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Computed Tomography Imaging in Medical Diagnosis
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Computed Tomography Imaging in Medical Diagnosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 8630

Special Issue Editor

Dr. Fabio Sandomenico

E-Mail Website
Guest Editor
Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy
Interests: melanoma; sarcoma; thyroid cancer; head and neck cancer; lymphoma; immunotherapy; lung cancer; computed tomography imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Computed tomography (CT) is a diagnostic imaging test used to create detailed images of internal organs, bones, soft tissue and blood vessels. In this Special Issue, we open a discussion on this topic and welcome original articles, reviews, and reports that explore new technologies, emerging service modalities, and ideas on technology adoption and the overall current and future impact of the pandemic on computed tomography practices.

Dr. Fabio Sandomenico
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • computed tomography
  • medical diagnosis
  • imaging
  • internal organs
  • bones
  • soft tissue
  • blood vessels

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Published Papers (8 papers)

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Research

Jump to: Review, Other

12 pages, 3438 KiB  
Article
Prognostic Value of Optic Nerve Sheath Diameters after Acute Ischemic Stroke According to Slice Thickness on Computed Tomography
by Han-Bin Lee, Sang Hoon Oh, Jinhee Jang, Jaseong Koo, Hyo Jin Bang and Min Hwan Lee
Diagnostics 2024, 14(16), 1754; https://doi.org/10.3390/diagnostics14161754 - 12 Aug 2024
Viewed by 644
Abstract
The optic nerve sheath diameter (ONSD) can predict intracranial pressure and outcomes in neurological disease, but it remains unclear whether a small ONSD can be accurately measured on routine CT images with a slice thickness of approximately 4–5 mm. We measured the ONSD [...] Read more.
The optic nerve sheath diameter (ONSD) can predict intracranial pressure and outcomes in neurological disease, but it remains unclear whether a small ONSD can be accurately measured on routine CT images with a slice thickness of approximately 4–5 mm. We measured the ONSD and ONSD/eyeball transverse diameter (ETD) ratio on routine-slice (4 mm) and thin-slice (0.6–0.75 mm) brain CT images from initial scans of acute ischemic stroke (AIS) patients. ONSD-related variables, National Institutes of Health Stroke Scale (NIHSS) scores, and age were compared between good (modified Rankin Scale [mRS] ≤ 2) and poor (mRS > 2) outcomes at discharge. Among 155 patients, 38 had poor outcomes. The thin-slice ONSD was different between outcome groups (p = 0.047), while the routine-slice ONSD showed no difference. The area under the curve (AUC) values for the ONSD and ONSD/ETD were 0.58 (95% CI, 0.49–0.66) and 0.58 (95% CI, 0.50–0.66) on the routine-slice CT, and 0.60 (95% CI, 0.52–0.68) and 0.62 (95% CI, 0.54–0.69) on the thin-slice CT. The thin-slice ONSD/ETD ratio correlated with initial NIHSS scores (r = 0.225, p = 0.005). After adjusting for NIHSS scores and age, ONSD-related variables were not associated with outcomes, and adding them to a model with NIHSS scores and age did not improve performance (all p-values > 0.05). Although ONSD measurements were not an independent outcome predictor, they correlated with stroke severity, and the thin-slice ONSD provided a slightly better prognostic performance than the routine-slice ONSD. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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12 pages, 2971 KiB  
Article
Prognostic Implication of Ventricular Volumetry in Early Brain Computed Tomography after Cardiac Arrest
by Ae Kyung Gong, Sang Hoon Oh, Jinhee Jang, Kyu Nam Park, Han Joon Kim, Ji Young Lee, Chun Song Youn, Jee Yong Lim, Hyo Joon Kim and Hyo Jin Bang
Diagnostics 2024, 14(16), 1701; https://doi.org/10.3390/diagnostics14161701 - 6 Aug 2024
Viewed by 677
Abstract
Brain swelling after cardiac arrest may affect brain ventricular volume. This study aimed to investigate the prognostic implications of ventricular volume on early thin-slice brain computed tomography (CT) after cardiac arrest. We measured the gray-to-white matter ratio (GWR) and the characteristics and volumes [...] Read more.
Brain swelling after cardiac arrest may affect brain ventricular volume. This study aimed to investigate the prognostic implications of ventricular volume on early thin-slice brain computed tomography (CT) after cardiac arrest. We measured the gray-to-white matter ratio (GWR) and the characteristics and volumes of the lateral, third, and fourth ventricles. The primary outcome was a poor 6-month neurological outcome. Of the 166 patients, 115 had a poor outcome. The fourth ventricle was significantly smaller in the poor outcome group (0.58 cm3 [95% CI, 0.43–0.80]) than in the good outcome group (0.74 cm3 [95% CI, 0.68–0.99], p < 0.001). Ventricular characteristics and other ventricular volumes did not differ between outcome groups. The area under the curve for the fourth ventricular volume was 0.68, comparable to 0.69 for GWR. Lower GWR (<1.09) and lower fourth ventricular volume (<0.41 cm3) predicted poor outcomes with 100% specificity and sensitivities of 8.7% (95% CI, 4.2–15.4) and 20.9% (95% CI, 13.9–29.4), respectively. Combining these measures improved the sensitivity to 25.2% (95% CI, 17.6–34.2). After adjusting for covariates, the fourth ventricular volume was independently associated with neurologic outcome. A marked decrease in fourth ventricular volume, with concomitant hypoattenuation on CT scans, more accurately predicted outcomes. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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10 pages, 457 KiB  
Article
Proposing Multiregional Diagnostic Reference Levels for Common CT Angiography Examinations in Saudi Arabia
by Ali Alhailiy, Essam Alkhybari, Mohammed Alshuhri, Abdullah Al-Othman, Tarek Hegazi, Mohammed Alsuhaimi, Sultan Alghamdi, Khaled Alenazi, Yazeed Alashban, Sami Alghamdi, Omar Quzi, Osama Jaafari, Saleh Alajlani, Abdulrahman Masmali, Yasser Hadi, Elbagir Manssor and Mustafa Mahmoud
Diagnostics 2024, 14(14), 1523; https://doi.org/10.3390/diagnostics14141523 - 15 Jul 2024
Viewed by 811
Abstract
Objectives: Diagnostic reference levels (DRLs) are crucial tools for optimizing radiation exposure during different radiological examinations. This study aimed to establish preliminary DRLs for commonly performed computed tomographic angiography (CTA) examinations in Saudi Arabia. Methods: Data for three types of CTA examinations (cerebral, [...] Read more.
Objectives: Diagnostic reference levels (DRLs) are crucial tools for optimizing radiation exposure during different radiological examinations. This study aimed to establish preliminary DRLs for commonly performed computed tomographic angiography (CTA) examinations in Saudi Arabia. Methods: Data for three types of CTA examinations (cerebral, pulmonary, and lower-extremity) were collected from six medical cities across Saudi Arabia. Data sets related to 723 CTAs with a mean patient weight of 75 kg were analysed in detail. The DRL values were determined based on the 75th, median, and 25th CT dose index volume (CTDIvol) and dose length product (DLP) values. Results: The established DRLs were 1221 mGy cm for cerebral CTAs, 475 mGy cm for pulmonary CTAs, and 1040 mGy cm for lower-extremity CTAs. These values were comparable to those reported in other studies. Conclusions: This study provides preliminary DRLs for three common CTA procedures in Saudi Arabia. The widespread implementation of a low kVp and a high level of image reconstruction (IR) presents an opportunity for further dose reduction. These findings can serve as a foundation for future nationwide DRL surveys and the optimization of CTA imaging protocols in Saudi Arabia. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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12 pages, 39872 KiB  
Article
Puncture Accuracy of Robot-Assisted CT-Based Punctures in Interventional Radiology: An Ex Vivo Study
by Yannick Scharll, Nenad Radojicic, Gregor Laimer, Peter Schullian and Reto Bale
Diagnostics 2024, 14(13), 1371; https://doi.org/10.3390/diagnostics14131371 - 27 Jun 2024
Cited by 1 | Viewed by 1399
Abstract
Objectives: The purpose of this study was to assess the performance of an optically tracked robot for computed-tomography (CT)-guided needle placements in a phantom study. Methods: In total, 240 needle punctures were carried out with the help of an optically tracked robotic device [...] Read more.
Objectives: The purpose of this study was to assess the performance of an optically tracked robot for computed-tomography (CT)-guided needle placements in a phantom study. Methods: In total, 240 needle punctures were carried out with the help of an optically tracked robotic device (Micromate) based on CT image datasets at three different slice thicknesses (1, 3, and 5 mm). Conically shaped targets inside a gelatin-filled plexiglass phantom were punctured. The target positioning error between the planned and actual needle trajectory was assessed by measuring the lateral positioning error (ND) between the target and the puncture needle and the Euclidean distance (ED) between the needle tip and target in control CTs. Results: The mean ND and ED for the thinnest CT slice thickness were 1.34 mm (SD ± 0.82) and 2.1 mm (SD ± 0.75), respectively. There was no significant impact of target depth on targeting accuracy for ND (p = 0.094) or ED (p = 0.187). The mean duration for the planning of one trajectory and for needle positioning were 42 s (SD ± 4) and 64 s (SD ± 7), respectively. Conclusions: In this ex vivo study, the robotic targeting device yielded satisfactory accuracy results at CT slice thicknesses of 1 and 3 mm. This technology may be particularly useful in interventions where the accurate placement of needle-like instruments is required. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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11 pages, 1187 KiB  
Article
Diagnostic Value of Four-Dimensional Dynamic Computed Tomography for Primary Hyperparathyroidism in Patients with Low Baseline Parathyroid Hormone Levels
by Zaid Al-Difaie, Max H. M. C. Scheepers, Sanne M. E. Engelen, Bastiaan Havekes, Nicole D. Bouvy and Alida A. Postma
Diagnostics 2023, 13(16), 2621; https://doi.org/10.3390/diagnostics13162621 - 8 Aug 2023
Cited by 1 | Viewed by 1306
Abstract
Low baseline levels of parathyroid hormone (PTH) are associated with a higher rate of multiglandular disease, lower localization rates of preoperative imaging modalities, and a higher rate of unsuccessful minimally invasive parathyroidectomies. The objective of this study is to assess the diagnostic value [...] Read more.
Low baseline levels of parathyroid hormone (PTH) are associated with a higher rate of multiglandular disease, lower localization rates of preoperative imaging modalities, and a higher rate of unsuccessful minimally invasive parathyroidectomies. The objective of this study is to assess the diagnostic value of four-dimensional dynamic computed tomography (4D-CT) in localizing primary hyperparathyroidism (pHPT) in patients with low baseline PTH levels, compared to patients with high baseline PTH levels. Patients with pHPT who received a 4D-CT scan as part of their standard diagnostic evaluation were divided into two groups based on the following criteria: (1) preoperative PTH levels less than 100 pg/mL and (2) patients with preoperative PTH levels greater than 100 pg/mL. All patients underwent parathyroidectomy based on 4D-CT findings, with intraoperative parathyroid hormone monitoring. The lesion-based sensitivity of 4D-CT was 88% in patients with low baseline PTH levels and 94.7% in patients with high baseline PTH levels (p = 0.33). However, the success rate of image-guided resection based on 4D-CT findings was 71.4% in the low baseline PTH group compared to 90.6% in the high baseline PTH group (p = 0.06). Our study demonstrated that 4D-CT has a high lesion-based sensitivity in patients with pHPT and low baseline PTH levels but led to a relatively low rate of successful image-guided resection in patients with low baseline PTH levels. Therefore, it is important to exercise increased caution during 4D-CT-guided surgical exploration of patients with low baseline PTH levels to ensure successful surgical resection of all parathyroid lesions. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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19 pages, 12493 KiB  
Article
Three-Dimensional Voxel-Wise Quantitative Assessment of Imaging Features in Hepatocellular Carcinoma
by Chongfei Huang, Shihong Ying, Meixiang Huang, Chenhui Qiu, Fang Lu, Zhiyi Peng and Dexing Kong
Diagnostics 2023, 13(6), 1170; https://doi.org/10.3390/diagnostics13061170 - 18 Mar 2023
Viewed by 1487
Abstract
Voxel-wise quantitative assessment of typical characteristics in three-dimensional (3D) multiphase computed tomography (CT) imaging, especially arterial phase hyperenhancement (APHE) and subsequent washout (WO), is crucial for the diagnosis and therapy of hepatocellular carcinoma (HCC). However, this process is still missing in practice. Radiologists [...] Read more.
Voxel-wise quantitative assessment of typical characteristics in three-dimensional (3D) multiphase computed tomography (CT) imaging, especially arterial phase hyperenhancement (APHE) and subsequent washout (WO), is crucial for the diagnosis and therapy of hepatocellular carcinoma (HCC). However, this process is still missing in practice. Radiologists often visually estimate these features, which limit the diagnostic accuracy due to subjective interpretation and qualitative assessment. Quantitative assessment is one of the solutions to this problem. However, performing voxel-wise assessment in 3D is difficult due to the misalignments between images caused by respiratory and other physiological motions. In this paper, based on the Liver Imaging Reporting and Data System (v2018), we propose a registration-based quantitative model for the 3D voxel-wise assessment of image characteristics through multiple CT imaging phases. Specifically, we selected three phases from sequential CT imaging phases, i.e., pre-contrast phase (Pre), arterial phase (AP), delayed phase (DP), and then registered Pre and DP images to the AP image to extract and assess the major imaging characteristics. An iterative reweighted local cross-correlation was applied in the proposed registration model to construct the fidelity term for comparison of intensity features across different imaging phases, which is challenging due to their distinct intensity appearance. Experiments on clinical dataset showed that the means of dice similarity coefficient of liver were 98.6% and 98.1%, those of surface distance were 0.38 and 0.54 mm, and those of Hausdorff distance were 4.34 and 6.16 mm, indicating that quantitative estimation can be accomplished with high accuracy. For the classification of APHE, the result obtained by our method was consistent with those acquired by experts. For the WO, the effectiveness of the model was verified in terms of WO volume ratio. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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Review

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15 pages, 6787 KiB  
Review
Dual-Energy and Photon-Counting Computed Tomography in Vascular Applications—Technical Background and Post-Processing Techniques
by Marcin Stański, Ilona Michałowska, Adam Lemanowicz, Katarzyna Karmelita-Katulska, Przemysław Ratajczak, Agata Sławińska and Zbigniew Serafin
Diagnostics 2024, 14(12), 1223; https://doi.org/10.3390/diagnostics14121223 - 11 Jun 2024
Cited by 1 | Viewed by 890
Abstract
The field of computed tomography (CT), which is a basic diagnostic tool in clinical practice, has recently undergone rapid technological advances. These include the evolution of dual-energy CT (DECT) and development of photon-counting computed tomography (PCCT). DECT enables the acquisition of CT images [...] Read more.
The field of computed tomography (CT), which is a basic diagnostic tool in clinical practice, has recently undergone rapid technological advances. These include the evolution of dual-energy CT (DECT) and development of photon-counting computed tomography (PCCT). DECT enables the acquisition of CT images at two different energy spectra, which allows for the differentiation of certain materials, mainly calcium and iodine. PCCT is a recent technology that enables a scanner to quantify the energy of each photon gathered by the detector. This method gives the possibility to decrease the radiation dose and increase the spatial and temporal resolutions of scans. Both of these techniques have found a wide range of applications in radiology, including vascular studies. In this narrative review, the authors present the principles of DECT and PCCT, outline their advantages and drawbacks, and briefly discuss the application of these methods in vascular radiology. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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Other

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11 pages, 6879 KiB  
Interesting Images
Computed Tomography Angiography as a Method for Diagnosing Intracavitary Coronary Arteries
by Paweł Gać, Bartosz Siudek, Agnieszka Głuszczyk, Jakub Plizga, Filip Grajnert and Rafał Poręba
Diagnostics 2024, 14(16), 1798; https://doi.org/10.3390/diagnostics14161798 - 16 Aug 2024
Viewed by 411
Abstract
The intracavitary coronary arteries (ICCA) course is a rare phenomenon, where the segments of the coronary artery go through the atria or ventricles of the heart. In the past, these changes were incidentally detected during invasive diagnostic procedures for other reasons, as well [...] Read more.
The intracavitary coronary arteries (ICCA) course is a rare phenomenon, where the segments of the coronary artery go through the atria or ventricles of the heart. In the past, these changes were incidentally detected during invasive diagnostic procedures for other reasons, as well as during postmortem examinations. As the use of multidetector computed tomography angiography (CTA) becomes more widespread, it has emerged that the incidence of ICCA has been underestimated. We present images from two coronary computed tomography angiography cases, which document the existence of ICCA in patients with non-specific chest pain. In the first case, in a 66-year-old woman, in addition to confirming coronary artery disease without significant stenosis (CAD-RADS 2-category 2 in the coronary-artery-disease-reporting and data system), the course of the middle section of the right coronary artery (RCA) in the lumen of the right atrium was demonstrated. In the second case, in a 47-year-old man in whom the presence of atherosclerotic lesions in the coronary arteries was excluded (CAD-RADS 0), the course of the distal segment of the left anterior descending (LAD) was found in the lumen of the apical layers of the right ventricle. To sum up, it should be stated that coronary CTA is a non-invasive diagnostic method that allows for visualization of the ICCA. In coronary CTA performed for indications consistent with the guidelines of scientific societies, attention should also be paid to the possible intracavitary course of the coronary arteries. The identification of such a course of the coronary arteries may be useful when preparing the patient for potential future invasive procedures involving the cardiac cavities. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)
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