Diagnostics

10 pages, 4333 KiB

Open AccessArticle

Ultra-High-Frequency Ultrasound Mapping of the Superficial Circumflex Iliac and Superficial Inferior Epigastric Vessels: An Anatomical Study

by Spencer Chia-Hao Kuo, Ryo Karakawa, Hirofumi Imai, Shintaro Kagimoto, Yukio Seki, Nobuko Suesada, Hidehiko Yoshimatsu and Tomoyuki Yano

Diagnostics 2025, 15(10), 1210; https://doi.org/10.3390/diagnostics15101210 (registering DOI) - 11 May 2025

Abstract

Background: The superficial vessel system in the lower abdomen, including the superficial circumflex iliac artery (SCIA) and superficial inferior epigastric artery (SIEA), is widely used in reconstructive microsurgery. Preoperative ultrasonography, particularly ultra-high-frequency ultrasound (UHFUS), enhances surgical planning by providing high-resolution imaging. This study [...] Read more.

Background: The superficial vessel system in the lower abdomen, including the superficial circumflex iliac artery (SCIA) and superficial inferior epigastric artery (SIEA), is widely used in reconstructive microsurgery. Preoperative ultrasonography, particularly ultra-high-frequency ultrasound (UHFUS), enhances surgical planning by providing high-resolution imaging. This study aimed to utilize UHFUS to examine the SCIA, SCIV, SIEA, and SIEV for reconstructive surgery planning. Methods: This prospective study included 25 patients undergoing free DIEP flap breast reconstruction. Patients with horizontal lower abdominal scars were excluded. Preoperative UHFUS, using a 48 MHz transducer, was performed to map and measure the superficial branch of SCIA (sSCIA), SCIV, SIEA, and SIEV. The vessel location, diameter, depth, and course were documented and analyzed. Results: Twenty-five female patients (50 hemiabdomens) aged 41 to 66 were included. The mean BMI was 21.6 kg/m² (range: 18.4–30.4 kg/m²). At the ASIS level, the mean diameter of the sSCIA, SIEA, SCIV, and SIEV were 0.76 mm, 0.63 mm, 1.72 mm, and 2.18 mm, respectively. A superior lateral pedicle course was observed in 98% of the sSCIA. All patients had at least one detectable superficial artery, with 96% showing detectable arteries on both sides of the lower abdomen. Conclusions: UHFUS effectively maps superficial vessels in the lower abdomen for reconstructive surgery. The SCIA and SCIV are reliably detectable, while the SIEA is less consistently identified. UHFUS enhances flap design by providing precise vessel localization and sizing, leading to safer and more efficient surgeries. Full article

(This article belongs to the Special Issue Machine-Extractable Knowledge from the Shape of Anatomical Structures 2024)

► Show Figures

Figure 1

11 pages, 238 KiB

Open AccessArticle

Clinical Yield of Colonoscopy in Evaluation of Young Women with Constipation: An Age- and Gender-Based Analysis

by Amani Beshara, Avraham Yitzhak, Revital Guterman, Ruhama Elhayany, Majed Khader, Sarah Weissmann and Naim Abu-Freha

Diagnostics 2025, 15(10), 1209; https://doi.org/10.3390/diagnostics15101209 (registering DOI) - 11 May 2025

Abstract

Background: Constipation is one of the most common gastrointestinal complaints among women, with a variety of contributing factors. We aimed to assess the role of colonoscopy in evaluating young women with constipation. Methods: A multi-center, large cohort, retrospective study included all data from [...] Read more.

Background: Constipation is one of the most common gastrointestinal complaints among women, with a variety of contributing factors. We aimed to assess the role of colonoscopy in evaluating young women with constipation. Methods: A multi-center, large cohort, retrospective study included all data from colonoscopies performed between 2016 and 2023 in seven endoscopy departments. The indications and findings of the procedures were collected, and findings of young women aged ≤40 y with constipation as an indication were compared to older women and men of the same age groups. Results: The cohort comprised 377,795 patients, including 198,629 (52.6%) females and 179,166 (47.4%) males. In total, 7872 females underwent colonoscopy for constipation and other indications (Cohort 1). In addition, 6852 women were referred for a colonoscopy for constipation only (Cohort 2). In sum, 75% of colonoscopies in women <40 y were normal in both cohorts. In Cohort 1, inflammatory bowel diseases (IBD) were significantly higher in women <40 y with Ulcerative Colitis (UC) (1.2%) and Crohn’s disease (CD) (0.7%), p < 0.001). The rate of IBD was lower but still significant in Cohort 2. In both cohorts, diverticulosis and polyp rates exponentially increased with age >40 y, p < 0.001. Higher rates of diverticulosis and polyps were found among males <40 y in Cohort 1. One case (0.1%) of Colorectal cancer (CRC) was found in <40 y women. Similar IBD and CRC rates were found in males and females of all ages, p > 0.05. Conclusions: The diagnostic yield of colonoscopy for investigating isolated constipation in young females is not significant. Diagnostic work-up should be guided by accurate clinical understanding. Full article

(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases)

15 pages, 899 KiB

Open AccessArticle

Positive Association Between Ultrasonographic Fatty Liver Indicator and the Severity of Coronary Artery Disease

by Tingqiu Wang, Zhigang Wang and Peng Luo

Diagnostics 2025, 15(10), 1208; https://doi.org/10.3390/diagnostics15101208 (registering DOI) - 10 May 2025

Abstract

Background: This study investigates the link between metabolic dysfunction-associated fatty liver disease (MAFLD) and coronary artery disease (CAD) using the ultrasonographic fatty liver indicator (US-FLI) to assess liver steatosis. Methods: A total of 204 patients were included, with hepatic steatosis evaluated [...] Read more.

Background: This study investigates the link between metabolic dysfunction-associated fatty liver disease (MAFLD) and coronary artery disease (CAD) using the ultrasonographic fatty liver indicator (US-FLI) to assess liver steatosis. Methods: A total of 204 patients were included, with hepatic steatosis evaluated through ultrasound characteristics, diagnosing fatty liver when US-FLI was ≥2. CAD severity was determined using the SYNTAX score (SS), categorizing 100 CAD patients into mild (SS ≤ 22) and moderate-severe (MS) (SS ≥ 23) groups. The association between US-FLI and SS in patients with MAFLD was evaluated through the multivariate logistic regression model. A receiver operating characteristic curve was applied to determine the accuracy, sensitivity, and specificity of US-FLI in predicting SS. Results: In the multivariate logistic regression analysis, US-FLI was an independent predictor of the CAD group (OR = 1.194, 95% CI: 1.008–1.414, p = 0.040) and the MS group (OR = 1.262, 95% CI: 1.025–1.553, p = 0.028). In the receiver operating characteristic curve analysis, a US-FLI value of 2 was found to be the optimal threshold point for diagnosing MS CAD patients (AUC = 0.620, 95% CI: 0.509–0.713, p = 0.039), with a sensitivity of 65.22% and a specificity of 55.56%. The diagnostic performance of MS CAD patients significantly improved when US-FLI was combined with type 2 diabetes mellitus (T2DM) (AUC = 0.732, 95% CI: 0.632–0.832, p < 0.001), with a sensitivity of 65.22% and specificity of 77.78%. Conclusions: US-FLI was independently and positively associated with CAD severity. US-FLI combined with T2DM had better diagnostic performance in patients with MS CAD. Full article

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

► Show Figures

Figure 1

26 pages, 1968 KiB

Open AccessReview

Atrial Cardiomyopathy in Atrial Fibrillation: A Multimodal Diagnostic Framework

by Paschalis Karakasis, Panayotis K. Vlachakis, Panagiotis Theofilis, Nikolaos Ktenopoulos, Dimitrios Patoulias, Barbara Fyntanidou, Antonios P. Antoniadis and Nikolaos Fragakis

Diagnostics 2025, 15(10), 1207; https://doi.org/10.3390/diagnostics15101207 (registering DOI) - 10 May 2025

Abstract

Atrial fibrillation (AF) is increasingly recognized as the clinical manifestation of an underlying atrial disease process rather than a purely electrical disorder. This evolving paradigm has given rise to the concept of atrial cardiomyopathy (AtCM), encompassing structural, electrical, contractile, and molecular remodeling of [...] Read more.

Atrial fibrillation (AF) is increasingly recognized as the clinical manifestation of an underlying atrial disease process rather than a purely electrical disorder. This evolving paradigm has given rise to the concept of atrial cardiomyopathy (AtCM), encompassing structural, electrical, contractile, and molecular remodeling of the atrial myocardium that contributes to AF initiation, maintenance, and progression. Although consensus definitions of AtCM now exist, its integration into clinical practice remains limited, with AF management still largely guided by arrhythmic patterns rather than substrate characterization. This review synthesizes current diagnostic strategies for AtCM within the context of AF, emphasizing a multimodal approach. We outline advances in cardiac imaging—including echocardiography, cardiac magnetic resonance, and computed tomography—for detailed assessment of atrial morphology, function, and fibrosis. Electroanatomic mapping is discussed as a key invasive tool for substrate localization, while electrocardiographic indices such as P-wave morphology and dispersion serve as accessible surrogates of electrical remodeling. In parallel, we examine the role of circulating biomarkers and emerging genomic, transcriptomic, and epigenomic markers in refining disease phenotyping. Despite promising progress, significant challenges remain. Standardization of imaging protocols, validation of biomarker thresholds, and integration of artificial intelligence tools are needed to enhance clinical utility. A diagnostic framework informed by atrial substrate assessment may support more tailored therapeutic decision-making in AF. Future research should prioritize the harmonization of diagnostic criteria and explore how substrate profiling in AF may refine risk stratification and improve clinical outcomes. Full article

(This article belongs to the Special Issue Grand Challenges in the Diagnosis and Management of Cardiovascular and Cerebrovascular Diseases)

► Show Figures

Figure 1

14 pages, 4088 KiB

Open AccessArticle

Is a 3-Minute Knee MRI Protocol Sufficient for Daily Clinical Practice? A SuperResolution Reconstruction Approach Using AI and Compressed Sensing

by Robert Hahnfeldt, Robert Terzis, Thomas Dratsch, Lajos Maximilian Basten, Philip Rauen, Johannes Oppermann, David Grevenstein, Jan Paul Janßen, Nour El-Hoda Abou Zeid, Kristina Sonnabend, Christoph Katemann, Stephan Skornitzke, David Maintz, Jonathan Kottlors, Grischa Bratke and Andra-Iza Iuga

Diagnostics 2025, 15(10), 1206; https://doi.org/10.3390/diagnostics15101206 - 9 May 2025

Abstract

Objectives: The purpose of this study was to assess whether a 3-min 2D knee protocol can meet the needs for clinical application if using a SuperResolution reconstruction approach. Methods: In this prospective study, a total of 20 volunteers underwent imaging of the knee [...] Read more.

Objectives: The purpose of this study was to assess whether a 3-min 2D knee protocol can meet the needs for clinical application if using a SuperResolution reconstruction approach. Methods: In this prospective study, a total of 20 volunteers underwent imaging of the knee using a 3T MRI scanner (Philips Ingenia Elition X 3.0T, Philips). The imaging protocol, consisting of a fat-saturated 2D proton density sequence in coronal, sagittal, and transverse orientations, as well as a sagittal T1-weighted sequence, was acquired with standard and ultra-low resolution. The standard sequences were reconstructed using an AI-assisted Compressed SENSE method (SmartSpeed). The ultra-low-resolution sequences have been reconstructed using a vendor-provided prototype. Four experienced readers (two radiologists and two orthopedic surgeons) evaluated the sequences for image quality, anatomical structures, and incidental pathologies. The consensus evaluation of two different experienced radiologists specialized in musculoskeletal imaging served as the gold standard. Results: The acquisition time for the entire protocol was 11:01 min for standard resolution and 03:36 min for ultra-low resolution. In the overall assessment, CS-SuperRes-reconstructed sequences showed slightly improved accuracy and increased specificity compared to the standard CS-AI method (0.87 vs. 0.86 and 0.9 vs. 0.87, respectively), while the standard method exhibited a higher sensitivity (0.73 vs. 0.57). Overall, 24 out of 40 pathologies were detected in the ultra-low-resolution images compared to 26 in the standard images. Conclusions: The CS-SuperRes method enables a 2D knee protocol to be completed in 3 min, with improved accuracy compared to the clinical standard. Full article

(This article belongs to the Topic Machine Learning and Deep Learning in Medical Imaging)

► Show Figures

Figure 1

13 pages, 736 KiB

Open AccessArticle

Comparing the Carpal Tunnel Area and Carpal Boundaries in Patients with Carpal Tunnel Syndrome and Healthy Volunteers: A Magnetic Resonance Imaging Study

by Yu-Ting Huang, Chii-Jen Chen, You-Wei Wang and Yi-Shiung Horng

Diagnostics 2025, 15(10), 1205; https://doi.org/10.3390/diagnostics15101205 - 9 May 2025

Abstract

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by compression of the median nerve (MN) within the carpal tunnel, which causes pain, paresthesia, or altered sensation. While a small carpal tunnel area is considered a risk factor for CTS, varying carpal [...] Read more.

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by compression of the median nerve (MN) within the carpal tunnel, which causes pain, paresthesia, or altered sensation. While a small carpal tunnel area is considered a risk factor for CTS, varying carpal tunnel dimensions in CTS patients have been obtained via axial computed tomography and magnetic resonance imaging (MRI). Methods: In this retrospective study, MR images from 49 CTS patients and 38 healthy controls were analyzed to investigate differences in the carpal tunnel area and carpal boundaries between the groups and to explore the relationships of these parameters with CTS severity. Results: Our findings revealed that compared with the controls, CTS patients presented significantly larger cross-sectional areas (CSAs) of the MN and carpal tunnel and increased MN flattening ratios. The CSAs of the MN showed moderate positive correlations with severity (r = 0.395, p < 0.001), symptom score (r = 0.354, p < 0.001), and disability score (r = 0.300, p < 0.001), while the carpal tunnel area showed weaker but significant correlations with severity (r = 0.268, p = 0.002), symptom score (r = 0.173, p = 0.026), and disability score (r = 0.183, p = 0.018). The ratios of the MN CSA to those of the carpal tunnel, the interior carpal boundary (ICB), the exterior carpal boundary (ECB), and the wrist were disproportionately greater in the CTS patients. Among them, both the MN-to-ICB and MN-to-ECB ratios had fair to good diagnostic values (area under the curve = 0.725 and 0.794, respectively). Conclusions: These results highlight the utility of MRI-derived CSA measurements and ratios in identifying pathophysiological changes in CTS patients, particularly crowding of the MN inside the carpal tunnel. Further studies are recommended to refine MRI-based diagnostic protocols for CTS. Full article

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

► Show Figures

Figure 1

12 pages, 2492 KiB

Open AccessReview

The Prevalence and Significance of Incidental Positron Emission Tomography Findings in the Brain Using Radiotracers Other than [¹⁸F]FDG: A Meta-Analysis

by Cesare Michele Iacovitti, Barbara Muoio, Domenico Albano, Alessio Rizzo, Marco Cuzzocrea, Gaetano Paone and Giorgio Treglia

Diagnostics 2025, 15(10), 1204; https://doi.org/10.3390/diagnostics15101204 - 9 May 2025

Abstract

Background: Incidental brain imaging findings could be clinically relevant, and advancements in molecular imaging could lead to their more frequent identification. The aim of this review is to establish the prevalence and clinical significance of brain incidentalomas at PET (BIPs) using radiotracers [...] Read more.

Background: Incidental brain imaging findings could be clinically relevant, and advancements in molecular imaging could lead to their more frequent identification. The aim of this review is to establish the prevalence and clinical significance of brain incidentalomas at PET (BIPs) using radiotracers other than [¹⁸F]FDG. Methods: A comprehensive literature search of studies about BIPs was carried out. Four different databases (PubMed/MEDLINE, EMBASE, the Cochrane library, and Google Scholar) were screened up to December 2024. Only original articles about BIPs using radiotracers other than [¹⁸F]FDG were selected. A proportion meta-analysis of the prevalence of BIPs was carried out using a random-effects model. Results: Fourteen studies were included in the review, using somatostatin receptor (SSTR) PET (n = 6), radiolabeled choline PET (n = 5), prostate-specific membrane antigen (PSMA) ligands PET (n = 1), [¹⁸F]Fluciclovine PET (n = 1), and [¹⁸F]FDOPA PET (n = 1). The pooled prevalence of BIPs was 4.6% for SSTR PET, 1.1% for choline PET, 1.2% for PSMA ligands PET, 2.5% for [¹⁸F]Fluciclovine PET, and 3.9% for [¹⁸F]FDOPA PET. When BIPs were further evaluated using MRI, meningiomas were the most frequent lesions detected, but both benign and malignant lesions could be incidentally diagnosed. Conclusions: BIPs using radiotracers other than [¹⁸F]FDG are not rare, in particular at SSTR PET, further justifying the extension of PET scans to the brain when radiotracers other than [¹⁸F]FDG are used. When detected, a BIP should be further evaluated using brain MRI. Both benign and malignant lesions could be incidentally detected in the brain. Further studies are warranted to better clarify the clinical impact of BIP detection. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Cancer/Tumors)

► Show Figures

Figure 1

11 pages, 866 KiB

Open AccessArticle

The Potential Morphological Stenosis Pattern of the Arcuate Foramen

by Ioannis Paschopoulos, Maria Piagkou, George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Fabrice Duparc, Fotis Demetriou, George Tsakotos, Rǎzvan-Costin Tudose, Mugurel Constantin Rusu and Oana Daniela Toader

Diagnostics 2025, 15(10), 1203; https://doi.org/10.3390/diagnostics15101203 - 9 May 2025

Abstract

Background: The arcuate foramen (AF), an osseous foramen, is probably formatted from the ossification of the posterior atlanto-occipital membrane. When this morphologically ossified variant exists, it encloses the vertebral artery (VA) third segment (V3). This close relationship may cause compression to the [...] Read more.

Background: The arcuate foramen (AF), an osseous foramen, is probably formatted from the ossification of the posterior atlanto-occipital membrane. When this morphologically ossified variant exists, it encloses the vertebral artery (VA) third segment (V3). This close relationship may cause compression to the VA with concomitant vertebrobasilar insufficiency, vertigo, headaches, or neck pain. In the published literature, no studies investigate the abovementioned potential compression pattern. The present study examines the AF ossification pattern (complete or partial type) and the variable VA diameter at the atlantal part (V3), concluding a potential risk for VA compression after correlating the relative diameters (AF and VA diameters). Materials and Methods: One hundred and fifty dried first cervical vertebrae (atlases) and one hundred fifty computed tomography (CT) scans were obtained for the present study. The presence of a complete or incomplete AF was evaluated, and when present, its diameter was measured. To correlate these findings with the vessel, 50 computed tomography angiographies (without AF presence) were obtained to measure the V3 segment diameter. Results: Out of the total 600 (N = 600) sides, 111 sides had incomplete AF (18.2%), and 67 sides had complete AF (11.1%). The AF mean diameter was 6.41 (1.12) mm. The diameter of the V3 segment ranged between 5.0 and 6.0 mm; therefore, three morphological stenosis patterns were identified. A low risk of compression (over 6.0 mm) was identified in 61.2% (N = 109 sides), a moderate risk (between 5.0–6.0 mm) was observed in 29.2% (N = 52 sides), and a high risk (under 5.0 mm) was recorded in 9.6% (N = 17 sides). There was no statistically significant correlation regarding sexes and age for the potential compression patterns. Conclusions: The present study revealed the morphological stenosis pattern of the AF to the V3 segment. The variation had a high risk of compression to the vessel in 9.6% of sides, indicating that it is not infrequent. Knowledge of these details is essential for clinicians when investigating vertebrobasilar insufficiency. Full article

(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)

7 pages, 599 KiB

Open AccessBrief Report

Automated Cell Counting in CSF Diagnostics Revisited—Friend or Foe?

by Axel Haarmann, Jörg Schubert, Udo Steigerwald and Michael K. Schuhmann

Diagnostics 2025, 15(10), 1202; https://doi.org/10.3390/diagnostics15101202 - 9 May 2025

Abstract

Background/Objectives: The gold standard for cerebrospinal fluid leukocyte counting is manual counting in a Fuchs–Rosenthal chamber. Recent advances in automated body-fluid-counting systems, offering a time- and labor-saving solution, are challenging this dogma. Yet, the equivalence of diagnostic accuracy is still debated in the [...] Read more.

Background/Objectives: The gold standard for cerebrospinal fluid leukocyte counting is manual counting in a Fuchs–Rosenthal chamber. Recent advances in automated body-fluid-counting systems, offering a time- and labor-saving solution, are challenging this dogma. Yet, the equivalence of diagnostic accuracy is still debated in the community. Methods: We compared manual and automated cell counting of cerebrospinal fluid samples of lumbar punctures and extraventricular drains with both low and high leukocyte counts, shedding light on the variability of results between man and machine. Results: Automated and manual cell counting showed a strong correlation across all samples, particularly in the subgroup of patients with fewer than 20 cells/µl, where outliers could become especially clinically relevant. Conclusions: We found the automated counting system to be highly accurate and not lacking in diagnostic sensitivity even at low cell counts, making it a powerful tool when used in the right clinical setting. Full article

(This article belongs to the Special Issue Advances in the Diagnosis of Nervous System Diseases—2nd Edition)

► Show Figures

Figure 1

11 pages, 232 KiB

Open AccessArticle

Maternal Risk Factors, Patterns, and Outcomes of Antenatal Congenital Anomalies: A Hospital-Based Study

by Seham M. Abufraijeh, Ahlam M. Al-Kharabsheh, Ala N. Uwais and Malek Al Qasem

Diagnostics 2025, 15(10), 1201; https://doi.org/10.3390/diagnostics15101201 - 9 May 2025

Abstract

Background/Objective: Congenital anomalies (CAs) are structural or functional abnormalities contributing to global neonatal morbidity and mortality. Data on antenatally diagnosed CAs in southern Jordan are limited. The present study reports their prevalence and patterns at the Maternal-Fetal Medicine Clinic of a governmental [...] Read more.

Background/Objective: Congenital anomalies (CAs) are structural or functional abnormalities contributing to global neonatal morbidity and mortality. Data on antenatally diagnosed CAs in southern Jordan are limited. The present study reports their prevalence and patterns at the Maternal-Fetal Medicine Clinic of a governmental hospital and examines associated maternal, pregnancy, and delivery outcomes. Methods: This retrospective, hospital-based study involved all pregnant women who presented to the clinic between January 2022 to December 2023 and were diagnosed with congenital fetal anomalies. Data about maternal characteristics, classification of fetal anomalies, and pregnancy outcomes were retrieved from medical files. Statistical analyses comprised chi-square tests, Fisher’s exact tests, independent t-tests, and multiple binary logistic regressions. Results: Among the 750 pregnant women, 74 (9.9%) were diagnosed with CAs. Urinary system anomalies were the most common (54.1%), followed by central nervous system (CNS) anomalies (37.8%). Major anomalies constituted 59.5%, whereas 40.5% were minor anomalies. Gestational age at diagnosis and birthweight were significantly associated with major anomalies (p < 0.05). All stillbirths (10.8%) and pregnancy losses before 24 weeks of gestation (9.5%) occurred in cases with major anomalies (p < 0.05). Though preterm delivery rates were higher with major anomalies, this association was not statistically significant. Conclusions: Major CAs (59.5%) in this southern Jordan cohort were strongly linked to stillbirths and early pregnancy loss, highlighting the need for early diagnosis and improved prenatal care. Targeted interventions, including anomaly scans and risk factor (RF) screening, may reduce the 9.9% prevalence observed. Full article

(This article belongs to the Special Issue Insights into Perinatal Medicine and Fetal Medicine)

14 pages, 2354 KiB

Open AccessReview

Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in Hospital-at-Home Model: Part II—Confounders and Mimickers

by Nin-Chieh Hsu, Yu-Feng Lin, Hung-Bin Tsai, Charles Liao and Chia-Hao Hsu

Diagnostics 2025, 15(10), 1200; https://doi.org/10.3390/diagnostics15101200 - 9 May 2025

Abstract

The hospital-at-home (HaH) model offers hospital-level care within patients’ homes and has proven effective for managing conditions such as pneumonia. The point-of-care ultrasonography (PoCUS) is a key diagnostic tool in this model, especially when traditional imaging modalities are unavailable. This review explores how [...] Read more.

The hospital-at-home (HaH) model offers hospital-level care within patients’ homes and has proven effective for managing conditions such as pneumonia. The point-of-care ultrasonography (PoCUS) is a key diagnostic tool in this model, especially when traditional imaging modalities are unavailable. This review explores how PoCUS can be optimized to manage pneumonia in HaH settings, focusing on its diagnostic accuracy in patients with comorbidities, differentiation from mimickers, and role in assessing disease severity. Pulmonary comorbidities, such as heart failure and interstitial lung disease (ILD), can complicate lung ultrasound (LUS) interpretation. In heart failure, combining lung, cardiac, and venous assessments (e.g., IVC collapsibility, VExUS score) improves diagnostic clarity. In ILD, distinguishing chronic changes from acute infections requires attention to B-line patterns and pleural abnormalities. PoCUS must differentiate pneumonia from conditions such as atelectasis, lung contusion, cryptogenic organizing pneumonia, eosinophilic pneumonia, and neoplastic lesions—many of which present with similar sonographic features. Serial LUS scoring provides useful information on pneumonia severity and disease progression. Studies, particularly during the COVID-19 pandemic, show correlations between worsening LUS scores and poor outcomes, including increased ventilator dependency and mortality. Furthermore, LUS scores correlate with inflammatory markers and gas exchange metrics, supporting their prognostic value. In conclusion, PoCUS in HaH care requires clinicians to integrate multi-organ ultrasound findings, clinical context, and serial monitoring to enhance diagnostic accuracy and patient outcomes. Mastery of LUS interpretation in complex scenarios is crucial to delivering personalized, high-quality care in the home setting. Full article

(This article belongs to the Special Issue Clinical Diagnosis and Management in Emergency and Hospital Medicine)

► Show Figures

Figure 1

11 pages, 2429 KiB

Open AccessArticle

Advancing Meibography Assessment and Automated Meibomian Gland Detection Using Gray Value Profiles

by Riccardo Forni, Ida Maruotto, Anna Zanuccoli, Riccardo Nicoletti, Luca Trimigno, Matteo Corbellino, Sònia Travé-Huarte, Giuseppe Giannaccare and Paolo Gargiulo

Diagnostics 2025, 15(10), 1199; https://doi.org/10.3390/diagnostics15101199 - 9 May 2025

Abstract

Objective: This study introduces a novel method for the automated detection and quantification of meibomian gland morphology using gray value distribution profiles. The approach addresses limitations in traditional manual and deep learning-based meibography analysis, which are often time-consuming and prone to variability. [...] Read more.

Objective: This study introduces a novel method for the automated detection and quantification of meibomian gland morphology using gray value distribution profiles. The approach addresses limitations in traditional manual and deep learning-based meibography analysis, which are often time-consuming and prone to variability. Methods: This study enrolled 100 volunteers (mean age 40 ± 16 years, range 18–85) who suffered from dry eye and responded to the Ocular Surface Disease Index questionnaire for scoring ocular discomfort symptoms and infrared meibography for capturing imaging of meibomian glands. By leveraging pixel brightness variations, the algorithm provides real-time detection and classification of long, medium, and short meibomian glands, offering a quantitative assessment of gland atrophy. Results: A novel parameter, namely “atrophy index”, a quantitative measure of gland degeneration, is introduced. Atrophy index is the first instrumental measurement to assess single- and multiple-gland morphology. Conclusions: This tool provides a robust, scalable metric for integrating quantitative meibography into clinical practice, making it suitable for real-time screening and advancing the management of dry eyes owing to meibomian gland dysfunction. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Prognosis of Eye Diseases)

► Show Figures

Figure 1

11 pages, 2668 KiB

Open AccessArticle

Early Dynamics of Circulating Tumor DNA Following Curative Hypofractionated Radiotherapy Related to Disease Control in Lung Cancer

by Kyungmi Yang, Jae Myoung Noh, Yeon Jeong Kim and Hongryull Pyo

Diagnostics 2025, 15(10), 1198; https://doi.org/10.3390/diagnostics15101198 - 9 May 2025

Abstract

Background/objectives: We aimed to characterize the dynamic pattern of circulating tumor DNA (ctDNA) during hypofractionated radiation therapy (RT) in patients with lung cancer and assess its clinical relevance. Metholds: Prospectively, 24 patients diagnosed with early-stage lung cancer underwent curative RT with 60–64 Gy [...] Read more.

Background/objectives: We aimed to characterize the dynamic pattern of circulating tumor DNA (ctDNA) during hypofractionated radiation therapy (RT) in patients with lung cancer and assess its clinical relevance. Metholds: Prospectively, 24 patients diagnosed with early-stage lung cancer underwent curative RT with 60–64 Gy in 4–20 fractions. Blood samples were collected at baseline (D0) and on post-RT days 1–3 and 7 (D1–3 and D7). The ctDNA was longitudinally analyzed using LiquidSCAN. To find a feasible index associated with outcome, total VAF(%), max VAF(%), total GE (hGE/mL) and max GE (hGE/mL), were evaluated. Results: Thirteen patients with available samples were analyzed with a median 22.2-month follow-up (range, 5.2–34.3 months). Four patients experienced progression between 7.9 and 16.6 months after RT (PD group), and the nine presented no evidence of disease (NED group). The Dmax, the day with the highest ctDNA level among D0–7, was significantly different between the groups with total GE and max GE (p = 0.035 and 0.021, respectively). According to the ROC curves, the max GE showed the best AUC (86.1%) and the cut-off value of the Dmax was 1.5 (sensitivity: 66.7%, specificity: 100%, positive-predictive value: 100%, and negative-predictive value: 57.1%). Tumor size ≥ 3 cm, squamous histology, and a daily dose 3–4 Gy were correlated with the Dmax = D2–3. The Dmax showed better disease control rate with marginal significance (p = 0.081). Conclusions: The timing of early ctDNA elevation may have the potential to predict RT response. The max GE may be an index to verify the ctDNA levels after RT. Full article

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

► Show Figures

Figure 1

12 pages, 626 KiB

Open AccessArticle

Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study

by Gabriel Viana Silva, Carolina Toledo Gontijo, Ana Paola Cruz Lunguinho, Mário Sérgio Gomes Caetano, Gustavo Yano Callado, Edward Araujo Júnior and Alberto Borges Peixoto

Diagnostics 2025, 15(10), 1197; https://doi.org/10.3390/diagnostics15101197 - 9 May 2025

Abstract

Objective: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. Methods: This was a retrospective cohort study that analyzed the medical records of pregnant women from [...] Read more.

Objective: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. Methods: This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC. Singleton pregnancies ≥ 37 weeks were included, excluding fetal malformations, chromosomal anomalies, and cases with missing data and cord blood gas. Results: Of the 3364 medical records analyzed, 466 were included—366 without and 100 with an NC. Among the cases with an NC, 91% had one loop and 9% had ≥ two loops; 82% were loose and 18% were tight. Pregnant women with an NC had a higher gestational age (39.7 vs. 39.1 weeks, p = 0.006), fewer deliveries (1.0 vs. 2.0, p = 0.035), and a higher prevalence of cesarean sections (99% vs. 60.4%, p < 0.001). An NC was associated with a lower Apgar score at the 1st minute (8 vs. 9, p = 0.014) and higher arterial cord blood pH (7.27 vs. 7.24, p = 0.020). The presence of a tight cord was significantly associated with a 7.52-fold increased risk of an Apgar score < 7 at the 1st minute [x²(1) = 5.92, OR: 7.52, 95% CI: 1.51–37.31, R² Nagelkerke: 0.14, p = 0.014]. Conclusions: There was no effect of the presence of an NC on adverse perinatal outcomes. However, the presence of a tight NC was associated with an increased risk of an Apgar score < 7 at the 1st minute, but no other effect on neonatal outcomes. Full article

(This article belongs to the Special Issue Diagnosis and Factors Associated with Perinatal Health, 2nd Edition)

► Show Figures

Figure 1

2 pages, 136 KiB

Open AccessEditorial

Editorial for “Latest Advances in Diagnosis and Management of Skin Cancer”

by Shi Huan Tay and Choon Chiat Oh

Diagnostics 2025, 15(10), 1196; https://doi.org/10.3390/diagnostics15101196 - 9 May 2025

Abstract

The rising global incidence of skin cancer has established this disease as a critical public health issue [...] Full article

(This article belongs to the Special Issue Latest Advances in Diagnosis and Management of Skin Cancer)

11 pages, 643 KiB

Open AccessArticle

Evaluation of Retinal and Optic Nerve Parameters in Recovered COVID-19 Patients: Potential Neurodegenerative Impact on the Ganglion Cell Layer

by Muhammet Kaim, Muhammet Bahattin Kır, Feyzahan Uzun and Hüseyin Findik

Diagnostics 2025, 15(10), 1195; https://doi.org/10.3390/diagnostics15101195 - 9 May 2025

Abstract

Background/Objectives: This study aimed to analyze optic nerve parameters, retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and subfoveal choroidal thickness (ChT) in patients who have recovered from coronavirus disease 2019 (COVID-19). Methods: This comparative study included 78 recovered COVID-19 [...] Read more.

Background/Objectives: This study aimed to analyze optic nerve parameters, retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and subfoveal choroidal thickness (ChT) in patients who have recovered from coronavirus disease 2019 (COVID-19). Methods: This comparative study included 78 recovered COVID-19 patients (16 men, 62 women) and 56 age- and sex-matched healthy controls (18 men, 38 women). COVID-19 was confirmed in all patients, either through the detection of viral RNA in nasopharyngeal swabs via reverse transcriptase polymerase chain reaction or by serological testing for SARS-CoV-2 antibodies. Spectral-domain optical coherence tomography (SD-OCT) was used to assess optic nerve parameters, RNFLT, GCLT, and ChT. Results: The mean age was 35.0 ± 8.3 years in the COVID-19 group and 31.5 ± 8.3 years in the control group, with no statistically significant differences in age or sex distribution between groups (p = 0.41 and p = 0.16, respectively). Optic nerve parameters and RNFLT (overall and across the four peripapillary quadrants) did not differ significantly between the COVID-19 and control groups. However, the mean ganglion cell–inner plexiform layer (GC-IPL) thickness was significantly reduced in all quadrants in the COVID-19 group compared to the controls. No significant difference was observed in mean subfoveal ChT between groups. Conclusions: A significant reduction in ganglion GCLT was observed in recovered COVID-19 patients compared to healthy controls, suggesting a potential neurodegenerative effect of the disease on the optic nerve. Full article

(This article belongs to the Special Issue Optical Coherence Tomography in Diagnosis of Ophthalmology Disease)

► Show Figures

Figure 1

20 pages, 28517 KiB

Open AccessArticle

Deep Learning-Assisted Diagnostic System: Implant Brand Detection Using Improved IB-YOLOv10 in Periapical Radiographs

by Yuan-Jin Lin, Shih-Lun Chen, Ya-Cheng Lu, Xu-Ming Lin, Yi-Cheng Mao, Ming-Yi Chen, Chao-Shun Yang, Tsung-Yi Chen, Kuo-Chen Li, Wei-Chen Tu, Patricia Angela R. Abu and Chiung-An Chen

Diagnostics 2025, 15(10), 1194; https://doi.org/10.3390/diagnostics15101194 - 8 May 2025

Abstract

Background and Objectives: Implant brand identification is critical in modern dental clinical diagnostics. With the increasing variety of implant brands and the difficulty of accurate identification in periapical radiographs, there is a growing demand for automated solutions. This study aims to leverage [...] Read more.

Background and Objectives: Implant brand identification is critical in modern dental clinical diagnostics. With the increasing variety of implant brands and the difficulty of accurate identification in periapical radiographs, there is a growing demand for automated solutions. This study aims to leverage deep learning techniques to assist in dental implant classification, providing dentists with an efficient and reliable tool for implant brand detection. Methods: We proposed an innovative implant brand feature extraction method with multiple image enhancement techniques to improve implant visibility and classification accuracy. Additionally, we introduced a PA resolution enhancement technique that utilizes Dark Channel Prior and Lanczos interpolation for image resolution upscaling. Results: We evaluated the performance differences among various YOLO models for implant brand detection. Additionally, we analyzed the impact of implant brand feature extraction and PA resolution enhancement techniques on YOLO’s detection accuracy. Our results show that IB-YOLOv10 achieves a 17.8% accuracy improvement when incorporating these enhancement techniques compared to IB-YOLOv10 without enhancements. In real-world clinical applications, IB-YOLOv10 can classify implant brands in just 6.47 ms per PA, significantly reducing diagnostic time. Compared to existing studies, our model improves implant detection accuracy by 2.3%, achieving an overall classification accuracy of 94.5%. Conclusions: The findings of this study demonstrate that IB-YOLOv10 effectively reduces the diagnostic burden on dentists while providing a fast and reliable implant brand detection solution, improves clinical efficiency, and establishes a robust deep learning approach for automated implant detection in PA. Full article

(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)

► Show Figures

Figure 1

14 pages, 1313 KiB

Open AccessCase Report

Various Phenotypes of Ectopic Pancreatic Tissue in Children: Case Series and Literature Review

by Elena Roxana Matran, Andra-Mihaela Diaconu, Oana Neagu and Alexandru-Ioan Ulmeanu

Diagnostics 2025, 15(10), 1193; https://doi.org/10.3390/diagnostics15101193 - 8 May 2025

Abstract

Background/Objectives: Ectopic pancreatic tissue (EPT), an infrequently documented condition within the pediatric population, is often asymptomatic. When clinical manifestations do occur, their severity is contingent upon the location, size, and involvement of the adjacent mucosa. Methods: This is a case series [...] Read more.

Background/Objectives: Ectopic pancreatic tissue (EPT), an infrequently documented condition within the pediatric population, is often asymptomatic. When clinical manifestations do occur, their severity is contingent upon the location, size, and involvement of the adjacent mucosa. Methods: This is a case series study, involving children aged 15 days–13 years diagnosed with EPT from a single institution. Results: Six cases of EPT were identified. Five of the six cases presented with both EPT and ectopic gastric tissue, located at the site of Meckel’s diverticulum, while one case presented EPT exclusively, which was localized in the duodenum I. A case of Littre’s hernia was identified in a newborn. Two of the six cases experienced gastrointestinal bleeding. Conclusions: The identification of EPT continues to pose a diagnostic challenge, as the symptoms are nonspecific and can sometimes be life-threatening. Additionally, there are currently no specific paraclinical investigations available for this purpose. Full article

(This article belongs to the Special Issue Diagnosis of Hepatobiliary and Pancreatic Diseases)

► Show Figures

Figure 1

14 pages, 586 KiB

Open AccessArticle

[18F]-FDG PET-CT in Malignant Melanoma

by Teodora Sidonia Mititelu, Mihaela Raluca Mititelu, Sandica Bucurica and Daniel Octavian Costache

Diagnostics 2025, 15(10), 1192; https://doi.org/10.3390/diagnostics15101192 - 8 May 2025

Abstract

Background/Objectives: Malignant melanoma (MM) is an aggressive neoplasm with a rising global incidence. Accurate staging and risk stratification are essential for guiding therapeutic decisions and improving patient prognosis. [18F]-FDG PET-CT enables the non-invasive assessment of tumor metabolic activity, offering a valuable adjunct [...] Read more.

Background/Objectives: Malignant melanoma (MM) is an aggressive neoplasm with a rising global incidence. Accurate staging and risk stratification are essential for guiding therapeutic decisions and improving patient prognosis. [18F]-FDG PET-CT enables the non-invasive assessment of tumor metabolic activity, offering a valuable adjunct to histopathological evaluation. However, the correlation between PET-CT findings and established prognostic markers in MM, such as Breslow thickness, ulceration, and mitotic rate, remains insufficiently explored. Methods: This retrospective observational study included 61 patients diagnosed with MM, of whom 48 met the inclusion criteria. Quantitative and qualitative variables such as SULmax, Breslow thickness, Ki-67 expression, and mitotic rate were analyzed using descriptive statistics, while correlations between PET-CT findings, SLNB, and histopathological characteristics were assessed using Spearman’s correlation test. A p-value < 0.05 was considered statistically significant. Results: Significant associations were identified between ulceration and both overall metastases (p = 0.01) and pulmonary metastases (p = 0.02). Breslow thickness showed a positive correlation with metastatic spread (p = 0.01), reinforcing its role as a key prognostic indicator. Perineural and vascular invasion were significantly associated with intra-abdominal metastases (p < 0.001 and p = 0.0007, respectively). Tumor-infiltrating lymphocytes (TILs) were inversely correlated with intra-abdominal metastases (p = 0.05), while sentinel lymph node positivity correlated with the presence of regional (p = 0.008) and distant (p = 0.02) metastases. Additionally, subcutaneous SULmax values were significantly higher in male patients compared to females (p = 0.04). Conclusions: Integrating PET-CT metabolic parameters with histopathological markers enhances the assessment of MM aggressiveness and metastatic potential. By refining risk stratification, PET-CT may contribute to personalized therapeutic strategies and improved patient management in MM. Full article

(This article belongs to the Special Issue Applications of PET/CT in Clinical Diagnostics)

► Show Figures

Figure 1

Journal Description

Diagnostics

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI