Tomography

Background: Correct preoperative evaluation of glioma grade and molecular profile is a prerequisite for tailored treatment strategies. Specifically, the 1p/19q codeletion status represents a major prognostic and therapeutic marker in low-grade gliomas (LGGs). Nevertheless, its assessment is presently performed through invasive histopathological and genetic studies, thus underlining the need for non-invasive alternative approaches. Methods: We introduce a non-invasive radiomics framework that combines quantitative MRI features with sophisticated ML and DL approaches for glioma grading and 1p/19q codeletion status prediction. High-dimensional radiomic features characterizing tumor geometry, intensity, and texture were derived from preoperative MRI-based tumor delineations. Features were normalized and optimized using correlation-based feature selection. Several traditional ML classifiers were compared and contrasted with DL models, such as convolutional neural networks (CNNs), recurrent neural networks (RNNs), and a CNN-Long Short-Term Memory (LSTM) hybrid model tailored to exploit both spatial feature hierarchies and feature correlations. Model validation was conducted using five-fold cross-validation and an independent test dataset, with accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) metrics. Results: Among all the models tested, the hybrid CNN-LSTM model performed the best, with an accuracy of 88.1% and an AUC of 0.93, outperforming conventional ML approaches and single-model DL architectures. Explainability analysis showed that the radiomic features of tumor heterogeneity and morphology had the most prominent impact on model performance. Conclusions: These findings indicate that the combination of radiomic features with hybrid DL models is capable of making non-invasive predictions of glioma grade and 1p/19q codeletion status. The new computational model has the potential to be used as a supplementary approach in precision neuro-oncology. Full article

Background: Acute abdominal emergencies represent a major diagnostic challenge in emergency medicine, requiring rapid and accurate integration of clinical, laboratory, and imaging data. Although laboratory parameters play a central role in real-world diagnostic workflows, the extent to which they are systematically represented and integrated within radiology research publications remains unclear. Objective: To evaluate how laboratory data are represented, contextualized, and functionally utilized in radiology publications focusing on computed tomography (CT)–based evaluation of acute abdominal emergencies. Methods: A methodological content analysis was conducted on 72 original radiology research articles published between 2020 and 2024. Eligible studies focused on CT-based imaging of acute abdominal emergency conditions. Publications were screened and analyzed at the title and abstract level using a predefined coding framework to assess the presence of laboratory data, types of laboratory parameters reported, their contextual role (background information, imaging trigger, diagnostic modifier, or prognostic indicator), degree of laboratory–imaging integration, and presence of decision-oriented reporting. Descriptive statistics were used to summarize reporting patterns. Results: Laboratory data were reported in 61.1% of all included studies (n = 44/72). However, their functional utilization varied substantially. Laboratory parameters were most frequently presented as background clinical information, whereas explicit use as imaging triggers (26.4%, n = 19/72), diagnostic modifiers (19.4%, n = 14/72), or components of explicit laboratory–imaging integration (15.3%, n = 11/72) was less common. Decision-oriented reporting was present in 23.6% of all studies (n = 17/72). Explicit integration was described in publications addressing diagnostically complex and time-sensitive conditions, such as acute bowel ischemia and severe acute pancreatitis. Conclusion: Laboratory data are commonly reported in CT-based radiology publications addressing acute abdominal emergencies; however, the manner in which these data are incorporated into imaging-centered diagnostic narratives varies across studies. Differences are observed in how laboratory–imaging relationships are described, with some publications presenting integrated discussion and others reporting imaging findings independently of laboratory context. These observations characterize reporting practices within the analyzed literature and do not imply statistical associations or causal effects. Full article

Objectives: Due to collimator limitations, Single-Photon Emission Computed Tomography (SPECT) suffers from relatively low spatial resolution, which hampers the detection of small lesions. This study proposes a super-resolution (SR) reconstruction algorithm for a parallel-beam, low-resolution (LR) multi-detector SPECT system and employs a neural network to estimate and correct for geometric errors in the LR detectors. Methods: A parallel-beam LR multi-detector SPECT system is presented, in which the detectors perform relative sub-pixel shifts. At each sampling angle, an SR reconstruction algorithm synthesizes high-resolution (HR) SPECT images from LR projections acquired by four offset LR detectors. To correct for geometric errors among these detectors, a randomly distributed gamma point source was designed to generate training data. A neural network was then employed to estimate the geometric errors, thereby refining the SR reconstruction. Results: Numerical simulation demonstrated that the proposed neural network could accurately identify the displacement-based geometric errors of the LR detectors. Utilizing these estimated parameters to correct the SR reconstruction process yielded results comparable to those obtained from direct reconstruction of HR projections, achieving a two-fold resolution improvement. Conclusions: Preliminary proof-of-principle for SR reconstruction in a parallel-beam LR multi-detector SPECT system was established. Further validation of the hardware performance is warranted. Full article

Background: Visceral artery aneurysms (VAAs) are rare but potentially life-threatening vascular lesions often clinically silent until rupture. The widespread use of advanced imaging has increased incidental detection, highlighting the need for accurate, noninvasive diagnostic strategies. Dual-Energy Computed Tomography Angiography (DECTA) offers potential advantages over conventional CT across diagnostic and post-treatment settings; however, its role in VAAs remains incompletely defined. This narrative review summarizes current evidence on DECTA applications in VAAs, focusing on diagnosis, emergency evaluation, and post-treatment follow-up. Methods: A non-systematic literature search of PubMed and Embase focusing on English-language articles up to June 2025 was performed. The search included peer-reviewed original research articles, systematic reviews, and meta-analyses addressing dual-energy CT and spectral CT in vascular and aneurysmal imaging. Case reports without technical data and non-English articles were excluded. Results: In the diagnostic phase, DECTA enhances tissue differentiation through virtual monoenergetic images, iodine maps, and material decomposition reconstructions. In the post-treatment setting, DECTA supports assessment after endovascular procedures, including coil embolization or stent graft placement. In VAAs, these techniques may improve aneurysm delineation, reduce metal artifacts after endovascular treatment, enable accurate detection of endoleaks or residual perfusion, and support volumetric follow-up. Virtual Non-Contrast images may reduce radiation exposure without compromising diagnostic confidence. Conclusions: DECTA represents a versatile imaging modality with potential benefits across the diagnostic, emergency, and post-treatment phases of VAA management. Although many applications are extrapolated from aortic and peripheral vascular disease, emerging evidence supports its growing clinical relevance. Further dedicated studies are needed to define its role in VAA-specific decision-making and follow-up. Full article

Objectives: To evaluate regional anatomical differences in brain volume, surface area, and cortical thickness between children with breath-holding spells (BHSs) and a control group using morphometric MRI analyses. Methods: Three-dimensional T1-weighted cranial MRI data from 48 children with BHSs and 50 control children were retrospectively analyzed, yielding volumetric, surface area, and cortical thickness measures for 135 brain regions. All measurements were assessed relative to total intracranial volume (ICV). Group comparisons were performed using analysis of covariance with age, sex, and ICV as covariates, followed by Benjamini–Hochberg false discovery rate correction (q < 0.05). Results: The BHS group exhibited reduced bilateral amygdala volumes (left: q = 0.042; right: q = 0.038). Both cortical thickness and volume were reduced in the right anterior insula (thickness: q = 0.046; volume: q = 0.049). In addition, cortical thickness was reduced in the bilateral anterior cingulate cortices (left: p = 0.019, q = 0.045; right: p = 0.017, q = 0.043) as well as in the right medial frontal cortex (p = 0.009, q = 0.036). Subregional cerebellar analysis demonstrated volume reductions in the right lobule VI (q = 0.031), left lobule VIIA (Crus I) (q = 0.043), and vermis IX–X (q = 0.039). Conclusions: Detecting measurable morphometric changes in brain regions involved in autonomic and emotional regulation in children with BHSs will contribute to understanding the neurobiological characteristics associated with BHSs. Full article

Objectives: This retrospective, multi-center study analyzed pre-existing anonymized clinical data from electronic health records and imaging archives. The analysis utilized real-world clinical data from 200 patients across four tertiary care centers, without additional patient recruitment or interventions. This study aims to investigate the impact of metabolic and physiological factors—specifically blood glucose levels, cortisol concentrations, fasting duration, and tumor histology—on the quality and diagnostic reliability of ¹⁸F-FDG PET/CT imaging in patients with primary brain tumors and inflammatory lesions. Methods: A total of 200 patients with primary brain tumors (including astrocytoma, glioblastoma, meningioma, and oligodendroglioma) were evaluated across four institutions using standardized protocols. The study examined the effects of prolonged fasting (>12 h), hyperglycemia (>150 mg/dL), and strict fasting (4–6 h) on tumor-to-background contrast and visual analog scale (DQS) scores. Results: Prolonged fasting was associated with elevated cortisol levels (correlation +0.54, p < 0.001), while hyperglycemia significantly reduced tumor SUVmax by up to 20% (r = −0.35, p = 0.012). Strict fasting and glucose control resulted in improved tumor-to-background contrast and DQS scores (r = +0.83, p < 0.001). Glioblastomas exhibited the highest SUVmax (9.1 ± 3.5), indicating aggressive metabolic activity, whereas meningiomas showed elevated cortisol levels (20.5 ± 6.8 µg/dL) linked to disruption of the hypothalamic–pituitary axis. Regression analysis confirmed that both cortisol and glucose levels independently degraded image quality (β = −0.25 and −0.18, respectively; p < 0.05). Conclusions: The findings highlight the necessity for harmonized patient preparation protocols. Recommendations are in alignment with the SNMMI Procedure Standard/EANM Practice Guideline for Brain [¹⁸F] FDG PET imaging. Full article

Background: This study aimed to investigate the association between femoroacetabular impingement (FAI) morphology and femoral head bone marrow edema of unknown etiology on hip magnetic resonance imaging (MRI), and to assess the added value of computed tomography-based three-dimensional maximum intensity projection (CT-MIP) measurements in identifying a predisposition to acetabular overcoverage. Methods: Hip MRI examinations performed between January 2007 and 2025 were retrospectively reviewed. Cases with bone marrow edema attributable to identifiable etiologies were excluded. Twenty-six patients with available hip or pelvis computed tomography (CT) examinations obtained within one year were included, along with an age- and sex-matched control group imaged for indications unrelated to hip pain. A total of 104 hip joints were evaluated. Alpha angles were measured on axial oblique CT reformations. Virtual pelvic radiographs generated from CT-based three-dimensional reconstructions were used for lateral center-edge angle (LCEA) measurements, and acetabular coverage was quantified using the acetabular coverage index derived from CT-MIP images. Appropriate statistical analyses were performed, with p < 0.05 considered statistically significant. Results: FAI was identified in 82.7% of cases with bone marrow edema of unknown etiology on MRI (p < 0.001), with pincer-type morphology being the most prevalent subtype (55.8%). Bone marrow edema was significantly more common in pincer-type FAI compared with other subtypes (p < 0.001) and predominantly involved the posterolateral femoral head. Mean alpha angle, LCEA, and acetabular coverage index values were significantly higher in the case group than in controls (p < 0.001). For the detection of pincer-type FAI, CT-MIP-based acetabular coverage index demonstrated superior diagnostic performance compared with LCEA (AUC, 0.917 vs. 0.855; p = 0.017), with an optimal cutoff value of 0.93 yielding high specificity and accuracy. All measurements showed excellent intraobserver and interobserver reliability. Conclusions: Femoral head bone marrow edema of unknown etiology may serve as a radiologic clue to underlying pincer-type FAI, while CT-MIP-based analyses may provide incremental value beyond conventional angular measurements in characterizing acetabular overcoverage. Full article

Background/Objectives: Tissue conductivity reflects ionic composition (e.g., sodium), providing critical insights into various diseases. Ultrashort echo time quantitative conductivity mapping (UTE-QCM) offers a method to obtain this information, which is particularly effective for musculoskeletal (MSK) tissues with short T2 relaxation times. The aim of this study is to develop a UTE-QCM framework using ultrashort echo time double echo steady-state (UTE-DESS) and validate its feasibility in the knee. Methods: An ultrashort echo time double echo steady-state (UTE-DESS) sequence was used to acquire S+ and S− images and estimate the transmit radiofrequency field (B1⁺) phase at 3T. The B1⁺ phase was derived by canceling the phase evolution in the free induction decay using these images. This phase data was then processed using two widely used QCM reconstruction methods for comparison: parabolic fitting and an integral-based method. The proposed UTE-QCM framework was validated using a phantom containing three different concentrations of sodium chloride (0%, 0.5%, and 1%). Additionally, three healthy volunteers were recruited to validate UTE-QCM in knee imaging. Results: In both phantom and in vivo experiments, the integral-based QCM demonstrated improved robustness to noise compared to parabolic fitting. In the sodium phantom, the estimated conductivity showed high linearity with sodium concentrations. In the in vivo knee, the generated conductivity maps successfully visualized both long and short T2 tissues. Conclusions: We demonstrated the feasibility of UTE-QCM as a novel quantitative imaging tool targeting short T2 tissues in the MSK system. This technique may facilitate the diagnosis and prognosis of joint disorders. Full article

Background/Objectives: We compared the visibility of breast cancer using the newly developed standing automated breast ultrasound system (MammouS-N) and digital breast tomosynthesis (DBT), and identified factors influencing lesion visibility. Methods: We prospectively enrolled 100 women (mean age: 51.6 years; range: 26–76 years) who were diagnosed with breast cancer and were scheduled to undergo DBT between January and July 2024. They underwent DBT and an ultrasound on the same day. Two radiologists evaluated the visibility scores (0–5) of lesions corresponding to biopsy-confirmed breast cancers identified using magnetic resonance imaging. The Wilcoxon signed-rank test was used to compare the visibility scores of cancers identified on DBT and/or MammouS-N images. Results: Among the 100 women, invasive ductal carcinoma was the most common malignancy (73%). DBT findings included negative findings (7%), masses (46%), masses with calcification (29%), calcifications only (15%), and architectural distortions (3%). On MammouS-N ultrasound, most lesions were classified as masses (93%), whereas 7% were non-mass lesions. For Reviewer 1, MammouS-N demonstrated significantly higher visibility scores (higher scores: 26 on MammouS-N, seven on DBT; equal scores: 67, z = −3.234, p = 0.001). For Reviewer 2, the two modalities showed no significant difference in visibility (higher scores: 27 on MammouS-N, 28 on DBT, equal scores: 45, z = −0.040, p = 0.968). Noncalcified lesions that were obscured on DBT were better visualized on MammouS-N (p < 0.001) by both reviewers. Conclusions: MammouS-N holds promise as an imaging modality complementary to DBT in women with dense breast tissue, particularly for non-calcified lesion detection. Full article

Background: Emergency radiology often demands rapid integration of clinical cues, biochemical markers, and imaging findings to support time-critical diagnostic reasoning. However, educational resources that explicitly structure this interdisciplinary integration particularly between radiology and laboratory medicine remain limited. Objective: Our objective was to develop an Integrated Radiology–Biochemistry Diagnostic Flow Framework as a simulation-based methodological proof-of-concept and to document its structure, logic pathways, and internal consistency across common emergency presentations. Methods: We designed an algorithmic framework combining (i) clinical triggers, (ii) targeted biochemical markers with predefined threshold and trajectory rules, (iii) imaging indication and modality selection (US/CTA/MRI/NCCT), and (iv) key radiologic patterns linked to escalation pathways. No patient data or human participants were included. Instead, forty fully synthetic emergency scenarios were generated to populate the framework and to examine logical completeness, branching coherence, and red-flag escalation routes. Results: The framework yielded scenario-specific diagnostic flowcharts that systematically connect biochemical escalation cues with imaging selection and expected imaging findings. The synthetic scenario library demonstrated consistent branching logic across conditions and enabled transparent visualization of imaging-centered decision pathways suitable for simulation-based teaching and structured case discussion. Conclusions: This study reports a reproducible methodological proof-of-concept framework and a synthetic emergency scenario library. Further learner-based studies are required to evaluate usability, perceived realism, and educational effectiveness in authentic training settings. Full article

Background: We aimed to determine paranasal sinus volumes using 3D volumetric measurements and to evaluate the effect of anatomical variations on these volumes, ensuring balanced age and sex distribution during childhood. Methods: Thirteen age groups (0–16 years), each including 10 males and 10 females, were formed. After excluding sinus pathologies, a total of 260 subjects were randomly selected from CT head examinations. Right and left frontal, maxillary, and sphenoid sinus volumes were calculated using 3D Slicer software (version 5.6.2) following manual segmentation of axial CT slices. Also, the presence of right and left Agger Nasi cells, Haller cells, Onodi cells, and concha bullosa were recorded. Results: No significant difference was found between males and females in sinus volumes (p > 0.05). Mean right and left maxillary sinus volumes were 6.23 cm³ and 6.27 cm³ (p = 0.551); frontal sinuses were 0.79 cm³ and 0.86 cm³ (p = 0.170); and sphenoid sinuses were 1.64 cm³ and 1.85 cm³ (p = 0.041). Sphenoid sinus pneumatization appeared in 30% of the 0–6-month group and in over 75% of older groups. Frontal pneumatization began at age 2–3 and exceeded 50% after age 4. Agger Nasi, Haller, Onodi cells, and concha bullosa were detected in 58.8%, 31.2%, 10%, and 22.3% of cases, respectively. Anatomical variations showed no significant effect on sinus volumes (p > 0.05). Conclusions: We developed a paranasal sinus volume chart applicable to routine practice, showing that anatomical variations had no significant impact on the development. This is the first study to investigate the impact of anatomical variations on sinus development and volume, along with the age at which variations emerge, with a balanced distribution of age and sex. Full article

Objective: The number of operators performing mechanical thrombectomy (MT) may influence procedural outcomes; however, evidence remains limited and conflicting. This study aimed to comprehensively evaluate the impact of single versus dual operators on procedure time, radiation dose, and angiographic success in patients undergoing MT for acute ischemic stroke. Methods: In this single-center, retrospective cohort study, 285 consecutive patients who underwent MT for large-vessel occlusion between January 2020 and December 2024 were included. Patients were grouped according to institutional workflow: single-operator procedures (n = 157) and dual-operator procedures (n = 128). The primary endpoints were procedure time and radiation dose parameters, including total Kerma-Area Product (PKA). Secondary endpoints included successful reperfusion (TICI ≥ 2b), complete reperfusion (TICI 3), and first-pass success (FPS, defined as TICI 2c/3 with a single pass). Results: Baseline characteristics were comparable between groups. The dual-operator group had significantly shorter median procedure times (52.5 vs. 85.0 min, p < 0.001) and lower total PKA (p < 0.001). Reperfusion rates were significantly higher in the dual-operator group, both for successful reperfusion (TICI ≥ 2b: 80.5% vs. 64.3%, p = 0.004) and complete reperfusion (TICI 3: 76.6% vs. 58.5%, p = 0.002). First-pass success was also more frequent (60.0% vs. 44.5%, p = 0.0146), and the mean number of passes was lower (1.66 vs. 2.00, p = 0.0057). Conclusions: Mechanical thrombectomy performed with two experienced operators was associated with greater procedural efficiency, reduced patient radiation exposure, and higher angiographic success compared with single-operator procedures. These findings support considering the dual-operator model as an approach that may inform workforce planning and workflow decisions in stroke centers. Full article

Background/Objectives: This study evaluated the clinical image quality of three-dimensional synthetic MRI (3D SI) compared with conventional MRI (cMRI), focusing on tissue contrast, anatomical detail, and motion sensitivity. Methods: Patients with nonspecific neurological symptoms were included. Both cMRI and 3D SI were acquired on single-vendor 1.5 T and 3 T scanners with slice thicknesses of 1.0–1.7 mm. Two experienced neuroradiologists and one fellow independently evaluated matched scans using a 0–100 scale. Assessed parameters included signal-to-noise ratio (SNR), gray–white matter contrast, artifacts, motion robustness, and confidence in detecting perivascular spaces, white matter lesions, and subtle pathology. Interrater agreement was measured using Krippendorff’s alpha and ICC2. Multiple linear regression analyzed associations between image quality ratings and imaging method. Results: Images of 31 patients were analyzed. Three-dimensional SI demonstrated sufficient-to-good overall image quality and high robustness to motion. Cortical-surface-to-cerebrospinal-fluid contrast on FLAIR was rated lower for 3D SI than for cMRI. False-positive lesion detection occurred more frequently on 3D SI FLAIR, particularly among experienced readers. cMRI achieved significantly higher T1-weighted SNR than 3D SI (8.76 points, p < 0.001). Experienced readers consistently rated SNR and tissue contrast higher than the fellow. Vascular signal range was broader on 3D SI, reducing sensitivity to vascular abnormalities. Conclusions: Three-dimensional synthetic MRI provides clinically usable image quality and fulfills its primary diagnostic purpose, offering advantages in acquisition efficiency and robustness to motion. Nevertheless, limitations in cortical contrast, vascular signal characterization, and reader-dependent interpretive variability constrain its reliability for subtle or detail-critical findings. Full article

Background/Objectives: This study aimed to investigate the relationship between carotid artery anatomy and geometry and white matter hyperintensities (WMH) and to determine whether it is a risk factor for the disease. Methods: The geometry and anatomy of both carotid arteries were evaluated with the three-dimensional vessel model obtained from the computed tomography angiography (CTA) data, and the segmentation software calculated the geometrical features of the arteries. In this model, vascular diameter, vascular cross-sectional area, carotid bifurcation and internal carotid artery (ICA) angles, as well as ICA tortuosity index (TI) measurements of the common carotid artery (CCA) and ICA were determined. Results: Compared with the non-WMH group, increased carotid bifurcation and ICA angle and higher ICA TI values were found in the WMH group (p < 0.001). In multivariate regression analysis, increased carotid bifurcation angle, higher ICA TI values, age, hypertension, and stroke history were identified as independent risk factors for the development of WMH (p < 0.05). In addition, age, carotid bifurcation angles and ICA angles were found to be associated with the severity of WMH (p < 0.05). Conclusions: Considering the vascular pathologies involved in the pathogenesis of WMH, identifying these risk factors may help determine individuals who are at an increased risk. Full article

Background/Objectives: Diffusion-weighted imaging (DWI) is a magnetic resonance technique used to map the apparent diffusion coefficient ($ADC$) of water in human tissue. $ADC$ assessment plays a central role in clinical diagnostics, as malignant tissues typically exhibit reduced water mobility and, thus, lower $ADC$ values. Accurately measuring the $ADC$ requires effective fat suppression to prevent contamination from the residual fat signal, which is commonly believed to cause $ADC$ underestimation. This study aimed to demonstrate that $ADC$ overestimation may occur as well. Methods: Our theoretical analysis shows that out-of-phase conditions between fat and water signals lead to $ADC$ overestimations. We performed demonstration experiments on fat–water phantoms and the breasts of 10 healthy female volunteers. In particular, we considered three out-of-phase conditions: First and second, short-time inversion recovery (STIR) fat suppression with incorrect inversion time and incorrect flip angle, respectively. Third, phase differences due to spectral fat saturation. The $ADC$ values were assessed in regions of interest (ROIs) that included both water and residual fat signals. Results: In the phantoms and the volunteer data, ROIs containing both fat and water signals consistently exhibited lower $ADC$ values under in-phase conditions and higher $ADC$ values under out-of-phase conditions. Conclusions: We demonstrated that out-of-phase conditions can result in $ADC$ overestimation in the presence of residual fat signals, potentially resulting in false-negative classifications where malignant lesions are misinterpreted as benign due to an elevated $ADC$. Out-of-phase fat and water signals might also reduce lesion conspicuity in high b-value images, potentially masking clinically relevant findings. Full article

Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) serves as a visual biofeedback tool, providing real-time imaging to enhance PFM training, motor learning, and treatment adherence. Aim: This narrative review evaluates the role and efficacy of RUSI in pelvic floor rehabilitation. Method: A comprehensive search of PubMed, Cochrane, and MEDLINE was conducted using keywords related to pelvic floor rehabilitation, ultrasound, and biofeedback, limited to English-language publications up to July 2025. Systematic reviews, meta-analyses, and clinical trials were prioritized. Results: Transperineal and transabdominal ultrasound improve PFM function across diverse populations. In post-prostatectomy men, transperineal ultrasound-guided training enhanced PFM contraction and reduced urinary leakage. In postpartum women with pelvic girdle pain, transabdominal ultrasound-guided biofeedback combined with exercises decreased pain and improved function. Ultrasound-guided pelvic floor muscle contraction demonstrated superior performance compared to verbal instruction. Notably, 57% of participants who were unable to contract the pelvic floor muscles with verbal cues achieved a correct contraction with ultrasound biofeedback, and this approach also resulted in more sustained improvements in PFM strength. Compared to other biofeedback modalities, RUSI demonstrated outcomes that are comparable to or superior to those of alternative methods. However, evidence is limited by a lack of standardized protocols and randomized controlled trials comparing RUSI with other modalities. Conclusions: RUSI is an effective visual biofeedback tool that enhances outcomes of PFM training in pelvic floor rehabilitation. It supports clinical decision-making and patient engagement, particularly in cases where traditional assessments are challenging. Further research, including the development of standardized protocols and comparative trials, is necessary to optimize the clinical integration of this method and confirm its superiority over other biofeedback methods. Full article

Background: The pterygomaxillary region is a complex anatomical area formed by the junction of the maxillary, palatine, and sphenoid bones and contains critical neurovascular structures. Accurate assessment of this region during Le Fort I osteotomy is essential, particularly to prevent hemorrhage and nerve injury that may occur during the pterygomaxillary separation phase. This study aims to investigate the morphometric characteristics of the pterygomaxillary region using cone-beam computed tomography (CBCT) and to evaluate the effects of age, sex, and laterality on these anatomical parameters. Materials and Methods: In this retrospective study, CBCT scans of 200 individuals (100 males and 100 females) aged 20–80 years were analyzed. Axial measurements included distances between the piriform rim, the descending palatine artery, the pterygomaxillary osteotomy line, and the pterygomaxillary fissure. Additionally, the thickness and width of the pterygomaxillary region and pterygoid process, lengths of the medial and lateral pterygoid laminae, and the distance between the greater palatine canal and the medial pterygoid lamina apex were recorded. Measurements were statistically evaluated by sex, age group, and laterality. Results: The following parameters demonstrated statistically significant differences based on the conducted measurements: The distance between the piriform rim and the descending palatine artery was significantly greater on the left side (p < 0.001). The length of the lateral pterygoid lamina increased with advancing age (p = 0.048). The thickness of the pterygomaxillary region was significantly greater in females (p = 0.014). Additionally, the distance between the greater palatine canal and the terminal point of the medial pterygoid lamina was significantly higher in males (p < 0.001). Conclusions: The pterygomaxillary region exhibits anatomical variations that may lead to serious complications during Le Fort I osteotomy. Detailed preoperative evaluation of this area using CBCT can guide surgical planning and help prevent potential vascular and neural complications. Full article

Background/Objectives: Pancreatic cancer is among the most aggressive malignancies, with poor survival rates. Emerging evidence suggests that body composition, including skeletal muscle mass and adiposity distribution, plays a crucial role in predicting patient outcomes. However, its impact on survival in pancreatic cancer remains incompletely understood. The aim of this systematic review was to assess the correlation between body composition parameters and survival outcomes in pancreatic cancer patients, focusing on overall survival. Methods: A comprehensive literature search was conducted, including three main components: pancreatic cancer, body composition, and survival outcomes. Results: 23 studies were included in this review. The findings indicate that body composition can serve as a predictor of survival in pancreatic cancer patients, with 21 studies reporting a significant correlation. The most frequently observed predictor, with 11 studies reporting, was not a baseline parameter but rather changes in parameters over time during treatment. However, discrepancies remain regarding the extent of predictive power and the relative importance of individual components. Conclusions: Specific body composition parameters hold potential as prognostic indicators of survival in pancreatic cancer patients. However, further research is necessary to establish consistent patterns and to clarify which parameters are most predictive and under what conditions. Full article

Background/Objectives: Super-resolution deep-learning reconstruction (SR-DLR) is an advanced image reconstruction technique, but its effect on dynamic myocardial computed tomography perfusion (CTP) imaging has not been evaluated. This study aimed to examine the impact of SR-DLR on image quality and perfusion parameters in dynamic myocardial CTP. Methods: Thirty-five patients who underwent dynamic myocardial CTP for coronary artery disease assessment were retrospectively analyzed. Two CTP datasets were reconstructed using hybrid iterative reconstruction (HIR) and SR-DLR. Image quality was compared qualitatively and quantitatively, including image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and edge rise slope (ERS). Equivalence of CT-derived myocardial blood flow (CT-MBF) between two reconstructions was tested using a previously reported 15% equivalence margin. Intra-patient variability of CT-MBF was evaluated using the robust coefficient of variation (rCV). Results: In the qualitative assessment, SR-DLR had significantly higher scores in contrast (4.0 vs. 2.0) and sharpness (4.5 vs. 2.5) compared with HIR (p < 0.001), while contrast scores were similar. In the quantitative assessment, SR-DLR demonstrated significantly lower image noise (19.4 vs. 29.4 HU), and improved SNR (6.1 vs. 4.1), CNR (13.7 vs. 10.9), and ERS (171.0 vs. 135.1 HU/mm) (all p < 0.001). Mean global CT-MBF was comparable (3.15 ± 0.91 mL/g/min for HIR vs. 3.18 ± 0.97 mL/g/min for SR-DLR) and equivalence was confirmed (p = 0.022). SR-DLR significantly reduced rCV compared with HIR (36.0% vs. 41.0%, p < 0.001). Conclusions: SR-DLR enhances image quality in dynamic myocardial CTP while maintaining mean global CT-MBF and reducing intra-patient variability. Full article