Journal of Clinical Imaging Science最新文献

Sample size is an essential step in any research study because it directly affects precision and statistical power. This article describes the main factors that determine the number of observations needed (power of a hypothesis test, significance criterion, minimum expected difference, variability, and asymmetry of the hypothesis test) and techniques for minimizing these factors. Our paper clearly presents examples of sample size calculations in radiology related to descriptive (mean and proportion) and comparative (two means, two proportions, intraclass correlations, and analysis of variance) studies. These examples are solved both manually and computationally using free R-based software.

Copyright is a crucial aspect of scholarly publishing, governing the ownership, distribution, and permissible use of academic content. Traditional copyright laws grant exclusive rights to authors or publishers. In the era of open-access publication, Creative Commons (CC) licenses offer the flexibility to share scholarly work more openly while maintaining proper attribution. Understanding these licensing options is essential for researchers. This article explores the fundamental concepts of copyright, licensing, and CC in the context of scholarly publishing. It briefly explains how to search for copyright and licensing information on an article, properly attribute credit, and obtain permission for content reuse from the copyright holder. Failure to comply with copyright regulations can result in consequences such as legal disputes, financial penalties, and reputational damage. Hence, an understanding and responsible application of copyright and licensing principles are therefore essential for ethical and legally compliant scholarly communication.

Objectives: The objective of the study is to assess the utility of the perivascular space diffusion tensor imaging - along the perivascular space (DTI-ALPS) index in evaluating the activity of the brain glymphatic system in patients with type 2 diabetes mellitus (T2DM) and cognitive impairment.

Material and methods: This study included 40 T2DM patients with cognitive impairment and 40 healthy controls (HCs). All participants underwent DTI, and the DTI-ALPS index was calculated based on relevant DTI parameters. Statistical analyses were performed using the Statistical Package for the Social Sciences version 26.0, with significance set at P < 0.05.

Results: The DTI-ALPS index in T2DM patients with cognitive impairment were significantly lower than that of the HCs. A significant negative correlation was observed between the DTI-ALPS index and glycated hemoglobin levels, while positive correlations were found with vitamin D, Montreal Cognitive Assessment scores, and high-density lipoprotein cholesterol levels.

Conclusion: This study confirms glymphatic dysfunction in T2DM patients with cognitive impairment, as indicated by the reduced DTI-ALPS index. Furthermore, it demonstrates the feasibility of utilizing the DTI-ALPS method to assess glymphatic system activity in this patient population.

Objectives: Ulnar variance (UV), i.e., the length of the ulna relative to the radius is a radiographic measurement commonly used to estimate fracture compression of distal radius fractures. Different methods for measuring UV have been described in the literature. The aim of this study was to assess the inter- and intra-rater reliability of three different methods of measuring UV among raters with different professional backgrounds and levels of experience.

Material and methods: Nine raters, one musculoskeletal radiologist, three radiology residents, one PhD student, one medical student, and three reporting radiographers, participated in the study. They measured UV on 21 radiographs using three different measurement methods: The method of central reference point (CRP), the lateral method (LM), and the method of perpendiculars (MoP). Inter-rater reliability was assessed using the intra-class correlation coefficient (ICC), while intra-rater agreement was estimated using Bland-Altman (BA) analysis with limits of agreement (LoA).

Results: Inter-rater reliability estimated by ICCs was 0.91, 0.96, and 0.97 for the methods of CRP, LM, and MoP, respectively. Intra-rater agreement, assessed by BA LoA for rater1/rater2, was ±2.94/±1.45, ±1.92/±2.36, and ±2.14/±1.33 for the methods of CRP, LM, and MoP, respectively.

Conclusion: All three methods of measurement displayed excellent reliability with ICCs ranging from 0.91 to 0.97. The findings suggest that UV measurements can be reliably obtained across raters with different professional backgrounds and levels of experience using all three methods of measuring.

Objectives: The purpose of this study was to evaluate the feasibility, safety, and efficacy of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of liver hepatocellular carcinoma (HCC) lesions in patients with pre-existing diuretic-resistant ascites. There is logical hesitation among clinicians to pursue MWA in these decompensated patients for fear of worsening an already bleak prognosis, but there is limited evidence to justify this behavior.

Material and methods: A retrospective review of HCC treated with percutaneous MWA at a single center was performed. 18 patients who underwent CT-guided MWA with pre-existing diuretic-resistant ascites were identified. A control group of 29 patients who underwent CT-guided MWA without pre-existing diuretic-resistant ascites was identified, which was further narrowed to 18 patients after matching by Model for End-Stage Liver Disease-Sodium score and age. The effectiveness of treatment was compared between the two groups and evaluated by disease-free survival, residual disease, and overall survival over 36 months. Kaplan-Meier curves plotting the survival function were constructed to compare these variables in both groups.

Results: MWA was successfully performed in all patients. The probability of survival at 1 year for the ascites and matched control groups were 0.778 and 1.00, respectively (P = 0.038). The probability of survival at 3 years for the ascites and matched control groups were 0.556 and 0.630, respectively (P = 0.237). There were no significant differences between residual disease and disease-free survival between the two groups at 1 or 3 years.

Conclusion: CT-guided percutaneous MWA for HCC in select patients with pre-existing diuretic-resistant ascites is a feasible, safe, and effective treatment option.

Left ventricular diverticulum (LVD) is a rare congenital anomaly characterized by an abnormal outpouching of the left ventricular wall. It is often identified during childhood, as it is commonly associated with midline thoracoabdominal defects and other congenital heart abnormalities. Here, we present a 10-month-old boy with a LVD and omphalocele posted for surgical management who had difficulty weaning in the post-operative period. We discuss the unique challenges that necessitate meticulous planning and execution to optimize right ventricular function and prevent pulmonary arterial hypertension in such patients.

Point-of-care ultrasound (POCUS) has emerged as a cost-effective diagnostic tool that significantly enhances physical examinations. Serving as an extension of traditional examination methods, POCUS is particularly appealing to the next generation of clinicians. It holds the potential to become the modern-day stethoscope in various medical assessments and procedures. At the University of Rochester, we are in the midst of a major initiative, deploying 2,000 POCUS probes while simultaneously reinforcing compliance standards for image storage and documentation across established POCUS platforms. Three years into our 4-year deployment plan, we will discuss the evolution of our governance structure, improved utilization, continued educational initiatives, and credentialing strategies. Over the past decade, POCUS adoption has grown organically, and our goal is to implement a comprehensive strategy that ensures adherence to established protocols for image storage and documentation. At present, we have successfully deployed 1,199 probes, up from 789 in year 2, with integration across more than 70 departments and divisions within our information technology (IT) platform. Notably, this implementation has led to a 26% growth in hospital charges, highlighting the tangible impact of POCUS integration. However, achieving compliance and education among established providers continues to be a challenge. The integration of fellowship-trained POCUS physicians into various departments has been invaluable, and developing physician champions has significantly improved both utilization and compliance. Recent initiatives include transitioning from traditional bladder scanners to ultrasound (US) probes mounted on iPad stands and developing a nursing POCUS-guided US program. Nursing education has played a pivotal role in supporting this transition. Over the first 6 months, 86 US probes used by nursing staff have facilitated approximately 70,000 bladder examinations.

Saphenous vein graft aneurysm (SVGA) is a rare but potentially life-threatening complication of coronary artery bypass grafting (CABG). Its incidence is likely underreported due to asymptomatic cases and undiagnosed acute events. While SVGAs are more commonly associated with right atrial compression, presentation as a left atrial mass is rare. We present the case of an 85-year-old man with a history of CABG, who was incidentally found to have a left atrial appendage (LAA) density on a computed tomography (CT) chest, abdomen, and pelvis performed for unrelated symptoms of back pain and constipation. The density was initially suspected to be an LAA thrombus. However, a dedicated cardiac CT with delayed-phase imaging revealed a largely thrombosed aneurysmal saphenous vein graft to the obtuse marginal artery, which indented the LAA, mimicking an intracardiac mass. This case underscores the critical role of multimodality imaging, particularly cardiac CT, in differentiating vascular aneurysms from true intracardiac masses. Given the patient's asymptomatic status, conservative management with close follow-up was pursued. This case adds to the limited literature on SVGAs mimicking left atrial pathology and highlights the importance of recognizing this rare entity to avoid unnecessary interventions. It also emphasizes the evolving role of cardiac CT as a noninvasive, high-yield diagnostic tool for complex post-CABG anatomical assessments.

Objectives: The objective of the study was to evaluate the efficacy of ultra-high-resolution computed tomography (UHRCT) in comparison to conventional resolution computed tomography (CT) for the characterization of lung nodules.

Material and methods: 104 non-contrast chest UHRCT scans (mean age of 66 years, 57 females) with pulmonary nodules were retrospectively collected (February-November 2022), and corresponding normal-resolution (NR) reconstructions were synthesized using a validated algorithm. Five blinded radiologists scored the following for each localized nodule in the ultra-high-resolution (UHR) and NR datasets: Margin clarity (5-point Likert scale), image quality "IQ" (3-point), density confidence (0-100%), and size (long/short axes). Image noise (voxel standard deviation) was calculated within the trachea. Differences between UHR and NR were tested using the Wilcoxon signed-rank test. Intrareader agreement was quantified with intraclass correlation coefficient (ICC), and ordinal association between margin clarity and IQ was quantified with Kendall's τ coefficient.

Results: Margin clarity, IQ, and density confidence were significantly higher for UHR (P < 0.001). No significant differences between UHR and NR were observed in the variability (standard deviation across readers) for measuring long and short axes (P > 0.100). Intrareader agreement for UHR and NR was poor for margin clarity, IQ, and density confidences (ICC < 0.250) but moderate for short axes (ICC = 0.731) and good for long axes (ICC = 0.807). Ordinal association between margin clarity and IQ was moderate for UHR (τ = 0.566) and good for IQ (τ = 0.637). Image noise was significantly higher (P < 0.001) for UHR compared to NR.

Conclusion: UHRCT offers significant improvements in the visualization of lung nodules compared to conventional resolution CT, albeit with an increase in image noise.