Search

Objective The potential of electromagnetic (EM) knee imaging system verified on ex-vivo pig knee joint as an essential step before clinical trials is demonstrated. The system, which includes an antenna array of eight printed biconical elements operating at the band 0.7-2.2 GHz, is portable and cost-effective. Importantly, it can provide daily monitoring and onsite real-time examinations imaging tool for knee injuries. Methods Six healthy hind legs from three dead adult pigs were removed at the hip and suspended in the developed system. For each pig, the right- and left-knee were scanning sequentially. Then ligament tear was emulated by injecting distilled water into the left knee joint of each pig for early (5 mL water) and mid-stage (10 mL water) injuries. The injured left knees were re-scanned. A modified multi-static fast delay, multiply and sum algorithm (MS-FDMAS) is used to reconstruct imaging of the knee. All knees connective tissues, such as anterior and posterior cruciate ligaments (ACL, PCL), lateral and medial collateral ligaments (LCL, MCL), tendons, and meniscus, are extracted from a healthy hind leg along with collected synovial fluid. The extracted tissues and fluid were characterized and modelled as their data are not available in the literature, then imported to build an equivalent model for pig knee of 1 mm3 resolution in a realistic simulation environment. Results The obtained results proved potential of the proposed system to detect ligament/tendon tears. Conclusion The proposed system has the potential to detect early knee injuries in a realistic environment. Significance Contactless EM knee imaging system verified on ex-vivo pig joints confirms its potential to reconstruct knee images. This work lays the groundwork for clinical EM system for detecting and monitoring knee injuries.

Purpose We investigate the influence of moving blood-attenuation effects when using "delay alternating with nutation for tailored excitation" (DANTE) pulses in conjunction with blood oxygen level dependent (BOLD) of functional MRI (fMRI) at 3 T. Based on the effects of including DANTE pulses, we propose quantification of cerebral blood volume (CBV) changes following functional stimulation. Methods Eighteen volunteers in total underwent fMRI scans at 3 T. Seven volunteers were scanned to investigate the effects of DANTE pulses on the fMRI signal. CBV changes in response to visual stimulation were quantified in 11 volunteers using a DANTE-prepared dual-echo EPI sequence. Results The inflow effects from flowing blood in arteries and draining vein effects from flowing blood in large veins can be suppressed by use of a DANTE preparation module. Using DANTE-prepared dual-echo EPI, we quantitatively measured intravascular-weighted microvascular CBV changes of 25.4%, 29.8%, and 32.6% evoked by 1, 5, and 10 Hz visual stimulation, respectively. The extravascular fraction ( increment S/S)(extra) at TE = 30 ms in total BOLD signal was determined to be 64.8 +/- 3.4%, which is in line with previous extravascular component estimation at 3 T. Results show that the microvascular CBV changes are linearly dependent on total BOLD changes at TE = 30 ms with a slope of 0.113, and this relation is independent of stimulation frequency and subject. Conclusion The DANTE preparation pulses can be incorporated into a standard EPI fMRI sequence for the purpose of minimizing inflow effects and reducing draining veins effects in large vessels. Additionally, the DANTE-prepared dual-echo EPI sequence is a promising fast imaging tool for quantification of intravascular-weighted CBV change in the microvascular space at 3 T.

Contrast-enhanced ultrasound (CEUS) for the differentiation of benign and malignant peripheral pulmonary lesions has been considered experimental for many years. This study was aimed at evaluating the feasibility of CEUS as a diagnostic modality in this area of discussion. CEUS diagnostic accuracy was explored by comparison with contrast-enhanced computed tomography (CECT). The collective included 449 patients with 449 definitive diagnoses (benign, 178; malignant, 271). Logistic regression analysis of CEUS data revealed that delayed time to enhancement, chaotic pattern of distribution of vessels and mild extent of enhancement were independent risk factors for predicting malignancy. Time to wash-out and homogeneity of enhancement did not differ between the two groups (p > 0.05). Based on histopathology or clinical follow-up as a reference standard, CEUS and CECT had similar diagnostic accuracies of 80.16% and 81.75%, respectively. CEUS is a potentially useful imaging tool for diagnosing peripheral pulmonary lesions.

Zinc oxide (ZnO) nanoparticles, because of the reality of their biocompatibility are utilized for biomedical applications. The modern technique-based characterization is needed to find out the pharmacology and biological impact of ZnO nanoparticles. Further, these techniques also help to check the biological and toxic levels of ZnO particles. These nanoparticles to maximize their performance can be folded up in a 3-D structure and also have a different range of shapes. ZnO nanoparticles are utilized in many technical devices like sensor and imaging tool devices. ZnO nanoparticles have various useful activities in human life. ZnO nanoparticles also have the application to help in the healing of a wound. ZnO nanoparticles have healing activity against diabetes and cancer. ZnO particles are formed by various methods, like the sol–gel method, hydrothermal method, and by green method. Zinc oxide nanoparticles are also produced by natural method from plant leaf of Sambucus ebulcus and their physiochemical important findings are further examined for use. The X-ray [radiation mediated] diffraction observation, shown that ZnO nanoparticles are highly crystallized. The dimensions of prepared ZnO nanoparticles are observed differently in different conditions. Further, there are large numbers of techniques for the production of ZnO nanoparticles.

Primary CNS vasculitis is an inflammatory brain disease commonly misdiagnosed affecting the medium and small vessels of the CNS. Due to its broad and non-specific clinical and radiological manifestations; Its diagnosis remains challenging. New diagnostic tools and biomarkers which increase specificity and facilitate the diagnosis for patients with suspected vasculitis are highly desirable to enable physicians to start therapy that can alter its potential aggressive course like immunosuppressant. This case report highlights the potential role of 18F-choline PET/MRI as a novel imaging tool that might help in the right clinical scenario in the diagnosis of this disease. Furthermore, it speculates on its secondary role in monitoring the response to immunosuppressant therapy.

To identify a useful non-imaging tool to screen paediatric patients with traumatic brain injury for intracranial haemorrhage (ICH). We retrospectively analysed patients aged .

Ultrasound is a key imaging tool for the evaluation of the kidney. Over the last two decades, methods to measure the mechanical properties of soft tissues have been developed and used in clinical practice, though the use in the kidney has not been as widespread as for other applications. The mechanical properties of the kidney are determined by the structure and composition of the renal parenchyma as well as the perfusion characteristics. As pathological processes change these factors, the mechanical properties change and can be used for diagnostic purposes as well as monitoring treatment or disease progression. Ultrasound-based elastography methods for evaluating the mechanical properties of the kidney use focused ultrasound beams to perturb the kidney and then high frame rate ultrasound methods are used to measure the resulting motion. The motion is analyzed to estimate the mechanical properties. This review will describe the principles of these methods and discuss several seminal studies related to characterizing the kidney. Additionally, an overview of the clinical use of elastography methods in native and kidney allografts will be provided. Perspectives on future developments and uses of elastography technology along with other complementary ultrasound imaging modalities will be provided.

This study highlights the clinical features and treatment response of polypoidal choroidal vasculopathy (PCV) among three different branching vascular network (BVN) morphologies in optical coherence tomography angiography (OCTA), and further correlates the BVN features with those under fluorescent angiography (FA) and indocyanine green angiography (ICGA). In total, we reviewed 70 eyes with PCV followed up for > 12 months. OCTA, ICGA and FA images were obtained at baseline and post-treatments. BVN was assessed using OCTA and divided into three types by a previously described BVN classification: type 1 (trunk), type 2 (glomeruli), and type 3 (stick). At baseline, type 1 BVN had the poorest vision and thinnest subfoveal choroidal thickness (SFCT), whereas type 3 had the best vision and thickest SFCT. The aforementioned trend sustained after treatments. Each BVN morphology in OCTA showed typical features in FA + ICGA and encompassed significant correlation (p = 0.004). In conclusion, OCTA is an innovative imaging tool for the detection and classification of BVN in PCV. Furthermore, OCTA has advantages of being noninvasive and free of systemic toxicities. The BVN can be divided into three types based on morphological characteristics in OCTA, which play crucial roles in clinical presentations and treatment outcomes.

Ultrasound (US) has been increasingly used as an important imaging tool to assess the urethra in children. The earliest reports of pediatric urethral sonography involved imaging the urethra in a non-voiding state, during physiological voiding of urine, and after instillation of saline. The introduction of US contrast agents has continued to improve visualization of urethral anatomy. Contrast-enhanced US of the urethra can be performed during the voiding phase of a standard contrast-enhanced voiding urosonography (ceVUS) exam or with retrograde instillation of a contrast agent, depending on the exam indication. Both techniques are well tolerated by children and provide accurate information about urethral pathology and periurethral soft tissues. This article reviews the technical aspects and imaging findings of urethral pathologies in children using contrast-enhanced US, both by the voiding and retrograde instillation techniques.

The diagnosis and treatment of bipolar depression (BDep) poses complex clinical challenges for psychiatry. Proton magnetic resonance spectroscopy (1H-MRS) is a useful imaging tool for investigating in vivo levels of brain neuro-metabolites, critical to understanding the process of mood dysregulation in Bipolar Disorder. Few studies have evaluated longitudinal clinical outcomes in BDep associated with 1H-MRS metabolic changes. This study aimed to longitudinally assess brain 1H-MRS metabolites in the anterior cingulate cortex (ACC) correlated with improvement in depression (from BDep to euthymia) after lithium treatment in BDep patients versus matched healthy controls (HC). Twenty-eight medication-free BDep patients and 28 HC, matched for age and gender, were included in this study. All subjects were submitted to a 3-Tesla brain 1H-MRS scan in the ACC using a single-voxel (8cm3) PRESS sequence at baseline. At follow-up (6 weeks), 14 BDep patients repeated the exam in euthymia. Patients with current BDep had higher baseline Myo-inositol/Cr (mI/Cr) and Choline/Cr (Cho/Cr) compared to HC. After six weeks, mI/Cr or Cho/Cr levels in subjects that achieved euthymia no longer differed to levels in HC, while high Cho/Cr levels persisted in non-responders . Elevated ACC mI/Cr and Cho/Cr in BDep might indicate increased abnormal membrane phospholipid metabolism and phosphatidylinositol (PI) cycle activity. Return of mI/Cr and Cho/Cr to normal levels after lithium-induced euthymia suggests a critical regulatory effect of lithium targeting the PI cycle involved in mood regulation.

Repetitive vibratory trauma in cyclists is one of the most common causes of ulnar nerve compression at the wrist. This study describes five cases of clinically suspected compression syndrome of the deep terminal branch of the ulnar nerve (DBUN) defined by high-resolution ultrasound (HRUS) with a 18-MHz linear transducer. Reliable HRUS visualization of the DBUN was feasible in all patients. The affected nerves had focally swollen and hypo-echoic changed segments. HRUS is a good imaging tool for the evaluation of a suspicious DBUN neuropathy if no electrodiagnostic testing is available or in patients with mild to moderate clinical symptoms with inconclusive electrodiagnostic results.

Imaging cellular and extracellular structures and processes in situ and in vivo is highly desired for the understanding and diagnosis of human diseases. High resolution optical coherence tomography (HR-OCT) is particularly suitable for this task because it can provide real-time, 3-D images of a large tissue volume at subcellular resolution. Over the past two decades, tremendous technical advances have been made to tackle the fundamental and practical limitations of HR-OCT for applications in various clinical fields. Meanwhile, novel scientific and clinical applications of HR-OCT have also been proposed and validated. This review aims to provide an update on the progress of technology development, with a focus on axial focus extension, aberration correction, and fiber-optic probe development. This review also aims to summarize the newly established capabilities of HR-OCT in fundamental and clinical research, in an effort to promote multidisciplinary research using this powerful imaging tool.

Cystoscopic examination remains the gold standard technique for initial diagnosis of bladder cancer (BCa). Despite significant progress in enhanced cystoscopic techniques, blue light cystoscopy and narrow band imaging are the only ones well supported by high-level evidence and, if available, should be used during initial staging of BCa. Multiparametric MRI could be an important imaging tool in local staging of BCa. With ever-expanding targeted therapy and immunotherapy options in both muscle-invasive and non-muscle-invasive BCa, molecular subtyping could become an essential part of initial histologic staging in the near future.

Summary Despite its simple acquisition technique, the chest X‐ray remains the most common first‐line imaging tool for chest assessment globally. Recent evidence for image analysis using modern machine learning points to possible improvements in both the efficiency and the accuracy of chest X‐ray interpretation. While promising, these machine learning algorithms have not provided comprehensive assessment of findings in an image and do not account for clinical history or other relevant clinical information. However, the rapid evolution in technology and evidence base for its use suggests that the next generation of comprehensive, well‐tested machine learning algorithms will be a revolution akin to early advances in X‐ray technology. Current use cases, strengths, limitations and applications of chest X‐ray machine learning systems are discussed.

BACKGROUND: Cardiac magnetic resonance (CMR) as advanced diagnostic tool for the heart has been introduced in our institution since September 2019. AIM: We report on the first fifty consecutive patients using this imaging modality. METHODS AND MATERIALS: Strict protocol for CMR procedure, imaging quality assessment, contraindications, and informed consent were established. Patients selected for CMR were enrolled in a prospective registry. Visualizing the heart chambers, heart muscle and heart valves, resulted in acquiring complex imaging of the heart structure and function. When applicable, patients received gadolinium contrast agent for Late Gadolinium Enhancement (LGE). Adenosine was used for stress induced myocardial perfusion study. In this study, we report on the initial CMR procedures in the first 15 months. RESULTS: The age of the patients ranges from 17 to 82 and the number of male and female patients was well balanced. No absolute contraindications were met in any patient. Relative contraindications were noted but did not prevent from performing the scan. Different cardiac pathologies were encountered in the examined patients. Most common was the ischemic heart disease – 19 (38%). We had 15 (30%) out of 46 (92%) CMR procedures with LGE showing fibrotic scaring. Quality image assessment was scaled from poor to excellent. Most of the assessments were graded very good and good (46% and 48%), no poor, and very poor noted. CONCLUSION: CMR has been successfully introduced in Kosovo as excellent imaging tool for diagnosing and characterizing a nearly exhaustive spectrum of heart diseases.

Introduction Despite scaphoid fractures being relatively uncommon pro-active treatment of suspected fractures has been seen as a risk management strategy. The poor positive predictive value of X-rays has led to published guidelines advocating MRI as a first-line or early imaging tool. It is unclear whether UK hospitals have been able to introduce early scanning and this national survey sought to establish the current management strategies for patients with a suspected scaphoid fracture. Method An electronic survey of UK emergency departments (ED) was conducted to establish the initial and follow up strategies for patients with negative imaging. Comparison of first and second-line imaging modalities was undertaken together with review of the clinical speciality responsible for ongoing management. Results 166 UK NHS Trusts were identified with emergency department facilities of which 66 (39.8%) responded. All sites perform an X-ray as the initial examination. For those with a negative examination ED follow up was the most common approach (54.6%), although many sites refer patients to other specialities including orthopaedics (39.4%) for follow up. The data demonstrated inconsistencies in the number of follow-up episodes and the different imaging investigations utilised. Frustration with the challenges presented by this patient cohort was evident. Conclusion The suspected scaphoid fracture represents an ongoing challenge to the NHS with many resource intensive pathways reliant on access to complex imaging investigations. Implications for practice Our study identified that UK Emergency Departments have limited early access to complex imaging for scanning of the scaphoid. A range of strategies are used for follow up of suspected scaphoid fractures and these are resource intensive. Overtreatment of patients with suspected scaphoid fracture is used as a risk management approach.

The diagnosis of residual or chronic elbow instability is often challenging. Sonography allows a dynamic examination of the elbow joint without any radiation exposure. The purpose of this prospective single-center study was to investigate the application of sonography for the evaluation of ligamentous instabilities of the elbow joint. Therefore, asymptomatic (stable) and acute dislocated (unstable) elbows were examined by sonography.A total of 72 elbows in 36 participants (23 women and 13 men; mean age, 40 ± 17 years [range, 18-82 years]) were examined. Group 1 (G1 [normal]) included 40 unaffected, asymptomatic elbow joints; 28 elbows belonged to 14 voluntary participants (bilateral), whereas 12 asymptomatic elbows belonged to patients who had an acute elbow dislocation (contralateral elbow). Group 2 (G2 [hypermobile]) included 20 hypermobile elbow joints in 10 participants (bilateral), and group 3 (G3 [unstable]) included 12 acute unstable elbow joints without bony lesions. Radiographic assessment included sonography of both elbow joints with standardized measurements of the neutral and stressed radiocapitellar and ulnohumeral distances (calculated as Δ values). Two investigators independently performed all measurements. Additionally, plain radiographs and magnetic resonance imaging of the affected elbow joints were obtained in G3.On the radial side, the mean radiocapitellar Δ was statistically higher in G3 (2.2 ± 1.6 mm) than in G1 (0.5 ± 0.4 mm, P.01) or G2 (0.8 ± 0.6 mm, P.01). G3 also showed an increased ulnohumeral Δ (2.7 ± 0.7 mm) compared with G1 (1.0 ± 0.7 mm, P.01) or G2 (0.9 ± 0.3 mm, P.01). No significant differences in the mean radiocapitellar Δ (P = .06) and ulnohumeral Δ (P = .26) were found between G1 and G2. Within G3, Δ was significantly higher at the affected elbow joint than at the contralateral, unaffected elbow joint (P = .04 for the radial side and P = .04 for the ulnar side). The inter-rater correlation coefficient was 0.82 for the radial side and 0.74 for the ulnar side. Patients with collateral ligament injuries, diagnosed on magnetic resonance imaging, showed higher Δ values than those with intact collateral ligaments, although no significant difference was found.Sonography of the elbow joint is a valuable imaging tool for the assessment of ligamentous instability. Nevertheless, a distinction between healthy and hypermobile elbow joints is not possible, and therefore, obtaining a complete clinical history and examination is vital. We further recommend comparing the affected elbow joint with the contralateral side to access intraindividual differences.

Diffusion-weighted imaging (DWI) thermometry is a magnetic resonance-based imaging tool that allows the noninvasive measurement of brain core temperature. Although only applicable to cerebrospinal fluid, it is thought to be potentially useful in assessing the thermal pathophysiology of the brain in both patients and healthy subjects. The objective of this article is to provide a concise but thorough review of the basic physical principles and the principal applications of DWI thermometry as a potential method to elucidate the pathophysiology of several brain diseases and neurologic syndromes.

Biliary malformations in children are rare, but important to recognize. Diagnostic delay compromises outcomes. Some may be diagnosed prenatally, others in the newborn period, usually with clinical presentation of jaundice, with or without abdominal pain and fever. A strong level of suspicion is needed with any patient. Abdominal ultrasound, which is widely available, is an excellent initial imaging tool. Further work up may include magnetic resonance cholangiopancreatography (MRCP) to completely define the biliary tree. Surgical management is the primary treatment for many biliary disorders.

Historically thoracic MRI has been limited by the lower proton density of lung parenchyma, cardiac and respiratory motion artifacts and long acquisition times. Recent technological advancements in MR hardware systems and improvement in MR pulse sequences have helped overcome these limitations and expand clinical opportunities for non-vascular thoracic MRI. Non-vascular thoracic MRI has been established as a problem-solving imaging modality for characterization of thymic, mediastinal, pleural chest wall and superior sulcus tumors and for detection of endometriosis. It is increasingly recognized as a powerful imaging tool for detection and characterization of lung nodules and for assessment of lung cancer staging. The lack of ionizing radiation makes thoracic MRI an invaluable imaging modality for young patients, pregnancy and for frequent serial follow-up imaging. Lack of familiarity and exposure to non-vascular thoracic MRI and lack of consistency in existing MRI protocols have called for clinical practice guidance. The purpose of this guide, which was developed by the Canadian Society of Thoracic Radiology and endorsed by the Canadian Association of Radiologists, is to familiarize radiologists, other interested clinicians and MR technologists with common and less common clinical indications for non-vascular thoracic MRI, discuss the fundamental imaging findings and focus on basic and more advanced MRI sequences tailored to specific clinical questions.

Purpose The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT). Methods Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen’s kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements. Results Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight. Conclusion Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.

Since the widespread of acute respiratory syndrome infection caused by coronavirus-19, unenhanced computed tomography (CT) was considered a useful imaging tool commonly used in early diagnosis and monitoring of patients with complicated Covid-19 pneumonia. If there is clinical or laboratory suspicion of pulmonary embolism complicating Covid-19 pneumonia, CT angiogram of the pulmonary arteries may be necessary. Here we describe the case of a 52 years old man, affected by a high-risk myelodysplastic syndrome patient, with Covid-19 pneumonia, complicated by a bilateral massive acute pulmonary embolism. An unenhanced CT and then a CT pulmonary angiography were made, and the patient was immediately hospitalized and treated.

Since the widespread of acute respiratory syndrome infection caused by Coronavirus-19, unenhanced computed tomography (CT) was considered a useful imaging tool commonly used in early diagnosis and monitoring of patients with complicated Covid-19 pneumonia. Many typical imaging features of this disease were described such as bilateral multilobar ground-glass opacity (GGO) with a prevalent peripheral or posterior distribution, mainly in the lower lobes, and sometimes consolidative opacities superimposed on GGO. As less common findings were mentioned septal thickening, bronchiectasis, pleural thickening, and subpleural involvement. Here we describe the case of a patient, with Covid-19 pneumonia, that had the spider web sign, a triangular or angular GGO in the subpleural lung, documented at CT.

The pulmonary valve (PV) has historically been ignored by imaging studies. Disorders of the PV encountered in adult cardiac patients are increasingly encountered due to advanced care of patients with congenital heart disease and associated PV diseases. Despite advances in PV imaging, multiple challenges remain when it comes to obtaining high quality PV images. While 2D TTE is the usual initial imaging tool for PV, excellent views of the PV annulus and its one or two leaflets are obtained in less than half of patients. The 3D echocardiography en face view allows all three leaflets to be evaluated concurrently, as well as assessments of the RV outflow tract and main pulmonary artery, which has improved quantitative assessment of PV diseases. Increasing image quality and experience with live/real time 3D TEE amplifies its utility in accurate evaluation and helps guide and monitor successful percutaneous PV interventions. 2D TTE remains the first line diagnostic tool; however, 3D TTE and 3D TEE provide better image quality which increases diagnostic accuracy and guidance to therapy. In this review article, we stress improvement in 3D echocardiography and its role in diagnostic and therapeutic options for PV diseases.

Purpose The increasing tendency of chest CT usage throughout the COVID-19 epidemic requires new tools and a systematic scheme for diagnosing and assessing the lung involvement in Coronavirus Disease 2019 (COVID-19). To investigate the use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest CT Involvement Score (CT-IS) in COVID-19 pneumonia. Material and methods This retrospective study enrolled 280 hospitalized patients diagnosed with COVID-19 pneumonia in a tertiary hospital in Turkey. All patients underwent non-contrast CT chest imaging. Two radiologists interpreted all CT images according to CO-RADS classification without knowing the clinical features, laboratory findings. We used CT involvement score (CT-IS) for assessing chest CT images of COVID-19 patients. Also, we examined the relationship between CT-IS and clinical outcomes in COVID-19 patients. Results Of the patients, 111(39.6%) had positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results. CO-RADS 5 group patients had statistically significant positive RT-PCR results than the other groups (P

Summary: A malignant tumour that develops from the bronchial epithelium and then invades the lungs. It ranks third after colorectal and breast cancer. In Mali, computed tomography (CT) is the main imaging tool used at all stages of treatment. We had initiated this study with the objective of specifying the place of CT in the diagnosis of primary bronchopulmonary cancer at the hospital of Mali. Method: This is a prospective and descriptive study conducted by the Medical Imaging and Thoracic Surgery departments at Mali Hospital from March 2014 to February 2015. All the patients who have benefited from a CT scan and presenting at least one histologically confirmed bronchopulmonary tumor were included. Results: We were recruiting 60 patients with bronchopulmonary cancers out of 500 referred for a thoracic CT scan performed, a frequency of 12%. There was one male patient with a sex ratio of 4H/1F. The average age was 60 years. The history of smoking was 85%. The symptoms were dominated by general condition (63.33%), cough (25%) and haemoptysis (58.33%). CT scans were performed in all patients. The lesions were located more in the lower lobes (71%). The tumours were: heterogeneous tissue density (70%), spiculated contours (80%), and the histology was more non-small cell carcinoma. Conclusion: The incidence of bronchopulmonary cancer is very high and its prognosis is poor at an advanced stage. The evaluative role of CT and biopsy guidance has given it a place of choice in its management. The diagnosis of certainty remains histology.

Cardiovascular computed tomography (CCT) is a well-validated noninvasive imaging tool with an ever-expanding array of applications beyond the assessment of coronary artery disease. These include the evaluation of structural heart diseases, congenital heart diseases, peri-procedural electrophysiology applications, and the functional evaluation of ischemia. This breadth requires a robust and diverse training curriculum to ensure graduates of CCT training programs meet minimum competency standards for independent CCT interpretation. This statement from the Society of Cardiovascular Computed Tomography aims to supplement existing societal training guidelines by providing a curriculum and competency framework to inform the development of a comprehensive, integrated training experience for cardiology and radiology trainees in CCT. This article is being published synchronously in Radiology: Cardiothoracic Imaging, Journal of Cardiovascular Computed Tomography, and JACC: Cardiovascular Imaging. © 2020 Society of Cardiovascular Computed Tomography. Published by RSNA with permission.

Background\ud \ud Cardiac magnetic resonance imaging (MRI) is emerging as an important imaging tool in the assessment of heart failure with preserved ejection fraction (HFpEF). This systematic review and meta-analysis aim to synthesise and consolidate the current literature on cardiac MRI for prognostication of HFpEF.\ud \ud \ud Methods design\ud \ud Systematic review and meta-analysis. Data sources: Scopus (PubMed and Embase) for studies published between 2008 and 2019. Eligibility criteria for study selection were studies that evaluated the prognostic role of cardiac MRI in HFpEF. Random effects meta-analyses of the reported hazard ratios (HR) for clinical outcomes was performed.\ud \ud \ud Results\ud \ud Initial screening identified 97 studies. From these, only nine (9%) studies met all the criteria. The main cardiac MRI methods that demonstrated association to prognosis in HFpEF included late gadolinium enhancement (LGE) assessment of scar (n = 3), tissue characterisation with T1-mapping (n = 4), myocardial ischaemia (n = 1) and right ventricular dysfunction (RVSD) (n = 1). The pooled HR for all 9 studies was 1.52 (95% CI 1.05–1.99, P < 0.01). Sub-evaluation by cardiac MRI methods revealed varying HRs: LGE (net n = 402, HR = 1.6, 95% CI 0.42–2.78, P = 0.008); T1-mapping (n = 1623, HR = 1.25, 95% CI 0.891–1.60, P < 0.001); myocardial ischaemia or RVSD (n = 325, HR = 3.19, 95% CI 0.30–6.08, P = 0.03).\ud \ud \ud Conclusion\ud \ud This meta-analysis demonstrates that multiparametric cardiac MRI has value in prognostication of patients with HFpEF. HFpEF patients with a detectable scar on LGE, fibrosis on T1-mapping, myocardial ischaemia or RVSD appear to have a worse prognosis.\ud \ud \ud PROSPERO registration number\ud \ud CRD42020187228.

Aim: The aim of this study is to study the morphological measurements of external and internal anatomic landmarks in human maxillary and mandibular molars and their correlation with critical pulp chamber morphology. Materials and Methods: A total of 200 mandibular and maxillary molar teeth of patients were evaluated. Teeth whose pulp chamber were not violated by caries, restoration, fracture crown, and those having closed apex were included in the study. Teeth were subjected to radiovisiography of bitewing projection and imaging tool was utilized for measuring-A: Distance from the pulp chamber floor to the furcation, B: Distance from the pulp chamber ceiling to the furcation, C: Distance from the buccal cusp tip to the furcation, D: Distance from the buccal cusp to the floor of the pulp chamber, E: Distance from the buccal cusp to the ceiling of pulp chamber, and F: Pulp chamber height. Differences in the measurements were examined using the Student's t-test and Pearson correlations. All results were considered statistically significant if P < 0.05. Results: There were significant differences found among the various measurements between young and old population groups (P < 0.05). The highest percentage variance was found for the height of the pulp chamber (P < 0.001). Conclusions: The knowledge of pulp chamber morphology should be integrated with preoperative radiograph and intraoperative tactile perception during endodontic access preparation.

Positron emission tomography (PET) is a nuclear medicine examination involving the injection of radiotracers that provide a functional assessment of biochemical, physiologic, and pathophysiologic processes. PET radiotracers contain radioactive elements that undergo positron decay and subsequent annihilation with nearby electrons to produce two 511-keV photons traveling in opposite directions at 180 degrees from each other. Modern PET cameras implementing coincidence detection with the help of computer software use this opposite photon trajectory to reconstruct a spatial distribution. Computed tomography (CT) complements the examination to provide anatomic correlation and attenuation correction. Hybrid or fusion PET-CT imaging has become a crucial imaging tool utilized for detection, staging, and treatment follow-up of various benign and malignant conditions. F18-fludeoxyglucose (F18-FDG) is the most commonly used PET radiotracer. A glucose analog, F18-FDG capitalizes on the known propensity for malignant cells to overutilize glucose by favoring glycolytic metabolism.1 Otto Warburg discovered this principle in the 1930s, and it is known as the Warburg effect.2 The predisposition for malignant tumors to demonstrate hypermetabolism of glucose provides the basis for F18-FDG PET cancer imaging. While highly sensitive and versatile for imaging a variety of solid and hematologic tumors, F18-FDG has certain limitations, including lack of target specificity because of the ubiquitous utilization of glucose in the body and poor sensitivity for tumors with more indolent behavior and lower utilization of glucose. These F18-FDG limitations have prompted development of several new target-specific radiotracers with more specific mechanisms of localization.1 One such PET radiotracer is gallium (Ga)-68 DOTATATE that is commonly used in the imaging of neuroendocrine tumors. Our case demonstrates how a negative F18-FDG PET-CT examination does not necessarily equate to benignity and how not all malignant lesions are hypermetabolic. We illustrate the importance of understanding the mechanism of localization for PET radiotracers in the evaluation and characterization of unknown lesions.

The atomic force microscope (AFM) has found its way to the arsenal of tools available to the forensic practitioner for the analysis of samples at the nano and microscales. As a non-destructive probing tool that requires minimal sample preparation, the AFM is very attractive, particularly in the case of minimal or precious sample. To date, the use of the AFM has primarily been in the arena of imaging where it has been complementary to other microscopic examination tools. Forensic applications in the visual examination of evidence such as blood stains, questioned documents, and hair samples have been reported. While a number of reviews have focused on the use of AFM as an imaging tool for forensic analyses, here we not only discuss these works, but also point to a versatile enhancement in the capabilities of this nanoscale tool - namely its use for force spectroscopy. In this mode, the AFM can determine elastic moduli, adhesion forces, energy dissipation, and the interaction forces between cognate ligands, that can be spatially mapped to provide a unique spatial visualization of properties. Our goals in this review are to provide a context for this capability of the AFM, explain its workings, cover some exemplary works pertaining to forensic sciences, and present a critical analysis on the advantages and disadvantages of this modality. Equipped with this high-resolution tool, imaging and biophysical analysis by the AFM can provide a unique complement to other tools available to the researcher for the analysis and characterization of forensic evidence.

Exploring the changes in the polarity of intracellular lipid droplets (LDs) during the evolution of cancer is important for cancer detection and treatment. Therefore, we designed and synthesized a new type of polarity-sensitive fluorescent probe, CTPE, which uses coumarin as the polarity-sensitive group and tetraphenylethylene as the electron-donating group to target LDs. Due to its special intramolecular charge transfer mechanism, CTPE emitted a weak green fluorescence in high-polar solvents, and a strong green fluorescence in low-polar solvents, thus exhibiting a drastic change in fluorescence signal as a function of the solvent polarity. In virtue of the probe CTPE, tumorous tissues have been successfully identified from normal ones and the decrease in LDs’ polarity could be revealed with the evolution of cancer. Moreover, the changes in the LDs’ polarity in drugs-treated tumor were observed at the tissue level, endowing its capacity for anti-cancer drug efficacy evaluation. This work provides a promising imaging tool for LDs tracking in cancer research and clinical diagnosis.

Introduction. The prevalence of intracranial aneurysms is estimated to be around 3% in the general population. Although these are often incidental findings, they potentially carry the risk of rupture, with all of the devastating consequences of SAH. State of the art. Several risk factors of aneurysm rupture have been identified, including aneurysm size, irregular shape, and location. Although it is widely accepted that the risk of rupture increases with size, small aneurysms remain the cause of a significant percentage of aneurysmal SAH. Up to 30% of patients with acute aneurysmal SAH have multiple aneurysms. Determining the site of rupture in these patients can be challenging, given that the results of imaging studies and clinical symptoms are sometimes inconclusive. It would be extremely useful to identify new imaging biomarkers of aneurysm instability which could have an impact on patient management and qualification for treatment. High-resolution vessel wall magnetic resonance imaging (HR-VW MRI) opens up new possibilities for improved characterisation of intracranial vasculature. One of the most promising clinical applications of this new imaging tool is the evaluation of intracranial aneurysms. Clinical implications. Aneurysm wall enhancement (AWE) on HR-VW MRI is believed to be a marker for wall inflammation and, potentially, for aneurysm instability. In this article, we summarise the published literature on AWE with special emphasis on its use in determining the site of rupture in the setting of acute SAH in patients with multiple aneurysms, as well as its role in identifying unruptured aneurysms which are at the greatest risk of rupture. Future directions. More and larger studies are needed to definitively establish the role of AWE on HR-VW MRI in the diagnostic workup of patients with intracranial aneurysms.

Due to its specificity, fluorescence microscopy has become a quintessential imaging tool in cell biology. However, photobleaching, phototoxicity, and related artifacts continue to limit fluorescence microscopy’s utility. Recently, it has been shown that artificial intelligence (AI) can transform one form of contrast into another. We present phase imaging with computational specificity (PICS), a combination of quantitative phase imaging and AI, which provides information about unlabeled live cells with high specificity. Our imaging system allows for automatic training, while inference is built into the acquisition software and runs in real-time. Applying the computed fluorescence maps back to the quantitative phase imaging (QPI) data, we measured the growth of both nuclei and cytoplasm independently, over many days, without loss of viability. Using a QPI method that suppresses multiple scattering, we measured the dry mass content of individual cell nuclei within spheroids. In its current implementation, PICS offers a versatile quantitative technique for continuous simultaneous monitoring of individual cellular components in biological applications where long-term label-free imaging is desirable., Quantitative phase imaging suffers from a lack of specificity in label-free imaging. Here, the authors introduce Phase Imaging with Computational Specificity (PICS), a method that combines phase imaging with machine learning techniques to provide specificity in unlabeled live cells with automatic training.

Cone beam computed tomography (CBCT) is a well-established imaging modality with numerous proven applications across multiple clinical disciplines. More recently, CBCT has emerged as an important imaging tool for bronchoscopists, primarily used during transbronchial biopsy of peripheral pulmonary lesions (PPLS). For this application CBCT has proved useful in navigating devices to a target lesion, in confirming device tool-in-lesion, as well as during tissue acquisition. In addition, CBCT is poised to play an important role in trials evaluating bronchoscopic ablation by helping to determine the location of the ablative probe relative to the target lesion. Before adopting this technology, it is key for bronchoscopists to learn some basic concepts that will allow them to have a safer and more successful experience with CBCT. Hence, in the current manuscript, we will focus on both technical and practical aspects of CBCT imaging, ranging from systems considerations, image quality, radiation dose and dose-reduction strategies, procedure room set-up, and best practices for CBCT image acquisition.

Purpose The purpose of this study was to evaluate the cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of the complex finger fractures with articular involvement. Methods We created a decision tree model simulating the diagnostic pathway of complex finger fractures, suggesting the use of CBCT as alternative to multi-slice computed tomography (MSCT), and we compared their clinical outcomes, costs, and cost-effectiveness for a hypothetical cohort of 10,000 patients. Measures of effectiveness are analysed by using quality-adjusted life years, incremental cost-effectiveness ratio, and net monetary benefit. Results Diagnosis of a complex finger fracture performed with CBCT costed 67.33€ per patient, yielded 9.08 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 29.94€ and a net monetary benefit of 9.07 € at 30,000€ threshold. Using MSCT for diagnosis costed 106.23 €, yielded 8.18 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 371.15 € and a net monetary benefit of 8.09 €. CBCT strategy dominated the MSCT strategy. The acceptability curve shows that there is 98% probability of CBCT being the optimal strategy at 30,000€ threshold (1 EUR equal to 1.11 USD; updated on 02/02/2020). Conclusion CBCT in complex finger fractures management is cost saving compared with MSCT and may be considered a valuable imaging tool in preoperative assessment, allowing early detection and appropriate treatment. It shortens the time to completion of diagnostic work-up, reduces the number of additional diagnostic procedures, improves quality of life, and may reduce costs in a societal perspective.

Aim:The overall aim of this study was to evaluate the use of Virtual Environment for Radiotherapy Training Image-Guided Radiotherapy (VERT™IGRT) as a teaching and assessment tool for 3D image matching competency within the radiotherapy clinical setting and explore radiographer perceptions, experiences and integration of VERT™IGRT as an imaging tool.Materials and methods:A mixed-methods study was utilised to measure clinical image matching competencies in the first quantitative phase through means of a workbook and imaging assessment. Phase II used qualitative semi-structured interviews to explore radiographer perceptions.Results:Workbooks enabled participants to prepare for image assessments. Interview findings were highlighted in three distinctive themes: (1) The need for supervision, guidance and feedback; (2) Experience and practice leads to confidence and competence and (3) Technology supports process but not evaluation.Findings:VERT™IGRT provides a sound platform for training therapeutic radiographer image matching skills, but needs to be delivered with continuous feedback to develop individual decision-making skills. The technology provides opportunities for staff to increase confidence in utilsing image matching technology, but analytical and evaluation skills require supervision and continuous feedback which should be embedded in any educational training programme.

Introduction: Facing the recognized obstacles of chest computerized tomography (CT) and chest x-ray (CXR), lung ultrasound (LUS) is a promising alternative imaging tool gathering the benefits of real-time diagnosis with lower difficulties. This study aims to evaluate the effectiveness of LUS as a diagnostic modality in surgical critical care in contrast to chest x-ray. Patients and Methods: In this study, for each of the 92 included patients, when chest CT is indicated, CXR was requested and the BLUE protocol for LUS examination was initiated simultaneously. LUS data were recorded while analysis of CXR finding was performed by independent radiologist who was unaware of CT or LUS findings. Results: For each patient, 4 lung areas were examined with LUS and compared to CXR. LUS showed higher specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) of LUS in contrast to chest x-ray. A significantly lower time was required for LUS to reach the diagnosis compared to CXR (10.2± 4 minutes vs. 33±17 minutes respectively, p less than 0.01). Conclusion: LUS is a useful tool in screening and diagnosis detection of various pulmonary problems in surgical ICU; it can be used as daily bedside diagnostic tool for the critically ill patients adding the use of other chest imaging modalities.

The 2019 novel coronavirus, known as COVID-19, has greatly affected the way sonographers care for their patients. Sonography can be a useful imaging tool for surveillance and diagnosis of various conditions associated with COVID-19 patients or patients under investigation (PUIs). Currently, there are limited resources and protocols for preventing the transmission of COVID-19 from ultrasound equipment. Our institution has created a detailed protocol for scanning COVID-19 patients or PUIs to address this important issue.

Use of the 12-lead electrocardiogram (ECG) is fundamental for the assessment of heart disease, including arrhythmias, but cannot always reveal the underlying mechanism or the location of the arrhythmia origin. Electrocardiographic imaging (ECGi) is a non-invasive multi-lead ECG-type imaging tool that enhances conventional 12-lead ECG. Although it is an established technology, its continuous development has been shown to assist in arrhythmic activation mapping and provide insights into the mechanism of cardiac resynchronization therapy (CRT). This review addresses the validity, reliability, and overall feasibility of ECGi for use in a diverse range of arrhythmias. A systematic search limited to full-text human studies published in peer-reviewed journals was performed through Medline via PubMed, using various combinations of three key concepts: ECGi, arrhythmia, and CRT. A total of 456 studies were screened through titles and abstracts. Ultimately, 42 studies were included for literature review. Evidence to date suggests that ECGi can be used to provide diagnostic insights regarding the mechanistic basis of arrhythmias and the location of arrhythmia origin. Furthermore, ECGi can yield valuable information to guide therapeutic decision-making, including during CRT. Several studies have used ECGi as a diagnostic tool for atrial and ventricular arrhythmias. More recently, studies have tested the value of this technique in predicting outcomes of CRT. As a non-invasive method for assessing cardiovascular disease, particularly arrhythmias, ECGi represents a significant advancement over standard procedures in contemporary cardiology. Its full potential has yet to be fully explored.

Since propeller flaps are elevated as island flaps and most often nourished by a single perforator nearby the defect, it is challenging to change the flap design intraoperatively when a reliable perforator cannot be found where expected to exist. Thus, accurate preoperative mapping of perforators is essential in the safe planning of propeller flaps. Various methods have been reported so far: (1) handheld acoustic Doppler sonography (ADS), (2) color duplex sonography (CDS), (3) perforator computed tomographic angiography (P-CTA), and (4) magnetic resonance angiography (MRA). To facilitate the preoperative perforator assessment, P-CTA is currently considered as the gold standard imaging tool in revealing the three-dimensional anatomical details of perforators precisely. Nevertheless, ADS remains the most widely used tool due to its low cost, faster learning, and ease of use despite an undesirable number of false-positive results. CDS can provide hemodynamic characteristics of the perforator and is a valid and safer alternative particularly in patients in whom ionizing radiation and/or contrast exposure should be limited. Although MRA is less accurate in detecting smaller perforators of caliber less than 1.0 mm and the intramuscular course of perforators at the present time, MRA is expected to improve in the future due to the recent developments in technology, making it as accurate as P-CTA. Moreover, it provides the advantage of being radiation-free with fewer contrast reactions.

Background Evaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease. DWI has been proved to be practicable and reliable examination for the assessment of renal function and parenchymal damage in some renal diseases. Our aim is to appraise DWI sequence and ADC measurement as a potential tool of renal function assessment as well as establishing a possible relationship between the different CKD stages and the renal parenchymal ADC values changes. Results Regarding the cause of CKD, nine patients (45%) had glomerulonephritis, 5 patients (25%) had hemolytic uremic syndrome, 2 patients (10%) had lupus nephritis, 2 patients (10%) had nepheronophthisis, and 1 patient (1.5%) had infantile nepherosis, whereas the cause of CKD was unknown in 1 patient (1.5%). The stages of CKD were classified according to KIDGO guidelines: 6 patients (30%) were stage 1, 4 patients (20%) were stage 2, 3 patients (15%) were stage 3, 2 patients (10%) were stage 4, and 5 patients (25%) were stage 5. The patients’ group (group A) had a mean ADC value (1.85 × 10−3 ± 0.24) which was significantly lower than that of the control group (group B) (2.21 × 10−3 ± 0.12). As for the correlation between stage of CKD and ADC, we found it to be a moderate negative one with r’ value of − .655 and a significant p value of < 0.001. Conclusion DWI is recognized as a promising imaging tool that can take part in the assessment of the morphological and functional changes in diffuse renal parenchymal disease, hence playing an important role in the early diagnosis and staging of chronic kidney disease.

Background: Sonography is the best screening modality to detect renal insufficiency in patients. Because ultrasonographic observations such as echogenicity, longitudinal length, parenchymal and cortical thickness reflect irreversible changes, when it comes to assessing the development of the disease, ultrasonography is a better imaging tool. Aims: Our aimed to compare renal echogenicity with serum creatinine levels and to investigate the importance of renal echogenicity in the detection of CKD development and the use of sonographic imaging in CKD classification. Materials and methods: 80patients above 30 years of age who had been diagnosed with CKD according to the guidelines of the National Kidney Foundation were included in the study. serum creatinine levels. Renal cortical echogenicity was compared with serum creatinine. A P value less than 0.05 was considered statistically significant. Results: In total 80 patients, 38 patients(48%) had sonological Grade 1 CKD, 29(36%) had Grade 2 CKD, 9(11%) had Grade 3 CKD, and 4(5%) had Grade 4 CKD. The mean serum creatinine was 2.7 mg/dl for Grade 1, 3.7 mg/dl for Grade 2 it is 3.9 mg/dl for Grade 3 and 7.8 mg/dl for Grade 4. There was a statistically significant positive association between serum creatinine and the grading of cortical echogenicity. The statistically significant positive association between mean longitudinal size and renal echogenicity, parenchymal thickness and renal echogenicity, cortical thickness and renal echogenicity was also statistically significant. Conclusion: In CKD patients, renal cortical echogenicity and its grading compared to longitudinal length, parenchymal thickness, and cortical thickness is the strongest sonographic parameter that correlates with serum creatinine. It can be used as a parameter of renal activity because renal cortical echogenicity has the advantage of being irreversible compared with serum creatinine levels.

In the post renal transplant setting, pulmonary infections comprise an important set of complications. Microbiological diagnosis although specific is often delayed and insensitive. Radiography is the most common and first imaging test for which patient is referred, however it is relatively insensitive. HRCT is a very useful imaging tool in the scenario where radiography is negative or inconclusive and high clinical suspicion for infection is present. HRCT features vary among the various pathogens and also depend on the level of immunocompromise. Certain HRCT findings are characteristic for specific pathogens and may help narrow diagnosis. In this review article , we will summarize the imaging findings of various pulmonary infections encountered in post renal transplant patients.

Cardiac amyloidosis is a heterogeneous and challenging diagnostic disease with poor prognosis that is now being altered by introduction of new therapies. Echocardiography remains the first-line imaging tool, and when disease is suspected on echocardiography, cardiac magnetic resonance imaging and nuclear imaging play critical roles in the non-invasive diagnosis and evaluation of cardiac amyloidosis. Advances in multi-modality cardiac imaging allowing earlier diagnosis and initiation of novel therapies have significantly improved the outcomes in these patients. Cardiac imaging also plays important roles in the risk stratification of patients presenting with cardiac amyloidosis. In the current review, we provide a clinical and imaging focused update, and importantly outline the imaging protocols, diagnostic and prognostic utility of multimodality cardiac imaging in the assessment of cardiac amyloidosis.

Cardiac CTA is an indispensable imaging tool for TAVR procedure planning. Post-processing of the dual-energy CT utilizing dual-source and kV-switching approach enables an increase in the density ...