BMC Medical Imaging最新文献

Purpose: The purpose of this study was to assess the structural characteristics of the styloid process (SP) using cone-beam computed tomography (CBCT) examination in patients with maxillofacial diseases. The study aimed to determine the prevalence of elongated styloid process (ESP) and its relationship to gender in the study population. Radiographic records of 498 subjects were evaluated retrospectively. Radiological examinations including measurements of the structure, length, volume, and angulations of styloid process were performed on CBCT images. Males had significantly longer styloid process in both sides than females in the study population and a strong positive linear relationship was found between left and right sides' process length (r = 0.83; p < 0.001). The mean internal oblique angle of styloid process differed between genders, but there were no statistically significant differences in the mean anterior oblique angle. Out of 498 subjects, 62 (24.13%) females and 101 (41.91%) males had elongated left styloid process (≥ 30 mm), while 75 (29.18%) and 90 (37.34%) had right side respectively.

Methods: Radiographic records of 498 subjects were evaluated retrospectively. Radiological examinations including measurements of the structure, length, volume, and angulations of styloid process were performed on CBCT images.

Results: Males had significantly longer styloid process in both sides than females in the study population and a strong positive linear relationship was found between left and right sides' process length (r = 0.83; p < 0.001). The mean internal oblique angle of styloid process differed between genders, but there were no statistically significant differences in the mean anterior oblique angle. Out of 498 subjects, 62 (24.13%) females and 101 (41.91%) males had elongated left styloid process (≥30 mm), while 75 (29.18%) and 90 (37.34%) had right side respectively.

Conclusions: This study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Within the study in 498 subjects in China, it was observed that the males, on average, had significantly longer styloid process and narrower internal oblique angle than females either in left or right side. Around 33% of the study population had ESP.

Background: The objective of this study was to investigate the association between focal breast edema (FBE) and adjacent vessel sign (AVS) with tumor size, histologic grade, lymphovascular invasion, axillary lymph node status, Ki-67 index, and molecular subtype in breast cancer. These findings have provided valuable insights into the biological characteristics and prognosis of mass-type invasive ductal carcinoma (M-IDC).

Methods: We retrospectively included patients with M-IDC between January 2016 and December 2021. FBE was evaluated using T2-weighted sequence. AVS was assessed using maximum-intensity projection images obtained using early dynamic contrast-enhanced magnetic resonance imaging. The breast peritumor score (BPS) was defined as follows: BPS 1, absence of both edema and AVS; BPS 2, AVS without edema; BPS 3, AVS with peritumoral edema; BPS 4, AVS with prepectoral edema; and BPS 5, AVS with subcutaneous edema. The correlation between different BPS scores and clinicopathological variables was examined using Kendall's tau-b correlation coefficient. The DeLong test was used to compare the performances of three clinicopathological models combined with peritumoral features (FBE, AVS, and BPS) in predicting luminal A-like M-IDC.

Results: In 228 patients with M-IDC, BPS was positively correlated with tumor size, histologic grade, lymphovascular invasion, axillary lymph node status, Ki-67 index, and negatively correlated with estrogen receptor expression (all P < 0.05). Furthermore, BPS 1 was more likely to be present in patients with luminal A-like breast cancer (P < 0.001). Among the three prediction models, the clinicopathological model combined with the BPS model demonstrated superior diagnostic performance for luminal A-like breast cancer.

Conclusions: The BPS is a valuable, non-invasive biomarker for assessing the aggressiveness of M-IDC and can facilitate treatment planning.

Background: Current mainstream cardiovascular magnetic resonance-feature tracking (CMR-FT) methods, including optical flow and pairwise registration, often suffer from the drift effect caused by accumulative tracking errors. Here, we developed a CMR-FT method based on deformable groupwise registration with a locally low-rank (LLR) dissimilarity metric to improve myocardial tracking and strain estimation accuracy.

Methods: The proposed method, Groupwise-LLR, performs feature tracking by iteratively updating the entire displacement field across all cardiac phases to minimize the sum of the patchwise signal ranks of the deformed movie. The method was compared with alternative CMR-FT methods including the Farneback optical flow, a sequentially pairwise registration method, and a global low rankness-based groupwise registration method via a simulated dataset (n = 20), a public cine data set (n = 100), and an in-house tagging-MRI patient dataset (n = 16). The proposed method was also compared with two general groupwise registration methods, nD + t B-Splines and pTVreg, in simulations and in vivo tracking.

Results: On the simulated dataset, Groupwise-LLR achieved the lowest point tracking errors (p = 0.13 against pTVreg for the temporally averaged point tracking errors in the long-axis view, and p < 0.05 for all other cases), voxelwise strain errors (all p < 0.05), and global strain errors (p = 0.05 against pTVreg for the longitudinal global strain errors, and p < 0.05 for all other cases). On the public dataset, Groupwise-LLR achieved the lowest contour tracking errors (all p < 0.05), reduced the drift effect in late-diastole, and preserved similar inter-observer reproducibility as the alternative methods. On the patient dataset, Groupwise-LLR correlated better with tagging-MRI for radial strains than the other CMR-FT methods in multiple myocardial segments and levels.

Conclusions: The proposed Groupwise-LLR reduces the drift effect and provides more accurate myocardial tracking and strain estimation than the alternative methods. The method may thus facilitate a more accurate estimation of myocardial strains for clinical assessments of cardiac function.

Background: This study aimed to assess the feasibility and performance of 5.0 T MRI in MR Cholangiopancreatography (MRCP) imaging compared to 3.0 T, focusing on detail visualization, signal-to-noise ratio (SNR), and image artifacts.

Methods: A prospective study from May to October 2023 involved 20 healthy subjects and 19 with biliary dilation. Both groups underwent MRCP using 3.0 T and 5.0 T scanners. The detail visualization capability of the biliary tree and the SNR of the images were quantitatively evaluated. Two experienced MRI diagnostic physicians assessed the image artifacts qualitatively on a scale of 1 to 5. The t-test or Wilcoxon signed-rank test compared the quantitative results of biliary visualization and SNR between 3.0 T and 5.0 T scanners, while the Wilcoxon signed-rank test was used for comparing the level of image artifacts between the two scanners. The inter reader consistency was tested using Kappa test.

Results: In both healthy subjects and those with biliary dilation, the 5.0 T group exhibited significantly higher numbers of biliary tree branches, along with greater total and maximum branch lengths, compared to the 3.0 T group (P<0.05). Although the maximum branch length was higher in the 5.0 T group among healthy subjects, this difference was not statistically significant (P = 0.053). No notable differences were observed in SNR and image artifact levels between the two groups across both field strengths (P>0.05).

Conclusions: MRCP at 5.0 T offers superior biliary tree visualization compared to 3.0 T. The performance regarding SNR and image artifacts between the two is relatively comparable.

Objective: Ductal carcinoma in situ (DCIS) of the breast has a wide disease spectrum with risks of progression to invasive cancer linked to pathological factors. High-grade histology, large tumor volume, and comedonecrosis are adverse prognostic factors. This study explores the correlation between conventional ultrasound (Con-US) and shears wave elastography (SWE) features with DCIS prognostic factors and evaluates their predictive efficacy.

Methods: A retrospective analysis was conducted on clinical data, Con-US, and SWE imaging features of 83 DCIS patients who underwent surgical resection between June 2018 and December 2022. Binary logistic regression analysis was performed to explore the relationship between sonogram indices and pathological prognostic factors.

Results: The results revealed that microcalcification observed on Con-US was an independent risk factor for high-grade DCIS and comedonecrosis [odds ratio (OR): 5.316 and 4.512]. In SWE analysis, the Emax value was significantly different between the non-high-grade and high-grade DCIS groups(P = 0.006), with an Emax value greater than 75.03 kPa identified as an independent risk factor for high-grade DCIS [OR:1.022, the area under the curve (AUC): 0.682, 95% confidence interval (CI): 0.555-0.808]. Additionally, the Ecolor, Emax, Emean, and Emean SD values were statistically different between the groups with and without comedonecrosis (P = 0.049, 0.006, 0.012, 0.022), with an Emean value exceeding 30.45 kPa identified as an independent risk factor for comedonecrosis (OR:1.025, AUC:0.708, 95% CI:0.562-0.854). Furthermore, combining microcalcification on Con-US with specific SWE indicators demonstrated an improved predictive specificity for high-grade DCIS and comedonecrosis (0.902 and 0.889, respectively). No significant difference was found in other indexes on SWE.

Conclusions: The microcalcification signs on Con-US, Emax and Emean values on SWE analysis are associated with the high nuclear grade and comedonecrosis of DCIS, the combination of Con-US and SWE can improve the predictive specificity of DCIS-related prognostic factors.

Background: The study aimed to investigate the predictive value of delta-radiomics derived from computed tomography (CT) for pathological complete response (pCR) to neoadjuvant immunochemotherapy (NICT) among patients with esophageal squamous cell carcinoma (ESCC), helping clinicians determine whether to modify the neoadjuvant treatment strategy, proceed to surgery, or forgo surgery altogether.

Methods: A total of 140 ESCC patients from two institutions (Database 1 = 93; Database 2 = 47) who underwent NICT and surgery were retrospectively included in the study. The training set consisted of patients from Database 1, while the testing set included patients from Database 2. All patients underwent contrast-enhanced CT scans before the start of the treatment and prior to the operation. The delta-radiomics features were calculated as the relative net change of radiomics features between the two-time points. Feature selection was conducted using Pearson correlation analysis, intraclass correlation coefficients, and the fivefold cross-validation with least absolute shrinkage and selection analysis. Four models were established, comprising a clinical model, a pre-treatment radiomics model, a delta-radiomics model, and a mixed model. Area under the curve (AUC) and decision curve analysis were used to assess the performance and the clinical value of the models.

Results: Less than half of the tumors (40/140, 28.6%) showed pCR following NICT. The delta-radiomics model displayed AUC of 0.827 and 0.790 in the training and testing set for predicting pCR, which was superior to the clinical model based on age and clinical tumor node metastasis (cTNM) stage (0.758 and 0.615) and the pre-treatment radiomics model (0.787 and 0.621). Furthermore, the delta-radiomics model demonstrated a more excellent AUC value in the testing set than the mixed model (0.847 and 0.719), which integrated clinical and delta-radiomics features.

Conclusions: The delta-radiomics model exhibited better diagnostic performance in preoperative prediction of pCR for NICT in ESCC patients compared to the clinical, pre-treatment radiomics, and mixed models.

Background: Evaluating myocardial function using cardiac magnetic resonance (CMR) feature tracking provides a comprehensive cardiac assessment, particularly a detailed evaluation for patients with repaired tetralogy of Fallot (rTOF). This study aimed to identify factors associated with arrhythmias in rTOF patients utilizing conventional CMR techniques, including myocardial strain measurements.

Methods: This single-center, retrospective study included 245 rTOF patients who underwent CMR between 2017 and 2023. Patients were stratified based on the presence or absence of arrhythmias during follow-up. The biventricular strain was assessed using CMR-derived feature tracking. Demographic, clinical, and imaging data were collected, and statistical analyses were performed to identify factors associated with arrhythmic events.

Results: The median age at surgery was 5.6 years (range 1-44 years), with the median age at CMR was 27.5 years (range 15-69 years). Over the follow-up period, 25 patients (10.2%) experienced atrial or ventricular arrhythmias. Univariate analysis revealed significant associations between arrhythmic events and older age at surgery and CMR, lower functional class, larger heart size on chest radiograph, and prolonged QRS duration (QRSd). Additionally, arrhythmias were associated with increased right ventricular (RV) volume, reduced RV and left ventricular (LV) ejection fraction (EF), and impaired strain values. Multivariate binary logistic regression, adjusting for age at surgery, NYHA class, QRSd, and cardiothoracic ratio, identified that a lower RV EF (adjusted odds ratio [aOR] 6.97), RV global radial strain (GRS) (aOR 6.68), RV global circumferential strain (GCS) (aOR 6.36), RV global longitudinal strain (GLS) (aOR 3.14), and LV GRS (aOR 3.02) were all significantly associated with arrhythmias.

Conclusion: This study highlights the significant contribution of CMR-derived myocardial strain measurements in predicting arrhythmic events in patients with rTOF. In addition to conventional RV EF, strain metrics-particularly those of the right ventricle- emerged as strong, independent predictors of arrhythmias, offering valuable prognostic information for clinical management in this patient population. These findings underscore the importance of myocardial strain analysis as a complementary tool to conventional imaging in evaluating arrhythmic risk in rTOF patients.

Clinical trial number: Not applicable.

Objective: We aimed to quantitatively analyze the perfusion characteristics of pancreatic neuroendocrine tumors (pNETs) utilizing dual-source CT imaging.

Methods: Dual-source CT perfusion scans were obtained from patients with pNETs confirmed by surgical or biopsy pathology. Perfusion parameters, including blood flow (BF), blood volume (BV), capillary permeability surface (PS), mean transit time (MTT), contrast transit time to the start (TTS), and contrast transit time to the peak (TTP), were statistically analyzed and compared with nearby healthy tissue. Time density curves (TDCs) were plotted to further understand the dynamic enhancement characteristics of the tumors. Additionally, receiver operating characteristic curves (ROCs) were generated to assess their diagnostic value.

Results: Twenty patients with pNETs, containing 26 lesions, were enrolled in the study, including 6 males with 8 lesions and 14 females with 18 lesions. The average values of BF, BV, PS, MTT, TTP and TTS for the 26 lesions (336.61 ± 216.72 mL/100mL/min, 41.96 ± 16.99 mL/100mL, 32.90 ± 11.91 mL/100 mL/min, 9.44 ± 4.40 s, 19.14 ± 5.6 s, 2.57 ± 1.6 s) were different from those of the adjacent normal pancreatic tissue (44.32 ± 55.35 mL/100mL/min, 28.64 ± 7.95 mL/100mL, 26.69 ± 14.88 mL/100 mL/min, 12.89 ± 3.69 s, 20.33 ± 5.18 s, 2.69 ± 1.71 s). However, there were no statistical differences in PS and TTS between the lesions and the adjacent normal pancreatic tissue (P > 0.05). The areas under the ROC curve for BF, BV, and PS were all greater than 0.5, whereas the areas under the ROC curve for MTT, TTP, and TTS were all less than 0.5.

Conclusion: CT perfusion parameters such as BF, BV, MTT, and TTP can distinguish pNETs from healthy tissue. The area under the ROC curve for BF, BV, and PS demonstrates substantial differentiating power for diagnosing pNET lesions.

Myocardial infarction (MI) is a life-threatening medical condition that necessitates both timely and precise diagnosis. The enhancement of automated method to detect MI diseases from Normal patients can play a crucial role in healthcare. This paper presents a novel approach that utilizes the Discrete Wavelet Transform (DWT) for the detection of myocardial signals. The DWT is employed to break down ECG signals into distinct frequency components and subsequently to selectively filter out noise by thresholding the high-frequency details, resulting in denoised ECG signals for myocardial signal detection. These denoised signals are fed into lightweight one-dimensional Convolutional Neural Networks (CNN) for binary classification into Myocardial Infarction (MI) and Normal categories. The paper explores three distinct approaches: utilizing all signals, incorporating under-sampling and up-sampling to address class imbalances, with both noised and denoised signals. Evaluation of the suggested model is done with the help of two publicly available datasets: PTB-XL, a large publicly available electrocardiography dataset and PTB Diagnostic ECG Database. Results obtained through 5-fold cross-validation on the trained model show that the model has achieved an accuracy of 96%, precision of 97% and F1 score of 95%. On cross-validation with the PTB-ECG dataset, this paper achieved an accuracy of 91.18%.

Background: Microvascular ultrasound imaging techniques such as Angio PLanewave UltraSensitive (Angio-PL.U.S.) have been used to detect microvascular blood flow in various organs and tissues. However, the advantage of Angio-PL.U.S. for assessing muscle microvascularity over other non-invasive imaging modalities has not been investigated. This cross-sectional study compared ultrafast Angio-PL.U.S. and conventional color Doppler flow imaging (CDFI) techniques for assessing intramuscular blood perfusion.

Methods: Forty-five older adults participated (age = 59.1 ± 7.6). The vascularity index (VI) was used to quantify intramuscular blood flow of the bilateral biceps brachii (BB) and medial gastrocnemius (MG). Intra-limb (difference in VI between CDFI and Angio-PL.U.S. techniques) and inter-limb differences [percent side-to-side differences (%SSD) in VI between dominant and non-dominant sides] were compared using Wilcoxon Signed Ranks and Mann-Whitney U tests, respectively. Associations between techniques were assessed using Spearman's rho (ρ).

Results: No significant differences were observed between dominant and non-dominant BB (p ≥ 0.053) and MG (p ≥ 0.756) for both CDFI-VI and Angio-PL.U.S.-VI. Only VI measures for the non-dominant BB demonstrated significant intra-limb difference between techniques (p = 0.002). A significant %SSD between techniques was observed for BB (p = 0.022) but not MG (p = 0.225). Strong to very strong correlations were observed between CDFI-VI and Angio-PL.U.S.-VI across all muscles (ρ = 0.616-0.814, p ≤ 0.001).

Conclusion: Ultrafast Angio-PL.U.S. and conventional ultrasound imaging techniques were comparable when used in conjunction with the VI for quantifying resting intramuscular blood flow. Angio-PL.U.S. appeared to be more sensitive in detecting bilateral disparities in upper extremity muscles. However, further research is needed to validate these findings and investigate the potential clinical utility of this technique for characterizing disease progression in populations with global or unilateral musculoskeletal tissue alterations.