques, such as AlexNet and ResNet. In addition, trainable and non-trainable parameters of the proposed model and the existing techniques are also compared to evaluate the computational efficiency. The experimental results show that the proposed multi-scale CNN model outperforms AlexNet and ResNet in terms of accuracy and efficiency at a lower computational cost. Based on experimental results, it is found that our proposed MCNN2 achieved accuracy and F1-score of 91.2% and 91%, respectively, which is significantly higher than the existing AlexNet and ResNet techniques. Moreover, our findings suggest that the proposed model is more effective and efficient in facilitating clinical research and practice for MRI classification. Full article
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10 pages, 991 KiB  
Article
The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department
by Alberto Negro, Francesco Somma, Mario Tortora, Marina Lugarà, Stefania Tamburrini, Maria Gabriella Coppola, Valeria Piscitelli, Fabrizio Fasano, Carmine Sicignano, Ottavia Vargas, Gianvito Pace, Mariarosaria Giardiello, Michele Iannuzzi, Gabriella Toro, Fiore De Simone, Marco Catalano, Roberto Carbone, Concetta Rocco, Pietro Paolo Saturnino, Luigi Della Gatta, Alessandro Villa, Fabio Tortora, Laura Gemini, Ferdinando Caranci and Vincenzo D’Agostinoadd Show full author list remove Hide full author list
Tomography 2022, 8(4), 1895-1904; https://doi.org/10.3390/tomography8040160 - 26 Jul 2022
Cited by 1 | Viewed by 1629
Abstract
Background: The diagnosis of acute spondylodiscitis can be very difficult because clinical onset symptoms are highly variable. The reference examination is MRI, but very often the first diagnostic investigation performed is CT, given its high availability in the acute setting. CT allows rapid [...] Read more.
Background: The diagnosis of acute spondylodiscitis can be very difficult because clinical onset symptoms are highly variable. The reference examination is MRI, but very often the first diagnostic investigation performed is CT, given its high availability in the acute setting. CT allows rapid evaluation of other alternative diagnoses (e.g., fractures), but scarce literature is available to evaluate the accuracy of CT, and in particular of multi-detector computed tomography (MDCT), in the diagnosis of suspected spondylodiscitis. The aim of our study was to establish MDCT accuracy and how this diagnostic method could help doctors in the depiction of acute spondylodiscitis in an emergency situation by comparing the diagnostic performance of MDCT with MRI, which is the gold standard. Methods: We searched our radiological archive for all MRI examinations of patients who had been studied for a suspicion of acute spondylodiscitis in the period between January 2017 and January 2021 (n = 162). We included only patients who had undergone MDCT examination prior to MRI examination (n = 25). The overall diagnostic value of MDCT was estimated, using MRI as the gold standard. In particular, the aim of our study was to clarify the effectiveness of CT in radiological cases that require immediate intervention (stage of complications). Therefore, the radiologist, faced with a negative CT finding, can suggest an elective (not urgent) MRI with relative serenity and without therapeutic delays. Results: MDCT allowed identification of the presence of acute spondylodiscitis in 13 of 25 patients. Specificity and positive predictive value were 100% for MDCT, while sensitivity and negative predictive value were 68% and 50%, respectively, achieving an overall accuracy of 76%. In addition, MDCT allowed the identification of paravertebral abscesses (92%), fairly pathognomonic lesions of spondylodiscitis pathology. Conclusions: The MDCT allows identification of the presence of acute spondylodiscitis in the Emergency Department (ED) with a satisfactory accuracy. In the case of a positive CT examination, this allows therapy to be started immediately and reduces complications. However, we suggest performing an elective MRI examination in negative cases in which pathological findings are hard to diagnose with CT alone. Full article
(This article belongs to the Section Neuroimaging)
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10 pages, 439 KiB  
Article
Baseline Characteristics Associated with Good Collateral Status Using Hypoperfusion Index as an Outcome
by Omar Hamam, Tushar Garg, Omar Elmandouh, Richard Wang, Alperen Aslan, Amara Ahmed, Abdallah Moustafa and Vivek Yedavalli
Tomography 2022, 8(4), 1885-1894; https://doi.org/10.3390/tomography8040159 - 25 Jul 2022
Viewed by 1715
Abstract
Up to 30% of ischemic stroke cases are due to large vessel occlusion (LVO), causing significant morbidity. Studies have shown that the collateral circulation of patients with acute ischemic stroke (AIS) secondary to LVO can predict their clinical and radiological outcomes. The aim [...] Read more.
Up to 30% of ischemic stroke cases are due to large vessel occlusion (LVO), causing significant morbidity. Studies have shown that the collateral circulation of patients with acute ischemic stroke (AIS) secondary to LVO can predict their clinical and radiological outcomes. The aim of this study is to identify baseline patient characteristics that can help predict the collateral status of these patients for improved triage. In this IRB approved retrospective study, consecutive patients presenting with AIS secondary to anterior circulation LVO were identified between September 2019 and August 2021. The baseline patient characteristics, laboratory values, imaging features and outcomes were collected using a manual chart review. From the 181 consecutive patients initially reviewed, 54 were confirmed with a clinical diagnosis of AIS and anterior circulation LVO. In patients with poor collateral status, the body mass index (BMI) was found to be significantly lower compared to those with good collateral status (26.4 ± 5.6 vs. 31.7 ± 12.3; p = 0.045). BMI of >35 kg/m2 was found to predict the presence of good collateral status. Age was found to be significantly higher (70.5 ± 9.6 vs. 58.9 ± 15.6; p = 0.034) in patients with poor collateral status and M1 strokes associated with older age and BMI. Full article
(This article belongs to the Section Neuroimaging)
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4 pages, 215 KiB  
Editorial
Women in Radiology: Perceived or True Barrier?
by Federica Vernuccio, Filippo Crimì, Alessia Pepe and Emilio Quaia
Tomography 2022, 8(4), 1881-1884; https://doi.org/10.3390/tomography8040158 - 24 Jul 2022
Viewed by 1419
Abstract
Numbers are facts, and facts need to be publicly discussed for any change to happen [...] Full article
12 pages, 2677 KiB  
Case Report
Direct Visualization of Cervical Interlaminar Epidural Injections Using Sonography
by Nana Maeda, Manabu Maeda and Yasuhito Tanaka
Tomography 2022, 8(4), 1869-1880; https://doi.org/10.3390/tomography8040157 - 22 Jul 2022
Cited by 4 | Viewed by 2554
Abstract
In this case series, we describe a novel ultrasound (US)-guided cervical interlaminar epidural steroid injections (CILESIs) procedure that does not depend on the loss-of-resistance method for epidural space identification. A needle is introduced into three US-identified structures (triple bar sign), the interspinal ligament, [...] Read more.
In this case series, we describe a novel ultrasound (US)-guided cervical interlaminar epidural steroid injections (CILESIs) procedure that does not depend on the loss-of-resistance method for epidural space identification. A needle is introduced into three US-identified structures (triple bar sign), the interspinal ligament, ligamentum flavum, and dura mater. The injectants are monitored using superb microvascular imaging during injection. Here, we demonstrate the use of US-guided CILESIs in nine cases and propose the use of sonography, rather than conventional methods, for easier and safer cervical epidural injections. Sonography for direct visualization of cervical epidural injection may allow for outpatient injections. Full article
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15 pages, 8307 KiB  
Article
Deep Learning-Based Segmentation of Post-Mortem Human’s Olfactory Bulb Structures in X-ray Phase-Contrast Tomography
by Alexandr Meshkov, Anvar Khafizov, Alexey Buzmakov, Inna Bukreeva, Olga Junemann, Michela Fratini, Alessia Cedola, Marina Chukalina, Andrei Yamaev, Giuseppe Gigli, Fabian Wilde, Elena Longo, Victor Asadchikov, Sergey Saveliev and Dmitry Nikolaev
Tomography 2022, 8(4), 1854-1868; https://doi.org/10.3390/tomography8040156 - 22 Jul 2022
Viewed by 3048
Abstract
The human olfactory bulb (OB) has a laminar structure. The segregation of cell populations in the OB image poses a significant challenge because of indistinct boundaries of the layers. Standard 3D visualization tools usually have a low resolution and cannot provide the high [...] Read more.
The human olfactory bulb (OB) has a laminar structure. The segregation of cell populations in the OB image poses a significant challenge because of indistinct boundaries of the layers. Standard 3D visualization tools usually have a low resolution and cannot provide the high accuracy required for morphometric analysis. X-ray phase contrast tomography (XPCT) offers sufficient resolution and contrast to identify single cells in large volumes of the brain. The numerous microanatomical structures detectable in XPCT image of the OB, however, greatly complicate the manual delineation of OB neuronal cell layers. To address the challenging problem of fully automated segmentation of XPCT images of human OB morphological layers, we propose a new pipeline for tomographic data processing. Convolutional neural networks (CNN) were used to segment XPCT image of native unstained human OB. Virtual segmentation of the whole OB and an accurate delineation of each layer in a healthy non-demented OB is mandatory as the first step for assessing OB morphological changes in smell impairment research. In this framework, we proposed an effective tool that could help to shed light on OB layer-specific degeneration in patients with olfactory disorder. Full article
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3 pages, 170 KiB  
Editorial
Finding a Good Balance between Pressure to Publish and Scientific Integrity and How to Overcome Temptation of Scientific Misconduct
by Emilio Quaia and Federica Vernuccio
Tomography 2022, 8(4), 1851-1853; https://doi.org/10.3390/tomography8040155 - 19 Jul 2022
Cited by 3 | Viewed by 1465
Abstract
Nowadays, there is a progressive increase in pressure to publish as well as greater emphasis on publishing in high impact journals, even sometimes with significant financial incentives attached [...] Full article
15 pages, 4550 KiB  
Case Report
Secondary Complications in COVID-19 Patients: A Case Series
by Maria Paola Belfiore, Gaetano Maria Russo, Luigi Gallo, Umberto Atripaldi, Stefania Tamburrini, Valentina Caliendo, Luigi Impieri, Maria Teresa Del Canto, Giovanni Ciani, Pasquale Parrella, Maria Luisa Mangoni di Santo Stefano, Antonio Alessandro Heliot Salvia, Fabrizio Urraro, Valerio Nardone, Nicola Coppola, Alfonso Reginelli and Salvatore Cappabianca
Tomography 2022, 8(4), 1836-1850; https://doi.org/10.3390/tomography8040154 - 15 Jul 2022
Cited by 4 | Viewed by 2001
Abstract
Introduction. Coronavirus SARS-CoV-2, the causative agent of COVID-19, primarily causes a respiratory tract infection that is not limited to respiratory distress syndrome, but it is also implicated in other body systems. Systemic complications were reported due to an exaggerated inflammatory response, which involves [...] Read more.
Introduction. Coronavirus SARS-CoV-2, the causative agent of COVID-19, primarily causes a respiratory tract infection that is not limited to respiratory distress syndrome, but it is also implicated in other body systems. Systemic complications were reported due to an exaggerated inflammatory response, which involves severe alveolar damage in the lungs and exacerbates the hypercoagulation that leads to venous thrombosis, ischemic attack, vascular dysfunction and infarction of visceral abdominal organs. Some complications are related to anticoagulant drugs that are administrated to stabilize hypercoagulability, but increase the risk of bleeding, hematoma and hemorrhage. The aim of this study is to report the diagnostic role of CT in the early diagnosis and management of patients with severe COVID-19 complications through the most interesting cases in our experience. Material and Methods. The retrospective analysis of patients studied for COVID-19 in our institution and hospitals, which are part of the university training network, was performed. Cases. Pneumomediastinum, cortical kidney necrosis, splenic infarction, cerebral ischemic stroke, thrombosis of the lower limb and hematomas are the most major complications that are reviewed in this study. Conclusions. Since the onset of the COVID-19 pandemic, the CT imaging modality with its high sensitivity and specificity remains the preferred imaging choice to diagnose early the different complications associated with COVID-19, such as thrombosis, ischemic stroke, infarction and pneumomediastinum, and their management, which significantly improved the outcomes. Full article
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16 pages, 970 KiB  
Article
Verification of Usability of Medical Image Data Using Projective Photography for Designing Clothing for Breast Cancer Patients
by Youn Joo Kim
Tomography 2022, 8(4), 1820-1835; https://doi.org/10.3390/tomography8040153 - 14 Jul 2022
Cited by 1 | Viewed by 1751
Abstract
Manufacturing a customized mastectomy bra, using medical images obtained for breast cancer treatment, could be suggested as an alternative instead of the anthropometric method. However, the breast shape of a medical image is deformed from the anthropometric method as the measurement posture is [...] Read more.
Manufacturing a customized mastectomy bra, using medical images obtained for breast cancer treatment, could be suggested as an alternative instead of the anthropometric method. However, the breast shape of a medical image is deformed from the anthropometric method as the measurement posture is different between the anthropometric method for making clothes and the medical image. As a breast consists of adipose tissues and a few muscles without bones, there is a possibility that a bra can be manufactured if the volume is constant. Therefore, a hypothesis was established that the volume of the breast would be constant, even if the measurement methods were different. As a result of the comparison of 3D-SIM and PPM by MRI, 18 items could be measured simultaneously. Nine items showed differences according to the measurement method. The next step in the case of 3D-SIM was calculating the volume by separating the breast shape into a cone and a hemispherical shape; in the case of MRI, an ellipsoidal volume formula was applied. A t-test was performed on the results obtained, showing no significant difference. Therefore, it was proven that the volume of the breast does not change despite the difference in the measurement and the measurement method. Full article
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16 pages, 6577 KiB  
Article
Deep Learning Automation of Kidney, Liver, and Spleen Segmentation for Organ Volume Measurements in Autosomal Dominant Polycystic Kidney Disease
by Arman Sharbatdaran, Dominick Romano, Kurt Teichman, Hreedi Dev, Syed I. Raza, Akshay Goel, Mina C. Moghadam, Jon D. Blumenfeld, James M. Chevalier, Daniil Shimonov, George Shih, Yi Wang and Martin R. Prince
Tomography 2022, 8(4), 1804-1819; https://doi.org/10.3390/tomography8040152 - 13 Jul 2022
Cited by 10 | Viewed by 5222
Abstract
Organ volume measurements are a key metric for managing ADPKD (the most common inherited renal disease). However, measuring organ volumes is tedious and involves manually contouring organ outlines on multiple cross-sectional MRI or CT images. The automation of kidney contouring using deep learning [...] Read more.
Organ volume measurements are a key metric for managing ADPKD (the most common inherited renal disease). However, measuring organ volumes is tedious and involves manually contouring organ outlines on multiple cross-sectional MRI or CT images. The automation of kidney contouring using deep learning has been proposed, as it has small errors compared to manual contouring. Here, a deployed open-source deep learning ADPKD kidney segmentation pipeline is extended to also measure liver and spleen volumes, which are also important. This 2D U-net deep learning approach was developed with radiologist labeled T2-weighted images from 215 ADPKD subjects (70% training = 151, 30% validation = 64). Additional ADPKD subjects were utilized for prospective (n = 30) and external (n = 30) validations for a total of 275 subjects. Image cropping previously optimized for kidneys was included in training but removed for the validation and inference to accommodate the liver which is closer to the image border. An effective algorithm was developed to adjudicate overlap voxels that are labeled as more than one organ. Left kidney, right kidney, liver and spleen labels had average errors of 3%, 7%, 3%, and 1%, respectively, on external validation and 5%, 6%, 5%, and 1% on prospective validation. Dice scores also showed that the deep learning model was close to the radiologist contouring, measuring 0.98, 0.96, 0.97 and 0.96 on external validation and 0.96, 0.96, 0.96 and 0.95 on prospective validation for left kidney, right kidney, liver and spleen, respectively. The time required for manual correction of deep learning segmentation errors was only 19:17 min compared to 33:04 min for manual segmentations, a 42% time saving (p = 0.004). Standard deviation of model assisted segmentations was reduced to 7, 5, 11, 5 mL for right kidney, left kidney, liver and spleen respectively from 14, 10, 55 and 14 mL for manual segmentations. Thus, deep learning reduces the radiologist time required to perform multiorgan segmentations in ADPKD and reduces measurement variability. Full article
(This article belongs to the Section Artificial Intelligence in Medical Imaging)
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13 pages, 2676 KiB  
Article
Mortality Prediction Analysis among COVID-19 Inpatients Using Clinical Variables and Deep Learning Chest Radiography Imaging Features
by Xuan V. Nguyen, Engin Dikici, Sema Candemir, Robyn L. Ball and Luciano M. Prevedello
Tomography 2022, 8(4), 1791-1803; https://doi.org/10.3390/tomography8040151 - 13 Jul 2022
Cited by 4 | Viewed by 1724
Abstract
The emergence of the COVID-19 pandemic over a relatively brief interval illustrates the need for rapid data-driven approaches to facilitate clinical decision making. We examined a machine learning process to predict inpatient mortality among COVID-19 patients using clinical and chest radiographic data. Modeling [...] Read more.
The emergence of the COVID-19 pandemic over a relatively brief interval illustrates the need for rapid data-driven approaches to facilitate clinical decision making. We examined a machine learning process to predict inpatient mortality among COVID-19 patients using clinical and chest radiographic data. Modeling was performed with a de-identified dataset of encounters prior to widespread vaccine availability. Non-imaging predictors included demographics, pre-admission clinical history, and past medical history variables. Imaging features were extracted from chest radiographs by applying a deep convolutional neural network with transfer learning. A multi-layer perceptron combining 64 deep learning features from chest radiographs with 98 patient clinical features was trained to predict mortality. The Local Interpretable Model-Agnostic Explanations (LIME) method was used to explain model predictions. Non-imaging data alone predicted mortality with an ROC-AUC of 0.87 ± 0.03 (mean ± SD), while the addition of imaging data improved prediction slightly (ROC-AUC: 0.91 ± 0.02). The application of LIME to the combined imaging and clinical model found HbA1c values to contribute the most to model prediction (17.1 ± 1.7%), while imaging contributed 8.8 ± 2.8%. Age, gender, and BMI contributed 8.7%, 8.2%, and 7.1%, respectively. Our findings demonstrate a viable explainable AI approach to quantify the contributions of imaging and clinical data to COVID mortality predictions. Full article
(This article belongs to the Section Artificial Intelligence in Medical Imaging)
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10 pages, 2333 KiB  
Brief Report
Neurocognitive Mechanisms Underlying Internet/Smartphone Addiction: A Preliminary fMRI Study
by Suk Won Han and Cheol Hwan Kim
Tomography 2022, 8(4), 1781-1790; https://doi.org/10.3390/tomography8040150 - 11 Jul 2022
Cited by 3 | Viewed by 2045
Abstract
The present study investigated the neurocognitive mechanisms underlying smartphone/internet addiction. We tested a specific hypothesis that the excessive, uncontrolled use of smartphones should be related to the ability of controlling attention in a purely endogenous and self-regulatory manner. In an fMRI experiment, in [...] Read more.
The present study investigated the neurocognitive mechanisms underlying smartphone/internet addiction. We tested a specific hypothesis that the excessive, uncontrolled use of smartphones should be related to the ability of controlling attention in a purely endogenous and self-regulatory manner. In an fMRI experiment, in which 43 adults participated, we had participants detect and identify specified target stimuli among non-targets. In some trials, 10 s oddball movies were presented as distractors. While the participants try to filter out the distractors and focus their attention on the main task, the activation profiles of the frontoparietal brain regions were examined. The results showed that the people with a higher risk of being addicted to smartphone use failed to filter out distractors via the endogenous control of attention. The neuroimaging data showed that the high-risk group showed significantly lower levels of activation in the frontopolar cortex (FPC). We conclude that people at a high risk of smartphone addiction have difficulty endogenously shifting their attention from distracting stimuli toward goal-directed behavior, and FPC plays a critical role in this self-regulatory control of attention. Full article
(This article belongs to the Section Brain Imaging)
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11 pages, 1937 KiB  
Article
Assessment of Correlation between Dual-Energy Ct (De-Ct)-Derived Iodine Concentration and Local Flourodeoxyglucose (Fdg) Uptake in Patients with Primary Non-Small-Cell Lung Cancer
by Michael Brun Andersen, Aska Drljevic-Nielsen, Jesper Thygesen, Matthijs Ferdinand Kruis, Karin Hjorthaug, Finn Rasmussen and Jasper Albertus Nijkamp
Tomography 2022, 8(4), 1770-1780; https://doi.org/10.3390/tomography8040149 - 08 Jul 2022
Viewed by 1442
Abstract
(1) The current literature contains several studies investigating the correlation between dual-energy-derived iodine concentration (IC) and positron emission tomography (PET)-derived Flourodeoxyglucose (18F-FDG) uptake in patients with non-small-cell lung cancer (NSCLC). In previously published studies, either the entire tumor volume or a [...] Read more.
(1) The current literature contains several studies investigating the correlation between dual-energy-derived iodine concentration (IC) and positron emission tomography (PET)-derived Flourodeoxyglucose (18F-FDG) uptake in patients with non-small-cell lung cancer (NSCLC). In previously published studies, either the entire tumor volume or a region of interest containing the maximum IC or 18F-FDG was assessed. However, the results have been inconsistent. The objective of this study was to correlate IC with FDG both within the entire volume and regional sub-volumes of primary tumors in patients with NSCLC. (2) In this retrospective study, a total of 22 patients with NSCLC who underwent both dual-energy CT (DE-CT) and 18F-FDG PET/CT were included. A region of interest (ROI) encircling the entire primary tumor was delineated, and a rigid registration of the DE-CT, iodine maps and FDG images was performed for the ROI. The correlation between tumor measurements and area-specific measurements of ICpeak and the peak standardized uptake value (SUVpeak) was found. Finally, a correlation between tumor volume and the distance between SUVpeak and ICpeak centroids was found. (3) For the entire tumor, moderate-to-strong correlations were found between SUVmax and ICmax (R = 0.62, p = 0.002), and metabolic tumor volume vs. total iodine content (R = 0.91, p < 0.001), respectively. For local tumor sub-volumes, a negative correlation was found between ICpeak and SUVpeak (R = −0.58, p = 0.0046). Furthermore, a strong correlation was found between the tumor volume and the distance in millimeters between SUVpeak and ICpeak centroids (R = 0.81, p < 0.0001). (4) In patients with NSCLC, high FDG uptakes and high DE-CT-derived iodine concentrations correlated on a whole-tumor level, but the peak areas were positioned at different locations within the tumor. 18F-FDG PET/CT and DE-CT provide complementary information and might represent different underlying patho-physiologies. Full article
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11 pages, 3384 KiB  
Article
Reduction in Acquisition Time and Improvement in Image Quality in T2-Weighted MR Imaging of Musculoskeletal Tumors of the Extremities Using a Novel Deep Learning-Based Reconstruction Technique in a Turbo Spin Echo (TSE) Sequence
by Daniel Wessling, Judith Herrmann, Saif Afat, Dominik Nickel, Ahmed E. Othman, Haidara Almansour and Sebastian Gassenmaier
Tomography 2022, 8(4), 1759-1769; https://doi.org/10.3390/tomography8040148 - 06 Jul 2022
Cited by 8 | Viewed by 1937
Abstract
Background: The aim of this study was to assess the technical feasibility and the impact on image quality and acquisition time of a deep learning-accelerated fat-saturated T2-weighted turbo spin echo sequence in musculoskeletal imaging of the extremities. Methods: Twenty-three patients who underwent MRI [...] Read more.
Background: The aim of this study was to assess the technical feasibility and the impact on image quality and acquisition time of a deep learning-accelerated fat-saturated T2-weighted turbo spin echo sequence in musculoskeletal imaging of the extremities. Methods: Twenty-three patients who underwent MRI of the extremities were prospectively included. Standard T2w turbo inversion recovery magnitude (TIRMStd) imaging was compared to a deep learning-accelerated T2w TSE (TSEDL) sequence. Image analysis of 23 patients with a mean age of 60 years (range 30–86) was performed regarding image quality, noise, sharpness, contrast, artifacts, lesion detectability and diagnostic confidence. Pathological findings were documented measuring the maximum diameter. Results: The analysis showed a significant improvement for the T2 TSEDL with regard to image quality, noise, contrast, sharpness, lesion detectability, and diagnostic confidence, as compared to T2 TIRMStd (each p < 0.001). There were no differences in the number of detected lesions. The time of acquisition (TA) could be reduced by 52–59%. Interrater agreement was almost perfect (κ = 0.886). Conclusion: Accelerated T2 TSEDL was technically feasible and superior to conventionally applied T2 TIRMStd. Concurrently, TA could be reduced by 52–59%. Therefore, deep learning-accelerated MR imaging is a promising and applicable method in musculoskeletal imaging. Full article
(This article belongs to the Special Issue New Advances in Magnetic Resonance Imaging (MRI))
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17 pages, 1911 KiB  
Review
Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques
by Panagiotis Theofilis, Marios Sagris, Alexios S. Antonopoulos, Evangelos Oikonomou, Konstantinos Tsioufis and Dimitris Tousoulis
Tomography 2022, 8(4), 1742-1758; https://doi.org/10.3390/tomography8040147 - 06 Jul 2022
Cited by 10 | Viewed by 2828
Abstract
Coronary atherosclerosis is a complex, multistep process that may lead to critical complications upon progression, revolving around plaque disruption through either rupture or erosion. Several high-risk features are associated with plaque vulnerability and may add incremental prognostic information. Although invasive imaging modalities such [...] Read more.
Coronary atherosclerosis is a complex, multistep process that may lead to critical complications upon progression, revolving around plaque disruption through either rupture or erosion. Several high-risk features are associated with plaque vulnerability and may add incremental prognostic information. Although invasive imaging modalities such as optical coherence tomography or intravascular ultrasound are considered to be the gold standard in the assessment of vulnerable coronary atherosclerotic plaques (VCAPs), contemporary evidence suggests a potential role for non-invasive methods in this context. Biomarkers associated with deleterious pathophysiologic pathways, including inflammation and extracellular matrix degradation, have been correlated with VCAP characteristics and adverse prognosis. However, coronary computed tomography (CT) angiography has been the most extensively investigated technique, significantly correlating with invasive method-derived VCAP features. The estimation of perivascular fat attenuation as well as radiomic-based approaches represent additional concepts that may add incremental information. Cardiac magnetic resonance imaging (MRI) has also been evaluated in clinical studies, with promising results through the various image sequences that have been tested. As far as nuclear cardiology is concerned, the implementation of positron emission tomography in the VCAP assessment currently faces several limitations with the myocardial uptake of the radiotracer in cases of fluorodeoxyglucose use, as well as with motion correction. Moreover, the search for the ideal radiotracer and the most adequate combination (CT or MRI) is still ongoing. With a look to the future, the possible combination of imaging and circulating inflammatory and extracellular matrix degradation biomarkers in diagnostic and prognostic algorithms may represent the essential next step for the assessment of high-risk individuals. Full article
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