scholarly journals Improved CT-detection of acute bowel ischemia using frequency selective non-linear image blending

2017 ◽  
Vol 6 (7) ◽  
pp. 205846011771822
Author(s):  
Sven Schneeweiss ◽  
Michael Esser ◽  
Wolfgang Thaiss ◽  
Hans Boesmueller ◽  
Hendrik Ditt ◽  
...  
Keyword(s):  
Multidetector Ct ◽  
Imaging Modality ◽  
Bowel Ischemia ◽  
Diagnostic Efficacy ◽  
Image Blending ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Non Linear ◽  
Frequency Selective ◽  
Bowel Segments

Background Computed tomography (CT) as a fast and reliable diagnostic technique is the imaging modality of choice for acute bowel ischemia. However, diagnostic is often difficult mainly due to low attenuation differences between ischemic and perfused segments. Purpose To compare the diagnostic efficacy of a new post-processing tool based on frequency selective non-linear blending with that of conventional linear contrast-enhanced CT (CECT) image blending for the detection of bowel ischemia. Material and Methods Twenty-seven consecutive patients (19 women; mean age = 73.7 years, age range = 50–94 years) with acute bowel ischemia were scanned using multidetector CT (120 kV; 100–200 mAs). Pre-contrast and portal venous scans (65–70 s delay) were acquired. All patients underwent surgery for acute bowel ischemia and intraoperative diagnosis as well as histologic evaluation of explanted bowel segments was considered “gold standard.” First, two radiologists read the conventional CECT images in which linear blending was adapted for optimal contrast, and second (three weeks later) the frequency selective non-linear blending (F-NLB) image. Attenuation values were compared, both in the involved and non-involved bowel segments creating ratios between unenhanced and CECT. Results The mean attenuation difference between ischemic and non-ischemic wall in the portal venous scan was 69.54 HU (reader 2 = 69.01 HU) higher for F-NLB compared with conventional CECT. Also, the attenuation ratio between contrast-enhanced and pre-contrast CT data for the non-ischemic walls showed significantly higher values for the F-NLB image (CECT: reader 1 = 2.11 (reader 2 = 3.36), F-NLB: reader 1 = 4.46 (reader 2 = 4.98)]. Sensitivity in detecting ischemic areas increased significantly for both readers using F-NLB (CECT: reader 1/2 = 53%/65% versus F-NLB: reader 1/2 = 62%/75%). Conclusion Frequency selective non-linear blending improves detection of bowel ischemia compared with conventional CECT by increasing attenuation differences between ischemic and perfused segments.

scholarly journals EXTH-30. EXPANDING THE UTILITY OF PRE-CLINICAL CONTRAST ENHANCED CT (CE-CT) FOR TUMOR DETECTION IN ORTHOTOPIC GBM MODELS USING RADIOMICS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii93-ii93
Author(s):  
Kate Connor ◽  
Emer Conroy ◽  
Kieron White ◽  
Liam Shiels ◽  
William Gallagher ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Texture Features ◽  
Tumor Detection ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Enhanced Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Work Supports ◽  
Selection Of

Abstract Despite magnetic resonance imaging (MRI) being the gold-standard imaging modality in the glioblastoma (GBM) setting, the availability of rodent MRI scanners is relatively limited. CT is a clinically relevant alternative which is more widely available in the pre-clinic. To study the utility of contrast-enhanced (CE)-CT in GBM xenograft modelling, we optimized CT protocols on two instruments (IVIS-SPECTRUM-CT;TRIUMPH-PET/CT) with/without delivery of contrast. As radiomics analysis may facilitate earlier detection of tumors by CT alone, allowing for deeper analyses of tumor characteristics, we established a radiomic pipeline for extraction and selection of tumor specific CT-derived radiomic features (inc. first order statistics/texture features). U87R-Luc2 GBM cells were implanted orthotopically into NOD/SCID mice (n=25) and tumor growth monitored via weekly BLI. Concurrently mice underwent four rounds of CE-CT (IV iomeprol/iopamidol; 50kV-scan). N=45 CE-CT images were semi-automatically delineated and radiomic features were extracted (Pyradiomics 2.2.0) at each imaging timepoint. Differences between normal and tumor tissue were analyzed using recursive selection. Using either CT instrument/contrast, tumors > 0.4cm3 were not detectable until week-9 post-implantation. Radiomic analysis identified three features (waveletHHH_firstorder_Median, original_glcm_Correlation and waveletLHL_firstorder_Median) at week-3 and -6 which may be early indicators of tumor presence. These features are now being assessed in CE-CT scans collected pre- and post-temozolomide treatment in a syngeneic model of mesenchymal GBM. Nevertheless, BLI is significantly more sensitive than CE-CT (either visually or using radiomic-enhanced CT feature extraction) with luciferase-positive tumors detectable at week-1. In conclusion, U87R-Luc2 tumors > 0.4cm3 are only detectable by Week-8 using CE-CT and either CT instrument studied. Nevertheless, radiomic analysis has defined features which may allow for earlier tumor detection at Week-3, thus expanding the utility of CT in the preclinical setting. Overall, this work supports the discovery of putative prognostic pre-clinical CT-derived radiomic signatures which may ultimately be assessed as early disease markers in patient datasets.

scholarly journals Role of Computed Tomography Scan in the Evaluation of Pancreatic Lesions

2021 ◽  
Vol 10 (11) ◽  
pp. 819-824
Author(s):  
Sharvari Shashikant Gulve ◽  
Pratapsingh Hanumantsingh Parihar ◽  
Rajasbala Pradeep Dhande
Keyword(s):  
Computed Tomography ◽  
Chronic Pancreatitis ◽  
Ct Scan ◽  
Clinical Laboratory ◽  
Imaging Modality ◽  
High Morbidity ◽  
Pancreatic Lesion ◽  
Diagnostic Modality ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

BACKGROUND Pancreatic lesions range from inflammation to malignancy and are associated with high morbidity and mortality. Imaging pancreatic lesion is challenging as pancreas is located retroperitoneally and with close proximity to bowel and major blood vessels. Abdominal pain, vomiting, and nausea are commonly reported symptoms. They are associated with high morbidity. Multi detector computed tomography (MDCT) is the modality of choice for detecting pancreatic pathology. It is highly sensitive in detecting necrosis, pancreatitis, peripancreatic fluid collections, calcification, neoplasm, pancreatic enlargement, atrophy and cystic lesions of pancreas. Computed tomography (CT) scan has made it possible to identify and detect various benign and malignant pancreatic lesions. METHODS A prospective observational study of 180 patients with complaints suggestive of pancreatic disease was done based on clinical, laboratory and ultrasonography in the Department of Radiodiagnosis, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe). Siemens Somatom 16 slice CT scan machine was used. All 180 patients underwent plain and contrast enhanced CT scan. RESULTS Out of 180 study participants 105 (58.33 %) were with acute pancreatitis followed by 43 (23.89 %) with chronic pancreatitis, 21 (11.67 %) with acute exacerbation of chronic pancreatitis, 10 (5.56 %) participants with carcinoma pancreas and 1 (0.56 %) participant with pancreatic injury participated in the study. CONCLUSIONS Contrast enhanced computed tomography (CECT) is an excellent diagnostic modality to stage severity of inflammatory process, staging of neoplastic lesions and traumatic injury. It is most accurate and affordable non-invasive imaging modality for the evaluation of pancreatic lesions. It is a standard investigation to identify and quantify distribution of various pancreatic lesions and also evaluates activeness and progression of disease. Thus, it helps in accurate diagnosis and characterization of lesion and in proper treatment of patients. KEY WORDS Pancreas, Imaging, Computed Tomography

Comparison of Contrast-Enhanced CT, PET/CT, PET, and Low-Dose Non-Contrast Enhanced CT Imaging of Diffuse Large B-Cell, Follicular, Small Lymphocytic/CLL, and Marginal Zone Lymphomas.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1402-1402 ◽  
Author(s):  
Elise A. Chong ◽  
Drew A. Torigian ◽  
Abass Alavi ◽  
Jakub Svoboda ◽  
Anthony R Mato ◽  
...  
Keyword(s):  
Pet Imaging ◽  
Low Dose ◽  
Imaging Modality ◽  
Ct Imaging ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Enhanced Ct ◽  
Ct Studies

Abstract Abstract 1402 Poster Board I-424 Introduction: Anatomic imaging using contrast-enhanced computed tomography (CT) is essential for management of lymphomas. Functional imaging using 18FDG-PET (PET) improves detection of certain lymphomas, specifically, diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Currently, PET imaging is performed with co-registration of low-dose non-contrast enhanced CT images used for anatomic correlation and attenuation correction of PET images (PET/CT). It has been suggested that the low-dose non-enhanced CT cannot substitute for diagnostic contrast-enhanced CT imaging since the arterial and venous phases of contrast enhancement improve detection of lesions. Given the differential sensitivity for detection of specific lymphomas by PET imaging, we hypothesized that FDG could substitute for intravenous contrast in imaging of certain lymphomas, and that PET/CT or PET imaging could potentially obviate the need for contrast-enhanced CT. To test this hypothesis, we performed an independent and blinded radiology review of these imaging studies in patients (pts) with DLBCL, FL, small lymphocytic lymphoma/chronic lymphocytic leukemia (CLL/SLL) or marginal zone lymphoma (MZL) who had contrast-enhanced CT, PET, PET/CT, and low-dose non-enhanced CT available for retrospective review. Patients and Methods: Pts with a diagnosis of DLBCL, FL, CLL/SLL, or MZL with PET/CT and contrast-enhanced CT studies performed at the Hospital of the University of Pennsylvania within 6 weeks of each other without intervening therapy were studied. Pts with clinically suspected progression of lymphoma between studies were excluded. Radiologists, blinded to clinical information or other imaging results, separately interpreted image sets of low-dose non-enhanced CT, PET, fusion PET/CT, and contrast-enhanced CT studies. The presence or absence of disease at 44 nodal and 48 (female) or 49 (male) extranodal sites was recorded for each site for each imaging modality. Concordant findings across imaging modalities were defined as positive for involvement by lymphoma; discordant findings were reconciled using all available clinical and radiologic information with follow-up for progression or regression of abnormality, or by biopsy. Results: Between May 2006 and January 2008, 55 pts with either DLBCL (n=31), FL (n=13), CLL/SLL (n=5), or MZL (n=6) had complete images sets available for review. All patients had at least 18 months of clinical follow-up after imaging. A total of 282 sites met criteria for involvement by lymphoma. The rates of detection for specific lymphomas by each imaging modality are shown below: Conclusions: Our results suggest that combined PET/CT imaging is more sensitive than contrast-enhanced CT imaging for detection of DLBCL and at least as sensitive as contrast-enhanced CT imaging for detection of FL. In comparison, contrast-enhanced CT imaging appears superior to PET/CT imaging for CLL/SLL; while further studies are needed to confirm superiority of contrast-enhanced CT imaging in MZL. The routine use of both contrast enhanced CT and PET/CT modalities for staging of lymphoma may be unnecessary, potentially increasing both the cost of medical care and radiation exposure. Additional studies are needed to determine which imaging modality is optimal for each type of lymphoma. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Orocutaneous Fistula or Traumatic Infectious Skin Lesion: A Diagnostic Dilemma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mayank Vermani ◽  
Vimal Kalia ◽  
Sumita Singh ◽  
Sunny Garg ◽  
Shweta Aggarwal ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Treatment Plan ◽  
Diagnostic Dilemma ◽  
Volume Imaging ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Dental Origin ◽  
3D Volume ◽  
The Impact

Orocutaneous fistula (OCF) (of dental origin) is an uncommon but well-described condition in the literature. These are often misdiagnosed by physicians and dentists. Careful selection of investigating modality is important in case of diagnostically challenging cases. A 19-year-old female came with a complaint of a lesion on the chin reported with h/o trauma with the impact on chin presented as diagnostic dilemma because of unusual case history and clinical examination. Commonly used radiographic investigations like IOPA and orthopantomograph did not resolve the dilemma whereas advanced imaging modality like CT scan, 3D volume imaging, and contrast enhanced CT played an important role in the diagnosis of OCF and selecting the treatment plan.

Computed tomographic and histological findings of Hansen type I intervertebral disc herniation in dogs

2013 ◽  
Vol 26 (05) ◽  
pp. 379-384 ◽  
Author(s):  
C. L. Vitale ◽  
S. C. Essman ◽  
P. Pithua ◽  
J. R. Coates ◽  
K. Kuroki
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Imaging Modality ◽  
Thoracolumbar Spine ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Type I ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

SummaryObjective: To evaluate whether noncontrast-enhanced computed tomography (CT) as a stand-alone imaging modality can be used to define the Hansen type I intervertebral disc herniation (IVDH) lesion and also whether the Hounsfield unit (HU) value of herniated disc is relevant to clinical duration and to histopathological chronicity of extruded disc material.Methods: Information from a series of CT studies performed on 45 dogs with a presumptive diagnosis of Hansen type I IVDH was used. Clinical duration of IVDH was estimated based on time from onset of signs per owner communication to time of surgical intervention. Hansen type I IVDH was confirmed at surgery. Retrieved herniated disc was histologically examined. The HU values were analyzed to correlate the clinical duration and histopathological chronicity of the disc lesion.Results: Non-contrast-enhanced CT provided sufficient diagnostic information to plan surgery in 42 of 45 dogs (93%). The value of the HU was significantly higher in clinically chronic cases (n = 12) compared to peracute cases (n = 11) (p <0.05). The HU values were significantly correlated with clinical duration (r = 0.482, p = 0.0008) and histopathological chronicity of the herniated disc (r = 0.408, p = 0.0056).Conclusion: Consistent with the previous reports, the use of non-contrast-enhanced CT alone was sufficient for the diagnosis and surgical planning in most patients with Hansen type I IVDH in the thoracolumbar spine. In addition, the present study suggested that HU values on CT images may be useful in the evaluation of disease chronicity of IVDH.

scholarly journals ROLE OF MULTI-SLICE SPIRAL CT IN EVALUATION OF NECK MASS WITH CYTOLOGICAL CORRELATION

2020 ◽  
pp. 11-13
Author(s):  
Das Runa ◽  
Aniruddha Ghosh
Keyword(s):  
Computed Tomography ◽  
Imaging Modality ◽  
Spiral Ct ◽  
Neck Mass ◽  
Display Time ◽  
Neck Masses ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Anatomical Localization

Abstract: The swellings in the neck can be caused by innumerable pathological lesions arising from the various anatomical structures lying therein. Multi-Detector CT (MDCT) has now become the new standard in a radiological imaging modality. The utilization of MDCT has resulted in improved resolution and considerable reductions in scan acquisition and display time. Aim and Objective: This study is an effort to assess the role of MDCT in detection, characterization and diagnosing neck pathologies that correlate cytologically. Material and Methods: A study of 50 cases in a clinically suspected neck mass was studied for 1 year. Contrast-enhanced Ct neck was done and Specific CT criteria were used to characterize the mass so that a probable diagnosis could be made. MDCT diagnoses then compared with cytological results to conclude the efficiency of MDCT analysis of neck mass. Conclusion: Multi-detector computed tomography helps in precise anatomical localization and characterization of neck masses. Hence, it will be a method of choice for initial evaluation, preoperative planning, and biopsy targeting and postoperative follow-up. Key Words: Neck mass; Cervical lymph node; Computed tomography; Carcinoma.

scholarly journals Association of Contrast-Enhanced CT Findings with Etiology and Outcome in Patients with Portal Venous Gas and Pneumatosis Intestinalis: A Single Center Case Series Study

2021 ◽  
Author(s):  
Naohiro Yoshida ◽  
Yoshihiko Sadakari ◽  
Kazuhito Tamehiro ◽  
Kazuma Ohkawara ◽  
Hiroyuki Nakane ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pneumatosis Intestinalis ◽  
Bowel Ischemia ◽  
Portal Venous Gas ◽  
Ct Findings ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Relationship ◽  
Group 1

Abstract Background: Contrast-enhanced computed tomography (CT) is a reliable diagnostic tool often used to investigate the etiology of portal venous gas (PVG) and pneumatosis intestinalis (PI). However, there are few reports that offer an analysis of the relationship between particular CT findings and clinical outcomes. In this paper, we sought to close that gap and present the results of our analyses that reveal which CT findings are correlated with life-threatening cases.Methods: 39 patients were diagnosed with PVG or PI from contrast-enhanced CT scans and underwent treatment at St. Mary’s Hospital from January 2009 to December 2018. We reviewed patients’ medical charts, laboratory data, and CT scan images retrospectively. We defined cases resulting in operation or death as group 1, and patients with conservative treatment who survived as group 2. We then analyzed the relationship between each CT finding and clinical feature.Results: The primary underlying diseases identified for PVG and PI were bowel ischemia (13/39), enteritis (9/39), constipation (5/39), iatrogenic disease (4/39), and hemodialysis (3/39). Poor enhancement of the intestinal wall and extrahepatic venous gas were correlated with bowel ischemia (p=0.0002 and p=0.0003, respectively). Free air was less correlated with bowel ischemia (p=0.02). Wall thickness was correlated with enteritis (p=0.02). Mortality in cases with bowel ischemia and perforation was quite high (60%) even if patients underwent surgery (33.3%). Conversely, patients with enteritis, constipation, hemodialysis and gastric dilatation who did not require surgery resulted in more favorable outcomes with conservative treatment. In the multivariate analysis, extra hepatic venous gas was the only solitary factor correlated with group 1 (p=0.0008).Conclusions: Extra hepatic venous gas was the strongest predictive factor of clinical outcome in contrast-enhanced CT findings correlated with bowel ischemia and required surgical treatment. The other CT findings were useful in diagnosing the underlying disease, but were not correlated with clinical outcomes. The necessity for surgical treatment remains dependent on the root cause.

scholarly journals The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

2019 ◽  
pp. 4407-4410
Author(s):  
Farideh Gharekhanloo ◽  
Masoud Esnaashari
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multidetector Ct ◽  
Contrast Enhanced Ct ◽  
Technological Advances ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

Adhesion band is a major cause of small bowel obstruction. Traditionally, the obtained results of computed tomography (CT) scan were indicative of adhesion band as an etiology for small bowel obstruction. However, adhesion is easily diagnosed today due to technological advances in radiology and high-quality multidetector CT. It is important to avoid the possible complications of bowel obstruction in the early and appropriate surgical intervention. This article is a report of a 45-year-old woman with abdominal pain and history of previous abdominal surgery. A contrast-enhanced CT scan showed multiple adhesion bands ensued the abrupt narrowing of bowel diameter and closed small-bowel loops obstruction. Furthermore, multiple bands were clearly observed and adhesiolysis was performed in the surgery.

scholarly journals Hemoperitoneum from Corpus Luteal Cyst Rupture: A Practical Approach in Emergency Room

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Valeria Fiaschetti ◽  
Aurora Ricci ◽  
Angela Lia Scarano ◽  
Valeria Liberto ◽  
Daniele Citraro ◽  
...  
Keyword(s):  
Corpus Luteum ◽  
Imaging Modality ◽  
Delayed Diagnosis ◽  
Reproductive Age ◽  
Acquisition Time ◽  
Ultrasound Study ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Acute Pelvic Pain ◽  
Cyst Rupture

Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women’s fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS) is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT) is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI) nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images limit its usefulness in characterization of acute gynecological complications. We report a case of a young patient with hemoperitoneum from hemorrhagic corpus luteum correctly identified by transabdominal USS and contrast-enhanced CT.

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