Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.9
3.3
Journals
Diagnostics
Editor’s Choice
share announcement

Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Order results
Result details
Results per page
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
15 pages, 966 KB  
Article
Long-Term Cardiovascular and Mortality Risk in Patients with Pre-Existing Arrhythmia Post-SARS-CoV-2 Infection
by Suhani Pahuja, Roham Hadidchi, Janhavi Tonge, Sonya Henry and Tim Q. Duong
Diagnostics 2026, 16(1), 38; https://doi.org/10.3390/diagnostics16010038 - 22 Dec 2025
Viewed by 693
Abstract
Background/Objectives: Individuals with arrhythmia who survived COVID-19 could be susceptible to long-term cardiovascular complications and clinical outcomes. Methods: We performed a retrospective cohort study of adults with a history of arrhythmia in the Montefiore Health System (1 January 2016–17 August 2024). COVID-19 status [...] Read more.
Background/Objectives: Individuals with arrhythmia who survived COVID-19 could be susceptible to long-term cardiovascular complications and clinical outcomes. Methods: We performed a retrospective cohort study of adults with a history of arrhythmia in the Montefiore Health System (1 January 2016–17 August 2024). COVID-19 status was determined by a positive or negative polymerase-chain-reaction test. Outcomes included all-cause mortality, first-time myocardial infarction (MI), heart failure (HF), ischemic or hemorrhagic stroke, and major adverse cardiovascular events (MACE: defined as MI, HF, stroke, or death) > 30 days post-index date. Cox proportional hazards and Fine–Gray competing risk models, adjusted for demographic, clinical, socioeconomic, and COVID-19 vaccination variables, were employed. The association of outcomes with blood biomarkers taken at time of infection were also assessed in hospitalized COVID-19 patients. Results: Among the 6830 arrhythmia patients, 985 were hospitalized for COVID-19, 1591 were not hospitalized for COVID-19, and 4254 did not have COVID-19. Patients hospitalized for COVID-19 had a higher risk of all-cause mortality (adjusted hazard ratio = 2.90, 95% confidence-interval [2.08, 4.04]), first-time MI, HF, and MACE compared to controls without COVID-19. No increased risk was observed among non-hospitalized COVID-19-positive patients compared to controls, except for all-cause mortality. Older age, male sex, Medicaid, and significant comorbidities were associated with the risk of MACE. Elevated levels of creatinine, lactate dehydrogenase, D-dimer, neutrophil-to-lymphocyte ratio, low hemoglobin, and low left ventricular ejection fraction during infection were associated with higher future MACE risk. Conclusions. In individuals with arrhythmia, severe COVID-19 is associated with increased long-term risks of mortality and new-onset cardiovascular complications, while mild infection with mortality risk. These findings highlight the need for long-term cardiovascular monitoring in this population. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Heart Disease, 2nd Edition)
►▼ Show Figures

Figure 1

14 pages, 2196 KB  
Article
Prospective, Multicentre Feasibility Study of Remote Colon Capsule Endoscopy Using the OMOM CC100 System
by Alexandra Agache, Ervin Toth, Niels Qvist, Miguel Mascarenhas, Wojciech Marlicz, Benedicte Schelde-Olesen, Miguel Mascarenhas-Saraiva, Maria Marlicz, Gabriele Wurm Johansson, Artur Nemeth and Anastasios Koulaouzidis
Diagnostics 2026, 16(1), 20; https://doi.org/10.3390/diagnostics16010020 - 20 Dec 2025
Viewed by 824
Abstract
Background and Aims: Colon capsule endoscopy (CCE) provides a non-invasive alternative to traditional colonoscopy. This study evaluated the feasibility, safety, diagnostic yield (DY), and patient satisfaction of the OMOM CC100 CCE system, with special focus on fully remote (n = 30) and [...] Read more.
Background and Aims: Colon capsule endoscopy (CCE) provides a non-invasive alternative to traditional colonoscopy. This study evaluated the feasibility, safety, diagnostic yield (DY), and patient satisfaction of the OMOM CC100 CCE system, with special focus on fully remote (n = 30) and partially remote (n = 89) administration across four centres to advance decentralised models. Methods: This prospective, investigator-initiated, international multicentre feasibility study enrolled 119 patients aged 18–75 years at centres in Denmark, Sweden, Portugal, and Poland from July 2024 to May 2025. Indications included rectal bleeding, iron-deficiency anaemia, a positive faecal immunochemical test, changes in bowel habit, suspected inflammatory bowel disease (IBD), post-polypectomy or colorectal cancer (CRC) surgery surveillance, and a family history of CRC. The OMOM CC100 capsule was employed with a standardised bowel preparation regimen. Administration was fully remote in Denmark using the IntelliGI™ platform and partially remote (clinic ingestion, home completion) at the other sites. Primary outcomes encompassed procedure feasibility, completion rate (capsule excretion or anal verge visualisation), bowel cleanliness (Leighton-Rex scale ≥ 3), diagnostic yield, and patient satisfaction. Secondary measures included transit times, adverse events, and technical failures. Results: Median age was 55.7 years (65 males, 54 females). Overall completion rate was 79%, varying by centre: Sweden (90%), Portugal (81%), Denmark (80%), and Poland (63%). Adequate bowel cleanliness was achieved in 71% of cases. Diagnostic findings included polyps (25 patients), angioectasia (20), diverticulosis (17), and mucosal inflammation (17); 42% were normal. Fully remote administration yielded 80% completion and 89.7% satisfaction. No serious adverse events occurred; overall satisfaction was 81%, with 87% preferring home-based procedures. Conclusions: The OMOM CC100 CCE system is feasible, safe, with DY comparable to established systems. IntelliGI™-enabled remote administration promotes decentralised care, enhancing accessibility. Full article
(This article belongs to the Special Issue New Advances in Digestive Endoscopy)
►▼ Show Figures

Figure 1

13 pages, 826 KB  
Article
Risks of Stroke and Transient Cerebral Ischemia up to 4 Years Post-SARS-CoV-2 Infection in Large Diverse Urban Population in the Bronx
by Sagar Changela, Roham Hadidchi, Aditi Vichare, Liora Rahmani, Sonya Henry and Tim Q. Duong
Diagnostics 2025, 15(24), 3183; https://doi.org/10.3390/diagnostics15243183 - 13 Dec 2025
Viewed by 2510
Abstract
Background: SARS-CoV-2 infection could trigger hypercoagulation and hyperinflammation that may predispose patients to cerebrovascular events. The long-term risk of stroke among COVID-19 patients remains unclear. This study investigated the long-term risks of ischemic stroke and transient cerebral ischemia (TCI) among patients with and [...] Read more.
Background: SARS-CoV-2 infection could trigger hypercoagulation and hyperinflammation that may predispose patients to cerebrovascular events. The long-term risk of stroke among COVID-19 patients remains unclear. This study investigated the long-term risks of ischemic stroke and transient cerebral ischemia (TCI) among patients with and without COVID-19. Methods: We conducted an observational cohort study in the Montefiore Health System (February 2020–January 2024), with 52,117 COVID+ and 837,395 COVID− patients without prior cerebrovascular events. Demographics, comorbidities, insurance, unmet social needs, and median income were adjusted for using inverse probability weighting. Cox-proportional regression hazard ratios (HR) and their 95% confidence intervals were computed for ischemic stroke and TCI. Results: Compared to COVID− controls, ischemic stroke risk was higher among hospitalized COVID+ patients (HR = 1.32 [1.12–1.55]) and non-hospitalized COVID+ patients (1.21 [1.05–1.39]). Compared to COVID− controls, TCI risk was similar among hospitalized COVID+ patients (1.00 [0.75–1.33]), but higher among non-hospitalized COVID+ patients (2.15 [1.81–2.56]). Conclusions: Hospitalized and non-hospitalized COVID-19 patients had a higher long-term risk of ischemic stroke while only non-hospitalized COVID-19 patients had a higher long-term risk of TCI. These findings underscore the needs for long-term monitoring of cerebrovascular risk factors in COVID-19 survivors. Full article
(This article belongs to the Special Issue Neurological Diseases: Biomarkers, Diagnosis and Prognosis)
►▼ Show Figures

Figure 1

15 pages, 915 KB  
Article
Executive Functions and Subjective Cognitive Decline: The Moderating Role of Depressive Symptoms
by Marina Maffoni, Annalisa Magnani, Antonia Pierobon, Alessandra Mafferra, Fabrizio Pasotti, Carlo Dallocchio, Valeria Torlaschi, Daniela Mancini and Cira Fundarò
Diagnostics 2025, 15(24), 3164; https://doi.org/10.3390/diagnostics15243164 - 11 Dec 2025
Viewed by 823
Abstract
Background: Executive dysfunction may be an early marker of neurodegenerative disorders, even if it is difficult to detect objectively. Subjective cognitive decline (SCD) may reflect subtle deficits in executive functions (EFs); however, SCD is also strongly influenced by affective factors such as [...] Read more.
Background: Executive dysfunction may be an early marker of neurodegenerative disorders, even if it is difficult to detect objectively. Subjective cognitive decline (SCD) may reflect subtle deficits in executive functions (EFs); however, SCD is also strongly influenced by affective factors such as depression. Whether depressive symptoms alter the link between EFs and SCD remains unclear. The present study tested whether depressive symptoms moderate the association between executive functioning and SCD. Methods: In this cross-sectional study, 65 outpatients completed a comprehensive assessment including executive functions (FAB), self-reported cognitive difficulties (CFI self-report), and depressive symptoms (PHQ-9). Descriptive statistics were performed, as well as a moderation analysis using PHQ-9 as moderator of the relationship between FAB and CFI self-report. Results: Participants (age: 69.28 ± 9.03) showed preserved EFs (FAB = 15.42, SD = 2.11), mild depressive symptoms (PHQ-9 = 6.57, SD = 5.02), and modest subjective difficulties (CFI = 4.87, SD = 2.57). The FAB main effect was positive but non-significant (β = 0.155, p = 0.266), while PHQ-9 was a significant positive predictor (β = 0.470, p ≤ 0.001). The interaction effect was significant (95% CI: [−0.166, −0.015], β = −0.343, p = 0.020). Specifically, simple slope analysis showed that at low levels of depression (−1 SD), better executive functioning was associated with higher SCD (β = 0.498, p = 0.039). Instead, the association was negative but non-significant at moderate (β = 0.155, p = 0.266) and high levels of depression (+1 SD) (β = −0.188, p = 0.229). Conclusions: In SCD, depressive symptoms are a stronger correlate of subjective cognitive difficulties than executive functions. Moreover, higher depression may modulate the executive functions–complaint link, reducing and potentially reversing it as symptom burden increases. Screening and treatment of depressive symptoms should be integrated into SCD assessment and care. Longitudinal and multicenter studies are needed to more deeply understand these preliminary results. Full article
(This article belongs to the Special Issue Subjective Experiences of Decline and Dementia Risk: Cognitive, Functional, and Emotional Predictors of Cognitive Decline)
►▼ Show Figures

Figure 1

25 pages, 4011 KB  
Review
MRI of the Scrotum and Penis: Current Applications and Clinical Relevance
by Bartosz Regent, Karolina Nowak, Katarzyna Skrobisz, Marcin Matuszewski and Michał Studniarek
Diagnostics 2025, 15(24), 3134; https://doi.org/10.3390/diagnostics15243134 - 9 Dec 2025
Viewed by 1675
Abstract
Background: Magnetic resonance imaging (MRI) plays an increasingly important role in the evaluation of scrotal and penile disorders, complementing ultrasonography in cases where findings are equivocal or complex. With its superior soft-tissue contrast, multiplanar capability, and advanced functional sequences, MRI provides unparalleled anatomic [...] Read more.
Background: Magnetic resonance imaging (MRI) plays an increasingly important role in the evaluation of scrotal and penile disorders, complementing ultrasonography in cases where findings are equivocal or complex. With its superior soft-tissue contrast, multiplanar capability, and advanced functional sequences, MRI provides unparalleled anatomic and tissue characterization across a wide range of male genital pathologies. Summary: This review summarizes current clinical applications of MRI in scrotal and penile imaging and discusses its diagnostic value, protocol optimization, and interpretive features. In scrotal pathology, MRI accurately differentiates torsion, trauma, infection, and neoplasms, aiding in the distinction between benign and malignant testicular lesions and supporting testis-sparing management. Quantitative diffusion and perfusion metrics further refine lesion characterization. In andrology, MRI biomarkers such as apparent diffusion coefficient (ADC), magnetization transfer ratio (MTR), and proton spectroscopy serve as promising non-invasive indicators of spermatogenic activity in male infertility. In penile imaging, MRI enables precise local staging of carcinoma, assessment of plaque morphology and activity in Peyronie’s disease, evaluation of tissue viability in priapism, and detection of prosthesis-related complications. Conclusions: MRI has become an essential problem-solving tool in the assessment of scrotal and penile diseases, enhancing diagnostic confidence and surgical planning. Future directions include protocol standardization, quantitative parameter validation, and the integration of radiomics and artificial intelligence to improve reproducibility and clinical impact. Full article
(This article belongs to the Special Issue Innovations in Medical Imaging for Precision Diagnostics)
►▼ Show Figures

Figure 1

18 pages, 3614 KB  
Article
Post-Surgical Reassessment of Breast Cancer IHC: Concordance, Δ-Metrics, and Treatment-Relevant Reclassification
by Ramona Andreea Cioroianu, Michael Schenker, Tradian Ciprian Berisha, Virginia-Maria Rădulescu, George Ovidiu Cioroianu, Raluca Chirculescu, Ana Maria Petrescu, Mihaela Popescu, Anda Lorena Dijmărescu and Stelian Ștefăniță Mogoantă
Diagnostics 2025, 15(24), 3128; https://doi.org/10.3390/diagnostics15243128 - 9 Dec 2025
Viewed by 482
Abstract
Background/Objectives: Immunohistochemical (IHC) profiles assessed on core biopsies guide initial therapy in breast cancer; however, paired changes between biopsy and surgical specimens may alter treatment pathways. We aimed to quantify paired biomarker dynamics (ER, PR, HER2, Ki-67) and the proportion of patients [...] Read more.
Background/Objectives: Immunohistochemical (IHC) profiles assessed on core biopsies guide initial therapy in breast cancer; however, paired changes between biopsy and surgical specimens may alter treatment pathways. We aimed to quantify paired biomarker dynamics (ER, PR, HER2, Ki-67) and the proportion of patients undergoing clinically actionable reclassification. Methods: We conducted a single-center retrospective study of 79 patients with paired pre- and post-surgical IHC for ER, PR, HER2 (0/1+/2+/3+ with reflex ISH for 2+), and Ki-67 (20% cut-off). Paired categorical shifts were tested with McNemar’s test; agreement was quantified using Cohen’s κ (95% CI); and multivariable logistic regression examined correlates of neoadjuvant chemotherapy (NACT). Two-sided p < 0.05 denoted statistical significance. Results: Post-surgical reassessment showed measurable conversions: PR-negative increased from 15.19% to 27.85%, while PR-positive decreased 84.81%→72.15%; HER2 3+ contracted 11.39%→6.33% with a parallel rise in 2+ (equivocal) 17.72%→24.05%; Ki-67 < 20% rose 37.97%→56.96%, whereas the >30% category was absent post-surgery. McNemar tests indicated significant paired shifts for PR (p = 0.016) and Ki-67 (p = 0.009); agreement was substantial for ER (κ = 0.70) and lower for PR (κ = 0.49), HER2 (κ = 0.43), and Ki-67 (κ = 0.29). High proliferation (Ki-67 ≥ 20%) independently predicted NACT (OR = 4.36, 95% CI 1.48–12.80). Conclusions: Paired IHC reassessment from biopsy to surgery reveals biomarker conversions that can reclassify therapeutic eligibility (e.g., anti-HER2 candidacy, endocrine strategies). These data support selective confirmation of IHC on resection specimens in routine practice and provide Δ-metrics to inform decision-making; external validation in prospective cohorts is warranted. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
►▼ Show Figures

Figure 1

18 pages, 361 KB  
Review
Clinical Benefits and Limitations of Cone-Beam Computed Tomography in Endodontic Practice: A Contemporary Evidence-Based Review
by Jasmine Wong, Chengfei Zhang and Angeline Hui Cheng Lee
Diagnostics 2025, 15(24), 3117; https://doi.org/10.3390/diagnostics15243117 - 8 Dec 2025
Viewed by 1836
Abstract
Cone-beam computed tomography (CBCT) has transformed endodontic practice by enabling more precise diagnosis and treatment of pulpal and apical pathologies. The aim of this review was to summarize the current clinical applications, benefits and limitations of CBCT in endodontic practice. A search of [...] Read more.
Cone-beam computed tomography (CBCT) has transformed endodontic practice by enabling more precise diagnosis and treatment of pulpal and apical pathologies. The aim of this review was to summarize the current clinical applications, benefits and limitations of CBCT in endodontic practice. A search of electronic databases identified relevant literature on CBCT applications, innovations, and limitations. Emphasis was placed on identifying contemporary studies published in the last 5 years. In general, CBCT demonstrates better diagnostic efficacy across multiple applications, including identifying complex anatomy, detection of apical periodontitis, pre-surgical planning and the diagnosis and management of longitudinal root fractures, traumatic dental injuries and root resorptions. However, clinicians should balance the benefits of CBCT against its shortcomings, such as increased radiation exposure, presence of artifacts and higher costs. Proper use requires adherence to guidelines, optimized machine settings, and interpretation by trained individuals. Recent research explores the integration of CBCT with emerging technologies like artificial intelligence and guided systems. In summary, CBCT remains an essential tool for clinical decision-making in endodontics when used judiciously, with ongoing research continuing to expand its potential applications. Full article
(This article belongs to the Special Issue Application of Cone Beam Computed Tomography for Maxillofacial Diseases, Third Edition)
26 pages, 5565 KB  
Article
Explainable Federated Learning for Multi-Class Heart Disease Diagnosis via ECG Fiducial Features
by Tanjila Alam Sathi, Rafsan Jany, AKM Azad, Salem A. Alyami, Naif Alotaibi, Iqram Hussain and Md Azam Hossain
Diagnostics 2025, 15(24), 3110; https://doi.org/10.3390/diagnostics15243110 - 7 Dec 2025
Viewed by 666
Abstract
Background/Objectives: Cardiovascular disease (CVD) remains a leading cause of mortality and disability worldwide, with timely diagnosis critical for preventing long-term functional impairment. Electrocardiograms (ECGs) provide essential biomarkers of cardiac function, but their interpretation is often complex, particularly across multi-institutional datasets. Methods: This study [...] Read more.
Background/Objectives: Cardiovascular disease (CVD) remains a leading cause of mortality and disability worldwide, with timely diagnosis critical for preventing long-term functional impairment. Electrocardiograms (ECGs) provide essential biomarkers of cardiac function, but their interpretation is often complex, particularly across multi-institutional datasets. Methods: This study presents an explainable federated learning framework with long short-term memory (FL-LSTM) for multi-class heart disease classification, capable of distinguishing arrhythmia, ischemia, and healthy states while preserving patient privacy. Results: The model was trained and evaluated on three heterogeneous ECG datasets, achieving 92% accuracy, 99% AUC, and 91% F1 score, outperforming existing federated approaches. Model interpretability is provided via SHapley Additive exPlanations (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME), highlighting clinically relevant ECG biomarkers such as P-wave height, R-wave height, QRS complex, RR interval, and QT interval. Conclusions: By integrating temporal modeling, federated learning, and interpretable AI, the framework enables secure and collaborative cardiac diagnosis while supporting transparent clinical decision-making in distributed healthcare settings. Full article
(This article belongs to the Special Issue AI and Digital Health for Disease Diagnosis and Monitoring, 2nd Edition)
►▼ Show Figures

Figure 1

12 pages, 808 KB  
Article
Lung Ultrasound Offers Fast and Reliable Exclusion of Heart Failure in the Emergency Department: A Prospective Diagnostic Study
by Adis Keranović, Katja Kudrna Prašek and Ivan Gornik
Diagnostics 2025, 15(24), 3100; https://doi.org/10.3390/diagnostics15243100 - 6 Dec 2025
Viewed by 841
Abstract
Background/Objectives: Acute dyspnea is a common and urgent presentation in the emergency department, with acute heart failure (AHF) as one of its leading causes. Rapid differentiation between AHF and other etiologies is essential. Methods: This study aimed to evaluate the diagnostic [...] Read more.
Background/Objectives: Acute dyspnea is a common and urgent presentation in the emergency department, with acute heart failure (AHF) as one of its leading causes. Rapid differentiation between AHF and other etiologies is essential. Methods: This study aimed to evaluate the diagnostic accuracy of lung ultrasound (LUS) and compare it to chest X-ray (CXR) and NT-proBNP accuracy in patients with acute dyspnea, and to assess the potential of LUS for fast bedside diagnosis. This prospective study included 242 adult patients presenting with acute dyspnea of ≤3 days’ duration. All underwent NT-proBNP testing, CXR, and LUS according to a standardized protocol. The final diagnosis was established by experienced clinicians using all available clinical, laboratory, and imaging data, blinded to the LUS results. Diagnostic performance measures of LUS, CXR, and NT-proBNP were evaluated, and examination times of LUS and CXR were compared. Results: LUS achieved the highest sensitivity (95.3%) and negative predictive value (90.8%) for AHF, outperforming NT-proBNP (87.5%, 74.2%) and CXR (84.4%, 79.0%). CXR showed the highest specificity (65.8%) and positive predictive value (73.5%), while LUS specificity was moderate (51.8%). The LUS results were available significantly faster (median 10.0 min) than CXR (median 62.5 min). Conclusions: LUS demonstrated diagnostic accuracy comparable to CXR and NT-proBNP, with superior sensitivity, negative predictive value, and shorter time to results. These findings support its use as a rapid, non-invasive, first-line tool for excluding AHF in acute dyspnea patients. Full article
(This article belongs to the Special Issue Advances in Ultrasound)
►▼ Show Figures

Figure 1

25 pages, 373 KB  
Review
Rapid Molecular Diagnostics for MDR Nosocomial Infections in ICUs: Integration with Prevention, Stewardship, and Novel Therapies
by Karina Cristina Marin, Stelian Adrian Ritiu, Adelina Băloi, Claudiu Rafael Barsac, Dorel Sandesc, Marius Papurica, Alexandru Florin Rogobete, Daiana Toma, Mirela Tamara Porosnicu, Ciprian Gindac, Madalina Butaș and Ovidiu Horea Bedreag
Diagnostics 2025, 15(23), 3060; https://doi.org/10.3390/diagnostics15233060 - 30 Nov 2025
Viewed by 913
Abstract
Background/Objectives: Multidrug-resistant (MDR) nosocomial infections remain a major challenge in intensive care units (ICUs), where delays in diagnosis and suboptimal antimicrobial therapy significantly impact outcomes. This narrative review synthesizes international literature and local epidemiological data from Western Romania to examine the role [...] Read more.
Background/Objectives: Multidrug-resistant (MDR) nosocomial infections remain a major challenge in intensive care units (ICUs), where delays in diagnosis and suboptimal antimicrobial therapy significantly impact outcomes. This narrative review synthesizes international literature and local epidemiological data from Western Romania to examine the role of rapid molecular diagnostics in the management of MDR infections and their integration with prevention and antimicrobial stewardship (AMS) strategies. Methods: Evidence was collected through a narrative literature review using PubMed, WHO, and ECDC sources published between 2010 and 2025. Key terms included “rapid molecular diagnostics,” “sepsis,” “ICU,” “UNYVERO,” “GeneXpert,” “BioFire,” and “carbapenem resistance.” Studies were selected based on clinical relevance to rapid diagnostics and MDR pathogens; no PRISMA-based systematic methodology was applied. Results: Diagnostic performance varies by platform and clinical syndrome. UNYVERO Hospitalized Pneumonia panel demonstrates a sensitivity range of 88.8–91.4% and specificity of 94.9–99.5% in respiratory infections, with a turnaround time of approximately 4–5 h. The GeneXpert Carba-R assay identifies major carbapenemases within 45–60 min with reported sensitivity 96–100% and specificity of 93–99%. BioFire® Pneumonia and Blood Culture Identification panels similarly provide rapid syndromic results within 1 h, enabling earlier optimization of antimicrobial therapy. Local ICU data from Western Romania identified a substantial burden of carbapenem-resistant Acinetobacter baumannii, underscoring the need for rapid resistance detection to guide therapy. Conclusions: Rapid molecular diagnostics, when integrated with prevention bundles and AMS programs, facilitate earlier targeted therapy, support responsible antimicrobial use, and improve clinical decision-making in MDR infections. Their value is amplified in settings with high resistance prevalence. Wider implementation, combined with surveillance and access to novel antimicrobials, is essential to improve outcomes in critically ill patients. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
23 pages, 1166 KB  
Review
Recent Trend of Laboratory Tests in Common Gastrointestinal Tract Disorders
by Terence A. Agbor and Waliul I. Khan
Diagnostics 2025, 15(23), 2998; https://doi.org/10.3390/diagnostics15232998 - 26 Nov 2025
Viewed by 1577
Abstract
The gastrointestinal (GI) tract is a complex organ system affected by multiple disorders with diverse etiologies ranging from infections to immune dysfunction disorders and cancers. Various GI disorders, such as Helicobacter pylori infection, inflammatory bowel disease (IBD), celiac disease, irritable bowel syndrome (IBS), [...] Read more.
The gastrointestinal (GI) tract is a complex organ system affected by multiple disorders with diverse etiologies ranging from infections to immune dysfunction disorders and cancers. Various GI disorders, such as Helicobacter pylori infection, inflammatory bowel disease (IBD), celiac disease, irritable bowel syndrome (IBS), and colon cancer, are common and cause significant morbidity, mortality, and healthcare costs. These disorders present with overlapping signs and symptoms, warranting the need for accurate laboratory diagnostic tests for appropriate treatment implementation and treatment monitoring. The gold standard confirmatory diagnostic test for most GI disorders is endoscopy and biopsy for histological analysis. Biomarkers in blood and stool are also routinely used either as first-line screening tests or for treatment monitoring in many GI disorders. This review summarizes common GI disorders along with related currently used clinical laboratory tests in screening, diagnosis, and monitoring of these diseases, outlining the methodology, utilization, advantages, and limitations of these tests. We also highlight the effectiveness of each test as well as the professional recommendations and clinical guidelines for their use where available. Finally, we shed some light on potential future tests and biomarkers that aid in diagnosing GI disorders and how these biomarkers can be used in conjunction to complement the current tests. Some of the potential future biomarkers discussed include the differential expression of gut microbiota and their respective metabolites, as well as cytokines, as potential tests that can be used to diagnose diseases, distinguish between disease subtypes, predict disease severity and occurrence, and optimize treatment decisions. Comprehending the effectiveness of various methodologies for laboratory diagnosis of GI disorders is crucial for health care personnel, including clinical laboratory professionals and clinicians, regarding testing options, test utilization, and interpretations of results. Insights into future tests in GI diseases in the context of microbiomes, metabolites, and immune mediators based on advanced technology are also important in their appropriate clinical utilization. Full article
(This article belongs to the Special Issue Recent Advances in Clinical Biochemistry, 2nd Edition)
►▼ Show Figures

Figure 1

16 pages, 1850 KB  
Article
Comprehensive Evaluation of a Point-of-Care Testing Platform for Decentralized Primary Healthcare: Ensuring Analytical Quality Through Central Laboratory Oversight
by Giacomo Moretti, Francesca Danila Alcaro, Luigi Colacicco and Andrea Urbani
Diagnostics 2025, 15(23), 2977; https://doi.org/10.3390/diagnostics15232977 - 24 Nov 2025
Viewed by 581
Abstract
Background/Objectives: Point-of-care testing (POCT) is increasingly adopted in primary healthcare to facilitate rapid screening and monitoring of chronic conditions. Ensuring that its analytical quality is comparable to central laboratory testing is crucial for safe and effective implementation. This study aims to rigorously evaluate [...] Read more.
Background/Objectives: Point-of-care testing (POCT) is increasingly adopted in primary healthcare to facilitate rapid screening and monitoring of chronic conditions. Ensuring that its analytical quality is comparable to central laboratory testing is crucial for safe and effective implementation. This study aims to rigorously evaluate the analytical performance of the Allegro POCT system against established central laboratory reference methods to determine its suitability for decentralized healthcare settings. Methods: We assessed the correlation, concordance, and bias of glycated hemoglobin (HbA1c), glucose (GLUC), total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL), triglycerides (TRIG), creatinine (CREA), and C-reactive protein (CRP). Using a cohort of 100 residual patient samples, measurements from the Allegro POCT system were compared against reference methods on the Atellica CH 930 Analyzer and TOSOH G8 system. The statistical analysis was performed using Deming regression, Bland–Altman plots, and Pearson correlation. Results: HbA1c and GLUC demonstrated strong linearity and correlation (Pearson’s r = 0.9863 and r = 0.9994, respectively). A slight positive bias was noted for HbA1c at higher concentrations. In the lipid panel, CHOL showed a significant positive bias (mean bias +14.2 mg/dL), while TRIG exhibited a substantial negative bias (mean bias −37.0 mg/dL) and wide limits of agreement. HDL and CREA showed good linearity but only moderate agreement. CRP demonstrated excellent concordance with the reference method (Pearson’s r = 0.9955) and minimal bias. Conclusions: The Allegro system exhibits acceptable analytical performance for GLUC and CRP, rendering it suitable for decentralized use. HbA1c and CREA performance is adequate, though caution is advised due to observed biases. However, the significant biases for CHOL and TRIG underscore the indispensable role of central laboratory oversight in any POCT program. Rigorous initial validation and continuous quality monitoring under a robust governance framework are essential to ensure the reliability and clinical utility of POCT. Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
►▼ Show Figures

Figure 1

19 pages, 4353 KB  
Article
Genomic Characterization of Papillary Thyroid Carcinoma: Age Differences in Tumor Aggressiveness and Immune Infiltration
by Wei Ao, Shuqian Chen, Tenghong Liu, Bo Wang and Wenxin Zhao
Diagnostics 2025, 15(23), 2937; https://doi.org/10.3390/diagnostics15232937 - 21 Nov 2025
Viewed by 712
Abstract
Background: Adolescents and young adults (AYA) with papillary thyroid carcinoma (PTC) often present with more extensive cervical lymph node metastasis (LNM) than older adults (AD). We aimed to identify age-associated molecular and immune features that might explain this phenotype and to explore potential [...] Read more.
Background: Adolescents and young adults (AYA) with papillary thyroid carcinoma (PTC) often present with more extensive cervical lymph node metastasis (LNM) than older adults (AD). We aimed to identify age-associated molecular and immune features that might explain this phenotype and to explore potential translational implications for managing aggressive AYA PTC. Methods: We analyzed clinical and transcriptomic data from 501 PTC cases in The Cancer Genome Atlas (TCGA), stratified as AYA (<30 years, n = 64) and AD (≥30 years, n = 437). An institutional RNA-seq cohort (n = 13; 7 AYA, 6 AD) was used to screen for differentially expressed genes (DEGs). DEGs were defined by p ≤ 0.05 and |log2 fold change| ≥ 1. Intersection with invasion- and dissemination-related gene sets yielded a final age-related DEG list. Functional enrichment (GO/KEGG via DAVID), PPI network analysis (STRING, Cytoscape/cytoHubba), and immune deconvolution (CIBERSORT LM22) were performed. Protein-level validation was carried out by immunohistochemistry (IHC) in an independent cohort (n = 56; 28 AYA, 28 AD). Statistical comparisons used chi-square/Fisher’s exact tests for categorical variables, t-tests or nonparametric tests for continuous variables, and EdgeR with FDR correction for transcriptomic analyses. Results: In TCGA, LNM was more frequent in AYA than in AD (62.1% vs. 47.8%, p = 0.031). From intersected analyses, we identified 239 core DEGs distinguishing highly invasive, age-related tumors. Key upregulated genes in AYA included CXCR4, OPCML and S100A2; downregulated genes included ATP1A3, CHL1, HLA-DRA and IL-1β. Enriched pathways involved extracellular matrix organization, cell adhesion, calcium signaling and canonical oncogenic cascades (PI3K-Akt, MAPK, Wnt, Ras). Immune deconvolution showed reduced naïve B cells, M1 and M2 macrophages and resting mast cells and an increased proportion of M0 macrophages in AYA tumors. IHC validated differential protein expression for seven markers. Collectively, the data indicate an immune-suppressed, immune-excluded microenvironment in AYA PTC. Conclusions: AYA PTC exhibits distinct molecular and immune features that may underlie its propensity for lymphatic dissemination. These findings support evaluation of translational strategies, such as CXCR4 inhibition, restoration of antigen presentation, and macrophage reprogramming, to convert “cold” tumors into immune-permissive lesions. Validation in larger, prospective, multicenter cohorts is required. Full article
(This article belongs to the Special Issue Recent Advances in Endocrinology Pathology)
►▼ Show Figures

Figure 1

14 pages, 3548 KB  
Article
Characterization of Peripheral Retinal Degenerations and Rhegmatogenous Lesions Using Ultra-Widefield Swept Source OCT Integrated with a Novel Scanning Laser Ophthalmoscope
by Daniela Bacherini, Clara Rizzo, Giulio Vicini, Diego Luciani, Lorenzo Vannozzi, Gianni Virgili, Fabrizio Giansanti and Cristina Nicolosi
Diagnostics 2025, 15(22), 2930; https://doi.org/10.3390/diagnostics15222930 - 20 Nov 2025
Cited by 1 | Viewed by 728
Abstract
Background/Objectives: The purpose of this study was to evaluate the implementation of ultra-widefield swept-source optical coherence tomography (SS-OCT) in characterizing peripheral retinal degenerations and rhegmatogenous lesions, and to assess its potential implications for clinical management. These lesions are often challenging to visualize [...] Read more.
Background/Objectives: The purpose of this study was to evaluate the implementation of ultra-widefield swept-source optical coherence tomography (SS-OCT) in characterizing peripheral retinal degenerations and rhegmatogenous lesions, and to assess its potential implications for clinical management. These lesions are often challenging to visualize with conventional techniques, highlighting the need for advanced imaging modalities to improve detection and characterization. Methods: We conducted a retrospective observational study involving patients diagnosed with peripheral retinal degenerations and/or rhegmatogenous lesions referred to our center. All participants underwent comprehensive ophthalmological evaluation, including slit-lamp biomicroscopy, dilated fundus examination, and peripheral SS-OCT imaging. Key parameters assessed included the presence of vitreoretinal attachment, vitreous traction, full-thickness retinal defects, and subretinal fluid associated with the peripheral lesions under investigation. Results: A total of 107 eyes from 95 patients were included. The mean spherical equivalent was −2.18 ± 2.5 diopters, and mean BCVA was 0.03 ± 0.11. Peripheral SS-OCT imaging successfully captured and characterized 130 retinal lesions, including retinal tears (n = 34), lattice degeneration (n = 25), retinal holes (n = 21), peripheral retinoschisis (n = 17), and schisis/detachment (n = 7). Less commonly observed lesions were snail track degeneration (n = 4), white without pressure (n = 4) microcystic degeneration (n = 2), dialysis (n = 2), condensed vitreous (n = 2), and paving stone degeneration (n = 1). SS-OCT provided high-resolution visualization of the peripheral retina and vitreoretinal interface, revealing findings such as vitreous traction, everted edges in retinal holes, and associated subretinal fluid, some of which were not clinically detectable and, in several cases, directly influenced management decisions. Conclusions: Ultra-widefield SS-OCT significantly enhanced the visualization of peripheral retinal degenerations and rhegmatogenous lesions, providing clinically meaningful details that may influence diagnosis and clinical decision-making. Full article
(This article belongs to the Special Issue Novel Optical Imaging Technologies in Ophthalmology and Neuroscience: Advances and Applications)
►▼ Show Figures

Figure 1

21 pages, 337 KB  
Review
The Interleukin Network in Sepsis: From Cytokine Storm to Clinical Applications
by Marcello Candelli, Marta Sacco Fernandez, Gloria Rozzi, Giorgio Sodero, Andrea Piccioni, Giulia Pignataro, Donato Rigante and Francesco Franceschi
Diagnostics 2025, 15(22), 2927; https://doi.org/10.3390/diagnostics15222927 - 19 Nov 2025
Cited by 2 | Viewed by 1713
Abstract
Background and Objectives: Despite major advances in medical science and critical care, sepsis remains a leading cause of morbidity and mortality worldwide: it arises from dysregulated host response to infections and may culminate in organ dysfunction. A hallmark of its pathogenesis is [...] Read more.
Background and Objectives: Despite major advances in medical science and critical care, sepsis remains a leading cause of morbidity and mortality worldwide: it arises from dysregulated host response to infections and may culminate in organ dysfunction. A hallmark of its pathogenesis is the cytokine storm, in which interleukins (ILs) serve as central mediators of both protective and deleterious immune responses. This review summarizes the current knowledge on the role of ILs in sepsis, emphasizing their potential as biomarkers and therapeutic targets. Material and Methods: We analyzed recent clinical and experimental studies focusing on the most studied ILs—including IL-1, IL-6, IL-10, IL-8, IL-12, IL-18, and IL-17—in the pathophysiology of sepsis. Attention was given to mechanistic insights, prognostic significance, and therapeutic strategies targeting IL pathways. Results: IL-1 and IL-6 emerged as key pro-inflammatory mediators, amplifying vascular permeability, coagulation activation, and shock, with IL-6 validated as a robust prognostic biomarker. IL-10 was identified as a pivotal anti-inflammatory cytokine, limiting tissue injury but fostering immunosuppression and secondary infections. Other ILs, such as IL-8, IL-12, IL-18, and IL-17, contributed to neutrophil recruitment, Th1/Th17 activation, organ-specific injury, and sepsis susceptibility. Therapeutic interventions targeting ILs, including the IL-1 receptor antagonist anakinra and IL-6 receptor blockade with tocilizumab, have shown promise in selected patient subgroups. Conclusions: ILs are central to the immunopathology of sepsis, acting both as drivers of hyperinflammation and mediators of immunosuppression. Their dual role underscores the relevance of ILs as diagnostic and prognostic biomarkers, as well as context-dependent therapeutic targets. Future approaches should prioritize precision immunomodulation aligned with the principles of personalized medicine to improve clinical outcomes in sepsis. Full article
(This article belongs to the Special Issue Early Diagnosis of Sepsis: Current Status and Challenges)
12 pages, 1075 KB  
Article
Utility of REMS-Derived Fragility Score and Trabecular Bone Score in Evaluating Bone Health in Type 2 Diabetes Mellitus
by Antonella Al Refaie, Caterina Mondillo, Guido Cavati, Sara Gonnelli, Maria Dea Tomai Pitinca, Elena Ceccarelli, Paola Pisani, Luigi Gennari, Stefano Gonnelli and Carla Caffarelli
Diagnostics 2025, 15(22), 2877; https://doi.org/10.3390/diagnostics15222877 - 13 Nov 2025
Viewed by 617
Abstract
Background/Objectives: A significantly higher fracture risk characterizes Type 2 diabetes mellitus (T2DM) patients when compared to the non-diabetic population, even though their average bone mineral density (BMD) tends to be normal or high. This elevated risk is primarily driven by defective bone [...] Read more.
Background/Objectives: A significantly higher fracture risk characterizes Type 2 diabetes mellitus (T2DM) patients when compared to the non-diabetic population, even though their average bone mineral density (BMD) tends to be normal or high. This elevated risk is primarily driven by defective bone quality. The trabecular bone score (TBS) and radiofrequency echographic multispectrometry (REMS) have recently been proposed to improve the assessment of bone quality in T2DM individuals. This study aimed to evaluate whether TBS and REMS can improve the identification of osteoporosis and fracture risk in these patients. Methods: BMD was measured in 223 consecutive T2DM patients (126 women and 97 man) and 102 controls. BMD values for the lumbar spine (LS), femoral neck (FN), and total hip (TH) were obtained via both dual-energy X-ray absorptiometry (DXA) and radiofrequency echographic multi-spectrometry (REMS). In all patients, TBS and Fragility Score (FS) by REMS were measured and prior major osteoporotic fractures (MOF) were assessed. Results: All BMD T-scores measured by REMS were significantly lower than those obtained by DXA at both lumbar and femoral sites. T2DM patients with previous MOF exhibited lower T-scores for both BMD-LS and BMD-TH, as assessed by DXA and REMS, compared with patients without fractures. However, these differences reached statistical significance for BMD-TH with both techniques and for BMD-LS with REMS, but not for BMD-LS with DXA. Moreover, patients with a history of MOF had significantly lower TBS values (p < 0.05) and significantly higher FS values at both lumbar (p < 0.05) and femoral (p < 0.01) sites compared with those without fractures. Conclusions: The results of this study suggest that the parameters obtained using REMS technology (BMD and FS) may be valuable tools for improving the diagnosis of osteoporosis and assessing fracture risk in patients with T2DM. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Musculoskeletal Diseases and Bone Fracture Risk)
►▼ Show Figures

Graphical abstract

13 pages, 487 KB  
Article
Clinical Relevance of Trace-Positive Results in Xpert MTB/RIF Ultra for Tuberculosis Diagnosis in a High-Burden Setting: A Retrospective Cohort Study
by Cristian Sava, Alin Iuhas, Cristian Marinău, Radu Galiș, Marius Rus and Mihaela Sava
Diagnostics 2025, 15(22), 2860; https://doi.org/10.3390/diagnostics15222860 - 12 Nov 2025
Viewed by 1393
Abstract
Background: The introduction of the “trace” category in the Xpert MTB/RIF Ultra assay has significantly improved the sensitivity of molecular tuberculosis diagnostics. While it enhances sensitivity, especially in paucibacillary and extrapulmonary cases, its specificity remains debatable, making its interpretation outside select populations [...] Read more.
Background: The introduction of the “trace” category in the Xpert MTB/RIF Ultra assay has significantly improved the sensitivity of molecular tuberculosis diagnostics. While it enhances sensitivity, especially in paucibacillary and extrapulmonary cases, its specificity remains debatable, making its interpretation outside select populations a topic of clinical uncertainty. Objectives: This study evaluates the diagnostic and clinical significance of trace-positive results obtained with the Xpert MTB/RIF Ultra assay in the context of a high-incidence TB setting, examining their association with clinical, imaging, and microbiological findings. Methods: A retrospective analysis was conducted on 65 samples with trace-positive Xpert Ultra results, collected over a six-year period from 59 distinct patients in a general hospital in Romania. Correlations were assessed with microscopy, culture, clinical features, imaging, treatment initiation, and prior TB history. A composite reference standard was used for diagnostic accuracy evaluation. Results: Of the 65 trace-positive samples, 29 (44.6%) were culture-positive and 5 (7.7%) were smear-positive. A high proportion of patients, 56 (94.9%), presented with TB-compatible symptoms, and 47 (79.6% of those with imaging) had highly suggestive radiological findings. Based on the composite reference standard, 47 patients (79.7%) were ultimately diagnosed with active TB. Anti-TB treatment was initiated in 44 patients (74.5%). Trace positivity was observed across various specimen types, including sputum, pleural fluid, and cerebrospinal fluid. Conclusions: In high TB burden environments, trace-positive Xpert Ultra results frequently reflect true disease when interpreted within the appropriate clinical and imaging framework. Our findings indicate that, in regions with high tuberculosis incidence such as Romania, trace-positive Xpert Ultra results may contribute meaningfully to clinical decision-making when interpreted alongside clinical and radiological findings, in alignment with current WHO guidance. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
►▼ Show Figures

Figure 1

27 pages, 1211 KB  
Review
Locally Advanced Cervical Cancer: Multiparametric MRI in Gynecologic Oncology and Precision Medicine
by Sara Boemi, Matilde Pavan, Roberta Siena, Carla Lo Giudice, Alessia Pagana, Marco Marzio Panella and Maria Teresa Bruno
Diagnostics 2025, 15(22), 2858; https://doi.org/10.3390/diagnostics15222858 - 12 Nov 2025
Viewed by 1048
Abstract
Background: Locally advanced cervical cancer (LACC) represents a significant challenge in oncology, requiring accurate assessment of local extent and metastatic spread. Multiparametric magnetic resonance imaging (mpMRI) has assumed a central role in the loco-regional characterization of the tumor due to its high soft-tissue [...] Read more.
Background: Locally advanced cervical cancer (LACC) represents a significant challenge in oncology, requiring accurate assessment of local extent and metastatic spread. Multiparametric magnetic resonance imaging (mpMRI) has assumed a central role in the loco-regional characterization of the tumor due to its high soft-tissue resolution and the ability to integrate functional information. Objectives: In this narrative review, we explore the use of mpMRI in the diagnosis, staging, and treatment response of LACC, comparing its performance with that of PET/CT, which remains complementary for remote staging. The potential of whole-body magnetic resonance imaging (WB-MRI) and hybrid PET/MRI techniques is also analyzed, as well as the emerging applications of radiomics and artificial intelligence. The paper also discusses technical limitations, interpretative variability, and the importance of protocol standardization. The goal is to provide an updated and translational summary of imaging in LACC, with implications for clinical practice and future research. Methods: Prospective and retrospective studies, systematic reviews, and meta-analyses on adult patients with cervical cancer were included. Results: Fifty-two studies were included. MRI demonstrated a sensitivity and specificity greater than 80% for parametrial and bladder invasion, but limited sensitivity (45–60%) for lymph node disease, lower than PET/CT. Multiparametric MRI was useful in early prediction of response to chemotherapy and radiotherapy and in distinguishing residual disease from fibrosis. The integration of MRI into Image-Guided Adaptive Brachytherapy (IGABT) resulted in improved oncological outcomes and reduced toxicity. The applications of radiomics and AI demonstrated enormous potential in predicting therapeutic response and lymph node status in the MRI study, but multicenter validation is still needed. Conclusions: MRI is the cornerstone of the local–regional staging of advanced cervical cancer; it has become an essential and crucial tool in treatment planning. Its use, combined with PET/CT for lymph node assessment and metastatic disease staging, is now the standard of care. Future prospects include the use of whole-body MRI and the development of predictive models based on radiomics and artificial intelligence. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
►▼ Show Figures

Figure 1

14 pages, 1040 KB  
Article
Clinical Relevance and Follow-Up of Incidental CT Imaging Findings for COVID-19 Diagnosis: A Retrospective Analysis
by Marc Marty, Bjarne Kerber, Frederik Abel, Jonas Kroschke, Thomas Frauenfelder and Sabine Franckenberg
Diagnostics 2025, 15(22), 2832; https://doi.org/10.3390/diagnostics15222832 - 8 Nov 2025
Viewed by 1174
Abstract
Background/Objectives: The aim of this study was to evaluate the prevalence of incidental findings in thoracic computed tomography (CT) performed because of COVID-19 and their potential impact on patient management. Methods: This retrospective analysis included 683 CT scans from 327 patients [...] Read more.
Background/Objectives: The aim of this study was to evaluate the prevalence of incidental findings in thoracic computed tomography (CT) performed because of COVID-19 and their potential impact on patient management. Methods: This retrospective analysis included 683 CT scans from 327 patients who underwent CT imaging of the thorax with or without the application of intravenous contrast-agents because of the primary indication of COVID-19. Radiological findings were categorized according to the COVID-19 Pneumonia Imaging Classification by four independent readers. Incidental findings were categorized according to a scale ranging from 0 (no patient impairment) to 3b (severe permanent impairment). Results: In the 683 CT-scans, typical COVID-19 findings were present in 273 scans (40.0%), atypical signs in 97 (14.2%), indeterminate findings in 40 (5.9%), and no signs of COVID-19 in 273 (40.0%). Incidental findings were reported in 94 out of 683 cases (13.8%), of which 63 (67.0%) were classified as category 0, 12 (12.8%) as category 1, 9 (9.6%) as category 2a, none (0.0%) as category 2b, 5 (5.3%) as category 3a, and 5 (5.3%) as category 3b. Conclusions: CT scans of the thorax for COVID-19 show a small but significant number of incidental findings that require further investigation. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
►▼ Show Figures

Figure 1

12 pages, 809 KB  
Article
The Clinical Relevance of Mast Cell Activation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
by Johanna Rohrhofer, Lilian Ebner, Johannes Schweighardt, Michael Stingl and Eva Untersmayr
Diagnostics 2025, 15(22), 2828; https://doi.org/10.3390/diagnostics15222828 - 7 Nov 2025
Cited by 1 | Viewed by 5842
Abstract
Background/Objectives: Growing evidence suggests that mast cell activation (MCA) may contribute to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a debilitating disorder characterized by persistent fatigue and post-exertional malaise (PEM). Particularly in relation to orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (POTS), this study [...] Read more.
Background/Objectives: Growing evidence suggests that mast cell activation (MCA) may contribute to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a debilitating disorder characterized by persistent fatigue and post-exertional malaise (PEM). Particularly in relation to orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (POTS), this study aimed to investigate the prevalence and clinical relevance of MCA in an Austrian ME/CFS patient cohort. Methods: Two data sets were analyzed. The CCCFS data set, a comprehensive, patient-centered online questionnaire consisting of 687 filled surveys, focuses on patient stratification. Self-reported clinical features, disease progression, and treatment responses were analyzed. Preliminary findings were validated in a second, retrospective study, analyzing data of 383 Austrian ME/CFS patients with regard to MCA involvement and OI. Results: Among followed-up ME/CFS patients, MCA prevalence increased over the disease course, with up to 25.3% meeting the criteria for clinically relevant MCA. ME/CFS patients with Mast Cell Activation Syndrome (MCAS) and OI reported symptom alleviation significantly more often following mast cell-targeted treatment than those without MCAS (p < 0.0001). With regard to IF-channel inhibitors, ME/CFS patients diagnosed with MCAS responded more frequently than those without MCAS (p = 0.076), while no significant differences were observed in response to beta blockers (p = 0.637). In both cohorts, OI, particularly POTS, was significantly more common in patients with MCA involvement. Conclusions: MCA appears to be a frequent and clinically relevant comorbidity in ME/CFS and is associated with a higher prevalence of OI, particularly POTS. Stratifying patients based on MCA involvement may support personalized treatment approaches and improve clinical outcomes. Full article
(This article belongs to the Special Issue Chronic Fatigue Syndrome: Clinical Diagnostics, Management, and Prognosis)
►▼ Show Figures

Figure 1

21 pages, 1108 KB  
Article
Sleep Trajectories in Amnestic and Non-Amnestic MCI: Longitudinal Insights from Subjective and Objective Assessments
by Areti Batzikosta, Despina Moraitou, Paschalis Steiropoulos, Elvira Masoura, Georgia Papantoniou, Ioanna-Giannoula Katsouri, Maria Sofologi, Glykeria Tsentidou and Magda Tsolaki
Diagnostics 2025, 15(21), 2815; https://doi.org/10.3390/diagnostics15212815 - 6 Nov 2025
Viewed by 848
Abstract
Background/Objectives: Sleep disturbances are increasingly recognized as dynamic biomarkers of cognitive decline; however, longitudinal and multimodal studies directly comparing amnestic (aMCI) and non-amnestic mild cognitive impairment (naMCI) remain limited. Methods: In a three-wave longitudinal design (~24 months), 179 older adults (46 healthy controls [...] Read more.
Background/Objectives: Sleep disturbances are increasingly recognized as dynamic biomarkers of cognitive decline; however, longitudinal and multimodal studies directly comparing amnestic (aMCI) and non-amnestic mild cognitive impairment (naMCI) remain limited. Methods: In a three-wave longitudinal design (~24 months), 179 older adults (46 healthy controls [HCs], 75 aMCI, 58 naMCI; mean age = 70.2 years, education = 12.3 years) were assessed with actigraphy and validated questionnaires (Athens Insomnia Scale, Pittsburgh Sleep Quality Index, STOP-BANG). Mixed ANOVAs and structural equation modeling tested group, time and mediation effects. Results: Subjective measures revealed a progressive worsening of insomnia and sleep quality in MCI, with naMCI exhibiting the steepest decline, while HCs remained largely stable. STOP-BANG trajectories indicated increasing sleep-disordered breathing risk across groups, most pronounced in naMCI. Objective indices corroborated these findings: total sleep time (TST) and sleep efficiency (SE) declined significantly in MCI, especially naMCI, while wake after sleep onset (WASO) increased longitudinally. By the third assessment, naMCI consistently showed the shortest TST and lowest SE. Mediation analyses identified SE as a central predictor of future subjective complaints, with indirect contributions from WASO and PSQI. Conclusions: Longitudinal trajectories, rather than cross-sectional comparisons, best differentiated MCI subtypes. NaMCI demonstrated the most aggressive deterioration in both objective and subjective sleep measures, highlighting its heightened vulnerability to sleep dysregulation and potential relevance for neurodegenerative progression. Clinically, sustained monitoring of SE, TST, and sleep-disordered breathing risk may provide prognostic value and inform early, targeted interventions in at-risk populations. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
►▼ Show Figures

Figure 1

16 pages, 2423 KB  
Review
Optimum Patient’s Selection for Atrial Fibrillation Ablation Using Echocardiography
by Matteo Cameli, Maria Concetta Pastore, Francesco Morrone, Giulia Elena Mandoli, Giovanni Benfari, Federica Ilardi, Matteo Lisi, Alessandro Malagoli, Simona Sperlongano, Ciro Santoro, Andrea Stefanini, Elena Placuzzi, Annalisa Pasquini, Miriam Durante, Aleksander Dokollari, Michael Y. Henein and Antonello D’Andrea
Diagnostics 2025, 15(21), 2793; https://doi.org/10.3390/diagnostics15212793 - 4 Nov 2025
Viewed by 1110
Abstract
Catheter ablation (CA) has become a validated technique for treating patients with symptomatic or paroxysmal atrial fibrillation (AF), as recommended by the latest 2024 European society of cardiology (ESC) guidelines, class II level A. The procedure is also recommended for patients with persistent [...] Read more.
Catheter ablation (CA) has become a validated technique for treating patients with symptomatic or paroxysmal atrial fibrillation (AF), as recommended by the latest 2024 European society of cardiology (ESC) guidelines, class II level A. The procedure is also recommended for patients with persistent AF without major risk factors for AF recurrence, as an alternative to antiarrhythmic medications class I or III. However, CA carries the risk of AF recurrence in 30–35% of patients, sometimes after the procedure. Multiple factors impact the onset, maintenance, and recurrence of AF after CA, including clinical, biohumoral, echocardiographic, genetic, and lifestyle factors. Beyond traditional predictors, emerging factors such as obstructive sleep apnea syndrome, chronic renal failure, chronic lung disease, physical activity patterns, gut microbiota composition, and epicardial fat thickness significantly influence outcomes. Therefore, optimizing patient’s selection for CA is an important strategy to minimize the risk of AF recurrence. Many echocardiographic parameters emerged as predictors of AF recurrence post-CA, but none stood out as a potential single factor. These factors include traditional markers such as left atrial size by 2D echocardiography, LV ejection fraction, LV diastolic function parameters as well as myocardial deformation addressed by the recently developed speckle tracking analysis. Additionally, the duration and type of AF represent fundamental risk factors, with longstanding persistent AF showing significantly higher recurrence rates compared to paroxysmal forms. Novel biomarkers including MR-proANP, caspase-8, hsa-miR-206, and neurotrophin-3 show promise in enhancing risk prediction capabilities. The aim of this review is to explore the most relevant echocardiographic parameters, including myocardial deformation, that could accurately predict recurrence of AF after CA, while also examining the role of emerging clinical and biochemical predictors in comprehensive patient selection strategies. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
►▼ Show Figures

Figure 1

20 pages, 15383 KB  
Review
Lung Ultrasound in Pediatrics: A Review with Core Principles That Every User Should Know
by Soultana Foutzitzi, Panos Prassopoulos, Athanasios Chatzimichail, Katerina Kambouri, Hippocrates Moschouris, Evlampia A. Psatha, Panagoula Oikonomou and Savas P. Deftereos
Diagnostics 2025, 15(21), 2782; https://doi.org/10.3390/diagnostics15212782 - 2 Nov 2025
Viewed by 1944
Abstract
Lung ultrasound (LUS) has emerged as a valuable diagnostic modality for the evaluation of respiratory disorders in neonates, infants and children. LUS has high diagnostic accuracy for identification of lung lesions in neonates, infants and children, where most lung lesions abut the pleura. [...] Read more.
Lung ultrasound (LUS) has emerged as a valuable diagnostic modality for the evaluation of respiratory disorders in neonates, infants and children. LUS has high diagnostic accuracy for identification of lung lesions in neonates, infants and children, where most lung lesions abut the pleura. Furthermore, LUS has the advantage of rapid execution and ease of use, and does not require ionizing radiation. Its sensitivity, cost-effectiveness, and clinical efficiency make it an important tool for supporting clinical decision-making and improving patient management. Moreover, LUS may represent a reliable alternative to chest radiography for the assessment of pediatric lung conditions and, in selected cases, could potentially replace routine chest X-rays (CXRs). Because LUS is a user-friendly technique that enables real-time imaging without radiation, it has increasingly been used in clinical practice in recent years. Here, we discuss the diagnostic role of LUS for the accurate identification of pulmonary lesions in pediatric patients. In addition, we present LUS sonographic findings associated with common pediatric lung diseases, including signs and artifacts that can be used during diagnosis and evaluation of pediatric patients. Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
►▼ Show Figures

Figure 1

16 pages, 923 KB  
Article
Transcervical, Transabdominal and Transvaginal Chorionic Villus Sampling for Prenatal Diagnosis in Zagreb, Croatia: A Prospective Single-Operator Study on 5500 Cases
by Petra Podobnik, Tomislav Meštrović, Mario Podobnik, Ivan Bertović-Žunec, Igor Lončar, Kristian Kurdija, Dženis Jelčić, Zlata Srebreniković and Slava Podobnik-Šarkanji
Diagnostics 2025, 15(21), 2750; https://doi.org/10.3390/diagnostics15212750 - 30 Oct 2025
Viewed by 1461
Abstract
Background/Objectives: Chorionic villus sampling (CVS) is a pivotal diagnostic tool for early prenatal detection of chromosomal and genetic abnormalities; however, the safety and diagnostic efficacy of different CVS approaches remain a subject of clinical interest. This monocentric study compares transcervical (TC-CVS), transabdominal [...] Read more.
Background/Objectives: Chorionic villus sampling (CVS) is a pivotal diagnostic tool for early prenatal detection of chromosomal and genetic abnormalities; however, the safety and diagnostic efficacy of different CVS approaches remain a subject of clinical interest. This monocentric study compares transcervical (TC-CVS), transabdominal (TA-CVS) and transvaginal (TV-CVS) techniques, focusing on procedure-related fetal loss and diagnostic yield. Methods: In this 15-year, single-operator prospective study, a total of 5500 women underwent CVS between 10 and 14 weeks of gestation at a single center. Sampling was performed via TA-CVS (n = 4500), TC-CVS (n = 850), or TV-CVS (n = 150). Outcomes assessed included fetal loss rates, sample adequacy, early complications and hemodynamic changes measured by Doppler ultrasound. A p-value < 0.05 (two-tailed) was considered statistically significant. Results: Spontaneous abortion rates were significantly lower following TA-CVS (0.18%; 8/4500) compared to TC-CVS (0.6%; 5/850) and TV-CVS (1.3%; 2/150) (χ2 = 24.56, p < 0.001). Post hoc pairwise analysis showed significantly lower fetal loss in TA-CVS compared to TC-CVS, but not between TA-CVS and TV-CVS. Cytogenetic abnormalities were detected in 220 cases (4.0%), and clinically significant copy number variants (CNVs) were confirmed in fetuses with major structural malformations. Five-year follow-up showed no diagnosed intellectual disability among assessed children. Optimal tissue weight (10–20 mg) was more frequent with TA-CVS (66.7%) than TC-CVS (35.3%) or TV-CVS (36.7%) (χ2 = 350.92, p < 0.001). In a Doppler subset (n = 400), uterine, spiral, and interplacental artery PI changes were non-significant; the umbilical (p = 0.032) and middle cerebral arteries (p < 0.001) showed transient PI reductions after sampling. Conclusions: Transabdominal CVS demonstrated the most favorable balance of safety and diagnostic quality, suggesting it should be the preferred first-line technique in early prenatal diagnosis. Standardized technique and operator training remain critical to optimize outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gynecological and Obstetric Diseases)
►▼ Show Figures

Figure 1

13 pages, 4332 KB  
Article
Brain Perfusion Scintigraphy in the Diagnostic Toolbox for the Confirmation of Brain Death: Practical Aspects and Examination Protocol
by Albrecht Günther, Anne Gunkel, Christian Geis, Dirk Brämer, Martin Brauer, Claus Doerfel, Michael Fritzenwanger, Martin Freesmeyer, Thomas Winkens, Robert Drescher and Anke Werner
Diagnostics 2025, 15(21), 2734; https://doi.org/10.3390/diagnostics15212734 - 28 Oct 2025
Viewed by 1071
Abstract
Background: In addition to clinical examinations, confirmatory investigations are frequently performed to determine brain death (BD). Among other perfusion tests, brain perfusion scintigraphy (BPS) has been shown to be a reliable tool for the detection of brain circulatory arrest, particularly in cases with [...] Read more.
Background: In addition to clinical examinations, confirmatory investigations are frequently performed to determine brain death (BD). Among other perfusion tests, brain perfusion scintigraphy (BPS) has been shown to be a reliable tool for the detection of brain circulatory arrest, particularly in cases with inconclusive clinical status or potential pharmacological interactions. Methods: Evaluation for brain death included standardized clinical examinations by two experienced neuro-intensive medicine specialists, followed by ancillary brain perfusion tests. BPS with the lipophilic tracer 99mTc-hexamethylpropyleneamine oxime (HMPAO) was performed according to a standardized protocol. Imaging results, additional confirmatory test results, as well as clinical parameters were prospectively recorded. Results: BPS was performed in 30 patients (18 male, 12 female; median age 55.5 years, range 0.1–79.8 years). Eight patients underwent decompressive craniectomy (DC) prior to BD evaluation, three patients were supported by veno-arterial extracorporeal membrane oxygenation (vaECMO), and one patient by a left ventricular assist device (LVAD). The median interval between the initial brain-damaging event and BPS was 4.0 days (range 1–18 days). BPS demonstrated brain perfusion cessation in all patients. A concomitant single-photon emission computed tomography (SPECT) was required in one patient. There were no technical failures requiring a re-examination. Conclusions: BPS is a feasible, safe, and technically robust confirmatory test in BD diagnosis. BPS yielded unambiguous results, particularly in cases with inconclusive results of other ancillary tests, in neonates, young children and patients after DC. It is applicable to patients supported by LVAD and vaECMO. Full article
(This article belongs to the Special Issue Neurological Disorders: Diagnosis and Management)
►▼ Show Figures

Figure 1

16 pages, 2776 KB  
Article
Optical Coherence Tomography Angiography (OCTA) Captures Early Micro-Vascular Remodeling in Non-Melanoma Skin Cancer During Superficial Radiotherapy: A Proof-of-Concept Study
by Gerd Heilemann, Giulia Rotunno, Lisa Krainz, Francesco Gili, Christoph Müller, Kristen M. Meiburger, Dietmar Georg, Joachim Widder, Wolfgang Drexler, Mengyang Liu and Cora Waldstein
Diagnostics 2025, 15(21), 2698; https://doi.org/10.3390/diagnostics15212698 - 24 Oct 2025
Viewed by 1248
Abstract
Background/Objectives: This proof-of-concept study evaluated whether optical coherence tomography angiography (OCTA) can non-invasively capture micro-vascular alterations in non-melanoma skin cancer (NMSC) lesions during and after superficial orthovoltage radiotherapy (RT) using radiomics and vascular features analysis. Methods: Eight patients (13 NMSC lesions) [...] Read more.
Background/Objectives: This proof-of-concept study evaluated whether optical coherence tomography angiography (OCTA) can non-invasively capture micro-vascular alterations in non-melanoma skin cancer (NMSC) lesions during and after superficial orthovoltage radiotherapy (RT) using radiomics and vascular features analysis. Methods: Eight patients (13 NMSC lesions) received 36–50 Gy in 6–20 fractions. High-resolution swept-source OCTA volumes (1.1 × 10 × 10 mm3) were acquired from each lesion at three time points: pre-RT, immediately post-RT, and three months post-RT. Additionally, healthy skin baseline was scanned. After artifact suppression and region-of-interest cropping, (i) first-order and texture radiomics and (ii) skeleton-based vascular features were extracted. Selected features after LASSO (least absolute shrinkage and selection operator) were explored with principal-component analysis. An XGBoost model was trained to classify time points with 100 bootstrap out-of-bag validations. Kruskal–Wallis tests with Benjamini–Hochberg correction assessed longitudinal changes in the 20 most influential features. Results: Sixty-one OCTA volumes were analyzable. LASSO retained 47 of 103 features. The first two principal components explained 63% of the variance, revealing a visible drift of lesions from pre- to three-month post-RT clusters. XGBoost achieved a macro-averaged AUC of 0.68 ± 0.07. Six features (3 texture, 2 first order, 1 vascular) changed significantly across time points (adjusted p < 0.05), indicating dose-dependent reductions in signal heterogeneity and micro-vascular complexity as early as treatment completion, which deepened by three months. Conclusions: OCTA-derived radiomic and vascular signatures tracked RT-induced micro-vascular remodeling in NMSC. The approach is entirely non-invasive, label-free, and feasible at the point of care. As an exploratory proof-of-concept, this study helps to refine scanning and analysis protocols and generates knowledge to support future integration of OCTA into adaptive skin-cancer radiotherapy workflows. Full article
(This article belongs to the Collection Biomedical Optics: From Technologies to Applications)
►▼ Show Figures

Figure 1

11 pages, 649 KB  
Review
A Narrative Review of Photon-Counting CT and Radiomics in Cardiothoracic Imaging: A Promising Match?
by Salvatore Claudio Fanni, Ilaria Ambrosini, Francesca Pia Caputo, Maria Emanuela Cuibari, Domitilla Deri, Alessio Guarracino, Camilla Guidi, Vincenzo Uggenti, Giancarlo Varanini, Emanuele Neri, Dania Cioni, Mariano Scaglione and Salvatore Masala
Diagnostics 2025, 15(20), 2631; https://doi.org/10.3390/diagnostics15202631 - 18 Oct 2025
Viewed by 2491
Abstract
Photon-counting computed tomography (PCCT) represents a major technological innovation compared to conventional CT, offering improved spatial resolution, reduced electronic noise, and intrinsic spectral capabilities. These advances open new perspectives for synergy with radiomics, a field that extracts quantitative features from medical images. The [...] Read more.
Photon-counting computed tomography (PCCT) represents a major technological innovation compared to conventional CT, offering improved spatial resolution, reduced electronic noise, and intrinsic spectral capabilities. These advances open new perspectives for synergy with radiomics, a field that extracts quantitative features from medical images. The ability of PCCT to generate multiple types of datasets, including high-resolution conventional images, iodine maps, and virtual monoenergetic reconstructions, increases the richness of extractable features and potentially enhances radiomics performance. This narrative review investigates the current evidence on the interplay between PCCT and radiomics in cardiothoracic imaging. Phantom studies demonstrate reduced reproducibility between PCCT and conventional CT systems, while intra-scanner repeatability remains high. Nonetheless, PCCT introduces additional complexity, as reconstruction parameters and acquisition settings significantly may affect feature stability. In chest imaging, early studies suggest that PCCT-derived features may improve nodule characterization, but existing machine learning models, such as those applied to interstitial lung disease, may require recalibration to accommodate the new imaging paradigm. In cardiac imaging, PCCT has shown particular promise: radiomic features extracted from myocardial and epicardial tissues can provide additional diagnostic insights, while spectral reconstructions improve plaque characterization. Proof-of-concept studies already suggest that PCCT radiomics can capture myocardial aging patterns and discriminate high-risk coronary plaques. In conclusion, evidence supports a growing synergy between PCCT and radiomics, with applications already emerging in both lung and cardiac imaging. By enhancing the reproducibility and richness of quantitative features, PCCT may significantly broaden the clinical potential of radiomics in computed tomography. Full article
(This article belongs to the Special Issue Cardiothoracic Imaging: Recent Techniques and Applications in Diagnostics, Third Edition)
►▼ Show Figures

Figure 1

23 pages, 3084 KB  
Systematic Review
Patterns of Lateral Lymph Node Involvement by Neck Level in cNIb Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis
by Dana M. Hartl, Karthik N. Rao, Andrés Coca Pelaz, Alessandra Rinaldo, Mark E. Zafereo, Greg W. Randolph, Iain J. Nixon, Marc Hamoir, K. Thomas Robbins, Luiz P. Kowalski, Pia Pace Asciak, Badr Soudi, Juan P. Rodrigo and Alfio Ferlito
Diagnostics 2025, 15(20), 2613; https://doi.org/10.3390/diagnostics15202613 - 16 Oct 2025
Viewed by 1449
Abstract
Background/Objectives: The optimal extent of lateral lymph node dissection in cN1b differentiated thyroid cancer remains controversial. This systematic review aimed to assess the frequency of lymph node involvement across neck levels I to V. Materials and Methods: A systematic review was conducted following [...] Read more.
Background/Objectives: The optimal extent of lateral lymph node dissection in cN1b differentiated thyroid cancer remains controversial. This systematic review aimed to assess the frequency of lymph node involvement across neck levels I to V. Materials and Methods: A systematic review was conducted following PRISMA guidelines. PubMed was searched for studies on lateral neck dissection in differentiated thyroid cancer. Included studies reported level-specified metastatic rates. Data on patient numbers and metastatic events were extracted. A random-effects meta-analysis with Freeman–Tukey double arcsine transformation was performed for each neck level to calculate pooled prevalence proportions and 95% confidence intervals. Heterogeneity was assessed using the I2 statistic. Results: Meta-analysis of 57 studies revealed that level III (68%, 95% CI: 63–73) and level IV (66%, 95% CI: 61–70) had the highest metastatic prevalence, followed by level IIA (46%, 95% CI: 37–56). Level V demonstrated an overall prevalence of 22% (95% CI: 18–26), with sublevel VB (19%, 95% CI: 11–28) significantly higher than VA (4%, 95% CI: 1–9). Level I (6%, 95% CI: 2–11) and sublevel IIB (14%, 95% CI: 9–20) showed the lowest risk. Significant heterogeneity (I2 71–94%) was observed across all levels. Conclusions: Our findings support sparing level I, and sublevels IIB and VA during lateral neck dissection. Current guidelines recommend systematic dissection of IIA, III, IV, and VB, although VB involvement was found to be only 19% in our study. Future personalization of the extent of neck dissection, based on individual risk factors, may be key to optimizing oncologic and functional outcomes. Full article
(This article belongs to the Special Issue Advances in Molecular Pathology and Imaging for Precision Diagnosis and Treatment of Tumors)
►▼ Show Figures

Figure 1

17 pages, 322 KB  
Review
From Fluid Responsiveness to Prognosis: The Emerging Role of Point-of-Care Echocardiography in Sepsis
by Andrea Piccioni, Gloria Rozzi, Giacomo Spaziani, Michela Novelli, Mariella Fuorlo, Marcello Candelli, Giulia Pignataro, Luca Santarelli, Marcello Covino, Antonio Gasbarrini and Francesco Franceschi
Diagnostics 2025, 15(20), 2612; https://doi.org/10.3390/diagnostics15202612 - 16 Oct 2025
Viewed by 1377
Abstract
Sepsis is a life-threatening condition that requires early recognition and intervention to improve patient outcomes. Optimizing hemodynamic management is crucial, and clinicians must utilize all available tools to guide therapy effectively. Echocardiography is a rapid, non-invasive, and repeatable method that has emerged as [...] Read more.
Sepsis is a life-threatening condition that requires early recognition and intervention to improve patient outcomes. Optimizing hemodynamic management is crucial, and clinicians must utilize all available tools to guide therapy effectively. Echocardiography is a rapid, non-invasive, and repeatable method that has emerged as a valuable tool in the management of septic patients. Studying its role can provide insights into both therapeutic guidance and prognostic assessment. The primary aim of this review is to highlight the importance of echocardiography in the hemodynamic management of patients with sepsis. The secondary objective is to assess its prognostic value, as echocardiography can inform both the immediate management of critically ill patients and their overall prognosis. A narrative review of the literature published in the last 15 years was conducted using PubMed, and references were managed with Mendeley. Articles focusing on adult and pediatric patients, as well as relevant animal studies, which evaluated echocardiographic assessment of cardiac function, fluid responsiveness, or hemodynamic management were included. Multiple studies demonstrate that echocardiography is a reliable, non-invasive, and easily repeatable tool for assessing fluid responsiveness in septic patients. It allows for dynamic monitoring of stroke volume, VTI, and other hemodynamic parameters, supporting tailored fluid and vasoactive therapy. Additionally, echocardiography provides prognostic insights, with right ventricular dysfunction emerging as a strong predictor of increased mortality. Other parameters, including global longitudinal strain and left ventricular diastolic function, further contribute to risk stratification. Echocardiography is an indispensable tool in the management of sepsis, offering both real-time guidance for hemodynamic optimization and valuable prognostic information. Its routine use can enhance personalized care and improve clinical outcomes in critically ill septic patients. Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
16 pages, 2562 KB  
Article
Skeletal Muscle 31P Magnetic Resonance Spectroscopy Study of Patients with Parkinson’s Disease: Energy Metabolism and Exercise Performance
by Jimin Ren, Neha Patel, Talon Johnson, Ross Querry and Staci Shearin
Diagnostics 2025, 15(20), 2573; https://doi.org/10.3390/diagnostics15202573 - 13 Oct 2025
Viewed by 1715
Abstract
Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremor, bradykinesia, rigidity, and postural instability. In the absence of disease-modifying therapies, exercise remains one of the few interventions shown to effectively reduce fall risk and improve mobility. [...] Read more.
Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremor, bradykinesia, rigidity, and postural instability. In the absence of disease-modifying therapies, exercise remains one of the few interventions shown to effectively reduce fall risk and improve mobility. However, it remains unclear whether skeletal muscle ATP metabolism is impaired in PD, and whether the benefits of exercise arise primarily from improvements in central motor control or peripheral metabolic adaptations. Methods: Fourteen individuals with PD and five healthy controls underwent kinetic 31P Magnetic Resonance Spectroscopy (MRS) to assess resting muscle ATP synthesis and dynamic 31P MRS during in-magnet exercise to evaluate oxidative phosphorylation in active muscle. Results: At rest, ATP synthesis rates mediated by ATPase and creatine kinase (CK) were on average 46 ± 23% and 24 ± 9% lower, respectively, in the PD group compared to controls (p < 0.005), suggesting peripheral mitochondrial dysfunction. During plantar flexion exercise at 15% of lean body mass, range of motion (ROM) was reduced by 22 ± 5% in PD participants (p = 0.01). Despite this, post-exercise recovery of phosphocreatine (PCr) and inorganic phosphate (Pi) was similar between groups. Recovery time constants for PCr and Pi correlated with participants’ total weekly exercise time, indicating a metabolic adaptation to regular physical activity. Modest ROM improvements were observed in both groups following calf-raise exercise training. Conclusions: Reduced skeletal muscle ATP metabolism may contribute to peripheral weakness in PD. Regular exercise appears to promote adaptive metabolic responses, highlighting the need for therapeutic strategies targeting both central and peripheral components of PD. Full article
(This article belongs to the Special Issue Applications of Quantitative MRI in Neurodegenerative Disorders and Peripheral Neuropathies)
►▼ Show Figures

Figure 1

16 pages, 3586 KB  
Article
Ultrasound Risk Stratification of Autonomously Functioning Thyroid Nodules: Cine Loop Video Sequences Versus Static Image Captures
by Larissa Rosenbaum, Martin Freesmeyer, Tabea Nikola Schmidt, Christian Kühnel, Falk Gühne and Philipp Seifert
Diagnostics 2025, 15(19), 2525; https://doi.org/10.3390/diagnostics15192525 - 6 Oct 2025
Viewed by 1201
Abstract
Background/Objectives: Autonomously functioning thyroid nodules (AFTNs) are most frequently diagnosed as benign. However, they show high ratings in ultrasound (US) risk stratification systems (RSSs) that utilize the current clinical standard methodology of conventional static image capture (SIC) documentation. The objective of this [...] Read more.
Background/Objectives: Autonomously functioning thyroid nodules (AFTNs) are most frequently diagnosed as benign. However, they show high ratings in ultrasound (US) risk stratification systems (RSSs) that utilize the current clinical standard methodology of conventional static image capture (SIC) documentation. The objective of this study was to evaluate the RSS ratings and respective fine needle cytology (FNC) recommendations of cine loop (CL) video sequences in comparison to SIC. Methods: 407 patients with 424 AFTNs were enrolled in this unicentric, retrospective study between 11/2015 and 11/2023. Recorded US CL and SIC were analyzed lesion-wise and compared regarding US features, Kwak and ACR TIRADS, ACR FNC recommendations, as well as assessment difficulties and artifacts. Statistical analyses were conducted using the Chi2 test and Spearman’s correlation coefficient in SPSS software. p-values < 0.05 were considered significant. Results: Strong to very strong correlations were observed for all US features, RSS ratings, and ACR FNC recommendations (Spearman’s correlation: each p < 0.001), comparing CL and SIC. For >60% of the AFTNs, ACR FNC recommendation was given. Kwak TIRADS were more consistent with the benign nature of AFTNs than the ACR ratings. CL captured significantly more “echogenic foci” than SIC (Chi2: p < 0.001). Artifacts (poor image quality, acoustic shadowing, sagittal incompletely displayed AFTN) were significantly more common on CL, affecting ~40% of AFTNs, compared to ~15% on SIC (Chi2: each p < 0.05). Weak correlation was observed for assessment confidence between CL and SIC, with SIC outperforming CL (Spearman’s correlation: each p < 0.001). Conclusions: A strong correlation was identified between CL and SIC in terms of RSS ratings and ACR FNC recommendations. Kwak is a superior representative of the benign character of AFTNs than ACR. However, CL provided more detailed information while being associated with decreased observer confidence and more artifacts. Specific operator training and technical improvements, including AI implementation, could improve image quality in future. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
►▼ Show Figures

Figure 1

24 pages, 334 KB  
Review
From Heart to Abdominal Aorta: Integrating Multi-Modal Cardiac Imaging Derived Haemodynamic Biomarkers for Abdominal Aortic Aneurysm Risk Stratification, Surveillance, Pre-Operative Assessment and Therapeutic Decision-Making
by Rafic Ramses and Obiekezie Agu
Diagnostics 2025, 15(19), 2497; https://doi.org/10.3390/diagnostics15192497 - 1 Oct 2025
Viewed by 1439
Abstract
Recent advances in cardiovascular imaging have revolutionized the assessment and management of abdominal aortic aneurysm (AAA) through the integration of sophisticated haemodynamic biomarkers. This comprehensive review evaluates the clinical utility and mechanistic significance of multiple biomarkers in AAA pathogenesis, progression, and treatment outcomes. [...] Read more.
Recent advances in cardiovascular imaging have revolutionized the assessment and management of abdominal aortic aneurysm (AAA) through the integration of sophisticated haemodynamic biomarkers. This comprehensive review evaluates the clinical utility and mechanistic significance of multiple biomarkers in AAA pathogenesis, progression, and treatment outcomes. Advanced cardiac imaging modalities, including four-dimensional magnetic resonance imaging (4D MRI), computational fluid dynamics (CFD), and specialized echocardiography, enable precise quantification of critical haemodynamic parameters. Wall shear stress (WSS) emerges as a fundamental biomarker, with values below 0.4 Pa indicating pathological conditions and increased risk for aneurysm progression. Time-averaged wall shear stress (TAWSS), typically maintaining values above 1.5 Pa in healthy arterial segments, provides crucial information about sustained haemodynamic forces affecting the vessel wall. The oscillatory shear index (OSI), ranging from 0 (unidirectional flow) to 0.5 (purely oscillatory flow), quantifies directional changes in WSS during cardiac cycles. In AAA, elevated OSI values between 0.3 and 0.4 correlate with disturbed flow patterns and accelerated disease progression. The relative residence time (RRT), combining TAWSS and OSI, identifies regions prone to thrombosis, with values exceeding 2–3 Pa−1 indicating increased risk. The endothelial cell activation potential (ECAP), calculated as OSI/TAWSS, serves as an integrated metric for endothelial dysfunction risk, with values above 0.2–0.3 Pa−1 suggesting increased inflammatory activity. Additional biomarkers include the volumetric perivascular characterization index (VPCI), which assesses vessel wall inflammation through perivascular tissue analysis, and pulse wave velocity (PWV), measuring arterial stiffness. Central aortic systolic pressure and the aortic augmentation index provide essential information about cardiovascular load and arterial compliance. Novel parameters such as particle residence time, flow stagnation, and recirculation zones offer detailed insights into local haemodynamics and potential complications. Implementation challenges include the need for specialized equipment, standardized protocols, and expertise in data interpretation. However, the potential for improved patient outcomes through more precise risk stratification and personalized treatment planning justifies continued development and validation of these advanced assessment tools. Full article
(This article belongs to the Special Issue Cardiovascular Diseases: Innovations in Diagnosis and Management)
12 pages, 704 KB  
Article
AI-Based 3D-Segmentation Quantifies Sarcopenia in Multiple Myeloma Patients
by Thuy-Duong Do, Tobias Nonnenmacher, Marieke Burghardt, Stefanie Zschäbitz, Marina Hajiyianni, Elias Karl Mai, Marc-Steffen Raab, Carsten Müller-Tidow, Hans-Ulrich Kauczor, Hartmut Goldschmidt and Ulrike Dapunt
Diagnostics 2025, 15(19), 2466; https://doi.org/10.3390/diagnostics15192466 - 26 Sep 2025
Viewed by 945
Abstract
Background: Sarcopenia is characterized by a loss of muscle mass and strength, resulting in functional limitations and an increased risk of falls, injuries and fractures. The aim of this study was to obtain detailed information on skeletal muscle changes in patients with multiple [...] Read more.
Background: Sarcopenia is characterized by a loss of muscle mass and strength, resulting in functional limitations and an increased risk of falls, injuries and fractures. The aim of this study was to obtain detailed information on skeletal muscle changes in patients with multiple myeloma (MM) during treatment. Methods: A total of 51 patients diagnosed with MM who had undergone whole-body low-dose computed tomography acquisition prior to induction therapy (T1) and post autologous stem cell transplantation (T2) were examined retrospectively. Total volume (TV), muscle volume (MV) and intramuscular adipose tissue volume (IMAT) of the autochthonous back muscles, the iliopsoas muscle and the gluteal muscles were evaluated on the basis of the resulting masks of the BOA tool with the fully automated combination of TotalSegmentator and a body composition analysis. An in-house trained artificial intelligence network was used to obtain a fully automated three-dimensional segmentation assessment. Results: Patients’ median age was 58 years (IQR 52–66), 38 were male and follow-up CT-scans were performed after a mean of 11.8 months (SD ± 3). Changes in MV and IMAT correlated significantly with Body-Mass-Index (BMI) (r = 0.7, p < 0.0001). Patients (n = 28) with a decrease in BMI (mean −2.2 kg/m2) during therapy lost MV (T1: 3419 cm3, IQR 3176–4000 cm3 vs. T2: 3226 cm3, IQR 3014–3662 cm3, p < 0.0001) whereas patients (n = 20) with an increased BMI (mean +1.4 kg/m2) showed an increase in IMAT (T1: 122 cm3, IQR 96.8–202.8 cm3 vs. T2: 145.5 cm3, IQR 115–248 cm3, p = 0.0002). Loss of MV varied between different muscle groups and was most prominent in the iliopsoas muscle (−9.8%) > gluteus maximus (−9.1%) > gluteus medius (−5.8%) > autochthonous back muscles (−4.3%) > gluteus minimus (−1.5%). Increase in IMAT in patients who gained weight was similar between muscle groups. Conclusions: The artificial intelligence-based three-dimensional segmentation process is a reliable and time-saving method to acquire in-depth information on sarcopenia in MM patients. Loss of MV and increase in IMAT were reliably detectable and associated with changes in BMI. Loss of MV was highest in muscles with more type 2 muscle fibers (fast-twitch, high energy) whereas muscles with predominantly type 1 fibers (slow-twitch, postural control) were less affected. This study provides valuable insight into muscle changes of MM patients during treatment, which might aid in tailoring exercise interventions more precisely to patients’ needs. Full article
(This article belongs to the Special Issue Advancements in the Diagnostics and Management of Musculoskeletal Diseases)
►▼ Show Figures

Figure 1

15 pages, 1168 KB  
Article
Laboratory Validation of a Fully Automated Point-of-Care Device for High-Order Multiplexing Real-Time PCR Detection of Respiratory Pathogens
by Libby C. W. Li, Deborah M. S. Tai, Anita Yee, Nancy B. Y. Tsui, Parker Y. L. Tsang, Sunny L. H. Chu, Chui Ting Leung, Bernice K. W. Leung, Winston Wong, Firaol Tamiru Kebede, Pete Y. M. Leung, Teresa Chung, Cyril C. Y. Yip, Jonathan H. K. Chen, Rosana W. S. Poon, Kelvin K. W. To, Kwok-Yung Yuen, Manson Fok, Johnson Y. N. Lau and Lok Ting Lau
Diagnostics 2025, 15(19), 2445; https://doi.org/10.3390/diagnostics15192445 - 25 Sep 2025
Cited by 1 | Viewed by 2838
Abstract
Background/Objectives: We have previously reported the engineering of a point-of-care (POC) system that fully automates the procedures for nucleic acid extraction and multiplexed real-time RT-PCR, with a major advantage of high-level multiplexing. In this study, we applied and validated the system in [...] Read more.
Background/Objectives: We have previously reported the engineering of a point-of-care (POC) system that fully automates the procedures for nucleic acid extraction and multiplexed real-time RT-PCR, with a major advantage of high-level multiplexing. In this study, we applied and validated the system in a respiratory tract infection setting. Methods: An automatic nested real-time RT-PCR assay was developed (POCm). It was a 40-plex assay that simultaneously detected 39 epidemiologically important respiratory pathogens in 1.5 h in the POC system. The analytical and clinical performance was evaluated. Results: The analytical sensitivities of the POCm assay were comparable to those of its single-plex counterparts performed manually on a bench-top. The minimum detectable concentrations ranged from 53 copies/mL to 5.3 × 103 copies/mL for all pathogen targets except hCoV-NL63 (5.3 × 104 copies/mL). The quantitative performance was demonstrated by the linear correlations between Ct values and input concentrations for all pathogen targets, with 24 of them demonstrating coefficients of correlation (r) greater than 0.9. The POCm assay was subsequently evaluated in 283 clinical samples. A high level of agreement (98.2–100%) was achieved for pathogen detection results between POCm and standard diagnostic methods. The POCm result was also fully concordant with the result of another commercial POC multiplex platform. For positive clinical samples, pairwise Ct values measured by POCm closely correlated with those of the bench-top reference method (r = 0.70). The feasibility of mutation genotyping of the viral subtype was further demonstrated. Conclusions: This study demonstrated the practicality of POCm for routine testing in clinical laboratories. Further clinical trials are being conducted to evaluate the clinical performance of the system. Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
►▼ Show Figures

Figure 1

17 pages, 4324 KB  
Article
Dysregulation of miRNAs in Sicilian Patients with Huntington’s Disease
by Michele Salemi, Francesca Antonia Schillaci, Maria Grazia Salluzzo, Giovanna Marchese, Giovanna Maria Ventola, Concetta Simona Perrotta, Vincenzo Di Stefano, Giuseppe Lanza and Raffaele Ferri
Diagnostics 2025, 15(19), 2454; https://doi.org/10.3390/diagnostics15192454 - 25 Sep 2025
Viewed by 899
Abstract
Background/Objectives: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder caused by a CAG nucleotide repeat expansion in the Huntingtin (HTT) gene. Dysregulation of microRNAs (miRNAs), key post-transcriptional regulators of gene expression, has been implicated in HD pathogenesis, although their [...] Read more.
Background/Objectives: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder caused by a CAG nucleotide repeat expansion in the Huntingtin (HTT) gene. Dysregulation of microRNAs (miRNAs), key post-transcriptional regulators of gene expression, has been implicated in HD pathogenesis, although their specific roles remain incompletely understood. Methods: Peripheral blood mononuclear cells from Sicilian HD patients and matched healthy controls were subjected to small RNA sequencing. Differential expression analysis was conducted using DESeq2 (version 1.44.0), with significance defined as |fold change| ≥ 1.5 and adjusted p ≤ 0.05. Ingenuity Pathway Analysis (IPA) was applied to assess functional enrichment, focusing on neurological diseases, inflammatory processes, and miRNA–RNA messenger (mRNA) interaction networks. Results: A total of 790 differentially expressed miRNAs were identified in HD patients (270 upregulated and 520 downregulated). IPA revealed enrichment in pathways related to organismal injury, neurological disease, and inflammatory responses. Four major regulatory networks linked differentially expressed miRNAs to neurodegenerative processes, with target genes involved in neuroinflammation, cellular stress responses, and metabolic dysfunction. Cross-referencing with previous RNA-seq data identified 5721 high-confidence miRNA–mRNA interactions, implicating 721 target genes across 54 key canonical pathways. Conclusions: HD patients exhibit a distinct and reproducible peripheral blood miRNA expression signature. These dysregulated miRNAs may represent accessible biomarkers and provide mechanistic insights into HD pathogenesis, with potential applications for diagnosis, prognosis, and therapeutic development. Full article
(This article belongs to the Special Issue Neurological Diseases: Biomarkers, Diagnosis and Prognosis)
►▼ Show Figures

Figure 1

30 pages, 4355 KB  
Review
Stents and Emerging Alternatives in Upper Gastrointestinal Endoscopy: A Comprehensive Review
by Francesca Bernardi, Giuseppe Dell’Anna, Paolo Biamonte, Alberto Barchi, Lorella Fanti, Alberto Malesci, Lorenzo Fuccio, Emanuele Sinagra, Giulio Calabrese, Antonio Facciorusso, Angelo Bruni, Gianfranco Donatelli, Silvio Danese and Francesco Vito Mandarino
Diagnostics 2025, 15(18), 2344; https://doi.org/10.3390/diagnostics15182344 - 16 Sep 2025
Cited by 4 | Viewed by 2819
Abstract
Endoscopy has revolutionized the management of gastrointestinal (GI) conditions, enabling less invasive treatments for cases that once required surgery. Among these innovations, endoscopically placed stents have played a crucial role in the treatment of upper GI tract diseases for many years. Today, stents [...] Read more.
Endoscopy has revolutionized the management of gastrointestinal (GI) conditions, enabling less invasive treatments for cases that once required surgery. Among these innovations, endoscopically placed stents have played a crucial role in the treatment of upper GI tract diseases for many years. Today, stents remain a valid first-line treatment for specific indications; however, advancements in endoscopic technologies have led to a reassessment of their role in some conditions. While stents are still the primary choice for palliation of malignant esophageal strictures, endoscopic vacuum therapy (EVT) has demonstrated superior outcomes for esophageal leaks, and Endoscopic UltraSonography-guided placement of lumen-apposing metal stents (LAMS) has outperformed traditional stents in gastric obstructions. This review evaluates current stent indications, highlighting upper GI conditions where they remain the best option, while also exploring emerging technologies and updated clinical guidelines to optimize patient care. Full article
(This article belongs to the Special Issue Advances in the Diagnostic Imaging of Gastrointestinal Diseases)
►▼ Show Figures

Figure 1

19 pages, 3431 KB  
Article
Computed Tomography Radiomics and Machine Learning for Prediction of Histology-Based Hepatic Steatosis Scores
by Winston T. Chu, Hui Wang, Marcelo A. Castro, Venkatesh Mani, C. Paul Morris, Thomas C. Friedrich, David H. O’Connor, Courtney L. Finch, Ji Hyun Lee, Philip J. Sayre, Gabriella Worwa, Anya Crane, Jens H. Kuhn, Ian Crozier, Jeffrey Solomon and Claudia Calcagno
Diagnostics 2025, 15(18), 2310; https://doi.org/10.3390/diagnostics15182310 - 11 Sep 2025
Viewed by 1434
Abstract
Background/Objective: Computed tomography (CT) can be used to non-invasively assess the health of the liver; however, radiologist evaluation and simple thresholding alone are insufficient for diagnosis of hepatic steatosis, necessitating biopsies. This study explored CT radiomics and machine learning to enable non-invasive, objective, [...] Read more.
Background/Objective: Computed tomography (CT) can be used to non-invasively assess the health of the liver; however, radiologist evaluation and simple thresholding alone are insufficient for diagnosis of hepatic steatosis, necessitating biopsies. This study explored CT radiomics and machine learning to enable non-invasive, objective, and quantitative prediction of steatosis severity across the macaque liver. Methods: In this retrospective study, CT images of 42 crab-eating macaques (age [yr] = 6.1 ± 1.7; sex [male/female] = 26/16) with varying degrees of hepatic steatosis were analyzed, and the results were compared to histology-based steatosis scores of livers from the same animals. After extracting radiomic features, a thorough array of statistical analyses, feature selection techniques, and machine learning models were applied to identify a distinct radiomic signature of histologically defined hepatic steatosis. Results: We identified 12 radiomic features that correlated with steatosis scores, and hierarchical clustering based on radiomic attributes alone revealed clusters roughly aligning with steatosis severity groups. The k-nearest neighbors model architecture best predicted histopathologic steatosis scores in both classification and regression tasks (area under the receiver operating characteristic curve [AUC ROC] = 0.89 ± 0.09; root-mean-square error [RMSE] = 0.60 ± 0.10). Feature analyses identified seven key radiomic features (six first-order features and one gray-level co-occurrence matrix feature) that were most important when predicting steatosis. Conclusions: We identified a CT radiomic signature of steatosis and demonstrated that histology-based steatosis scores can be predicted non-invasively and objectively using machine learning and CT radiomics as a potential alternative to invasive core biopsies. Given the strong similarities in liver structure, liver function, and hepatic steatosis pathophysiology between macaques and humans, these findings have the potential to translate to humans. Full article
(This article belongs to the Special Issue Artificial Intelligence-Driven Radiomics in Medical Diagnosis)
►▼ Show Figures

Figure 1

19 pages, 912 KB  
Article
Exploring IL-10 and NOS3 Genetic Variants as a Risk Factor for Neonatal Respiratory Distress Syndrome and Its Outcome
by Mădălina Anciuc-Crauciuc, George-Andrei Crauciuc, Florin Tripon, Marta Simon, Manuela Camelia Cucerea and Claudia Violeta Bănescu
Diagnostics 2025, 15(17), 2259; https://doi.org/10.3390/diagnostics15172259 - 6 Sep 2025
Viewed by 1934
Abstract
Background/Objective: Neonatal respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants. Interleukin-10 (IL-10) and endothelial nitric oxide synthase (eNOS, also known as NOS3) regulate inflammation and vascular tone, and genetic variants may influence the risk of [...] Read more.
Background/Objective: Neonatal respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants. Interleukin-10 (IL-10) and endothelial nitric oxide synthase (eNOS, also known as NOS3) regulate inflammation and vascular tone, and genetic variants may influence the risk of RDS. To investigate the association between IL-10 rs1800872 (c.-149+1984T>G), IL-10 rs1800896 (c.-149+2474T>C), and NOS3 rs2070744 (c.-149+1691C>T), NOS3 rs1799983 (c.894T>G) variants and the risk of RDS in a Romanian cohort of preterm neonates. Methods: This case–control study included 340 preterm neonates (113 with RDS, 227 controls) born at <36 weeks of gestation. Genotyping was performed using TaqMan SNP assays. Logistic regression adjusted for gestational age and sex estimated odds ratios (ORs) and 95% confidence intervals (CIs). ROC analyses evaluated predictive performance. Results: No significant differences in genotype or allele distributions were observed between RDS and control groups for any variant. Haplotype analysis also revealed no association with RDS susceptibility or severity. NOS3:c.894T>G variant was associated with reduced risk of severe RDS after correction (adjusted p = 0.009), though survival analysis showed no significant genotype-specific effects. Epistatic genotype interaction was observed for the IL-10 T/G + T/C, present only in RDS (p = 0.0026). ROC analysis revealed a clinical prediction of RDS (AUC = 0.996), while the addition of genetic variants improved discrimination for severity (AUC = 0.865; 95% CI: 0.773–0.957) and mortality (AUC = 0.913; 95% CI: 0.791–1.000). Conclusions: IL-10 and NOS3 variants were not individually associated with overall RDS susceptibility. The observed epistatic interactions and the potential protective effect of NOS3:c.894T>G against severe forms can suggest modulatory roles in disease progression. Larger, ethnically homogeneous cohorts are needed to confirm these findings and assess their potential for informing personalized care for neonates. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
►▼ Show Figures

Figure 1

11 pages, 594 KB  
Article
Nanopore 16S-Full Length and ITS Sequencing for Microbiota Identification in Intra-Abdominal Infections
by Jian-Jhou Liao, Yong-Sian Chen, Hui-Chen Lin, Yi-Ju Chen, Kuo-Lung Lai, Yan-Chiao Mao, Po-Yu Liu and Han-Ni Chuang
Diagnostics 2025, 15(17), 2257; https://doi.org/10.3390/diagnostics15172257 - 6 Sep 2025
Cited by 1 | Viewed by 1285
Abstract
Background/Objectives: Intra-abdominal infections (IAIs) constitute significant clinical challenges that can rapidly progress to life-threatening conditions if not promptly diagnosed and treated. Traditional pathogen identification methodologies, predominantly culture-based, frequently necessitate extended turnaround times (TATs) and exhibit limitations in detecting polymicrobial or anaerobic infections. [...] Read more.
Background/Objectives: Intra-abdominal infections (IAIs) constitute significant clinical challenges that can rapidly progress to life-threatening conditions if not promptly diagnosed and treated. Traditional pathogen identification methodologies, predominantly culture-based, frequently necessitate extended turnaround times (TATs) and exhibit limitations in detecting polymicrobial or anaerobic infections. Methods: We implemented Oxford Nanopore Technology (ONT) sequencing to analyze the microbiota in patients with IAIs at Taichung Veterans General Hospital. The study cohort comprised sixteen patients with IAIs. Following specimen collection, DNA extraction was performed, and then full-length 16S rRNA and ITS region amplification and subsequent ONT sequencing were conducted. Results: Conventional clinical culture-based methodologies detected pathogens in 13 patients. Among the 14 successfully sequenced specimens, ONT sequencing elucidated a diverse spectrum of bacteria and fungi, with read counts ranging from 375 to 19,716. Polymicrobial and anaerobe-enriched communities were predominantly observed in lower gastrointestinal tract infections, specifically colonic or small bowel perforations, whereas upper gastrointestinal perforations, including those of the stomach or duodenum, were frequently dominated by Streptococcus, Granulicatella, or Candida species. The sequencing identified pathogens concordant with culture results, including Escherichia coli, Enterococcus, and Candida albicans. In addition, anaerobic or low-abundance taxa were exclusively identifiable through sequencing methodologies. Conclusions: ONT sequencing facilitated results within up to 24 h and successfully detected pathogens in culture-negative cases. These findings underscore the utility of ONT sequencing as an expeditious and comprehensive diagnostic modality for IAIs. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
►▼ Show Figures

Figure 1

22 pages, 3504 KB  
Article
New Application for the Early Detection of Wound Infections Using a Near-Infrared Fluorescence Device and Forward-Looking Thermal Camera
by Ha Jong Nam, Se Young Kim and Hwan Jun Choi
Diagnostics 2025, 15(17), 2221; https://doi.org/10.3390/diagnostics15172221 - 1 Sep 2025
Viewed by 1666
Abstract
Background: Timely and accurate identification of wound infections is essential for effective management, yet remains clinically challenging. This study evaluated the utility of a near-infrared autofluorescence imaging system (Fluobeam®, Fluoptics, Grenoble, France) and a thermal imaging system (FLIR®, Teledyne [...] Read more.
Background: Timely and accurate identification of wound infections is essential for effective management, yet remains clinically challenging. This study evaluated the utility of a near-infrared autofluorescence imaging system (Fluobeam®, Fluoptics, Grenoble, France) and a thermal imaging system (FLIR®, Teledyne LLC, Thousand Oaks, CA, USA) for detecting bacterial and fungal infections in chronic wounds. Fluobeam® enables real-time visualization of microbial autofluorescence without exogenous contrast agents, whereas FLIR® detects localized thermal changes associated with infection-related inflammation. Methods: This retrospective clinical study included 33 patients with suspected wound infections. All patients underwent autofluorescence imaging using Fluobeam® and concurrent thermal imaging with FLIR®. Imaging findings were compared with microbiological culture results, clinical signs of infection, and semi-quantitative microbial burdens. Results: Fluobeam® achieved a sensitivity of 78.3% and specificity of 80.0% in detecting culture-positive infections. Fluorescence signal intensity correlated strongly with microbial burden (r = 0.76, p < 0.01) and clinical indicators, such as exudate, swelling, and malodor. Pathogens with high metabolic fluorescence, including Pseudomonas aeruginosa and Candida spp., were consistently identified. Representative cases demonstrate the utility of fluorescence imaging in guiding targeted debridement and enhancing intraoperative decision-making. Conclusions: Near-infrared autofluorescence imaging with Fluobeam® and thermal imaging with FLIR® offer complementary, noninvasive diagnostic insights into microbial burden and host inflammatory response. The combined use of these modalities may improve infection detection, support clinical decision-making, and enhance wound care outcomes. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
►▼ Show Figures

Figure 1

13 pages, 810 KB  
Article
Optimization of 16S RNA Sequencing and Evaluation of Metagenomic Analysis with Kraken 2 and KrakenUniq
by Nasserdine Papa Mze, Cécile Fernand-Laurent, Sonnentrucker Maxence, Olfa Zanzouri, Solen Daugabel and Stéphanie Marque Juillet
Diagnostics 2025, 15(17), 2175; https://doi.org/10.3390/diagnostics15172175 - 27 Aug 2025
Viewed by 2629
Abstract
Background/Objectives: 16S ribosomal RNA sequencing has, for several years, been the main means of identifying bacterial and archaeal species. Low-throughput Sanger sequencing is often used for the detection and identification of microbial species, but this technique has several limitations. The use of [...] Read more.
Background/Objectives: 16S ribosomal RNA sequencing has, for several years, been the main means of identifying bacterial and archaeal species. Low-throughput Sanger sequencing is often used for the detection and identification of microbial species, but this technique has several limitations. The use of high-throughput sequencers may be a good alternative to improve patient identification, especially for polyclonal infections and management. Kraken 2 and KrakenUniq are free, high-throughput tools providing a very rapid and accurate classification for metagenomic analyses. However, Kraken 2 can present false-positive results relative to KrakenUniq, which can be limiting in hospital settings requiring high levels of accuracy. The aim of this study was to establish an alternative next-generation sequencing technique to replace Sanger sequencing and to confirm that KrakenUniq is an excellent analysis tool that does not present false results relative to Kraken 2. Methods: DNA was extracted from reference bacterial samples for Laboratory Quality Controls (QCMDs) and the V2-V3 and V3-V4 regions of the 16S ribosomal gene were amplified. Amplified products were sequenced with the Illumina 16S Metagenomic Sequencing protocol with minor modifications to adapt and sequence an Illumina 16S library with a small 500-cycle nano-flow cell. The raw files (Fastq) were analyzed on a commercial Smartgene platform for comparison with Kraken 2 and KrakenUniq results. KrakenUniq was used with a standard bacterial database and with the 16S-specific Silva138, RDP11.5, and Greengenes 13.5 databases. Results: Seven of the eight (87.5%) QCMDs were correctly sequenced and identified by Sanger sequencing. The remaining QCMD, QCMD6, could not be identified through Sanger sequencing. All QCMDs were correctly sequenced and identified by MiSeq with the commercial Smartgene analysis platform. QCMD6 contained two bacteria, Acinetobacter and Klebsiella. KrakenUniq identification results were identical to those of Smartgene, whereas Kraken 2 yielded 25% false-positive results. Conclusions: If Sanger identification fails, MiSeq with a small nano-flow cell is a very good alternative for the identification of bacterial species. KrakenUniq is a free, fast, and easy-to-use tool for identifying and classifying bacterial infections. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
►▼ Show Figures

Figure 1

42 pages, 1982 KB  
Article
SHAP-Based Identification of Potential Acoustic Biomarkers in Patients with Post-Thyroidectomy Voice Disorder
by Salih Celepli, Irem Bigat, Bilgi Karakas, Huseyin Mert Tezcan, Mehmet Dincay Yar, Pinar Celepli, Mehmet Feyzi Aksahin, Oguz Hancerliogullari, Yavuz Fuat Yilmaz and Osman Erogul
Diagnostics 2025, 15(16), 2065; https://doi.org/10.3390/diagnostics15162065 - 18 Aug 2025
Cited by 1 | Viewed by 1594
Abstract
Objective: The objective of this study was to identify potential robust acoustic biomarkers for functional post-thyroidectomy voice disorder (PTVD) that may support early diagnosis and personalized treatment strategies, using acoustic analysis and explainable machine learning methods. Methods: Spectral and cepstral features were extracted [...] Read more.
Objective: The objective of this study was to identify potential robust acoustic biomarkers for functional post-thyroidectomy voice disorder (PTVD) that may support early diagnosis and personalized treatment strategies, using acoustic analysis and explainable machine learning methods. Methods: Spectral and cepstral features were extracted from /a/ and /i/ voice recordings collected preoperatively and 4–6 weeks postoperatively from a total of 126 patients. Various Support Vector Machine (SVM) and Boosting models were trained. SHapley Additive exPlanations (SHAP) analysis was applied to enhance interpretability. SHAP values from training and test sets were compared via scatter plots to identify stable candidate biomarkers with high consistency. Results: GentleBoost (AUC = 0.85) and LogitBoost (AUC = 0.81) demonstrated the highest classification performance. Performance metrics across all models were evaluated for statistical significance. DeLong’s test was conducted to assess differences between ROC curves. The features iCPP, aCPP, and aHNR were identified as stable candidate biomarkers, exhibiting consistent SHAP distributions in both training and test sets in terms of direction and magnitude. These features showed statistically significant correlations with PTVD (p < 0.05) and demonstrated strong effect sizes (Cohen’s d = −2.95, −1.13, −0.60). Their diagnostic relevance was further supported by post hoc power analyses (iCPP: 1.00; aCPP: 0.998). Conclusions: SHAP-supported machine learning models offer an objective and clinically meaningful approach for evaluating PTVD. The identified features may serve as potential biomarkers to guide individualized voice therapy decisions during the early postoperative period. Full article
(This article belongs to the Special Issue A New Era in Diagnosis: From Biomarkers to Artificial Intelligence)
►▼ Show Figures

Figure 1

19 pages, 487 KB  
Review
Smart Clothing and Medical Imaging Innovations for Real-Time Monitoring and Early Detection of Stroke: Bridging Technology and Patient Care
by David Sipos, Kata Vészi, Bence Bogár, Dániel Pető, Gábor Füredi, József Betlehem and Attila András Pandur
Diagnostics 2025, 15(15), 1970; https://doi.org/10.3390/diagnostics15151970 - 6 Aug 2025
Cited by 1 | Viewed by 2136
Abstract
Stroke is a significant global health concern characterized by the abrupt disruption of cerebral blood flow, leading to neurological impairment. Accurate and timely diagnosis—enabled by imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI)—is essential for differentiating stroke types and [...] Read more.
Stroke is a significant global health concern characterized by the abrupt disruption of cerebral blood flow, leading to neurological impairment. Accurate and timely diagnosis—enabled by imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI)—is essential for differentiating stroke types and initiating interventions like thrombolysis, thrombectomy, or surgical management. In parallel, recent advancements in wearable technology, particularly smart clothing, offer new opportunities for stroke prevention, real-time monitoring, and rehabilitation. These garments integrate various sensors, including electrocardiogram (ECG) electrodes, electroencephalography (EEG) caps, electromyography (EMG) sensors, and motion or pressure sensors, to continuously track physiological and functional parameters. For example, ECG shirts monitor cardiac rhythm to detect atrial fibrillation, smart socks assess gait asymmetry for early mobility decline, and EEG caps provide data on neurocognitive recovery during rehabilitation. These technologies support personalized care across the stroke continuum, from early risk detection and acute event monitoring to long-term recovery. Integration with AI-driven analytics further enhances diagnostic accuracy and therapy optimization. This narrative review explores the application of smart clothing in conjunction with traditional imaging to improve stroke management and patient outcomes through a more proactive, connected, and patient-centered approach. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring and Diagnosing in Critical Care)
►▼ Show Figures

Figure 1

21 pages, 799 KB  
Review
The Molecular Diagnosis of Invasive Fungal Diseases with a Focus on PCR
by Lottie Brown, Mario Cruciani, Charles Oliver Morton, Alexandre Alanio, Rosemary A. Barnes, J. Peter Donnelly, Ferry Hagen, Rebecca Gorton, Michaela Lackner, Juergen Loeffler, Laurence Millon, Riina Rautemaa-Richardson and P. Lewis White
Diagnostics 2025, 15(15), 1909; https://doi.org/10.3390/diagnostics15151909 - 30 Jul 2025
Cited by 3 | Viewed by 5503
Abstract
Background: Polymerase chain reaction (PCR) is highly sensitive and specific for the rapid diagnosis of invasive fungal disease (IFD) but is not yet widely implemented due to concerns regarding limited standardisation between assays, the lack of commercial options and the absence of [...] Read more.
Background: Polymerase chain reaction (PCR) is highly sensitive and specific for the rapid diagnosis of invasive fungal disease (IFD) but is not yet widely implemented due to concerns regarding limited standardisation between assays, the lack of commercial options and the absence of clear guidance on interpreting results. Objectives and Methods: This review provides an update on technical and clinical aspects of PCR for the diagnosis of the most pertinent fungal pathogens, including Aspergillus, Candida, Pneumocystis jirovecii, Mucorales spp., and endemic mycoses. Summary: Recent meta-analyses have demonstrated that quantitative PCR (qPCR) offers high sensitivity for diagnosing IFD, surpassing conventional microscopy, culture and most serological tests. The reported specificity of qPCR is likely underestimated due to comparison with imperfect reference standards with variable sensitivity. Although the very low limit of detection of qPCR can generate false positive results due to procedural contamination or patient colonisation (particularly in pulmonary specimens), the rates are comparable to those observed for biomarker testing. When interpreting qPCR results, it is essential to consider the pre-test probability, determined by the patient population, host factors, clinical presentation and risk factors. For patients with low to moderate pre-test probability, the use of sensitive molecular tests, often in conjunction with serological testing or biomarkers, can effectively exclude IFD when all tests return negative results, reducing the need for empirical antifungal therapy. Conversely, for patients with high pre-test probability and clinical features of IFD, qPCR testing on invasive specimens from the site of infection (such as tissue or bronchoalveolar lavage fluid) can confidently rule in the disease. The development of next-generation sequencing methods to detect fungal infection has the potential to enhance the diagnosis of IFD, but standardisation and optimisation are essential, with improved accessibility underpinning clinical utility. Full article
(This article belongs to the Special Issue Advances in Diagnostic and Therapeutic Strategies for Infectious Diseases)
►▼ Show Figures

Figure 1

23 pages, 481 KB  
Review
Bug Wars: Artificial Intelligence Strikes Back in Sepsis Management
by Georgios I. Barkas, Ilias E. Dimeas and Ourania S. Kotsiou
Diagnostics 2025, 15(15), 1890; https://doi.org/10.3390/diagnostics15151890 - 28 Jul 2025
Cited by 1 | Viewed by 4152
Abstract
Sepsis remains a leading global cause of mortality, with delayed recognition and empirical antibiotic overuse fueling poor outcomes and rising antimicrobial resistance. This systematic scoping review evaluates the current landscape of artificial intelligence (AI) and machine learning (ML) applications in sepsis care, focusing [...] Read more.
Sepsis remains a leading global cause of mortality, with delayed recognition and empirical antibiotic overuse fueling poor outcomes and rising antimicrobial resistance. This systematic scoping review evaluates the current landscape of artificial intelligence (AI) and machine learning (ML) applications in sepsis care, focusing on early detection, personalized antibiotic management, and resistance forecasting. Literature from 2019 to 2025 was systematically reviewed following PRISMA-ScR guidelines. A total of 129 full-text articles were analyzed, with study quality assessed via the JBI and QUADAS-2 tools. AI-based models demonstrated robust predictive performance for early sepsis detection (AUROC 0.68–0.99), antibiotic stewardship, and resistance prediction. Notable tools, such as InSight and KI.SEP, leveraged multimodal clinical and biomarker data to provide actionable, real-time support and facilitate timely interventions. AI-driven platforms showed potential to reduce inappropriate antibiotic use and nephrotoxicity while optimizing outcomes. However, most models are limited by single-center data, variable interpretability, and insufficient real-world validation. Key challenges remain regarding data integration, algorithmic bias, and ethical implementation. Future research should prioritize multicenter validation, seamless integration with clinical workflows, and robust ethical frameworks to ensure safe, equitable, and effective adoption. AI and ML hold significant promise to transform sepsis management, but their clinical impact depends on transparent, validated, and user-centered deployment. Full article
(This article belongs to the Special Issue Recent Advances in Sepsis)
►▼ Show Figures

Figure 1

12 pages, 541 KB  
Review
Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
by Dana-Maria Bilous, Mihai Ciocîrlan, Cătălina Vlăduț and Carmen-Georgeta Fierbințeanu-Braticevici
Diagnostics 2025, 15(15), 1871; https://doi.org/10.3390/diagnostics15151871 - 25 Jul 2025
Cited by 1 | Viewed by 2257
Abstract
Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have [...] Read more.
Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have reduced diagnostic reliability in this subgroup, due to impaired liver and renal function. Presepsin, a soluble fragment of CD14 released during phagocytic activation, has emerged as a promising biomarker for early sepsis detection. This systematic review explores the diagnostic and prognostic utility of presepsin in cirrhotic and non-cirrhotic patients with suspected infection. Data from multiple clinical studies indicate that presepsin levels correlate with infection severity and clinical scores such as SOFA and APACHE II. In cirrhotic patients, presepsin demonstrates superior sensitivity and specificity compared to conventional biomarkers, maintaining diagnostic value despite hepatic dysfunction. Its utility extends to differentiating bacterial infections from fungal infections and monitoring treatment response. While preliminary evidence is compelling, further prospective, multicenter studies are required to validate its integration into standard care algorithms. Presepsin may become a valuable addition to clinical decision-making tools, particularly in hepatology-focused sepsis management. Full article
(This article belongs to the Special Issue Recent Advances in Sepsis)
►▼ Show Figures

Figure 1

27 pages, 18604 KB  
Review
A Plea for a Paradigm Shift from X-Ray to Ultrasound in Adults: An Update for Emergency Physicians, General Practitioners, Orthopedists and Sports Medicine Physicians
by Joseph Osterwalder, Beatrice Hoffmann, Mike Blaivas, Rudolf Horn, Eric Matchiner and Christoph F. Dietrich
Diagnostics 2025, 15(14), 1827; https://doi.org/10.3390/diagnostics15141827 - 21 Jul 2025
Cited by 1 | Viewed by 1111
Abstract
This update is aimed at various specialists who deal with fractures, such as emergency physicians, general practitioners, orthopedists, and sports medicine physicians. The Global Burden of Disease 2019 Fracture Collaborators estimated the worldwide incidence to be at 178 million, i.e., 2.2 fractures per [...] Read more.
This update is aimed at various specialists who deal with fractures, such as emergency physicians, general practitioners, orthopedists, and sports medicine physicians. The Global Burden of Disease 2019 Fracture Collaborators estimated the worldwide incidence to be at 178 million, i.e., 2.2 fractures per 1000 people per year. Traditionally, X-rays are the first choice for suspected fractures. However, many fractures can also be detected or excluded with ultrasound. This option is especially attractive when available at the “point of care,”, i.e., at the patient’s bedside in the ambulatory or emergency setting. Point-of-care ultrasound provides clinicians with a simple, cost-effective imaging tool without radiation and complex infrastructure. The evidence suggests that ultrasound has high diagnostic sensitivity and can reliably rule out many fractures with a high degree of certainty. When applied correctly, it could potentially save millions of radiographs and, in some cases, even compete with the accuracy of X-rays and CT scans. These findings suggest a potential paradigm shift. This update discusses the advantages of ultrasound, its examination technique, sonoanatomy of fractures, and relevant indication groups, including its application for analgesia through nerve, fascia, and fascial plane blocks. Ultrasound’s diagnostic value supports its integration into routine fracture assessment, particularly in emergency and ambulatory care settings Full article
(This article belongs to the Special Issue Recent Advances and Application of Point of Care Ultrasound)
►▼ Show Figures

Figure 1

9 pages, 1044 KB  
Article
Differential Visual Outcomes in Neovascular AMD Based on Ellipsoid Zone Integrity and Fluid Presence: Insights from a Phase III Trial
by Justis P. Ehlers, Sari Yordi, Hasan Cetin, Reem Amine, Karen Matar, Asmita Indurkar, Katherine E. Talcott, Peter K. Kaiser, Arshad M. Khanani, Joanne Hu and Sunil K. Srivastava
Diagnostics 2025, 15(14), 1815; https://doi.org/10.3390/diagnostics15141815 - 18 Jul 2025
Cited by 1 | Viewed by 940
Abstract
Background/Objectives: To investigate the effect of ellipsoid zone (EZ) integrity and retinal fluid on best-corrected visual acuity (BCVA) in neovascular, age-related macular degeneration. Methods: This was a post hoc treatment-agnostic analysis of the phase 3 HAWK trial. Intraretinal fluid (IRF), subretinal [...] Read more.
Background/Objectives: To investigate the effect of ellipsoid zone (EZ) integrity and retinal fluid on best-corrected visual acuity (BCVA) in neovascular, age-related macular degeneration. Methods: This was a post hoc treatment-agnostic analysis of the phase 3 HAWK trial. Intraretinal fluid (IRF), subretinal fluid (SRF), and ellipsoid zone (EZ) integrity were quantified over 48 weeks. EZ integrity maintenance was defined as EZ-RPE central subfield thickness (CST) >20 µm; partial EZ attenuation was EZ-RPE CST >0 and ≤20 µm; total EZ attenuation was EZ-RPE CST = 0 µm. Results: During treatment, BCVA in eyes with no fluid (66.5 to 70.2 letters) was greater than in eyes with IRF (59.5 to 62.4 letters) but comparable to BCVA in eyes with SRF (64.9 to 68.8 letters). In eyes with no fluid, BCVA was consistently greater in eyes with EZ integrity maintained (73.4 to 78.4 letters) than in eyes with EZ partial attenuation (65.3 to 66.5 letters) or with EZ total attenuation (55.8 to 59.8 letters). Conclusions: Eyes without fluid with EZ preservation achieved the highest overall BCVA, especially when compared to eyes without fluid and a lack of EZ preservation and to eyes with SRF. Achieving a “dry” status with preservation of EZ integrity is important in optimizing visual outcomes. Full article
(This article belongs to the Section Biomedical Optics)
►▼ Show Figures

Figure 1

13 pages, 851 KB  
Article
Performance Evaluation of a Fully Automated Molecular Diagnostic System for Multiplex Detection of SARS-CoV-2, Influenza A/B Viruses, and Respiratory Syncytial Virus
by James G. Komu, Dulamjav Jamsransuren, Sachiko Matsuda, Haruko Ogawa and Yohei Takeda
Diagnostics 2025, 15(14), 1791; https://doi.org/10.3390/diagnostics15141791 - 16 Jul 2025
Cited by 2 | Viewed by 1541
Abstract
Background/Objectives: Concurrent outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B viruses (IAV/IBV), and respiratory syncytial virus (RSV) necessitate rapid and precise differential laboratory diagnostic methods. This study aimed to evaluate the multiplex molecular diagnostic performance of the [...] Read more.
Background/Objectives: Concurrent outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B viruses (IAV/IBV), and respiratory syncytial virus (RSV) necessitate rapid and precise differential laboratory diagnostic methods. This study aimed to evaluate the multiplex molecular diagnostic performance of the geneLEAD VIII system (Precision System Science Co., Ltd., Matsudo, Japan), a fully automated sample-to-result precision instrument, in conjunction with the VIASURE SARS-CoV-2, Flu & RSV Real Time PCR Detection Kit (CerTest Biotec, S.L., Zaragoza, Spain). Methods: The specific detection capabilities of SARS-CoV-2, IAV/IBV, and RSV genes were evaluated using virus-spiked saliva and nasal swab samples. Using saliva samples, the viral titer detection limits of geneLEAD/VIASURE and manual referent singleplex RT-qPCR assays were compared. The performance of geneLEAD/VIASURE in analyzing single- and multiple-infection models was scrutinized. The concordance between the geneLEAD/VIASURE and the manual assays was assessed. Results: The geneLEAD/VIASURE successfully detected all the virus genes in the saliva and nasal swab samples despite some differences in the Ct values. The viral titer detection limits in the saliva samples for SARS-CoV-2, IAV, IBV, and RSV using geneLEAD/VIASURE were 100, ≤10−2, 100, and 102 TCID50/mL, respectively, compared to ≤10−1, ≤100, ≤100, and ≤104 TCID50/mL, respectively, in the manual assays. geneLEAD/VIASURE yielded similar Ct values in the single- and multiple-infection models, with some exceptions noted in the triple-infection models when low titers of RSV were spiked with high titers of the other viruses. The concordance between geneLEAD/VIASURE and the manual assays was high, with Pearson’s R2 values of 0.90, 0.85, 0.92, and 0.95 for SARS-CoV-2, IAV, IBV, and RSV, respectively. Conclusions: geneLEAD/VIASURE is a reliable diagnostic tool for detecting SARS-CoV-2, IAV/IBV, and RSV in single- and multiple-infection scenarios. Full article
(This article belongs to the Special Issue Editorial Board Members' Collection Series: Molecular Diagnostics of Infectious Diseases)
►▼ Show Figures

Figure 1

12 pages, 3342 KB  
Article
An Additional 30-s Observation of the Right-Sided Colon Using a Novel Endoscopic System with Texture and Color Enhancement Imaging Decreases Polyp Miss Rates: A Multicenter Study
by Yoshikazu Inagaki, Naohisa Yoshida, Hikaru Hashimoto, Yutaka Inada, Takaaki Murakami, Takahito Shimomura, Kyoichi Kassai, Yuri Tomita, Reo Kobayashi, Ken Inoue, Ryohei Hirose, Osamu Dohi and Yoshito Itoh
Diagnostics 2025, 15(14), 1759; https://doi.org/10.3390/diagnostics15141759 - 11 Jul 2025
Cited by 2 | Viewed by 1450
Abstract
Background/Objectives: White light imaging (WLI) of colonoscopy has a 26% adenoma miss rate. We aimed to evaluate the effectiveness of an additional 30 s (Add-30s) observation of the right-sided colon using a novel system (EVIS X1; Olympus Co.) with texture and color enhancement [...] Read more.
Background/Objectives: White light imaging (WLI) of colonoscopy has a 26% adenoma miss rate. We aimed to evaluate the effectiveness of an additional 30 s (Add-30s) observation of the right-sided colon using a novel system (EVIS X1; Olympus Co.) with texture and color enhancement imaging (TXI). Methods: We reviewed 515 patients who underwent colonoscopy with Add-30s TXI between February 2021 and December 2023 at three affiliated hospitals. After initial right-sided colon observation with WLI, the colonoscope was reinserted into the cecum, and the right-sided colon was re-observed with Add-30s TXI. Adenoma and sessile serrated lesion (SSL) detection rate (ASDR) and adenoma detection rate (ADR) were examined. Multivariate analysis identified factors influencing lesion detection using the Add-30s TXI. The difference in WLI and TXI between the novel and previous scopes was performed using propensity score matching (PSM). The efficacy of WLI with the novel system was compared to that of the previous system. Results: Among the 515 cases, Add-30s TXI observation increased right-sided ADR and ASDR by 7.4% and 9.5%, respectively. The multivariate analysis showed novel scope as an independent factor for adenoma and SSL detection (odds ratio: 2.41, p < 0.01). Right-sided ADR and ASDR for Add-30s TXI were significantly higher in the novel scope than the previous scope (ADR, 25.2% vs. 15.3%; p = 0.04; ASDR, 32.4% vs. 18.9%; p = 0.02). ASDR for WLI observation was significantly higher in the novel system than the previous system (34.8% vs. 25.9%; p < 0.01). Conclusions: Add-30s TXI significantly improved the detection of missed adenomas and SSLs in the right-sided colon. Full article
(This article belongs to the Special Issue Recent Advances and Challenges in Gastrointestinal Endoscopy)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying article 1-50 on page 1 of 2.
Go to page     1 2 chevron_right
Back to TopTop