Federica Masino, L. Eusebi, Gianmichele Muscatella, Manuela Montatore, Giuseppe Sortino, Willy Giannubilo, Giuseppe Guglielmi
This narrative review aims to describe the current status of imaging in the evaluation of Bladder Cancer, considering conventional technologies such as Ultrasound, Computed Tomography Urography, and Magnetic Resonance Imaging as well as novel technologies such as Contrast-Enhanced Ultrasound and Dual Energy Computed Tomography. The article is organized by first presenting an introduction to both the anatomy of the bladder in order to understand the normal appearance on imaging, and both the main features of bladder cancer with a reference to epidemiology, clinic, classification, and treatment. Subsequently, the role of imaging is discussed with an explanation of the technique and the applications in Bladder Cancer assessment for each modality. Imaging plays a critical role in the detection and staging of Bladder Cancer. In particular, MRI is acquiring an increasing role, since it makes it possible to distinguish between MIBC and NMIBC using the VI-RADS score system, at the side of conventional technologies like CTU and the US. To ensure the right approach to the oncological patient CEUS and DECT represent emerging modalities with specific advantages.
{"title":"Conventional and innovative imaging modalities in Bladder Cancer: techniques and applications","authors":"Federica Masino, L. Eusebi, Gianmichele Muscatella, Manuela Montatore, Giuseppe Sortino, Willy Giannubilo, Giuseppe Guglielmi","doi":"10.17816/dd623889","DOIUrl":"https://doi.org/10.17816/dd623889","url":null,"abstract":"This narrative review aims to describe the current status of imaging in the evaluation of Bladder Cancer, considering conventional technologies such as Ultrasound, Computed Tomography Urography, and Magnetic Resonance Imaging as well as novel technologies such as Contrast-Enhanced Ultrasound and Dual Energy Computed Tomography. \u0000The article is organized by first presenting an introduction to both the anatomy of the bladder in order to understand the normal appearance on imaging, and both the main features of bladder cancer with a reference to epidemiology, clinic, classification, and treatment. Subsequently, the role of imaging is discussed with an explanation of the technique and the applications in Bladder Cancer assessment for each modality. \u0000Imaging plays a critical role in the detection and staging of Bladder Cancer. In particular, MRI is acquiring an increasing role, since it makes it possible to distinguish between MIBC and NMIBC using the VI-RADS score system, at the side of conventional technologies like CTU and the US. To ensure the right approach to the oncological patient CEUS and DECT represent emerging modalities with specific advantages.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Scoliosis is one of the most common spinal deformations that is usually diagnosed on frontal radiographs using Cobb’s method. The use of automatic measurement methods based on artificial intelligence can overcome many drawbacks of the usual method and can significantly save the time of the radiologist. AIM: to analyze the accuracy, advantages and disadvantages of a newly developed AI program for automatic diagnosis of scoliosis and measurement of Cobb’s angle on frontal radiographs. Methods: 112 digital radiographs were used to test the agreement of Cobb’s angle measurements between the new automatic method and the radiologist using Blant-Altman method on Microsoft Excel. A limited clinical accuracy test was also conducted using 120 radiographs. The accuracy of the system in defining the grade of scoliosis was evaluated by calculating sensitivity; specificity; accuracy; and area under the ROC curve (ROC AUC). RESULTS: The agreement of Cobb’s angle measurement between the system and the radiologist was found mostly in scoliosis with grades 1 and 2. Only 2.8% of the results were found to be unsatisfying with an angle variability of more than 5°. Diagnostic accuracy metrics of the limited clinical trial in Mariinsky city hospital had also proved the reliability of the system, with sensitivity = 0.97; specificity = 0.88; accuracy (general validity) = 0.93; area under the ROC curve (ROC AUC) = 0.93. CONCLUSION: Overall, the AI program can automatically and accurately define the grade of scoliosis and measure the angles of spinal curvatures on frontal radiographs.
{"title":"A new AI program for the automatic evaluation of scoliosis on frontal spinal radiographs: Accuracy, pros and cons.","authors":"Дима Халед Ибрагим Кассаб","doi":"10.17816/dd630093","DOIUrl":"https://doi.org/10.17816/dd630093","url":null,"abstract":"BACKGROUND: Scoliosis is one of the most common spinal deformations that is usually diagnosed on frontal radiographs using Cobb’s method. The use of automatic measurement methods based on artificial intelligence can overcome many drawbacks of the usual method and can significantly save the time of the radiologist. AIM: to analyze the accuracy, advantages and disadvantages of a newly developed AI program for automatic diagnosis of scoliosis and measurement of Cobb’s angle on frontal radiographs. Methods: 112 digital radiographs were used to test the agreement of Cobb’s angle measurements between the new automatic method and the radiologist using Blant-Altman method on Microsoft Excel. A limited clinical accuracy test was also conducted using 120 radiographs. The accuracy of the system in defining the grade of scoliosis was evaluated by calculating sensitivity; specificity; accuracy; and area under the ROC curve (ROC AUC). RESULTS: The agreement of Cobb’s angle measurement between the system and the radiologist was found mostly in scoliosis with grades 1 and 2. Only 2.8% of the results were found to be unsatisfying with an angle variability of more than 5°. Diagnostic accuracy metrics of the limited clinical trial in Mariinsky city hospital had also proved the reliability of the system, with sensitivity = 0.97; specificity = 0.88; accuracy (general validity) = 0.93; area under the ROC curve (ROC AUC) = 0.93. CONCLUSION: Overall, the AI program can automatically and accurately define the grade of scoliosis and measure the angles of spinal curvatures on frontal radiographs.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manuela Montatore, Marina Balbino, Federica Masino, Ruggiero Tupputi, Giuseppe Guglielmi
BACKGROUND AND AIM: Situs inversus totalis (SIT) of the viscerum is a benign condition, often diagnosed accidentally, which can affect male or female individuals. This case report shows a young female patient who accidentally discovers a SIT after a CT (computed tomography) done for acute abdominal pain. In this uncommon anatomical abnormality, the major visceral organs are reversed in the opposite direction. The study aims to highlight the significance of being aware of and considering the situs inversus in clinical practice, particularly when interpreting imaging findings and planning medical procedures is crucial for the differential diagnosis and the several comorbidities that could affect those groups of patients. The origin of SIT is still unknown, but this condition is frequently asymptomatic, especially in infants. METHODS: The patient in the study arrived at the Emergency Department with left flank pain, nausea, and fever, therefore a CT with a contrast medium was done; she had never had a CT scan before. RESULTS: The identification of SIT was unexpected and coincidental; the CT images were carefully examined. CONCLUSIONS: In patients with chest or abdominal pain after CT, the radiologists should be aware of the possibility of a SIT. This knowledge can help in the differential diagnosis avoiding unneeded interventions. Moreover, comorbidities affecting several systems, particularly cardiovascular and pulmonary problems, affect quite a few patients with SIT, which should be carefully examined.
背景和目的：粘膜全层病变（SIT）是一种良性疾病，通常是意外诊断出来的，男性或女性均可患病。本病例报告显示，一名年轻女性患者因急性腹痛接受 CT（计算机断层扫描）检查后意外发现了 SIT。在这种不常见的解剖异常中，主要内脏器官向相反方向反转。该研究旨在强调在临床实践中注意和考虑坐位反转的重要性，尤其是在解释影像学结果和计划医疗程序时，这对于鉴别诊断和可能影响这些患者群体的多种合并症至关重要。SIT 的起源尚不清楚，但这种情况经常没有症状，尤其是在婴儿身上。方法：研究中的患者因左侧腹痛、恶心和发烧来到急诊科，因此做了造影剂 CT 检查；她以前从未做过 CT 扫描。结果：SIT 的发现是意外和巧合；对 CT 图像进行了仔细检查。结论：对于 CT 扫描后出现胸痛或腹痛的患者，放射科医生应了解 SIT 的可能性。这一知识有助于鉴别诊断，避免不必要的干预。此外，影响多个系统的合并症，尤其是心血管和肺部问题，也会影响不少 SIT 患者，因此应仔细检查。
{"title":"An unknown situs viscerum inversus totalis, accidentally discovered after a CT scan","authors":"Manuela Montatore, Marina Balbino, Federica Masino, Ruggiero Tupputi, Giuseppe Guglielmi","doi":"10.17816/dd625432","DOIUrl":"https://doi.org/10.17816/dd625432","url":null,"abstract":"BACKGROUND AND AIM: Situs inversus totalis (SIT) of the viscerum is a benign condition, often diagnosed accidentally, which can affect male or female individuals. \u0000This case report shows a young female patient who accidentally discovers a SIT after a CT (computed tomography) done for acute abdominal pain. In this uncommon anatomical abnormality, the major visceral organs are reversed in the opposite direction. \u0000The study aims to highlight the significance of being aware of and considering the situs inversus in clinical practice, particularly when interpreting imaging findings and planning medical procedures is crucial for the differential diagnosis and the several comorbidities that could affect those groups of patients. The origin of SIT is still unknown, but this condition is frequently asymptomatic, especially in infants. \u0000METHODS: The patient in the study arrived at the Emergency Department with left flank pain, nausea, and fever, therefore a CT with a contrast medium was done; she had never had a CT scan before. \u0000RESULTS: The identification of SIT was unexpected and coincidental; the CT images were \u0000carefully examined. \u0000CONCLUSIONS: In patients with chest or abdominal pain after CT, the radiologists should be aware of the possibility of a SIT. This knowledge can help in the differential diagnosis avoiding unneeded interventions. Moreover, comorbidities affecting several systems, particularly cardiovascular and pulmonary problems, affect quite a few patients with SIT, which should be carefully examined.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irina B. Antonova, S. Aksenova, N. V. Nudnov, Anna Valentinovna Kriger
Backgrounds: Improving the MRI diagnosis of endocervical adenocarcinomas of the cervix, conducting a comparative analysis of MRI data and postoperative pathomorphological examination in assessing tumor invasion into the stroma of the cervix. Matherial and methods: We examined 123 patients diagnosed with cervical cancer (C53), who underwent diagnosis and treatment in the period from 2020 to 2023. We analyzed the results of examination of 22 (18%) patients with cervical adenocarcinoma. The average age of patients with cervical adenocarcinoma was 56 years. A multiparametric magnetic resonance examination of the pelvic organs was performed on 22 patients using tomographs with a magnetic field strength of 1.5 T. Surgical treatment including extirpation of the uterus and appendages with pelvic lymphadenectomy was performed on 14 patients (64%). Results: Over the past 3 years, there has been an increase in cervical adenocarcinoma up to 18%. The information content of MRI in assessing the depth of tumor invasion into the stroma of the cervix was: accuracy- 70%; sensitivity- 85.7%, specificity 33.3%, predictive value of a positive result - 75%, predictive value of a negative result 50%. The 4 types of macrostructure of tumor growth of endocervical adenocarcinoma, identified during the analysis of MR data, indicate locally aggressive tumor growth, a high frequency of dropouts into the endometrium, will allow the radiologist to structure a descriptive MR picture and better develop a treatment plan for the patient. Conclusions: MRI makes it possible to assess the localization, volume, and depth of invasion of cervical adenocarcinoma into the stroma and, thus, is recommended for use in patients with histologically verified cervical adenocarcinoma for the purpose of assessing the local extent of the tumor, staging according to the T criterion and adequate treatment planning and prognosis of the disease.
{"title":"Possibilities and limitations of MRI diagnostics of endocervical adenocarcinomas of the cervix.","authors":"Irina B. Antonova, S. Aksenova, N. V. Nudnov, Anna Valentinovna Kriger","doi":"10.17816/dd585195","DOIUrl":"https://doi.org/10.17816/dd585195","url":null,"abstract":"Backgrounds: Improving the MRI diagnosis of endocervical adenocarcinomas of the cervix, conducting a comparative analysis of MRI data and postoperative pathomorphological examination in assessing tumor invasion into the stroma of the cervix. \u0000Matherial and methods: We examined 123 patients diagnosed with cervical cancer (C53), who underwent diagnosis and treatment in the period from 2020 to 2023. We analyzed the results of examination of 22 (18%) patients with cervical adenocarcinoma. The average age of patients with cervical adenocarcinoma was 56 years. A multiparametric magnetic resonance examination of the pelvic organs was performed on 22 patients using tomographs with a magnetic field strength of 1.5 T. Surgical treatment including extirpation of the uterus and appendages with pelvic lymphadenectomy was performed on 14 patients (64%). \u0000Results: Over the past 3 years, there has been an increase in cervical adenocarcinoma up to 18%. The information content of MRI in assessing the depth of tumor invasion into the stroma of the cervix was: accuracy- 70%; sensitivity- 85.7%, specificity 33.3%, predictive value of a positive result - 75%, predictive value of a negative result 50%. The 4 types of macrostructure of tumor growth of endocervical adenocarcinoma, identified during the analysis of MR data, indicate locally aggressive tumor growth, a high frequency of dropouts into the endometrium, will allow the radiologist to structure a descriptive MR picture and better develop a treatment plan for the patient. \u0000Conclusions: MRI makes it possible to assess the localization, volume, and depth of invasion of cervical adenocarcinoma into the stroma and, thus, is recommended for use in patients with histologically verified cervical adenocarcinoma for the purpose of assessing the local extent of the tumor, staging according to the T criterion and adequate treatment planning and prognosis of the disease.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: Teleradiology has become an important tool in the field of emergency medicine, particularly in the area of emergency ultrasound interpretation. In emergency situations where time is of the essence, rapid diagnosis and treatment can mean the difference between life and death. Teleradiology is an innovative alternative to augment the staffing and fill the gaps of the on-site radiology personnel in emergency departments of the hospitals or during off-hours. Aim: To assess the impact of Teleradiology in Emergency Ultrasound interpretation. Methods: A retrospective study is carried out between January to December 2022 for a cohort of 33,616 patients from 86 hospitals across the United States. The study involves radiological interpretations of 37253 Ultrasonograms (USG) performed in the emergency setting by American Board Certified Radiologists empanelled by a teleradiology service provider, headquartered in Bangalore, India. Results: The telehealth model proposed in the studywas seen toprovide timely and quality reporting of 37253 scans of patients with a mean turn-around-time (TAT) of 35.71 minutes 95% CI (35.50-35.91). Conclusion: Our study demonstrates that a structured telesonography program with defined protocols for image capture, transmission and clinical communication can allow for successful immediate reporting of ultrasound examinations in the setting of emergency care.
{"title":"The Role of Teleradiology in Interpretation of Ultrasounds Performed in the Emergency Setting","authors":"Arjun Kalyanpur, Neetika Mathur","doi":"10.17816/dd624586","DOIUrl":"https://doi.org/10.17816/dd624586","url":null,"abstract":"Abstract \u0000Background: Teleradiology has become an important tool in the field of emergency medicine, particularly in the area of emergency ultrasound interpretation. In emergency situations where time is of the essence, rapid diagnosis and treatment can mean the difference between life and death. Teleradiology is an innovative alternative to augment the staffing and fill the gaps of the on-site radiology personnel in emergency departments of the hospitals or during off-hours. \u0000Aim: To assess the impact of Teleradiology in Emergency Ultrasound interpretation. \u0000Methods: A retrospective study is carried out between January to December 2022 for a cohort of 33,616 patients from 86 hospitals across the United States. The study involves radiological interpretations of 37253 Ultrasonograms (USG) performed in the emergency setting by American Board Certified Radiologists empanelled by a teleradiology service provider, headquartered in Bangalore, India. \u0000Results: The telehealth model proposed in the studywas seen toprovide timely and quality reporting of 37253 scans of patients with a mean turn-around-time (TAT) of 35.71 minutes 95% CI (35.50-35.91). \u0000Conclusion: Our study demonstrates that a structured telesonography program with defined protocols for image capture, transmission and clinical communication can allow for successful immediate reporting of ultrasound examinations in the setting of emergency care.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Balzano, Francesco Lattanzio, Giacomo Fascia, Manuela Montatore, Marina Balbino, Federica Masino, Domenico Mannatrizio, Giuseppe Guglielmi
BACKGROUND AND AIM: Adult intussusceptions are a rare cause of abdominal obstruction and are usually associated with a neoplastic disease; idiopathic forms are extremely rare. We report a case of an entero-colic intussusception in a young-adult female patient, who developed symptoms of abdominal obstruction. Imaging findings are reported. On histology, no underlying diseases were discovered. METHODS: The patient in the study presented at the hospital for a CT scan due to persistent abdominal pain and a CT was performed. RESULTS: The CT revealed an entero-colic invagination involving the ileocecal valve and the cecum, as well as a widespread edematous thickening of the colonic parietal walls CONCLUSIONS: Idiopathic entero-colic intussusception is an uncommon abdominal urgency in adults. Symptoms can be vague and persistent, delaying an accurate diagnosis. Imaging is crucial in these circumstances for making a diagnosis. Some CT results, such as a target-like bulk, can be suggestive.
{"title":"Idiopathic entero-colic intussusception: imaging findings in an abdominal emergency","authors":"R. Balzano, Francesco Lattanzio, Giacomo Fascia, Manuela Montatore, Marina Balbino, Federica Masino, Domenico Mannatrizio, Giuseppe Guglielmi","doi":"10.17816/dd623376","DOIUrl":"https://doi.org/10.17816/dd623376","url":null,"abstract":"BACKGROUND AND AIM: Adult intussusceptions are a rare cause of abdominal obstruction and are usually associated with a neoplastic disease; idiopathic forms are extremely rare. We report a case of an entero-colic intussusception in a young-adult female patient, who developed symptoms of abdominal obstruction. Imaging findings are reported. On histology, no underlying diseases were discovered. \u0000METHODS: The patient in the study presented at the hospital for a CT scan due to persistent abdominal pain and a CT was performed. \u0000RESULTS: The CT revealed an entero-colic invagination involving the ileocecal valve and the cecum, as well as a widespread edematous thickening of the colonic parietal walls \u0000CONCLUSIONS: Idiopathic entero-colic intussusception is an uncommon abdominal urgency in adults. Symptoms can be vague and persistent, delaying an accurate diagnosis. Imaging is crucial in these circumstances for making a diagnosis. Some CT results, such as a target-like bulk, can be suggestive.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Testini, L. Eusebi, F. Guerra, Willy Giannubilo, Manuel di Biase, Annunziata Russo, Giuseppe Guglielmi
Purpose of the Review: This review article aims to explain the role of Multiparametric MRI, in particular in prostate biopsy, to detect prostate cancer. Recent Findings: The use of multiparametric MRI in the diagnosis of prostate cancer has also allowed its use in MR guided biopsies, which according to many studies present high sensitivity and specificity in early diagnosis, staging, in patients with persistently elevated PSA despite previous negative prostate biopsies , and in the follow-up of patients under active surveillance. To perform a targeted prostate biopsy, three types of MRI guidance are available: -cognitive fusion, - direct MRI-guided biopsy, performed within an MRI tube (in-bore biopsies) - software coregistration of stored MRI with real-time ultrasound, using a fusion device. with mpMRI findings digitally overlaid on real-time TRUS images for targeted biopsy Each method has its advantages and disadvantages. Summary: MRI-targeted biopsy improves the quality of histological results compared to other approaches, with approximately 90% correct detection of significant index lesions Correct staging allows you to choose the best therapeutic options, adequately evaluate the prognosis, reducing the incidence of new biopsies and complications. The current objective is to make MRI-guided biopsy increasingly available, standardize the technique in order to minimize inter-operator variability and depending on the available system.
{"title":"Multiparametric MRI and MRI Fusion-Guided Biopsy for the Diagnosis of Prostate Cancer: current status","authors":"V. Testini, L. Eusebi, F. Guerra, Willy Giannubilo, Manuel di Biase, Annunziata Russo, Giuseppe Guglielmi","doi":"10.17816/dd623183","DOIUrl":"https://doi.org/10.17816/dd623183","url":null,"abstract":"Purpose of the Review: This review article aims to explain the role of Multiparametric MRI, in particular in prostate biopsy, to detect prostate cancer. \u0000Recent Findings: The use of multiparametric MRI in the diagnosis of prostate cancer has also allowed its use in MR guided biopsies, which according to many studies present high sensitivity and specificity in early diagnosis, staging, in patients with persistently elevated PSA despite previous negative prostate biopsies , and in the follow-up of patients under active surveillance. \u0000To perform a targeted prostate biopsy, three types of MRI guidance are available: \u0000-cognitive fusion, \u0000- direct MRI-guided biopsy, performed within an MRI tube (in-bore biopsies) \u0000- software coregistration of stored MRI with real-time ultrasound, using a fusion device. with mpMRI findings digitally overlaid on real-time TRUS images for targeted biopsy \u0000Each method has its advantages and disadvantages. \u0000Summary: MRI-targeted biopsy improves the quality of histological results compared to other approaches, with approximately 90% correct detection of significant index lesions \u0000Correct staging allows you to choose the best therapeutic options, adequately evaluate the prognosis, reducing the incidence of new biopsies and complications. \u0000The current objective is to make MRI-guided biopsy increasingly available, standardize the technique in order to minimize inter-operator variability and depending on the available system.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Chondromalacia is a common pathology of joints, leading to a decrease in the patient's quality of life. Magnetic resonance imaging is the method of choice for the diagnosis of articular cartilage defects [1]. T2 mapping of cartilage is a non-invasive quantitative technique that allows estimation of its T2-relaxation time, which may be relevant in cases where articular cartilage surveillance is recommended [2–5]. AIM: To study the magnetic resonance characteristics of knee cartilage using a routine protocol and T2 mapping technique in patients at risk of chondromalacia. MATERIALS AND METHODS: Magnetic resonance research of the knee joint was prospectively performed on 35 patients aged 18–70 years who signed informed voluntary consent in the period from 2022 to 2023. The study was approved by the local ethical committee of International Tomography Center (Novosibirsk, Russia). Exclusion criteria: exacerbation stage of comorbid diseases, knee joint osteoarthritis of stages 3–4. The main group consisted of patients with signs of chondromalacia; the group with initial degenerative changes — of patients with local areas of thinning and/or changes in the signaling characteristics of articular cartilage with minor/no degenerative changes of the joint. The control group consisted of patients without changes in cartilage signaling characteristics, traumatic and degenerative changes of the knee joint. The study of the knee joint was performed on a Philips INGENIA magnetic resonance tomograph (1.5T intensity) using the routine protocol: T2-weighted images, PD-SPAIR, PD-weighted images, T1-weighted images and T2 mapping technique with calculation of the T2-relaxation time of the cartilage tissue. Statistical analysis was performed using non-parametric research methods (Mann–Whitney U-test, Spearman correlation coefficient). The critical level of significance (p) is 0.05. RESULTS: The median age in the control group was 28.0 [24.0; 38.0] years, in the main group 48.0 [37.2; 55.7] years, and in the group with initial degenerative changes 48.0 [38.2; 59.5] years. Analysis of the localization of the cartilage defect of the knee joint revealed that chondromalacia was determined on the medial facet of the patella in 11 (91.6%) patients, on the lateral facet of the patella in 4 (33.3%) patients, and on the medial femoral condyle in 4 (33.3%) patients. When measuring cartilage thickness, a high individual variability of values was revealed with its significant decrease only in the defect area (p 0.05), with no significant differences between the groups in the other sections (p 0.05). When evaluating the values of cartilage T2-relaxation time, its statistically significant increase was revealed in the area of patella cartilage in patients from the main group and with initial degenerative changes (p 0.001 and p 0.01), cartilage of medial femoral condyle in patients with initial degenerative changes (p 0.05) in comparison with the control group. Correlati
{"title":"Application of T2 mapping to assess articular cartilage in patients at risk of developing chondromalacia","authors":"Daria Yu. Zubareva, O. Bogomyakova, A. Tulupov","doi":"10.17816/dd626650","DOIUrl":"https://doi.org/10.17816/dd626650","url":null,"abstract":"BACKGROUND: Chondromalacia is a common pathology of joints, leading to a decrease in the patient's quality of life. Magnetic resonance imaging is the method of choice for the diagnosis of articular cartilage defects [1]. T2 mapping of cartilage is a non-invasive quantitative technique that allows estimation of its T2-relaxation time, which may be relevant in cases where articular cartilage surveillance is recommended [2–5]. \u0000AIM: To study the magnetic resonance characteristics of knee cartilage using a routine protocol and T2 mapping technique in patients at risk of chondromalacia. \u0000MATERIALS AND METHODS: Magnetic resonance research of the knee joint was prospectively performed on 35 patients aged 18–70 years who signed informed voluntary consent in the period from 2022 to 2023. The study was approved by the local ethical committee of International Tomography Center (Novosibirsk, Russia). Exclusion criteria: exacerbation stage of comorbid diseases, knee joint osteoarthritis of stages 3–4. The main group consisted of patients with signs of chondromalacia; the group with initial degenerative changes — of patients with local areas of thinning and/or changes in the signaling characteristics of articular cartilage with minor/no degenerative changes of the joint. The control group consisted of patients without changes in cartilage signaling characteristics, traumatic and degenerative changes of the knee joint. The study of the knee joint was performed on a Philips INGENIA magnetic resonance tomograph (1.5T intensity) using the routine protocol: T2-weighted images, PD-SPAIR, PD-weighted images, T1-weighted images and T2 mapping technique with calculation of the T2-relaxation time of the cartilage tissue. Statistical analysis was performed using non-parametric research methods (Mann–Whitney U-test, Spearman correlation coefficient). The critical level of significance (p) is 0.05. \u0000RESULTS: The median age in the control group was 28.0 [24.0; 38.0] years, in the main group 48.0 [37.2; 55.7] years, and in the group with initial degenerative changes 48.0 [38.2; 59.5] years. Analysis of the localization of the cartilage defect of the knee joint revealed that chondromalacia was determined on the medial facet of the patella in 11 (91.6%) patients, on the lateral facet of the patella in 4 (33.3%) patients, and on the medial femoral condyle in 4 (33.3%) patients. When measuring cartilage thickness, a high individual variability of values was revealed with its significant decrease only in the defect area (p 0.05), with no significant differences between the groups in the other sections (p 0.05). When evaluating the values of cartilage T2-relaxation time, its statistically significant increase was revealed in the area of patella cartilage in patients from the main group and with initial degenerative changes (p 0.001 and p 0.01), cartilage of medial femoral condyle in patients with initial degenerative changes (p 0.05) in comparison with the control group. Correlati","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Cardiovascular diseases represent the leading cause of mortality worldwide [1]. A significant proportion of medical diagnoses are based on the evaluation of characteristic points in the electrocardiographic signal. For example, two important time intervals are P–R and Q–T, which have a significant impact on the patient’s health status [2]. However, the detection of minimal changes in amplitudes and intervals between waves over time is challenging through visual inspection alone. The difficulty is compounded by the lack of a clear-cut rule for determining the beginning and end of the Q–T interval, and the fact that the duration of the intervals varies with each heartbeat [3]. AIM: The study aimed to develop an algorithm to highlight the dynamics of interval duration changes when analyzing electrocardiographic signals. MATERIALS AND METHODS: The wavelet transform serves as a valuable analytical tool. Its ability to decompose signals into well-localized basis functions makes it well suited to distinguish electrocardiographic waves from noise [4]. Furthermore, its ability to change the scale allows for the detection of various local inhomogeneities in the electrocardiographic signal, as well as their durations. One of the main problems in using wavelet transform is the choice of the mother function. In this paper, we propose to use Hermite transform [5], due to which a mother function of arbitrary shape can be designed, which improves the detection efficiency. Moreover, the Hermite transform can be applied to the authentic electrocardiographic signal recording, ensuring the retention of the distinctive attributes of the patient’s signal. RESULTS: The result of the algorithm is a set of rhythmograms, each of which traces the changes over time of intervals of the electrocardiographic signal, for example, P–R or Q–T. The rhythmogram is a stochastic characteristic that allows estimation of the dispersion of Q–T intervals even during short time intervals and when changing the level of physical activity. This is why, by applying the statistical apparatus, it is possible to quantify the diagnostic efficiency of the proposed processing algorithm. CONCLUSIONS: The paper presents the main conclusions of the algorithm and the results of processing model electrocardiographic signals.
{"title":"Application of the modernized wavelet transform to highlight the dynamics of changes in the duration of intervals during electrocardiogram diagnostics","authors":"Charif Alali, Dmitry A. Balalkin","doi":"10.17816/dd626185","DOIUrl":"https://doi.org/10.17816/dd626185","url":null,"abstract":"BACKGROUND: Cardiovascular diseases represent the leading cause of mortality worldwide [1]. A significant proportion of medical diagnoses are based on the evaluation of characteristic points in the electrocardiographic signal. For example, two important time intervals are P–R and Q–T, which have a significant impact on the patient’s health status [2]. \u0000However, the detection of minimal changes in amplitudes and intervals between waves over time is challenging through visual inspection alone. The difficulty is compounded by the lack of a clear-cut rule for determining the beginning and end of the Q–T interval, and the fact that the duration of the intervals varies with each heartbeat [3]. \u0000AIM: The study aimed to develop an algorithm to highlight the dynamics of interval duration changes when analyzing electrocardiographic signals. \u0000MATERIALS AND METHODS: The wavelet transform serves as a valuable analytical tool. Its ability to decompose signals into well-localized basis functions makes it well suited to distinguish electrocardiographic waves from noise [4]. Furthermore, its ability to change the scale allows for the detection of various local inhomogeneities in the electrocardiographic signal, as well as their durations. \u0000One of the main problems in using wavelet transform is the choice of the mother function. In this paper, we propose to use Hermite transform [5], due to which a mother function of arbitrary shape can be designed, which improves the detection efficiency. Moreover, the Hermite transform can be applied to the authentic electrocardiographic signal recording, ensuring the retention of the distinctive attributes of the patient’s signal. \u0000RESULTS: The result of the algorithm is a set of rhythmograms, each of which traces the changes over time of intervals of the electrocardiographic signal, for example, P–R or Q–T. The rhythmogram is a stochastic characteristic that allows estimation of the dispersion of Q–T intervals even during short time intervals and when changing the level of physical activity. This is why, by applying the statistical apparatus, it is possible to quantify the diagnostic efficiency of the proposed processing algorithm. \u0000CONCLUSIONS: The paper presents the main conclusions of the algorithm and the results of processing model electrocardiographic signals.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. A. Kirillova, E. S. Semenova, P. V. Kozlova, E. D. Vyshedkevich, I. Mashchenko
BACKGROUND: One of the principal indications of placenta accreta is pathological vascular remodeling in the region of the placental site. This phenomenon, which may result from various mechanisms, can give rise to significant blood loss in women undergoing cesarean section [2]. AIM: The study aims to evaluate the correlation between different types of abnormal hypervascularization observed on pelvic magnetic resonance imaging in pregnant women with placenta accreta and blood loss during surgical delivery by cesarean section. MATERIALS AND METHODS: A total of 224 patients in the second and third trimesters of pregnancy with placenta previa and placenta accreta were examined. This was confirmed by ultrasound and magnetic resonance imaging, and subsequently by histopathologic examination. The mean age of the patients was 34.8±0.41 years (M±SE, p 0.05). Magnetic resonance imaging was conducted in accordance with a three-stage protocol on tomographs with magnetic field strengths of 1.5 and 3 Tesla. The diagnosis of placenta accreta was based on 11 signs, as outlined in the joint consensus statement of the Society of Abdominal Radiology and the European Society of Urogenital Radiology [1]. In addition, signs of hypervascularization were evaluated, including intrauterine (retroplacental, intramural, and subserosal) and extrauterine (parametrial, paracervical, and uterine-ovarian anastomosis zone) regions. The diagnostic criteria for hypervascularization were defined as an increase in the diameter of vessels, as indicated by areas of magnetic resonance signal dropout, their pronounced tortuosity, and their location in the corresponding anatomical regions relative to the uterus. Blood loss during labor was assessed in five categories: 1000 mL, 1000–1500 mL, 1500–2000 mL, 2000–3000 mL, and 3000 mL [3]. The correlation between variables was assessed using linear regression and Pearson’s correlation coefficient (r) and one-way analysis of variance. Differences were considered statistically significant at p 0.05. RESULTS: According to the data of correlation analysis, the formation of anterior (r=0.3591, p 0.0001) and lateral (r=0.2799, p 0.0001) parametrial vascular collateralization, as well as utero-ovarian anastomosis (r=0.1369, p=0.0407) had the most significant effect on the severity of postpartum hemorrhage. There was no statistically significant effect of retroplacental hypervascularization on the increase in blood loss volume (r=–0.01611, p=0.6051). CONCLUSIONS: The study demonstrated that patterns of abnormal vascular remodeling in the placental site can be clearly identified by magnetic resonance imaging and used as a predictor of severe hemorrhage. Pregnant women with such MRI findings should be referred to a level 3 perinatal center to ensure adequate control of increased risks of obstetric hemorrhage during operative delivery.
{"title":"Abnormal hypervascularity in placenta accreta spectrum disorders: when to expect severe blood loss during surgical delivery","authors":"E. A. Kirillova, E. S. Semenova, P. V. Kozlova, E. D. Vyshedkevich, I. Mashchenko","doi":"10.17816/dd626016","DOIUrl":"https://doi.org/10.17816/dd626016","url":null,"abstract":"BACKGROUND: One of the principal indications of placenta accreta is pathological vascular remodeling in the region of the placental site. This phenomenon, which may result from various mechanisms, can give rise to significant blood loss in women undergoing cesarean section [2]. \u0000AIM: The study aims to evaluate the correlation between different types of abnormal hypervascularization observed on pelvic magnetic resonance imaging in pregnant women with placenta accreta and blood loss during surgical delivery by cesarean section. \u0000MATERIALS AND METHODS: A total of 224 patients in the second and third trimesters of pregnancy with placenta previa and placenta accreta were examined. This was confirmed by ultrasound and magnetic resonance imaging, and subsequently by histopathologic examination. The mean age of the patients was 34.8±0.41 years (M±SE, p 0.05). Magnetic resonance imaging was conducted in accordance with a three-stage protocol on tomographs with magnetic field strengths of 1.5 and 3 Tesla. The diagnosis of placenta accreta was based on 11 signs, as outlined in the joint consensus statement of the Society of Abdominal Radiology and the European Society of Urogenital Radiology [1]. In addition, signs of hypervascularization were evaluated, including intrauterine (retroplacental, intramural, and subserosal) and extrauterine (parametrial, paracervical, and uterine-ovarian anastomosis zone) regions. The diagnostic criteria for hypervascularization were defined as an increase in the diameter of vessels, as indicated by areas of magnetic resonance signal dropout, their pronounced tortuosity, and their location in the corresponding anatomical regions relative to the uterus. Blood loss during labor was assessed in five categories: 1000 mL, 1000–1500 mL, 1500–2000 mL, 2000–3000 mL, and 3000 mL [3]. The correlation between variables was assessed using linear regression and Pearson’s correlation coefficient (r) and one-way analysis of variance. Differences were considered statistically significant at p 0.05. \u0000RESULTS: According to the data of correlation analysis, the formation of anterior (r=0.3591, p 0.0001) and lateral (r=0.2799, p 0.0001) parametrial vascular collateralization, as well as utero-ovarian anastomosis (r=0.1369, p=0.0407) had the most significant effect on the severity of postpartum hemorrhage. There was no statistically significant effect of retroplacental hypervascularization on the increase in blood loss volume (r=–0.01611, p=0.6051). \u0000CONCLUSIONS: The study demonstrated that patterns of abnormal vascular remodeling in the placental site can be clearly identified by magnetic resonance imaging and used as a predictor of severe hemorrhage. Pregnant women with such MRI findings should be referred to a level 3 perinatal center to ensure adequate control of increased risks of obstetric hemorrhage during operative delivery.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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