Search Results (1,244)

Background: The majority of parotid gland tumors are benign, e.g., pleomorphic adenoma (PA) and Warthin’s tumor (WT). From a biomedical point of view, oxidative stress is of significant importance due to its established association with the initiation and progression of various types of cancer, including parotid gland cancers. This study aimed to assess whether blood prooxidant–antioxidant markers could aid in diagnosing and guiding surgery for recurrent malignancies after parotid tumor treatment. Methods: We examined patients (n = 20) diagnosed with WT (n = 14) and PA (n = 6) using histopathological verification and computed tomography (CT) who qualified for surgical treatment. Blood samples were taken before the surgery and again 10 days later for biochemical analysis. The activities of the antioxidant enzymes (SOD, CAT and GPx), the non-enzymatic antioxidants (GSH and UA) and oxidative stress markers (MDA and TOS) were determined in the blood. The activities of CK and LDH and the concentrations of Cor and TAS were measured in the serum. Hb and Ht were determined in whole blood. Results: The patients’ SOD, CAT, and GPx activities after surgery did not differ significantly from their preoperative levels. However, following surgery, their serum TOS levels were significantly elevated in all the patients compared to baseline. In contrast, the plasma MDA concentrations were markedly reduced after surgery. Similarly, the GSH concentrations showed a significant decrease postoperatively. No significant changes were observed in the CK and LDH activities, TAS concentrations, or levels of Hb, Ht and Cor following surgery. Conclusions: The surgical removal of salivary gland tumors did not result in a reduction in oxidative stress at 10 days after surgery. Therefore, further studies are needed to determine the effectiveness of endogenous defense mechanisms in counteracting the oxidative stress induced by salivary gland tumors. Full article

Background and Objectives: The causes and clinical outcomes of renal perfusion abnormalities occurring after para-aortic lymphadenectomy (PANDx) for gynecologic malignancies are unknown. We investigated the potential involvement of accessory renal artery (ARA) obstruction in their development by reassessing perioperative contrast-enhanced computed tomography (CECT). Materials and Methods: This retrospective study investigated a clinical database to identify urinary contrast defects using CECT in all patients who had undergone PANDx between January 2020 and December 2024. The perfusion defects in the kidney detected by CECT were extracted by a gynecologic oncologist and evaluated by a radiologist and urologist for suspected obstruction of ARAs. Results: Postoperative renal contrast defects were observed in 3.8% (6/157) of patients. Renal parenchymal fibrosis, cortical atrophy, and parenchymal thinning were observed as universal findings in all patients showing renal contrast defects. In five of the six cases, ARAs supplying the infarcted renal segments were identified on preoperative CECT, and arterial obstruction was confirmed on postoperative imaging. The remaining case was considered to be latent pyelonephritis. All five patients underwent laparotomy, and preoperative CECT failed to detect ARAs. The median resected para-aortic lymph node was 23 nodes (range: 15–33) in five patients, showing no statistically significant difference compared to patients without perfusion abnormalities (p = 0.19). Postoperative serum creatinine levels remained stable. Conclusions: ARA obstruction appears to be a risk factor for segmental renal infarction after para-aortic lymphadenectomy in gynecological malignancies; however, the clinical impact on urinary function may be limited. Awareness of this potential complication is essential for gynecologic oncologists performing PANDx. Full article

Objective: This study aimed to evaluate whether modifying the post-processing algorithm of Twin-Spiral Dual-Energy computed tomography (DECT) improves infarct detection compared to conventional Dual-Energy CT (DECT) and Single-Energy CT (SECT) following endovascular therapy (EVT) for large vessel occlusion (LVO). Methods: We retrospectively analyzed 52 patients who underwent Twin-Spiral DECT after endovascular stroke therapy. Ten patients were used to generate a device-specific parameter (“y”) using an AI-based neural network (SynthSR). This parameter was integrated into the post-processing algorithm for edema map generation. Quantitative Hounsfield unit (HU) measurements were used to assess density differences in ischemic brain tissue across conventional virtual non-contrast (VNC) images and edema maps. Results: The median HU of infarcted tissue in conventional mixed DECT was 33.73 ± 4.58, compared to 22.96 ± 3.81 in default VNC images. Edema maps with different smoothing filter settings showed values of 14.39 ± 4.96, 14.50 ± 3.75, and 15.05 ± 2.65, respectively. All edema maps demonstrated statistically significant HU differences of infarcted tissue compared to conventional VNC images ($p<0.001$) while maintaining the density values of non-infarcted brain tissue. Conclusions: Enhancing the post-processing algorithm of conventional virtual non-contrast imaging improves infarct detection compared to standard mixed or virtual non-contrast reconstructions in Dual-Energy CT. Full article

The aim of the current study is to investigate the mechanical properties and ballistic performance of HARDOX 450 steel for defense applications in different conditions: uncoated, alumina-coated, and LINE X polyurea-coated. Tensile tests and Vickers microhardness measurements were conducted, along with fracture surface analysis using stereomicroscopy, scanning electron microscopy, and computed tomography. Experimental results showed that uncoated HARDOX 450 steel exhibited the highest strength and hardness, with ductile fracture features. Polyurea-coated HARDOX 450 steel samples retained good mechanical properties and demonstrated effective ballistic protection, including the containment of fragments. In contrast, alumina-coated HARDOX 450 steel samples exhibited reduced strength and ballistic resistance, attributed to the microstructural changes in HARDOX 450 steel caused by the high-temperature deposition process of alumina. Numerical simulations performed with the 5.56 × 45 mm bullet used in the simulation, along with its ballistic impact interaction with the Hardox 450 target model, aligned well with experimental ballistic impact results for all the samples. Overall, LINE X polyurea coating on HARDOX 450 steel proved to be the more suitable coating for applications requiring a balance of mechanical strength and ballistic impact resistance. Full article

Background/Objectives: The composition of the thrombus is not taken into account in the etiology determination of patients with acute ischemic stroke (AIS); however, it varies depending on the origin of the thrombus, as atherothrombotic thrombi contain more red blood cells and cardioembolic thrombi contain more fibrin and platelets. Radiomics has the potential to provide quantitative imaging data that may vary depending on the composition of thrombi. The aim of this study is to predict cardioembolic and atherothrombotic thrombi using radiomic features (RFs) from non-contrast computed tomography (NCCT) brain scans. Methods: A total of 845 RFs were extracted from each of the 41 patients included in the study. A predictive model was used to classify patients as either cardioembolic or atherothrombotic, and the results were compared with the TOAST criteria-based classification. Results: Ten RFs (one shape feature and nine texture features) were found to demonstrate a statistically significant correlation with cardioembolic or atherothrombotic origins. The predictive radiomics model achieved an area under the curve (AUC) of 0.842 and an accuracy of 0.902 (p < 0.001) in classifying stroke etiology. Conclusions: Radiomics based on NCCT can help to determine the etiology of AIS. Full article

Gastric cancer remains the fourth leading cause of cancer-related mortality worldwide. Advanced disease is associated with a poor prognosis, emphasizing the critical importance of early diagnosis through endoscopy. In addition to prognosis, disease extent also plays a pivotal role in guiding management strategies. Therefore, accurate locoregional staging (T and N staging) is vital for optimal prognostic and therapeutic planning. Endoscopic ultrasound (EUS) has long been an essential tool in this regard, with computed tomography (CT) and, more recently, positron emission tomography–computed tomography (PET–CT) serving as alternative imaging modalities. EUS is particularly valuable in the assessment of early gastric cancer, defined as tumor invasion confined to the mucosa or submucosa. These tumors are increasingly managed by endoscopic resection techniques offering improved post-treatment quality of life. EUS has also recently been utilized in the restaging process after neoadjuvant chemotherapy, aiding in the evaluation of tumor resectability and prognosis. Its performance may be further enhanced through the application of emerging techniques such as contrast-enhanced endosonography, EUS elastography, and artificial intelligence systems. In advanced, unresectable disease, complications such as gastric outlet obstruction (GOO) severely impact patient quality of life. In this setting, EUS-guided gastroenterostomy (EUS-GE) offers a less invasive alternative to surgical gastrojejunostomy. This review summarizes and critically analyzes the role of EUS in the context of gastric cancer, highlighting its applications across different stages of the disease and evaluating its performance relative to other diagnostic modalities. Full article

Background/Objectives: Computed tomography (CT) of the head is vital in diagnosing neurological conditions but poses concerns regarding radiation exposure. Traditional diagnostic reference levels (DRLs) are based on anatomical regions, potentially overlooking variations in radiation requirements driven by clinical indication. This study aimed to establish clinical indication-specific DRLs (DRLCIs) for adult head CT to support precision benchmarking and optimise patient safety. Methods: A retrospective observational study was conducted using data from 378 adult patients undergoing non-contrast CT head scans between September 2022 and February 2024. Data on patient demographics, protocols, and radiation dose metrics (Computed Tomography Dose Index Volume and Dose–Length Product) were extracted using DoseWatch™ software. Protocol parameters were standardised across clinical indications such as trauma, stroke, headache, seizure, and infection. Descriptive statistics and correlation analyses were performed. Descriptive statistics, including means, standard deviations, and percentile distributions, were calculated. Correlation analyses were conducted using Pearson’s correlation coefficient to examine relationships between dose metrics and patient variables such as age and body mass index. Results: Mean CTDIvol values ranged from 50.58 mGy (trauma) to 52.90 mGy (infection), while DLP values ranged from 1052.52 to 1219.98 mGy·cm. Percentile distributions were narrow, indicating effective protocol standardisation. The strongest correlation was observed between CTDIvol and DLP (r = 0.89), while age and body mass index showed negligible influence on dose metrics. Comparative analysis showed alignment with international benchmarks from the UK, Qatar, Bahrain, and Nigeria. Conclusions: This study establishes DRLCIs for adult head CT, demonstrating consistent radiation dose delivery across indications with minimal variability. Clinical indication-based benchmarking enhances dose optimisation and aligns with global radiological protection frameworks. Full article

Background/Objectives: The aim of this study was to determine whether extracellular volume (ECV) fraction as determined by contrast-enhanced computed tomography (CECT) can help distinguish between autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods: Participants comprised 101 patients, including 20 diagnosed with AIP (AIP group), 42 with histologically confirmed PDAC (PDAC group), and 39 without pancreatic disease (healthy group). Contrast enhancement (CE) was calculated as CT attenuation in Hounsfield units [HU] on equilibrium-phase CECT–CT attenuation on pre-contrast CT. The ECV fraction was calculated by measuring the region of interest within the pancreatic region and aorta on pre-contrast and equilibrium-phase CECT. CT measurements were compared among groups. CE and ECV fractions were also compared for diffuse (n = 12) and focal or segmental types (n = 8). Focal- or segmental-type AIP was defined as the involvement of one or two pancreas segments. Diagnostic efficacy was evaluated through receiver operating characteristic (ROC) analyses. Results: CE and ECV fractions differed significantly between the groups (p < 0.001 each). CE was significantly higher in the AIP group (56.8 ± 7.9 HU) than in the PDAC group (42.3 ± 17.0 HU, p < 0.001) or healthy group (32.2 ± 6.1 HU, p < 0.001). ECV fraction was significantly higher in the AIP group (47.2 ± 7.3%) than in the PDAC group (31.7 ± 12.0%, p < 0.001) or healthy group (27.5 ± 5.4%, p < 0.001). In the AIP group, no significant differences in CE (56.7 ± 8.2 HU vs. 56.9 ± 8.1 HU; p = 1.000) or ECV fraction (48.0 ± 5.6% vs. 46.6 ± 8.4%; p = 0.970) were seen between diffuse and focal or segmental types. Areas under the ROC curve for differentiating AIP from PDAC were 0.78 for CE and 0.86 for ECV fraction, showing no significant difference (p = 0.083). Conclusions: ECV fraction might be clinically useful in differentiating AIP from PDAC. Full article

Traumatic injury remains a major cause of death worldwide, with bleeding being one of its most critical and life-threatening consequences. Whole-body computed tomography (WBCT) has become a standard diagnostic method in trauma settings; however, timely interpretation remains challenging for acute care physicians. In this study, we propose a new automated method for detecting traumatic bleeding in CT images using a three-dimensional object detection model enhanced with an atrous spatial pyramid pooling (ASPP) module. Furthermore, we incorporate a false positive (FP) reduction approach based on multi-organ segmentation, as developed in our previous study. The proposed method was evaluated on a multi-institutional dataset of delayed-phase contrast-enhanced CT images using a six-fold cross-validation approach. It achieved a maximum sensitivity of 90.0% with 587.3 FPs per case and a sensitivity of 70.0% with 46.9 FPs per case, outperforming previous segmentation-based methods. In addition, the average processing time was reduced to 4.2 ± 1.1 min. These results suggest that the proposed method enables rapid and accurate bleeding detection, demonstrating its potential for clinical application in emergency trauma care. Full article

Spectral computed tomography (SCT) enables material decomposition, artifact reduction, and contrast enhancement, leveraging symmetry principles across its technical framework to enhance material differentiation and image quality. However, its nonlinear data acquisition process involving noise and scatter leads to a highly ill-posed inverse problem. To address this, we propose a dual-domain iterative reconstruction network that combines joint learning reconstruction with physical process modeling, which also uses the symmetric complementary properties of the two domains for optimization. A dedicated physical module models the SCT forward process to ensure stability and accuracy, while a residual-to-residual strategy reduces the computational burden of model-based iterative reconstruction (MBIR). Our method, which won the AAPM DL-Spectral CT Challenge, achieves high-accuracy material decomposition. Extensive evaluations also demonstrate its robustness under varying noise levels, confirming the method’s generalizability. This integrated approach effectively combines the strengths of physical modeling, MBIR, and deep learning. Full article

Background: Gorlin–Goltz syndrome (GGS), also known as basal cell nevus syndrome or nevoid basal cell carcinoma syndrome, is a rare genetic disorder caused by mutations in the PTCH1, PTCH2, or SUFU genes, leading to an increased risk of neoplasms. Craniofacial anomalies are among the most common features of GGS. This paper aimed to highlight the similarities and differences in clinical presentation across different ages and to emphasize the importance of including all family members in the diagnostic process. The diagnosis can often be initiated by a dentist through routine radiographic imaging. Case Presentation: We present a 17-year longitudinal follow-up of a male patient with recurrent multiple odontogenic keratocysts and other manifestations consistent with GGS. Nearly 20 years later, the patient’s mother presented with similar clinical features suggestive of GGS. Diagnostic imaging, including contrast-enhanced computed tomography (CT), cone-beam CT, magnetic resonance imaging, and orthopantomography, was performed, and the diagnosis was confirmed through genetic testing. Interdisciplinary management included age-appropriate surgical and dermatological treatments tailored to lesion severity. Conclusions: Given the frequent involvement of the stomatognathic system in GGS, dentists play a critical role in early detection and referral. Comprehensive family-based screening is essential for timely diagnosis, improved monitoring, and effective management of this multisystem disorder. Full article

Periodontitis is a chronic inflammatory disease caused by periodontopathic bacteria such as Porphyromonas gingivalis (P. gingivalis), which leads to alveolar bone destruction and systemic inflammation. Emerging evidence suggests that probiotics may mitigate periodontal pathology. To systematically evaluate the alleviative effects and mechanisms of different forms of probiotics, including live bacteria and postbiotics, on periodontitis, we first screened and identified Ligilactobacillus salivarius CCFM1332 (L. salivarius CCFM1332) through in vitro antibacterial and anti-biofilm activity assays. Subsequently, we investigated its therapeutic potential in a rat model of experimental periodontitis. The results demonstrated that both live L. salivarius CCFM1332 (PL) and its postbiotics (PP) significantly reduced the gingival index (GI) and probing depth (PD) in rats, while suppressing oral colonization of P. gingivalis. Serum pro-inflammatory cytokine levels were differentially modulated: the PL group exhibited reductions in interleukin-17A (IL-17A), interleukin-6 (IL-6), and interleukin-1β (IL-1β) by 39.31% (p < 0.01), 17.26% (p < 0.05), and 14.74% (p < 0.05), respectively, whereas the PP group showed decreases of 34.79% (p < 0.05), 29.85% (p < 0.01), and 19.74% (p < 0.05). Micro-computed tomography (Micro-CT) analysis demonstrated that compared to the periodontitis model group (PM), the PL group significantly reduced alveolar bone loss (ABL) by 30.1% (p < 0.05) and increased bone volume fraction (BV/TV) by 49.5% (p < 0.01). In contrast, while the PP group similarly decreased ABL by 32.7% (p < 0.05), it resulted in a 40.4% improvement in BV/TV (p > 0.05). Histological assessments via hematoxylin and eosin (H&E) and tartrate-resistant acid phosphatase (TRAP) staining confirmed that both the PL group and the PP group alleviated structural damage to alveolar bone-supporting tissues and reduced osteoclast-positive cell counts. This study suggests that live L. salivarius CCFM1332 and its postbiotics reduce alveolar bone resorption and attachment loss in rats through antibacterial and anti-inflammatory pathways, thereby alleviating periodontal inflammation in rats. Full article

Background: Two-dimensional periapical radiographs (PAs) only offer limited information regarding three-dimensional periodontal infrabony defects. In contrast, cone beam computed tomography (CBCT) enables visualization of the entire defect morphology. This study aimed to evaluate the agreement between CBCT and direct intrasurgical measurements (ISs) regarding the characteristics of infrabony defects, including measurements of defect depth, width, the type of defect (one-wall, two-wall, three-wall), and defect extension. Methods: Intrasurgical and radiographic assessments were performed by two calibrated examiners on 26 infrabony defects in 17 patients who underwent periodontal surgery. The defect depth, width, type, and extension were compared between intrasurgical observations and PA or CBCT findings. The CBCT assessment was performed mainly using axial reconstructions. Angle measurements were compared between CBCT and PAs. Results: The mean differences between CBCT and intrasurgical measurements were −0.11 ± 0.49 mm for depth and −0.07 ± 0.41 mm for width, with no significant differences. The ICC values were 0.938 and 0.923 for depth and width, respectively. The mean difference in width between PAs and ISs was significantly different (−0.36 ± 0.73 mm; p = 0.002). CBCT demonstrated high agreement with intrasurgical observations for defect type (κ = 0.819) and defect extension (κ = 0.855), while lower agreements were found for PAs. Conclusions: CBCT is a valid assessment modality for infrabony defects. It demonstrated strong agreement with ISs—as the gold standard—for depth and width measurements, and its agreement with ISs regarding defect type and extension appeared to surpass that of PAs. Full article

Tumor-associated macrophages (TAMs) are pivotal immune cells within the tumor stroma, whose dynamic alterations significantly impact tumor progression and therapeutic responses. Conventional methods for TAM detection, such as biopsy, are invasive and incapable of whole-body dynamic monitoring. In contrast, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) offer a non-invasive imaging approach by targeting TAM-specific biomarkers like CD206, TSPO, and CCR2. This review comprehensively summarizes the advancements in TAM-targeted imaging probes, including cell surface markers, metabolic/functional markers, and multifunctional nanoprobe, while assessing their potential in tumor immune surveillance and tumor targeting therapeutic applications. While current probes, including ⁶⁸Ga-NOTA-anti-CD206 and ⁶⁴Cu-Macrin, have exhibited high specificity and theragnostic potential in preclinical and early clinical trials, challenges such as target heterogeneity, off-target effects, and clinical translation persist. Moving forward, the advancement of multi-target probes, optimization of pharmacokinetics, and incorporation of multimodal imaging technologies are anticipated to further enhance the impact of TAM-targeted imaging in precision medicine and tumor immunotherapy, fostering the refinement of personalized treatment strategies and improving patient outcomes. Full article

Background: Cardiovascular diseases are the leading cause of global mortality, with 80% of coronary heart disease in patients over 65. Understanding aging cardiovascular structures is crucial. Photon-counting computed tomography (PCCT) offers improved spatial and temporal resolution and better signal-to-noise ratio, enabling texture analysis in clinical routines. Detecting structural changes in aging left-ventricular myocardium may help predict cardiovascular risk. Methods: In this retrospective, single-center, IRB-approved study, 90 patients underwent ECG-gated contrast-enhanced cardiac CT using dual-source PCCT (NAEOTOM Alpha, Siemens). Patients were divided into two age groups (50–60 years and 70–80 years). The left ventricular myocardium was segmented semi-automatically, and radiomics features were extracted using pyradiomics to compare myocardial texture features. Epicardial adipose tissue (EAT) density, thickness, and other clinical parameters were recorded. Statistical analysis was conducted with R and a Python-based random forest classifier. Results: The study assessed 90 patients (50–60 years, n = 54, and 70–80 years, n = 36) with a mean age of 63.6 years. No significant differences were found in mean Agatston score, gender distribution, or conditions like hypertension, diabetes, hypercholesterolemia, or nicotine abuse. EAT measurements showed no significant differences. The Random Forest Classifier achieved a training accuracy of 0.95 and a test accuracy of 0.74 for age group differentiation. Wavelet-HLH_glszm_GrayLevelNonUniformity was a key differentiator. Conclusions: Radiomics texture features of the left ventricular myocardium outperformed conventional parameters like EAT density and thickness in differentiating age groups, offering a potential imaging biomarker for myocardial aging. Radiomics analysis of left ventricular myocardium offers a unique opportunity to visualize changes in myocardial texture during aging and could serve as a cardiac risk predictor. Full article