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Search Results (186)

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Keywords = abdominal radiology

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11 pages, 1259 KiB  
Article
Exploring the Role of MRCP+ for Enhancing Detection of High-Grade Strictures in Primary Sclerosing Cholangitis
by James Franklin, Charlotte Robinson, Carlos Ferreira, Elizabeth Shumbayawonda and Kartik Jhaveri
J. Clin. Med. 2025, 14(15), 5530; https://doi.org/10.3390/jcm14155530 - 6 Aug 2025
Abstract
Background: Identifying high-grade strictures (HGS) in patients with primary sclerosing cholangitis (PSC) relies upon subjective assessments of magnetic resonance cholangiopancreatography (MRCP). Quantitative MRCP (MRCP+) provides objective evaluation of MRCP examinations, which may help make these assessments more consistent and improve patient management and [...] Read more.
Background: Identifying high-grade strictures (HGS) in patients with primary sclerosing cholangitis (PSC) relies upon subjective assessments of magnetic resonance cholangiopancreatography (MRCP). Quantitative MRCP (MRCP+) provides objective evaluation of MRCP examinations, which may help make these assessments more consistent and improve patient management and selection for intervention. We evaluated the impact of MRCP+ on clinicians’ confidence in diagnosing HGS in patients with PSC. Methods: Three expert abdominal radiologists independently assessed 28 patients with PSC. Radiological reads of MRCPs were performed twice, in a random order, three weeks apart, then a third time with MRCP+. HGS presence was recorded on semi-quantitative confidence scales. The cases where readers definitively agreed on presence/absence of HGS were used to assess inter- and intra-reader agreement and confidence. Results: When using MRCP alone, high intra-reader agreement was observed in identifying HGS within both intra- and extrahepatic ducts (64.3% and 70.8%, respectively), while inter-reader agreement was significantly lower for intrahepatic ducts (42.9%) than extrahepatic ducts (66.1%) (p < 0.01). Using MRCP+ in the third read significantly improved inter-reader agreement for intrahepatic HGS detection to 67.9% versus baseline reads (p = 0.02) and was comparable with extrahepatic ducts. Reader confidence tended to increase when supplemented with MRCP+, and inter-reader variability decreased. MRCP+ metrics had good performance in identifying HGS in both extra-hepatic (AUC:0.85) and intra-hepatic ducts (AUC:0.75). Conclusions: MRCP evaluation supported by quantitative metrics tended to increase individual reader confidence and reduce inter-reader variability for detecting HGS. Our results indicate that MRCP+ might help standardize MRCP assessment and subsequent management for patients with PSC. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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13 pages, 2691 KiB  
Article
Multidimensional Radiological Assessment of Delirium in the Emergency Department
by Alberto Francesco Cereda, Claudia Frangi, Matteo Rocchetti, Andrea Spangaro, Lorenzo Tua, Antonio Gabriele Franchina, Matteo Carlà, Lucia Colavolpe, Matteo Carelli, Anna Palmisano, Massimiliano Etteri and Stefano Lucreziotti
Healthcare 2025, 13(15), 1871; https://doi.org/10.3390/healthcare13151871 - 31 Jul 2025
Viewed by 200
Abstract
Background: Delirium is a common, underdiagnosed neuropsychiatric syndrome in older adults, associated with high mortality and functional decline. Given its multifactorial nature and overlap with frailty, radiological markers may improve risk stratification in the emergency department (ED). Methods: We conducted a retrospective study [...] Read more.
Background: Delirium is a common, underdiagnosed neuropsychiatric syndrome in older adults, associated with high mortality and functional decline. Given its multifactorial nature and overlap with frailty, radiological markers may improve risk stratification in the emergency department (ED). Methods: We conducted a retrospective study on a small sample of 30 patients diagnosed with delirium in the emergency department who had recently undergone brain, thoracic, or abdominal CT scans for unrelated clinical indications. Using post-processing software, we analyzed radiological markers, including coronary artery calcifications (to estimate vascular age), cerebral atrophy (via the Global Cortical Atrophy scale), and cachexia (based on abdominal fat and psoas muscle volumetry). Results: Five domains were identified as significant predictors of 12-month mortality in univariate Cox regression: vascular age, delirium etiology, cerebral atrophy, delirium subtype (hyperactive vs. hypoactive), and cachexia. Based on these domains, we developed an exploratory 10-point delirium score. This score demonstrated acceptable diagnostic accuracy for mortality prediction (sensitivity 0.93, specificity 0.73, positive predictive value 0.77, negative predictive value 0.91) in this limited cohort. Conclusions: While preliminary and based on a small, retrospective sample of 30 patients, this multidimensional approach integrating clinical and radiological data may help improve risk stratification in elderly patients with delirium. Radiological phenotyping, particularly in terms of vascular aging and sarcopenia/cachexia, offers objective insights into patient frailty and could inform more personalized treatment pathways from the ED to safe discharge home, pending further validation. Full article
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13 pages, 386 KiB  
Article
Overall Survival and Complication Rates in the Treatment of Liver Carcinoma: A Comparative Study of Ultrasound, Computed Tomography, and Combined Ultrasound and Computed Tomography Guidance for Radiofrequency Ablation
by Chia-Hsien Chien, Chia-Ling Chiang, Huei-Lung Liang, Jer-Shyung Huang and Chia-Jung Tsai
Diagnostics 2025, 15(14), 1754; https://doi.org/10.3390/diagnostics15141754 - 11 Jul 2025
Viewed by 365
Abstract
Background: Liver cancer is a major health concern worldwide. Radiofrequency ablation is a safe treatment option that can be guided by either ultrasound, computer tomography (CT), or fluoroscopy. Although ultrasound-guided radiofrequency ablation is commonly used in clinical practice, radiofrequency ablation guided by CT [...] Read more.
Background: Liver cancer is a major health concern worldwide. Radiofrequency ablation is a safe treatment option that can be guided by either ultrasound, computer tomography (CT), or fluoroscopy. Although ultrasound-guided radiofrequency ablation is commonly used in clinical practice, radiofrequency ablation guided by CT is more precise but requires more time and does not offer real-time monitoring, which may result in complications such as pneumothorax or organ damage. Objectives: In this study, we investigated the effect of ultrasound, CT, and combined ultrasound/CT guidance on patient survival and complication development. Methods: A total of 982 radiofrequency ablation sessions conducted on 553 patients were analyzed. Clinical outcomes were assessed during follow-up to determine the survival and recurrence rates of malignant tumors. Results: Overall, the three guidance approaches exhibited significant differences in terms of tumor size, number, complication development, and treatment duration. However, no significant differences were observed in survival rate. A comparison of the effect of CT guidance and ultrasound guidance on complication development revealed a higher odds ratio for CT guidance in some cases. A comparison of combined ultrasound/CT guidance and ultrasound guidance revealed nonsignificant differences in complication development. A comparison of CT guidance and combined ultrasound/CT guidance revealed a higher odds ratio for CT guidance in some cases. Radiofrequency ablation is a safe and effective treatment for liver tumors. However, CT has an increased incidence of complications. Conclusions: Combined ultrasound/computer tomography guidance is recommended for patients with multiple or large tumors or tumors near the hepatic dome or diaphragm. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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13 pages, 554 KiB  
Article
Correlating Patient Symptoms and CT Morphology in AI-Detected Incidental Pulmonary Embolisms
by Selim Abed, Lucas Brandstetter and Klaus Hergan
Diagnostics 2025, 15(13), 1639; https://doi.org/10.3390/diagnostics15131639 - 27 Jun 2025
Viewed by 401
Abstract
Background/Objectives: Incidental pulmonary embolisms (IPEs) may be asymptomatic and radiologists may discover them for unrelated reasons, and they can thereby go underdiagnosed and undertreated. Artificial intelligence (AI) has emerged as a possible aid to radiologists in identifying IPEs. This study aimed to [...] Read more.
Background/Objectives: Incidental pulmonary embolisms (IPEs) may be asymptomatic and radiologists may discover them for unrelated reasons, and they can thereby go underdiagnosed and undertreated. Artificial intelligence (AI) has emerged as a possible aid to radiologists in identifying IPEs. This study aimed to assess the clinical and radiological significance of IPEs that a deep learning AI algorithm detected and correlate them with thrombotic burden, CT morphologic signs of right heart strain, and clinical symptoms. Methods: We retrospectively evaluated 13,603 contrast-enhanced thoracic and abdominal CT scans performed over one year at a tertiary care hospital using a CE- and FDA-cleared AI algorithm. Natural language processing (NLP) tools were used to determine whether IPEs were reported by radiologists. We scored confirmed IPEs using the Mastora, Qanadli, Ghanima, and Kirchner scores, and morphologic indicators of right heart strain and clinical parameters such as symptomatology, administered anticoagulation, and 6-month outcomes were analyzed. Results: AI identified 41 IPE cases, of which 61% occurred in oncologic patients. Most emboli were segmental, with no signs of right heart strain. Only 10% of patients were symptomatic. Thrombotic burden scores were similar between oncologic and non-oncologic groups. Four deaths occurred—all in oncologic patients. One untreated case experienced the recurrence of pulmonary embolism. Despite frequent detection, many IPEs were clinically silent. Conclusions: AI can effectively detect IPEs that are missed on initial review. However, most AI-detected IPEs are clinically silent. Integrating AI findings with morphologic and clinical criteria is crucial to avoid overtreatment and to guide appropriate management. Full article
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11 pages, 783 KiB  
Review
Floating Thrombus on the Ascending Aorta and/or Aortic Arch, to Operate or Not to Operate: Two Case Reports and a Literature Review
by Estelle Demoulin, Jalal Jolou, Raoul Schorer, Bernhard Walder, Carl Glessgen, Christoph Huber and Mustafa Cikirikcioglu
J. Cardiovasc. Dev. Dis. 2025, 12(7), 248; https://doi.org/10.3390/jcdd12070248 - 27 Jun 2025
Viewed by 422
Abstract
Background and Aim: Floating aortic thrombi are rare but potentially life-threatening entities, associated with a high risk of systemic embolization and subsequent complications such as ischemic stroke or mesenteric infarction. Therapeutic strategies range from urgent surgical intervention to conservative medical management with anticoagulation, [...] Read more.
Background and Aim: Floating aortic thrombi are rare but potentially life-threatening entities, associated with a high risk of systemic embolization and subsequent complications such as ischemic stroke or mesenteric infarction. Therapeutic strategies range from urgent surgical intervention to conservative medical management with anticoagulation, depending on the patient’s clinical status and thrombus morphology. This report presents two cases of floating aortic thrombi managed with distinct approaches, surgical and medical, underscoring the importance of individualized treatment guided by embolic risk and comorbidities. Patients and Methods: The first case involves a 59-year-old male presenting with abdominal pain and emesis. Imaging confirmed mesenteric ischemia, necessitating emergent laparotomy and extensive jejunal resection. Postoperative imaging identified a mobile thrombus at the ascending aorta–aortic arch junction, with evidence of cerebral embolism. The patient underwent urgent surgical thrombectomy, ascending aortic resection, and hemiarch replacement. The second case describes an 88-year-old male who presented with bilateral upper limb paresthesia. Neuroimaging revealed acute supra- and infratentorial ischemic lesions suggestive of embolic stroke. A floating thrombus was identified in the ascending aorta, with an additional thrombus in the descending thoracic aorta. Given the patient’s advanced age, comorbid conditions, and thrombus stability, a conservative approach with systemic anticoagulation and close radiologic surveillance was chosen. Conclusions: These cases illustrate the need for tailored management of floating aortic thrombi. While surgical resection remains indicated in unstable or high-risk embolic cases, anticoagulation may suffice for stable lesions in patients with elevated surgical risk. Further studies are needed to establish standardized therapeutic guidelines. Full article
(This article belongs to the Special Issue Current Status and Future Challenges of Aortic Arch Surgery)
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11 pages, 2077 KiB  
Technical Note
Laparoscopic-Assisted Percutaneous Cryoablation of Abdominal Wall Desmoid Fibromatosis: Case Series and Local Experience
by Kadhim Taqi, Jaymie Walker, Cecily Stockley, Antoine Bouchard-Fortier, Stefan Przybojewski and Lloyd Mack
Surg. Tech. Dev. 2025, 14(3), 20; https://doi.org/10.3390/std14030020 - 24 Jun 2025
Viewed by 390
Abstract
Background: Desmoid tumors (DTs) are rare, non-metastatic but locally aggressive connective tissue neoplasms. While standard treatments include surgery, radiation, and ablation, current guidelines advocate active surveillance unless tumors progress or symptoms worsen. Cryotherapy has shown promise in treating DTs; however, its application in [...] Read more.
Background: Desmoid tumors (DTs) are rare, non-metastatic but locally aggressive connective tissue neoplasms. While standard treatments include surgery, radiation, and ablation, current guidelines advocate active surveillance unless tumors progress or symptoms worsen. Cryotherapy has shown promise in treating DTs; however, its application in rectus abdominis DTs has been limited due to proximity to critical intra-abdominal structures. Methods: This case series describes a novel approach involving laparoscopic-assisted cryoablation in three patients with rectus abdominis DTs. Laparoscopic visualization was employed to improve tumor localization and procedural safety during percutaneous cryoablation. Results: The average tumor size was 7.4 cm, and a mean of 14 cryoprobes were used per case. All patients experienced complete symptom resolution. One patient developed a complication—injury to the inferior epigastric artery—requiring embolization. Follow-up imaging at three months showed significant tumor shrinkage and necrosis in two patients. The third patient had increased lesion volume due to post-procedural hematoma, although radiological markers of cryoablation efficacy were present. Conclusions: Laparoscopic-assisted cryoablation appears to be a feasible and effective technique for treating rectus abdominis DTs, providing symptom relief and favorable early tumor response. Further studies are warranted to evaluate long-term outcomes and validate this approach in broader clinical settings. Full article
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14 pages, 1133 KiB  
Article
Predictive Utility of Structured MRI Reporting for Rectal Cancer Outcomes
by Eliodoro Faiella, Filippo Carannante, Federica Vaccarino, Gabriella Teresa Capolupo, Valentina Miacci, Gloria Perillo, Elva Vergantino, Bruno Beomonte Zobel, Marco Caricato and Domiziana Santucci
Diagnostics 2025, 15(12), 1472; https://doi.org/10.3390/diagnostics15121472 - 10 Jun 2025
Viewed by 525
Abstract
Background/Objectives: This retrospective study evaluates the predictive role of magnetic resonance imaging (MRI) in complications and recurrence in rectal cancer patients undergoing surgery and neoadjuvant therapy, highlighting the impact of structured reporting templates on MRI quality. Compared to traditional free-text reports, structured radiology [...] Read more.
Background/Objectives: This retrospective study evaluates the predictive role of magnetic resonance imaging (MRI) in complications and recurrence in rectal cancer patients undergoing surgery and neoadjuvant therapy, highlighting the impact of structured reporting templates on MRI quality. Compared to traditional free-text reports, structured radiology reports offer a point-by-point evaluation, improving clarity and completeness by thoroughly addressing all relevant findings. MRI is critical in rectal cancer staging, guiding treatment based on tumor characteristics like T stage, sphincter involvement, vascular invasion, and lymph node status. Methods: A retrospective analysis of MRI and reports from 67 rectal cancer patients at the time of diagnosis, who were subsequently treated with neoadjuvant radiochemotherapy and surgery, was conducted. MRI report features, including tumor location, morphology, T stage, sphincter infiltration, mesorectal fascia involvement, lymph nodes, and extramural vascular invasion, were evaluated against European Society of Gastrointestinal and Abdominal Radiology (ESGAR) recommendations. Multivariate and univariate analyses were performed to correlate MRI findings with postoperative outcomes such as complications, local recurrence, bleeding, and 30-day anastomotic leaks. Results: Sphincter involvement showed a strong association with increased complications (multivariate β = 0.410, univariate r = 0.270). Extramural vascular invasion was linked to higher rates of local recurrence (multivariate β = 0.199, univariate r = 0.127). Lymph node involvement correlated with an elevated risk of postoperative bleeding (multivariate β = 0.133, univariate r = 0.293). Additionally, advanced T staging predicted a higher incidence of 30-day anastomotic leaks (multivariate β = 0.210, univariate r = 0.261). These findings may provide clinically relevant insights to support personalized surgical planning and improve preoperative risk stratification. Conclusions: Detailed MRI reporting, aligned with structured templates, significantly guides surgical and therapeutic strategies in rectal cancer management. However, the retrospective nature of the study and the limited sample size may affect the generalizability of the results. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases)
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8 pages, 426 KiB  
Case Report
A Case of Horseshoe Kidney and Autosomal Dominant Polycystic Kidney Disease with PKD1 Gene Mutation
by Hyeongwan Kim, Soo Jin Lee and Won Kim
J. Clin. Med. 2025, 14(11), 4008; https://doi.org/10.3390/jcm14114008 - 5 Jun 2025
Viewed by 572
Abstract
Background/Objectives: Horseshoe kidney is a congenital anomaly characterized by the fusion of the kidneys at the lower pole. Polycystic kidney disease with horseshoe kidney is called polycystic horseshoe kidney. Genetic testing is essential for the diagnosis of polycystic horseshoe kidney disease because [...] Read more.
Background/Objectives: Horseshoe kidney is a congenital anomaly characterized by the fusion of the kidneys at the lower pole. Polycystic kidney disease with horseshoe kidney is called polycystic horseshoe kidney. Genetic testing is essential for the diagnosis of polycystic horseshoe kidney disease because it can result from a number of genetic disorders. Fewer than 20 cases of polycystic horseshoe kidney have been reported to date. However, polycystic horseshoe kidney disease was mostly diagnosed via autopsy or radiologic imaging techniques including computed tomography, magnetic resonance imaging, and angiography. Because polycystic kidney disease has various causes, genetic testing is essential for the diagnosis of autosomal dominant polycystic kidney disease (ADPKD) in patients with polycystic horseshoe kidney disease. At present, the diagnosis of ADPKD is made using genetic approaches, including next-generation sequencing. We reported a potentially pathogenic polycystin 1 (PKD1) gene in a patient with ADPKD and horseshoe kidney. Methods: We performed the sequencing of the PKD1 gene and radiological examinations (computed abdominal tomography). Results: Computed abdominal tomography revealed enlarged kidneys with multiple cysts fused at the lower poles, indicating polycystic HSK. The sequencing of the PKD1 gene revealed a heterozygous pathogenic variant c.165_171del (p.Leu56ArgfsTer15), which genetically confirmed the diagnosis of ADPKD. The patient was treated with an angiotensin II receptor blocker. Conclusions: In this case report, we suggest that genetic testing becomes the key approach to the diagnosis of ADPKD with horseshoe kidney. Additionally, this approach offers the benefit of avoiding the possibility of the condition being mistakenly diagnosed or diagnosed late due to its uncommon occurrence and nonspecific symptoms. Full article
(This article belongs to the Section Nephrology & Urology)
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12 pages, 600 KiB  
Article
Radiation Dose Reduction in Cancer Imaging with New-Model CT Scanners: A Quality of Care Evaluation
by Stefania Rizzo, Luca Bellesi, Ebticem Ben Khalifa, Stefano Presilla, Andrea D’Ermo, Francesco Magoga, Matteo Merli, Ermidio Rezzonico, Oriana D’Ecclesiis and Filippo Del Grande
Cancers 2025, 17(11), 1815; https://doi.org/10.3390/cancers17111815 - 29 May 2025
Viewed by 669
Abstract
Background/Objectives: The primary aim of this study was to evaluate whether the replacement of roughly one-decade-old computed tomography (CT) scanners with new-model CT scanners were associated with an additional reduction in the radiation dose delivered to oncological patients, in a radiological setting where [...] Read more.
Background/Objectives: The primary aim of this study was to evaluate whether the replacement of roughly one-decade-old computed tomography (CT) scanners with new-model CT scanners were associated with an additional reduction in the radiation dose delivered to oncological patients, in a radiological setting where the optimization of protocols had already reached very low radiation doses. An exploratory secondary objective was to evaluate the potential differences in the objective image quality between the CT scans obtained before and after the installation of the new-generation CT scanners. Methods: Chest and abdominal CT examinations conducted for oncologic purposes were retrospectively selected from two time periods—prior to scanner replacement (2022) and following an upgrade (2024)—after five CT systems in our radiology department were replaced. We extracted and compared the CT dose index (CTDI) and dose length product (DLP) for each CT phase. For the objective image quality evaluation, we calculated the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) at the center of the liver and the aorta. An appropriate statistical analysis was performed and a p-value < 0.05 was considered significant. Results: We included 14,601 CT acquisitions, of which 9013 (61.7%) were performed before and 5588 (38.3%) after the replacement of the CT scanners. There were significantly lower values for the CTDI and DLP with the new CT scanners compared to the old ones. The CTDI with the new CT scanners was significantly lower in all phases (p-value = 0.002 for unenhanced phase, and p < 0.001 for arterial, portal venous, and delayed phases). The DLP using the new CT scanners was significantly lower in the arterial, portal venous, and delayed phases (p < 0.001), and it was not significantly different in the unenhanced phase (p = 0.36). There was no significant difference in the SNR at the liver level (p = 0.72) or at the aorta level (p = 0.51). There was no significant difference in the CNR at the liver level (p = 0.24), whereas the CNR was higher with the new CT scanners at the aorta level (p = 0.03). Conclusions: The transition to new-model CT scanners resulted in a significant reduction in the radiation dose delivered by chest and abdomen CT scans, without compromising the objective image quality. Full article
(This article belongs to the Section Methods and Technologies Development)
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21 pages, 2133 KiB  
Article
A Study of Adrenal Incidentaloma-Related Hormonal Assays After First Integration of the Diagnosis Within Primary Healthcare
by Oana-Claudia Sima, Mihai Costachescu, Ana Valea, Mihaela Stanciu, Ioana Codruta Lebada, Tiberiu Vasile Ioan Nistor, Mihai-Lucian Ciobica, Claudiu Nistor and Mara Carsote
Diseases 2025, 13(6), 169; https://doi.org/10.3390/diseases13060169 - 26 May 2025
Viewed by 459
Abstract
Background: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up to three out of ten individuals confirmed with nonfunctioning adrenal incidentalomas (NFAs) actually present a mild autonomous cortisol secretion (MACS), which is distinct from Cushing’s syndrome. [...] Read more.
Background: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up to three out of ten individuals confirmed with nonfunctioning adrenal incidentalomas (NFAs) actually present a mild autonomous cortisol secretion (MACS), which is distinct from Cushing’s syndrome. Objective: We aimed to assess the cortisol secretion in newly detected adrenal incidentalomas in patients who were referred by their primary healthcare physician upon accidental detection of an adrenal tumor at abdominal computed tomography (CT) scan that was performed for unrelated (non-endocrine) purposes. Methods: This retrospective study included adults diagnosed with an adrenal incidentaloma via CT during the previous 3 months. Inclusion criteria: age ≥ 40 years (y). A triple stratification of exclusion criteria involved: (1) Clinical aspects and medical records such as active malignancies or malignancies under surveillance protocols, subjects under exogenous glucocorticoid exposure (current or during the previous year), or suggestive endocrine phenotypes for any hormonal ailment; (2) Radiological appearance of suspected/confirmed (primary or secondary) adrenal malignancy, adrenal cysts, or myelolipomas; (3) Endocrine assays consistent with active endocrine tumors. Protocol of assessment included baseline ACTH, morning plasma cortisol (C-B), cortisol at 6 p.m. (C-6 pm), and after 1 mg dexamethasone suppression testing (C-1 mg-DST), 24-h urinary free cortisol (UFC), and a second opinion for all CT scans. MACS were defined based on C-1 mg-DST ≥ 1.8 and <5 µg/dL (non-MACS: C-1 mg-DST < 1.8 µg/dL). Results: The cohort (N = 60, 78.33% female; 60.72 ± 10.62 y) associated high blood pressure (HBP) in 66.67%, respectively, type 2 diabetes (T2D) in 28.37% of the patients. Females were statistically significantly older than males (62.40 ± 10.47 vs. 54.62 ± 9.11 y, p = 0.018), while subjects with unilateral vs. bilateral tumors (affecting 26.67% of the individuals) and those with MACS-positive vs. MACS-negative profile had a similar age. Body mass index (BMI) was similar between patients with unilateral vs. bilateral incidentalomas, regardless of MACS. Patients were divided into five age groups (decades); most of them were found between 60 and 69 years (40%). Left-gland involvement was found in 43.33% of all cases. The mean largest tumor diameter was 26.08 ± 8.78 mm. The highest rate of bilateral tumors was 46.67% in the 50–59 y decade. The rate of unilateral/bilateral and tumor diameters was similar in females vs. males. The MACS-positive rate was similar in females vs. males (23.40% vs. 23.08%). A statistically significant negative correlation (N = 60) was found between BMI and C-B (r = −0.193, p = 0.03) and BMI and UFC (r = −0.185, p = 0.038), and a positive correlation was found between C-B and C-6 pm (r = 0.32, p < 0.001), C-B and UFC (r = 0.226, p = 0.011), and C-6 pm and C-1 mg-DST (r = 0.229, p = 0.010), and the largest tumor diameter and C-1 mg-DST (r = 0.241, p = 0.007). Conclusions: Adrenal incidentalomas belong to a complex scenario of detection in the modern medical era, requiring a multidisciplinary collaboration since the patients might be initially detected in different departments (as seen in the current study) and then referred to primary healthcare for further decision. In these consecutive patients, we found a higher female prevalence, a MACS rate of 23.33%, regardless of uni/bilateral involvement or gender distribution, and a relatively high rate (than expected from general data) of bilateral involvement of 26.67%. The MACS-positive profile adds to the disease burden and might require additional assessments during follow-up and a protocol of surveillance, including a tailored decision of tumor removal. The identification of an adrenal incidentaloma at CT and its hormonal characterization needs to be integrated into the panel of various chronic disorders of one patient. The collaboration between endocrinologists and primary healthcare physicians might improve the overall long-term outcomes. Full article
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11 pages, 626 KiB  
Article
Incidence and Risk Factors for Incisional Hernia Following Ileostomy Takedown: A Retrospective Cohort Study
by Tamás Talpai, Flaviu-Ionuţ Faur, Cătălin-Alexandru Pîrvu, Daniela Marinescu, Cristi Tarta, Dragos Nicolae Margaritescu, Stelian Pantea, Cristian Nica, Rãzvan-Sorin Albu, Tudor-Alexandru Popoiu, Razvan Lazea, Larisa Balanoiu and Valeriu Șurlin
J. Clin. Med. 2025, 14(10), 3597; https://doi.org/10.3390/jcm14103597 - 21 May 2025
Viewed by 3028
Abstract
Background: Incisional hernias are a frequent complication following ileostomy closure, with rates reaching 24%. Protective ileostomies are commonly performed in colorectal surgery, but their closure presents a significant risk for abdominal wall defects. Identifying risk factors for incisional hernias at the ileostomy [...] Read more.
Background: Incisional hernias are a frequent complication following ileostomy closure, with rates reaching 24%. Protective ileostomies are commonly performed in colorectal surgery, but their closure presents a significant risk for abdominal wall defects. Identifying risk factors for incisional hernias at the ileostomy site is crucial for improving patient outcomes. Methods: This retrospective study analyzed data from 95 patients who underwent loop ileostomy closure at two Romanian hospitals between 2018 and 2023. Patient demographics, surgical details, and follow-up data were reviewed. Incisional hernias were diagnosed through clinical examination or radiological imaging. Statistical analyses, including univariate and multivariate regression, were performed to identify independent risk factors. Results: The incidence of incisional hernias at the ileostomy site was 13.7% (13/95). Univariate analysis identified BMI (HR 30.08; p = 0.007), previous hernia (HR 7.99; p = 0.059), radiotherapy (HR 299.15; p = 0.029), and chemotherapy (HR 0.004; p = 0.026) as significant factors. Multivariate analysis confirmed BMI > 30 kg/m2 (HR 12.27; p = 0.002) and prior hernia (HR 8.14; p = 0.007) as independent risk factors. Conclusions: Obesity and previous hernias significantly increase the risk of incisional hernias following ileostomy closure. Radiological follow-up enhances early detection, and further studies should explore the benefits of prophylactic mesh reinforcement. Optimizing patient selection and surgical technique may reduce postoperative hernia rates, improving long-term outcomes. Full article
(This article belongs to the Special Issue Hernia Surgery and Postoperative Management)
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15 pages, 1981 KiB  
Article
Investigation of the Clinical Value of Three-Dimensional-Printed Personalised Vascular Models for the Education and Training of Clinicians When Performing Interventional Endovascular Procedures
by Deborah L. Daring and Zhonghua Sun
Appl. Sci. 2025, 15(10), 5695; https://doi.org/10.3390/app15105695 - 20 May 2025
Cited by 1 | Viewed by 542
Abstract
This study aimed to assess the clinical value of three-dimensional printed personalised vascular models (3DPPVMs) in assisting with the pre-operative planning and simulation of endovascular interventions. CT angiographic images of four cases, namely, abdominal aorta aneurysm (AAA), carotid artery stenosis, coronary artery stenosis, [...] Read more.
This study aimed to assess the clinical value of three-dimensional printed personalised vascular models (3DPPVMs) in assisting with the pre-operative planning and simulation of endovascular interventions. CT angiographic images of four cases, namely, abdominal aorta aneurysm (AAA), carotid artery stenosis, coronary artery stenosis, and renal artery stenosis, were selected, and 3DPPVMs were obtained. A total of 21 clinicians specialising in interventional radiology and vascular surgery were invited to participate in the study, comprising 6 radiologists and 15 vascular surgeons. Of these, 66.7% had not used a 3DPPVM prior to their participation. Considering all areas of experience and all four models, it was observed that 75% of the participants gave a ranking of 7 or above out of 10 with regard to the recommendation of the use of the 3DPPVMs. The mean scores of the participants’ ranking of the models ranged from 3.2 to 4.3 out of 5. The AAA model was ranked the highest for realism (4.10 ± 0.89, p = 0.002), the planning of interventions and simulations (3.90 ± 1.12 and 4.05 ± 0.95), the development of haptic skills (3.56 ± 0.98), reducing the procedure time (3.47 ± 1.12), and clarifying the pathology to patients (4.33 ± 0.69, p all >0.05), indicating consistency amongst the participants. The carotid artery model was ranked the highest for accurately displaying anatomical structures (4.3 ± 0.73). All the 3DPPVMs enhanced the understanding of the disease demonstrated, with rankings between 3.8 and 3.95. All the models aided in elucidating the intervention procedure required and in the planning of vascular interventions, with rankings of 3.5 and 3.9. The highest rankings were given by qualified clinicians with 8 or more years of experience. This study shows the potential value of using 3D-printed vascular models in education for clinicians and patients, as well as for clinical training and the pre-surgical simulation of endovascular stent-grafting procedures. Full article
(This article belongs to the Section Additive Manufacturing Technologies)
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18 pages, 622 KiB  
Review
Extended Focused Assessment with Sonography for Trauma in the Emergency Department: A Comprehensive Review
by Federico M. Bella, Alessandra Bonfichi, Ciro Esposito, Christian Zanza, Abdelouahab Bellou, Domenico Sfondrini, Antonio Voza, Andrea Piccioni, Antonio Di Sabatino and Gabriele Savioli
J. Clin. Med. 2025, 14(10), 3457; https://doi.org/10.3390/jcm14103457 - 15 May 2025
Cited by 1 | Viewed by 3382
Abstract
The Extended Focused Assessment with Sonography for Trauma (eFAST) plays a crucial role in the emergency department (ED) by providing rapid and non-invasive diagnostic information in trauma patients. It is a diagnostic-free fluid detection technique that uses sonography to assess trauma in different [...] Read more.
The Extended Focused Assessment with Sonography for Trauma (eFAST) plays a crucial role in the emergency department (ED) by providing rapid and non-invasive diagnostic information in trauma patients. It is a diagnostic-free fluid detection technique that uses sonography to assess trauma in different anatomical windows of the chest and abdomen and has been accepted in multiple studies as the initial diagnostic tool for torso injuries in blunt abdominal trauma. By promptly identifying potentially life-threatening injuries, such as haemoperitoneum, haemothorax, and cardiac tamponade, eFAST facilitates timely intervention and improves patient outcomes in the ED. The eFAST exam is reliable, with high sensitivity and specificity, even when performed by non-radiological personnel, saving time and resources in the chaotic emergency environment. This review aims to assess the diagnostic reliability and limitations of eFAST in different trauma conditions and to outline its goals in trauma critical care and in “ABCDE” resuscitation. Full article
(This article belongs to the Special Issue Advances in Trauma Care and Emergency Medicine)
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17 pages, 2456 KiB  
Article
The Accuracy of ChatGPT-4o in Interpreting Chest and Abdominal X-Ray Images
by Pietro G. Lacaita, Malik Galijasevic, Michael Swoboda, Leonhard Gruber, Yannick Scharll, Fabian Barbieri, Gerlig Widmann and Gudrun M. Feuchtner
J. Pers. Med. 2025, 15(5), 194; https://doi.org/10.3390/jpm15050194 - 10 May 2025
Viewed by 2596
Abstract
Background/Objectives: Large language models (LLMs), such as ChatGPT, have emerged as potential clinical support tools to enhance precision in personalized patient care, but their reliability in radiological image interpretation remains uncertain. The primary aim of our study was to evaluate the diagnostic accuracy [...] Read more.
Background/Objectives: Large language models (LLMs), such as ChatGPT, have emerged as potential clinical support tools to enhance precision in personalized patient care, but their reliability in radiological image interpretation remains uncertain. The primary aim of our study was to evaluate the diagnostic accuracy of ChatGPT-4o in interpreting chest X-rays (CXRs) and abdominal X-rays (AXRs) by comparing its performance to expert radiology findings, whilst secondary aims were diagnostic confidence and patient safety. Methods: A total of 500 X-rays, including 257 CXR (51.4%) and 243 AXR (48.5%), were analyzed. Diagnoses made by ChatGPT-4o were compared to expert interpretations. Confidence scores (1–4) were assigned and responses were evaluated for patient safety. Results: ChatGPT-4o correctly identified 345 of 500 (69%) pathologies (95% CI: 64.81–72.9). For AXRs 175 of 243 (72.02%) pathologies were correctly diagnosed (95% CI: 66.06–77.28), while for CXRs 170 of 257 (66.15%) were accurate (95% CI: 60.16–71.66). The highest detection rates among CXRs were observed for pulmonary edema, tumor, pneumonia, pleural effusion, cardiomegaly, and emphysema, and lower rates were observed for pneumothorax, rib fractures, and enlarged mediastinum. AXR performance was highest for intestinal obstruction and foreign bodies, and weaker for pneumoperitoneum, renal calculi, and diverticulitis. Confidence scores were higher for AXRs (mean 3.45 ± 1.1) than CXRs (mean 2.48 ± 1.45). All responses (100%) were considered to be safe for the patient. Interobserver agreement was high (kappa = 0.920), and reliability (second prompt) was moderate (kappa = 0.750). Conclusions: ChatGPT-4o demonstrated moderate accuracy for the interpretation of X-rays, being higher for AXRs compared to CXRs. Improvements are required for its use as efficient clinical support tool. Full article
(This article belongs to the Section Methodology, Drug and Device Discovery)
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30 pages, 6123 KiB  
Article
Sectional Anatomy with Micro-Computed Tomography and Magnetic Resonance Imaging Correlation of the Middle and Caudal Abdominal Regions in the Syrian Hamster (Mesocricetus auratus)
by Nima Mohammadzadeh, Jamal Nourinezhad, Abdolvahed Moarabi and Maciej Janeczek
Animals 2025, 15(9), 1315; https://doi.org/10.3390/ani15091315 - 1 May 2025
Viewed by 1072
Abstract
The abdomen is a key region in small animal veterinary practice, with the middle and caudal sections housing various organ systems that are susceptible to dysfunction, necessitating medical intervention or surgery. Sectional imaging techniques like CT and MRI are commonly used in small [...] Read more.
The abdomen is a key region in small animal veterinary practice, with the middle and caudal sections housing various organ systems that are susceptible to dysfunction, necessitating medical intervention or surgery. Sectional imaging techniques like CT and MRI are commonly used in small mammals, but no studies have focused on rodent abdomen. This study aimed to correlate micro-CT and MRI images of the middle and caudal abdominal regions with corresponding anatomical sections in Syrian hamsters (SHs), which are popular pets and experimental models. Ten healthy male SHs were used, and anatomical structures from frozen sections were compared with corresponding MCT and MRI images. Clinically relevant structures identified in anatomical sections were discernible on MCT and MRI scans. The key findings include the presence of glandular and non-glandular stomachs, the stomach and cecum primarily located on the left side, the absence of ampulla coli, sacculus rotundus, and cecal appendix, and sacculation of the colon, as well as the jejunum, mainly on the right side. The vesicular, coagulating, and prostate glands were also present, and the right kidney did not extend to the last thoracic vertebra. The results were similar to abdominal anatomical and radiologic studies in rats, mice, and guinea pigs, regardless of the rat’s and mice’s sacculated cecum and the guinea pig’s glandular stomach. However, significant differences were observed compared to the rabbit abdomen’s sectional anatomy and CT findings. This study highlights the diagnostic value of MCT and MRI in SHs and provides a valuable reference for interpreting cross-sectional abdominal images in SHs. Full article
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