Pub Date : 2024-10-04DOI: 10.1016/j.clinimag.2024.110307
Lea Azour , Leopoldo N. Segal , Rany Condos , William H. Moore , Nicholas Landini , Destiny Collazo , Daniel H. Sterman , Isabel Young , Jane Ko , Shari Brosnahan , James Babb , Hersh Chandarana
Objectives
To evaluate the clinical significance of low-field MRI lung opacity severity.
Methods
Retrospective cross-sectional analysis of post-acute Covid-19 patients imaged with low-field MRI from 9/2020 through 9/2022, and within 1 month of pulmonary function tests (PFTs), 6-min walk test (6mWT), and symptom inventory (SI), and/or within 3 months of St. George Respiratory Questionnaire (SGRQ) was performed.
Univariate and correlative analyses were performed with Wilcoxon, Chi-square, and Spearman tests. The association between disease and demographic factors and MR opacity severity, PFTs, 6mWT, SI, and SGRQ, and association between MR opacity severity with functional and patient-reported outcomes (PROs), was evaluated with mixed model analysis of variance, covariance and generalized estimating equations. Two-sided 5 % significance level was used, with Bonferroni multiple comparison correction.
Results
81 MRI exams in 62 post-acute Covid-19 patients (median age 57, IQR 41–64; 25 women) were included. Exams were a median of 8 months from initial illness. Univariate analysis showed lung opacity severity was associated with decreased %DLCO (ρ = −0.55, P = .0125), and lung opacity severity quartile was associated with decreased %DLCO, predicted TLC, FVC, and increased FEV1/FVC.
Multivariable analysis adjusting for sex, initial disease severity, and interval from Covid-19 diagnosis showed MR lung opacity severity was associated with decreased %DLCO (P < .001). Lung opacity severity was not associated with PROs.
Conclusion
Low-field MRI lung opacity severity correlated with decreased %DLCO in post-acute Covid-19 patients, but was not associated with PROs.
{"title":"Low-field MRI lung opacity severity associated with decreased DLCO in post-acute Covid-19 patients","authors":"Lea Azour , Leopoldo N. Segal , Rany Condos , William H. Moore , Nicholas Landini , Destiny Collazo , Daniel H. Sterman , Isabel Young , Jane Ko , Shari Brosnahan , James Babb , Hersh Chandarana","doi":"10.1016/j.clinimag.2024.110307","DOIUrl":"10.1016/j.clinimag.2024.110307","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the clinical significance of low-field MRI lung opacity severity.</div></div><div><h3>Methods</h3><div>Retrospective cross-sectional analysis of post-acute Covid-19 patients imaged with low-field MRI from 9/2020 through 9/2022, and within 1 month of pulmonary function tests (PFTs), 6-min walk test (6mWT), and symptom inventory (SI), and/or within 3 months of St. George Respiratory Questionnaire (SGRQ) was performed.</div><div>Univariate and correlative analyses were performed with Wilcoxon, Chi-square, and Spearman tests. The association between disease and demographic factors and MR opacity severity, PFTs, 6mWT, SI, and SGRQ, and association between MR opacity severity with functional and patient-reported outcomes (PROs), was evaluated with mixed model analysis of variance, covariance and generalized estimating equations. Two-sided 5 % significance level was used, with Bonferroni multiple comparison correction.</div></div><div><h3>Results</h3><div>81 MRI exams in 62 post-acute Covid-19 patients (median age 57, IQR 41–64; 25 women) were included. Exams were a median of 8 months from initial illness. Univariate analysis showed lung opacity severity was associated with decreased %DLCO (ρ = −0.55, <em>P</em> = .0125), and lung opacity severity quartile was associated with decreased %DLCO, predicted TLC, FVC, and increased FEV1/FVC.</div><div>Multivariable analysis adjusting for sex, initial disease severity, and interval from Covid-19 diagnosis showed MR lung opacity severity was associated with decreased %DLCO (<em>P</em> < .001). Lung opacity severity was not associated with PROs.</div></div><div><h3>Conclusion</h3><div>Low-field MRI lung opacity severity correlated with decreased %DLCO in post-acute Covid-19 patients, but was not associated with PROs.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110307"},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1016/j.clinimag.2024.110303
Andreas Michael Bucher , Julia Dietz , Constantin Ehrengut , Lukas Müller , Dominik Schramm , Alena Akinina , Michelle Drechsel , Roman Kloeckner , Malte Sieren , Peter Isfort , Marwin-Jonathan Sähn , Matthias A. Fink , Dorottya Móré , Bohdan Melekh , Felix G. Meinel , Hanna Schön , Matthias Stefan May , Lisa Siegler , Hanna Münzfeld , Richard Ruppel , Alexey Surov
Purpose
This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes.
Methods
In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation.
Results
PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65–2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %.
Conclusion
Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.
{"title":"The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study","authors":"Andreas Michael Bucher , Julia Dietz , Constantin Ehrengut , Lukas Müller , Dominik Schramm , Alena Akinina , Michelle Drechsel , Roman Kloeckner , Malte Sieren , Peter Isfort , Marwin-Jonathan Sähn , Matthias A. Fink , Dorottya Móré , Bohdan Melekh , Felix G. Meinel , Hanna Schön , Matthias Stefan May , Lisa Siegler , Hanna Münzfeld , Richard Ruppel , Alexey Surov","doi":"10.1016/j.clinimag.2024.110303","DOIUrl":"10.1016/j.clinimag.2024.110303","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes.</div></div><div><h3>Methods</h3><div>In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation.</div></div><div><h3>Results</h3><div>PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, <em>p</em> < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65–2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %.</div></div><div><h3>Conclusion</h3><div>Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"117 ","pages":"Article 110303"},"PeriodicalIF":1.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.clinimag.2024.110306
Jay Acharya , Anthony R. Zamary , Ahmad Alach , Joseph Kang , Anandh G. Rajamohan , Mark D. Mamlouk , Fernando Torres
With increasing use of broad-spectrum antibiotics, advances in organ and stem-cell transplant therapy, and the continued diabetes mellitus II epidemic, as well as other risk factors, reports of fungal infections of the CNS have been increasing. The most lethal subset is the angioinvasive fungal infection. Aspergillus fumigatus, Mucor, and Fusarium tend to affect immunocompromised individuals depending on their risk factors. Exserohilum rostratum and Cladophialaphora species tend to infect immunocompetent individuals. Early diagnosis and treatment are imperative for improved outcomes and reduced morbidity and mortality. Clinical presentation is often nonspecific, while neuroimaging can be helpful for accurate diagnosis. CT of the head and/or the maxillofacial structures is the primary imaging modality. Once the infection begins to proliferate, areas of vasogenic and cytotoxic edema, with regional mass effect and shift of the midline structures may be seen. These findings, however, are often nonspecific and may also be seen in underlying neoplasm, inflammatory processes, and other intracranial infections. Characteristic findings on T1, T2, diffusion-weighted imaging (DWI), and gradient echo sequences (GRE) may help to further narrow the differential diagnoses. We present a review of neuroimaging findings that will aid the neuroradiologist in distinguishing intracranial angioinvasive fungal infections and lead to improved patient outcomes.
随着广谱抗生素使用的增加、器官和干细胞移植疗法的进步、糖尿病 II 型的持续流行以及其他风险因素的影响，中枢神经系统真菌感染的报告也在不断增加。其中最致命的是血管侵袭性真菌感染。曲霉、粘孢子菌和镰刀菌往往会影响免疫力低下的人，这取决于他们的风险因素。Exserohilum rostratum 和 Cladophialaphora 物种则倾向于感染免疫功能正常的人。早期诊断和治疗对于提高疗效、降低发病率和死亡率至关重要。临床表现通常没有特异性，而神经影像学检查有助于准确诊断。头部和/或颌面部结构的 CT 是主要的成像方式。一旦感染开始扩散，可能会出现血管源性和细胞毒性水肿区域，并伴有区域性肿块效应和中线结构移位。然而，这些结果往往是非特异性的，也可能出现在潜在的肿瘤、炎症过程和其他颅内感染中。T1、T2、弥散加权成像（DWI）和梯度回波序列（GRE）的特征性发现有助于进一步缩小鉴别诊断的范围。我们将对神经放射成像结果进行综述，以帮助神经放射科医生区分颅内血管侵袭性真菌感染并改善患者预后。
{"title":"Review of neuroimaging findings of intracranial angioinvasive fungal infections","authors":"Jay Acharya , Anthony R. Zamary , Ahmad Alach , Joseph Kang , Anandh G. Rajamohan , Mark D. Mamlouk , Fernando Torres","doi":"10.1016/j.clinimag.2024.110306","DOIUrl":"10.1016/j.clinimag.2024.110306","url":null,"abstract":"<div><div>With increasing use of broad-spectrum antibiotics, advances in organ and stem-cell transplant therapy, and the continued diabetes mellitus II epidemic, as well as other risk factors, reports of fungal infections of the CNS have been increasing. The most lethal subset is the angioinvasive fungal infection. <em>Aspergillus fumigatus</em>, <em>Mucor</em>, and <em>Fusarium</em> tend to affect immunocompromised individuals depending on their risk factors<em>. Exserohilum rostratum</em> and <em>Cladophialaphora</em> species tend to infect immunocompetent individuals. Early diagnosis and treatment are imperative for improved outcomes and reduced morbidity and mortality. Clinical presentation is often nonspecific, while neuroimaging can be helpful for accurate diagnosis. CT of the head and/or the maxillofacial structures is the primary imaging modality. Once the infection begins to proliferate, areas of vasogenic and cytotoxic edema, with regional mass effect and shift of the midline structures may be seen. These findings, however, are often nonspecific and may also be seen in underlying neoplasm, inflammatory processes, and other intracranial infections. Characteristic findings on T1, T2, diffusion-weighted imaging (DWI), and gradient echo sequences (GRE) may help to further narrow the differential diagnoses. We present a review of neuroimaging findings that will aid the neuroradiologist in distinguishing intracranial angioinvasive fungal infections and lead to improved patient outcomes.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110306"},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1016/j.clinimag.2024.110305
Rebecca T. Sivarajah , Trevor R. Bean , Alison L. Chetlen
Many benign and malignant breast entities can present with diffuse unilateral magnetic resonance imaging (MRI) findings. The unilateral breast findings can be broken down into three broad categories including asymmetric diffuse masses/non-mass enhancement (NME), diffuse unilateral skin thickening, and diffuse asymmetric background enhancement. Although correlation with clinical history is always necessary, biopsy is often needed to make a definitive diagnosis. There are some findings on MRI which can help narrow the differential including morphology, distribution, T2W signal, enhancement kinetics, and associated skin thickening. Malignant entities which will be discussed in this review include ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, Paget disease, inflammatory breast cancer, and locally advanced breast cancer. Benign entities which will be discussed in this review include idiopathic granulomatous mastitis (IGM), infectious mastitis, pseudoangiomatous stromal hyperplasia, giant fibroadenoma, early and late radiation changes, unilateral breast feeding, and central venous obstruction, all which have varied MRI appearances. It is important for radiologists to be familiar with the common entities that can present with diffuse asymmetric unilateral MRI breast findings to ensure the correct diagnosis and management is undertaken.
{"title":"Diffuse unilateral MRI breast entities","authors":"Rebecca T. Sivarajah , Trevor R. Bean , Alison L. Chetlen","doi":"10.1016/j.clinimag.2024.110305","DOIUrl":"10.1016/j.clinimag.2024.110305","url":null,"abstract":"<div><div>Many benign and malignant breast entities can present with diffuse unilateral magnetic resonance imaging (MRI) findings. The unilateral breast findings can be broken down into three broad categories including asymmetric diffuse masses/non-mass enhancement (NME), diffuse unilateral skin thickening, and diffuse asymmetric background enhancement. Although correlation with clinical history is always necessary, biopsy is often needed to make a definitive diagnosis. There are some findings on MRI which can help narrow the differential including morphology, distribution, T2W signal, enhancement kinetics, and associated skin thickening. Malignant entities which will be discussed in this review include ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, Paget disease, inflammatory breast cancer, and locally advanced breast cancer. Benign entities which will be discussed in this review include idiopathic granulomatous mastitis (IGM), infectious mastitis, pseudoangiomatous stromal hyperplasia, giant fibroadenoma, early and late radiation changes, unilateral breast feeding, and central venous obstruction, all which have varied MRI appearances. It is important for radiologists to be familiar with the common entities that can present with diffuse asymmetric unilateral MRI breast findings to ensure the correct diagnosis and management is undertaken.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110305"},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1016/j.clinimag.2024.110304
Stephen J. Sozio , Arevik Abramyan , Andrew Soliman , Gaurav Gupta , Hai Sun , Emad Nourollah-Zadeh , Sudipta Roychowdhury , Sri Hari Sundararajan
Carotid blowout syndrome (CBS) is a potentially life-threatening complication in patients suffering head and neck cancer, in which rupture of the carotid artery and/or its branches can rapidly lead to life-threatening hemorrhage, shock, and death. CBS is categorized into three subtypes, which are characterized by extent of disease as evidenced by clinical presentation, physical exam findings, and imaging characteristics. Given the high morbidity and mortality associated with CBS, prompt recognition and treatment remains pivotal, as early intervention is associated with longer survival and lower complication rates. In turn, we present an overview of the hallmark imaging findings of CBS through a retrospective review of our institution's findings of these characteristic imaging findings in all patients who underwent evaluation and management of CBS at our facility across a 10-year period.
颈动脉爆裂综合征（CBS）是头颈部癌症患者的一种可能危及生命的并发症，颈动脉和/或其分支破裂可迅速导致大出血、休克和死亡，危及生命。CBS 可分为三个亚型，其特点是根据临床表现、体格检查结果和影像学特征确定的疾病程度。鉴于 CBS 的高发病率和高死亡率，及时识别和治疗仍然至关重要，因为早期干预可延长患者生存期并降低并发症发生率。接下来，我们将通过回顾性分析本机构在 10 年间对所有接受评估和治疗的 CBS 患者的特征性影像学检查结果，概述 CBS 的标志性影像学检查结果。
{"title":"CTA and DSA findings in carotid blowout syndrome: An overview and approach to imaging diagnosis","authors":"Stephen J. Sozio , Arevik Abramyan , Andrew Soliman , Gaurav Gupta , Hai Sun , Emad Nourollah-Zadeh , Sudipta Roychowdhury , Sri Hari Sundararajan","doi":"10.1016/j.clinimag.2024.110304","DOIUrl":"10.1016/j.clinimag.2024.110304","url":null,"abstract":"<div><div>Carotid blowout syndrome (CBS) is a potentially life-threatening complication in patients suffering head and neck cancer, in which rupture of the carotid artery and/or its branches can rapidly lead to life-threatening hemorrhage, shock, and death. CBS is categorized into three subtypes, which are characterized by extent of disease as evidenced by clinical presentation, physical exam findings, and imaging characteristics. Given the high morbidity and mortality associated with CBS, prompt recognition and treatment remains pivotal, as early intervention is associated with longer survival and lower complication rates. In turn, we present an overview of the hallmark imaging findings of CBS through a retrospective review of our institution's findings of these characteristic imaging findings in all patients who underwent evaluation and management of CBS at our facility across a 10-year period.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110304"},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Insight, words of wisdom and advice to the future generations are shared through storytelling and introspection from women radiologists who have personally impacted my own career and journey as a woman radiologist. Through historical data review and self-reported narratives on an electronically submitted questionnaire, noteworthy accomplishments of female radiologists whom I personally know or know through association over the last hundred and twenty-nine years are described, as well as the obstacles they had faced throughout their academic years of training and practice of radiology.
{"title":"Practicing radiology for 1000 years…by women","authors":"Judith Korek Amorosa , Anupriya Barot , Houda Bouhmam , Rebecca Scalabrino , Deborah Reede","doi":"10.1016/j.clinimag.2024.110300","DOIUrl":"10.1016/j.clinimag.2024.110300","url":null,"abstract":"<div><div>Insight, words of wisdom and advice to the future generations are shared through storytelling and introspection from women radiologists who have personally impacted my own career and journey as a woman radiologist. Through historical data review and self-reported narratives on an electronically submitted questionnaire, noteworthy accomplishments of female radiologists whom I personally know or know through association over the last hundred and twenty-nine years are described, as well as the obstacles they had faced throughout their academic years of training and practice of radiology.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110300"},"PeriodicalIF":1.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alzheimer's disease (AD) is a common neurodegenerative disorder that primarily affects older individuals. Due to its high incidence, an accurate and efficient stratification system could greatly aid in the clinical diagnosis and prognosis of AD patients. Convolutional neural networks (CNN) approaches have demonstrated exceptional performance in the automated stratification of AD, mild cognitive impairment (MCI) and cognitively normal (CN) participants using MRI, owing to their high predictive accuracy and reliability. Therefore, we aimed to develop an algorithm based on CNN and radiomic features derived from ROIs of bilateral hippocampus and amygdala in brain MRI for stratification between AD, MCI and CN.
Methods
In this study, we proposed a CNN and radiomic features-based algorithm using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. T1-weighted images were used. We utilized three datasets, including AD (199 cases, 602 images), MCI (200 cases, 948 images), and CN (200 cases, 853 images), to perform binary classification (AD vs. CN, AD vs. MCI, and MCI vs. CN). Finally, we obtained the accuracy (ACC) and the area under the curve of the receiver operating characteristic curve (AUC) to evaluate the performance of the algorithm.
Results
Our proposed algorithm achieved acceptable overall discrimination accuracy. In the term of AD vs CN, radiomic-based algorithm alone obtained ACC of 82.6 % and AUC of 88.8, CNN-based algorithm obtained ACC of 80 % and AUC of 87.2 and their fusion showed ACC of 84.4 % and AUC of 90. In the term of MCI vs CN, radiomic-based algorithm alone obtained ACC of 71.6 % and AUC of 77.8, CNN-based algorithm obtained ACC of 69 % and AUC of 75 and their fusion showed ACC of 72.7 % and AUC of 80. In the term of AD vs MCI, radiomic-based algorithm alone obtained ACC of 57 % and AUC of 57.5, CNN-based algorithm obtained ACC of 56.6 % and AUC of 57.7 and their fusion showed ACC of 58 % and AUC of 59.5.
Conclusion
In conclusion, it has been determined that hippocampus and amygdala-based stratification using CNN features and radiomic features-based algorithm is a promising method for the classification of AD, MCI, and CN participants.
Advances in knowledge
This study proposed an automated procedures based on MRI-derived radiomic features and CNN for classification between AD, MCI and CN.
{"title":"Automated classification of Alzheimer's disease, mild cognitive impairment, and cognitively normal patients using 3D convolutional neural network and radiomic features from T1-weighted brain MRI: A comparative study on detection accuracy","authors":"Amin Zarei , Ahmad Keshavarz , Esmail Jafari , Reza Nemati , Akram Farhadi , Ali Gholamrezanezhad , Habib Rostami , Majid Assadi","doi":"10.1016/j.clinimag.2024.110301","DOIUrl":"10.1016/j.clinimag.2024.110301","url":null,"abstract":"<div><h3>Objectives</h3><p>Alzheimer's disease (AD) is a common neurodegenerative disorder that primarily affects older individuals. Due to its high incidence, an accurate and efficient stratification system could greatly aid in the clinical diagnosis and prognosis of AD patients. Convolutional neural networks (CNN) approaches have demonstrated exceptional performance in the automated stratification of AD, mild cognitive impairment (MCI) and cognitively normal (CN) participants using MRI, owing to their high predictive accuracy and reliability. Therefore, we aimed to develop an algorithm based on CNN and radiomic features derived from ROIs of bilateral hippocampus and amygdala in brain MRI for stratification between AD, MCI and CN.</p></div><div><h3>Methods</h3><p>In this study, we proposed a CNN and radiomic features-based algorithm using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. T1-weighted images were used. We utilized three datasets, including AD (199 cases, 602 images), MCI (200 cases, 948 images), and CN (200 cases, 853 images), to perform binary classification (AD vs. CN, AD vs. MCI, and MCI vs. CN). Finally, we obtained the accuracy (ACC) and the area under the curve of the receiver operating characteristic curve (AUC) to evaluate the performance of the algorithm.</p></div><div><h3>Results</h3><p>Our proposed algorithm achieved acceptable overall discrimination accuracy. In the term of AD vs CN, radiomic-based algorithm alone obtained ACC of 82.6 % and AUC of 88.8, CNN-based algorithm obtained ACC of 80 % and AUC of 87.2 and their fusion showed ACC of 84.4 % and AUC of 90. In the term of MCI vs CN, radiomic-based algorithm alone obtained ACC of 71.6 % and AUC of 77.8, CNN-based algorithm obtained ACC of 69 % and AUC of 75 and their fusion showed ACC of 72.7 % and AUC of 80. In the term of AD vs MCI, radiomic-based algorithm alone obtained ACC of 57 % and AUC of 57.5, CNN-based algorithm obtained ACC of 56.6 % and AUC of 57.7 and their fusion showed ACC of 58 % and AUC of 59.5.</p></div><div><h3>Conclusion</h3><p>In conclusion, it has been determined that hippocampus and amygdala-based stratification using CNN features and radiomic features-based algorithm is a promising method for the classification of AD, MCI, and CN participants.</p></div><div><h3>Advances in knowledge</h3><p>This study proposed an automated procedures based on MRI-derived radiomic features and CNN for classification between AD, MCI and CN.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110301"},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-16DOI: 10.1016/j.clinimag.2024.110302
Yang Xu , Jing Lin , Jin-Mei Gao , Yu Yuan
Objective
To explore the ultrasonographic features and influencing factors of free-floating thrombus (FFT) detachment in the lower extremity deep veins (LEDVs) of patients with fractures.
Methods
Clinical data of patients diagnosed with FFT in the LEDVs and implanted with an inferior vena cava filter (IVCF) in our hospital between July 2021 and August 2023 were retrospectively analysed. The patients were divided into the thrombus detachment group (the experimental group, n = 92) and the non-thrombus detachment group (the control group, n = 103) based on the presence of detached thrombus in the IVCF. The effects of thrombus echogenicity, floating degree, thrombus location, thrombin time, D-dimer and fibrinogen on thrombus shedding were analysed. The nomogram method was used to establish the model and predict the probability of delayed postoperative recovery.
Results
The proportions of patients with extremely hypoechoic thrombus and medium and high floating degrees increased in the experimental group compared with those in the control group, and the differences between the two groups were statistically significant (P < 0.05). Extremely hypoechoic thrombus (P = 0.021, 95 % CI: 1.109–13.748) and high (P = 0.001, 95 % CI: 3.854–28.573) and medium floating degrees (P = 0.004, 95 % CI: 1.792–13.453) were risk factors for deep veins FFT (DV FFT) detachment. The results of receiver operating characteristic curve analysis showed that the area under the curve of the model was 0.893, with a 95 % CI of 0.856–0.937, indicating a high prediction accuracy.
Conclusion
Ultrasonographic parameters, including thrombus echogenicity and floating degree, are valuable in predicting DV FFT detachment in patients with traumatic fractures, providing references for IVCF implantation.
{"title":"Ultrasonographic assessment of the risk of free-floating thrombus detachment in the lower extremity deep veins in patients with fracture","authors":"Yang Xu , Jing Lin , Jin-Mei Gao , Yu Yuan","doi":"10.1016/j.clinimag.2024.110302","DOIUrl":"10.1016/j.clinimag.2024.110302","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the ultrasonographic features and influencing factors of free-floating thrombus (FFT) detachment in the lower extremity deep veins (LEDVs) of patients with fractures.</div></div><div><h3>Methods</h3><div>Clinical data of patients diagnosed with FFT in the LEDVs and implanted with an inferior vena cava filter (IVCF) in our hospital between July 2021 and August 2023 were retrospectively analysed. The patients were divided into the thrombus detachment group (the experimental group, <em>n</em> = 92) and the non-thrombus detachment group (the control group, <em>n</em> = 103) based on the presence of detached thrombus in the IVCF. The effects of thrombus echogenicity, floating degree, thrombus location, thrombin time, D-dimer and fibrinogen on thrombus shedding were analysed. The nomogram method was used to establish the model and predict the probability of delayed postoperative recovery.</div></div><div><h3>Results</h3><div>The proportions of patients with extremely hypoechoic thrombus and medium and high floating degrees increased in the experimental group compared with those in the control group, and the differences between the two groups were statistically significant (<em>P</em> < 0.05). Extremely hypoechoic thrombus (<em>P</em> = 0.021, 95 % <em>CI:</em> 1.109–13.748) and high (<em>P</em> = 0.001, 95 % <em>CI:</em> 3.854–28.573) and medium floating degrees (<em>P</em> = 0.004, 95 % <em>CI:</em> 1.792–13.453) were risk factors for deep veins FFT (DV FFT) detachment. The results of receiver operating characteristic curve analysis showed that the area under the curve of the model was 0.893, with a 95 % CI of 0.856–0.937, indicating a high prediction accuracy.</div></div><div><h3>Conclusion</h3><div>Ultrasonographic parameters, including thrombus echogenicity and floating degree, are valuable in predicting DV FFT detachment in patients with traumatic fractures, providing references for IVCF implantation.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110302"},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0899707124002328/pdfft?md5=d4056d1e4a75a361b939a9c840e5d508&pid=1-s2.0-S0899707124002328-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1016/j.clinimag.2024.110278
Sachin Chitalkar , Dipak Thakor , Ali Sheikhy , Jamie Cole , Sarah Fangmeyer , Fatemeh Nasri , Abdelmonem Ahmed , Ashkan Monfared , Md Reza Taheri
Purpose
The diagnosis of idiopathic intracranial hypertension (IIH) is often challenging in patients who do not present with classic symptoms. Brain MRI can play a pivotal role, as several imaging findings, such as an empty sella appearance (ESA), have been shown to be associated with IIH. Yet, none of the MRI signs have been shown to have a high sensitivity and specificity. In this study, we tested the hypothesis that presence of a geniculate ganglion diverticulum (GGD) is a potential imaging marker for the detection of IIH.
Materials and methods
This is an IRB-approved, single-institution, retrospective, observational study. Brain MRI examinations of patients referred to Radiology by Otology clinic over a period of 10 years were reviewed. 244 MRI exams fulfilling inclusion and exclusion criteria were independently screened for the presence of GGD and ESA by two Neuroradiology fellows. Electronic medical records (EMR) of patients in this study were reviewed for presence of clinical manifestations of IIH. Receiver operator characteristic (ROC) curves were generated to estimate the accuracy of each covariate in diagnosing IIH. The area under each ROC curve (AUC) was calculated to identify an accurate prognostic covariate. Statistical analysis was done using R programming language V 4.2.2.
Results
GGD was identified in MRI exams of 51 patients. A 2:1 propensity score (PS) matching for age, gender, and Body Mass Index (BMI) was used to select non-GGD control group for comparison with the GGD group. There was strong agreement between the 2 reviewers (kappa = 0.81, agreement = 95 %). Twelve patients in this study were diagnosed with IIH. There was a high incidence of GGD (OR = 12.19, 95 % CI (2.56, 58.10)) and ESA (OR = 4.97, 95 % CI (1.47, 16.74)) in IIH patients. The AUC observed in GGD for predicting IIH was 0.771 (0.655–0.888), specificity = 0.709 (0.638–0.780), and sensitivity = 0.833 (0.583–1). The AUC observed for ESA in predicting IIH was 0.682 (0.532–0.831), specificity = 0.780 (0.709–0.844), and sensitivity = 0.583 (0.333–0.833).
Conclusion
GGD is potentially a novel imaging marker of IIH with sensitivity higher than and specificity comparable to that of ESA.
Clinical relevance statement
Presence of GGD should raise the possibility of IIH.
{"title":"Geniculate ganglion diverticulum: a potential imaging marker in patients with idiopathic intracranial hypertension","authors":"Sachin Chitalkar , Dipak Thakor , Ali Sheikhy , Jamie Cole , Sarah Fangmeyer , Fatemeh Nasri , Abdelmonem Ahmed , Ashkan Monfared , Md Reza Taheri","doi":"10.1016/j.clinimag.2024.110278","DOIUrl":"10.1016/j.clinimag.2024.110278","url":null,"abstract":"<div><h3>Purpose</h3><p>The diagnosis of idiopathic intracranial hypertension (IIH) is often challenging in patients who do not present with classic symptoms. Brain MRI can play a pivotal role, as several imaging findings, such as an empty sella appearance (ESA), have been shown to be associated with IIH. Yet, none of the MRI signs have been shown to have a high sensitivity and specificity. In this study, we tested the hypothesis that presence of a geniculate ganglion diverticulum (GGD) is a potential imaging marker for the detection of IIH.</p></div><div><h3>Materials and methods</h3><p>This is an IRB-approved, single-institution, retrospective, observational study. Brain MRI examinations of patients referred to Radiology by Otology clinic over a period of 10 years were reviewed. 244 MRI exams fulfilling inclusion and exclusion criteria were independently screened for the presence of GGD and ESA by two Neuroradiology fellows. Electronic medical records (EMR) of patients in this study were reviewed for presence of clinical manifestations of IIH. Receiver operator characteristic (ROC) curves were generated to estimate the accuracy of each covariate in diagnosing IIH. The area under each ROC curve (AUC) was calculated to identify an accurate prognostic covariate. Statistical analysis was done using R programming language V 4.2.2.</p></div><div><h3>Results</h3><p>GGD was identified in MRI exams of 51 patients. A 2:1 propensity score (PS) matching for age, gender, and Body Mass Index (BMI) was used to select non-GGD control group for comparison with the GGD group. There was strong agreement between the 2 reviewers (kappa = 0.81, agreement = 95 %). Twelve patients in this study were diagnosed with IIH. There was a high incidence of GGD (OR = 12.19, 95 % CI (2.56, 58.10)) and ESA (OR = 4.97, 95 % CI (1.47, 16.74)) in IIH patients. The AUC observed in GGD for predicting IIH was 0.771 (0.655–0.888), specificity = 0.709 (0.638–0.780), and sensitivity = 0.833 (0.583–1). The AUC observed for ESA in predicting IIH was 0.682 (0.532–0.831), specificity = 0.780 (0.709–0.844), and sensitivity = 0.583 (0.333–0.833).</p></div><div><h3>Conclusion</h3><p>GGD is potentially a novel imaging marker of IIH with sensitivity higher than and specificity comparable to that of ESA.</p></div><div><h3>Clinical relevance statement</h3><p>Presence of GGD should raise the possibility of IIH.</p></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110278"},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The O-RADS MRI score stratifies adnexal mass risk with characteristics of T1-weighted, T2-weighed and dynamic contrast-enhanced (DCE) images. We explored a modified approach to evaluate the value of incorporation DWI/ADC with non-DCE-MRI in ORADS scoring system, and to assess the diagnostic performance and interreader consistency in differentiating ovarian neoplasm with different types.
Methods
This retrospective study included 218 women who underwent pelvic MRI with 221 ovarian tumors between January 2017 and December 2021. Two radiologists independently assessed each lesion using the original and modified O-RADS approach (incorporating DWI/ADC with non-DCE). Cohen's weighted-kappa and ROC analyses were employed to assess interreader consistency and diagnostic efficiency across all lesions and three ovarian neoplasms categories.
Results
The area under the ROC curve (AUC) of the original protocol was 0.945 for all lesions and 0.947, 0.992, and 0.758 for the epithelial cell, germ cell and sex cord-stromal neoplasms. The modified approach achieved AUCs of 0.959 for all lesions and 0.962, 0.997, and 0.837 for the three categories. The interreader agreement was ‘excellent’ for all lesions and ‘good’ for the subgroups with the original protocol, improving to ‘excellent’ for all categories with the modified approach.
Conclusion
A modified O-RADS incorporating DWI/ADC with non-DCE MRI yields high diagnostic performance in differentiation of different types of ovarian neoplasms. It further improves consistency in subgroup interpretation. The modified approach can serve as an effective diagnostic tool without DCE, further promoting its adoption in primary hospitals.
{"title":"Assessment of the O-RADS scoring system for the differentiation of different types of ovarian neoplasms: A modified approach with non-DCE-MRI","authors":"Tong Chen , Xujun Qian , Zhi Zhu , Yueyue Zhang , Chaogang Wei , Xiaohong Shen , Caiyuan Zhang , Junkang Shen","doi":"10.1016/j.clinimag.2024.110285","DOIUrl":"10.1016/j.clinimag.2024.110285","url":null,"abstract":"<div><h3>Purpose</h3><div>The O-RADS MRI score stratifies adnexal mass risk with characteristics of T1-weighted, T2-weighed and dynamic contrast-enhanced (DCE) images. We explored a modified approach to evaluate the value of incorporation DWI/ADC with non-DCE-MRI in ORADS scoring system, and to assess the diagnostic performance and interreader consistency in differentiating ovarian neoplasm with different types.</div></div><div><h3>Methods</h3><div>This retrospective study included 218 women who underwent pelvic MRI with 221 ovarian tumors between January 2017 and December 2021. Two radiologists independently assessed each lesion using the original and modified O-RADS approach (incorporating DWI/ADC with non-DCE). Cohen's weighted-kappa and ROC analyses were employed to assess interreader consistency and diagnostic efficiency across all lesions and three ovarian neoplasms categories.</div></div><div><h3>Results</h3><div>The area under the ROC curve (AUC) of the original protocol was 0.945 for all lesions and 0.947, 0.992, and 0.758 for the epithelial cell, germ cell and sex cord-stromal neoplasms. The modified approach achieved AUCs of 0.959 for all lesions and 0.962, 0.997, and 0.837 for the three categories. The interreader agreement was ‘excellent’ for all lesions and ‘good’ for the subgroups with the original protocol, improving to ‘excellent’ for all categories with the modified approach.</div></div><div><h3>Conclusion</h3><div>A modified O-RADS incorporating DWI/ADC with non-DCE MRI yields high diagnostic performance in differentiation of different types of ovarian neoplasms. It further improves consistency in subgroup interpretation. The modified approach can serve as an effective diagnostic tool without DCE, further promoting its adoption in primary hospitals.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110285"},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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