scholarly journals A new tool for assessing Pectus Excavatum by a semi-automatic image processing pipeline calculating the classical severity indexes and a new marker: the Volumetric Correction Index

2021 ◽  
Author(s):  
Rosella Denise Tro'
Keyword(s):  
Image Processing ◽  
Pectus Excavatum ◽  
Volumetric Analysis ◽  
Individual Variability ◽  
Linear Measurements ◽  
Processing Pipeline ◽  
Standard Clinical Practice ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Severity Indexes

Abstract Background In clinical assessment of Pectus Excavatum (PE), the indication to surgery is based not only on symptoms but also on quantitative markers calculated from Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans. According to clinical routine, these indexes are measured manually by radiologists with limited computer support. This process is time consuming and potentially subjected to inaccuracy and individual variability in measurements. Moreover, the existing indexes have limitations, since they are based on linear measurements performed on single slices rather than on volumetric data derived from all the thoracic scans. Results In this paper we present an image processing pipeline aimed at providing radiologists with a computer-aid tool in support of diagnosis of PE patients developed in MATLAB® and conceived for MRI images. This framework has a dual purpose: (i) to automatize computation of clinical indexes with a view to ease and standardize pre-operative evaluation; (ii) to propose a new marker of pathological severity based on volumetric analysis and overcoming the limitations of existing axial slice-based indexes. Final designed framework is semi-automatic, requiring some user interventions at crucial steps: this is realized through a Graphical User Interface (GUI) that simplifies the interaction between the user and the tools. We tested our pipeline on 50 pediatric patients from Gaslini Children’s Hospital and performed manual computation of indexes, comparing the results between the proposed tool and gold-standard clinical practice. Automatic indexes provided by our algorithm have shown good agreement with manual measurements by two independent readers. Moreover, the new proposed Volumetric Correction Index (VCI) has exhibited good correlation with standardized markers of pathological severity, proving to be a potential innovative tool for diagnosis, treatment, and follow-up. Conclusions Our pipeline represents an innovative image processing in PE evaluation, based on MRI images (radiation-free) and providing the clinician with a quick and accurate tool for automatically calculating the classical PE severity indexes and a new more comprehensive marker: the Volumetric Correction Index.

scholarly journals Conservatively treated massive prolapsed discs: a 7-year follow-up

2010 ◽  
Vol 92 (2) ◽  
pp. 147-153 ◽  
Author(s):  
RT Benson ◽  
SP Tavares ◽  
SC Robertson ◽  
R Sharp ◽  
RW Marshall
Keyword(s):  
Clinical Improvement ◽  
Oswestry Disability Index ◽  
Volumetric Analysis ◽  
Herniated Disc ◽  
Poor Correlation ◽  
Mri Scans ◽  
Disc Herniations ◽  
Magnetic Resonance Imaging Mri ◽  
Serial Mri

INTRODUCTION The natural history of a lumbar hernia of the nucleus pulposus (HNP) is not fully known and clear indications for operative intervention cannot be established from the literature. Several studies have shown that the largest discs appear to have the greatest tendency to resolve. The aim of this study was to investigate whether massive prolapsed discs can be safely managed conservatively once clinical improvement has occurred. PATIENTS AND METHODS Thirty-seven patients were studied by clinical assessments and serial magnetic resonance imaging (MRI) over 2 years. Patients had severe sciatica at first, but began to show clinical improvement despite the large disc hernia-tions. Clinical assessment included the Lasegue test and neurological appraisal. The Oswestry Disability Index was used to measure function and changes in function. Serial MRI studies allowed measurement of volume changes of the herniated disc material over a period of time. RESULTS Initial follow-up at an average of 23.2 months revealed that 83% had a complete and sustained recovery at the initial follow-up. Only four patients required a discectomy. The average Oswestry disability index improved from 58% to 15%. Volumetric analysis of serial MRI scans found an average reduction of 64% in disc size. There was a poor correlation between clinical improvement and the extent of disc resolution. CONCLUSIONS A massive disc herniation can pursue a favourable clinical course. If early progress is shown, the long-term prognosis is very good and even massive disc herniations can be treated conservatively.

scholarly journals Regional medical practice variation in high-cost healthcare services

2021 ◽  
Author(s):  
Michael Berger ◽  
Thomas Czypionka
Keyword(s):  
Medical Practice ◽  
Regional Variation ◽  
Multivariate Regression ◽  
Healthcare Services ◽  
Practice Variation ◽  
District Level ◽  
Healthcare Data ◽  
Regional Medical ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

AbstractMagnetic resonance imaging (MRI) is a popular yet cost-intensive diagnostic measure whose strengths compared to other medical imaging technologies have led to increased application. But the benefits of aggressive testing are doubtful. The comparatively high MRI usage in Austria in combination with substantial regional variation has hence become a concern for its policy makers. We use a set of routine healthcare data on outpatient MRI service consumption of Austrian patients between Q3-2015 and Q2-2016 on the district level to investigate the extent of medical practice variation in a two-step statistical analysis combining multivariate regression models and Blinder–Oaxaca decomposition. District-level MRI exam rates per 1.000 inhabitants range from 52.38 to 128.69. Controlling for a set of regional characteristics in a multivariate regression model, we identify payer autonomy in regulating access to MRI scans as the biggest contributor to regional variation. Nevertheless, the statistical decomposition highlights that more than 70% of the regional variation remains unexplained by differences between the observable district characteristics. In the absence of epidemiological explanations, the substantial regional medical practice variation calls the efficiency of resource deployment into question.

scholarly journals A detailed analysis of anatomical plausibility of crossed and uncrossed streamline rendition of the dentato-rubro-thalamic tract (DRT(T)) in a commercial stereotactic planning system

2021 ◽  
Author(s):  
Volker A. Coenen ◽  
Bastian E. Sajonz ◽  
Peter C. Reinacher ◽  
Christoph P. Kaller ◽  
Horst Urbach ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Ground Truth ◽  
Planning System ◽  
Single Subject ◽  
Fiber Structure ◽  
Native Space ◽  
Volume Of Interest ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Abstract Background An increasing number of neurosurgeons use display of the dentato-rubro-thalamic tract (DRT) based on diffusion weighted imaging (dMRI) as basis for their routine planning of stimulation or lesioning approaches in stereotactic tremor surgery. An evaluation of the anatomical validity of the display of the DRT with respect to modern stereotactic planning systems and across different tracking environments has not been performed. Methods Distinct dMRI and anatomical magnetic resonance imaging (MRI) data of high and low quality from 9 subjects were used. Six subjects had repeated MRI scans and therefore entered the analysis twice. Standardized DICOM structure templates for volume of interest definition were applied in native space for all investigations. For tracking BrainLab Elements (BrainLab, Munich, Germany), two tensor deterministic tracking (FT2), MRtrix IFOD2 (https://www.mrtrix.org), and a global tracking (GT) approach were used to compare the display of the uncrossed (DRTu) and crossed (DRTx) fiber structure after transformation into MNI space. The resulting streamlines were investigated for congruence, reproducibility, anatomical validity, and penetration of anatomical way point structures. Results In general, the DRTu can be depicted with good quality (as judged by waypoints). FT2 (surgical) and GT (neuroscientific) show high congruence. While GT shows partly reproducible results for DRTx, the crossed pathway cannot be reliably reconstructed with the other (iFOD2 and FT2) algorithms. Conclusion Since a direct anatomical comparison is difficult in the individual subjects, we chose a comparison with two research tracking environments as the best possible “ground truth.” FT2 is useful especially because of its manual editing possibilities of cutting erroneous fibers on the single subject level. An uncertainty of 2 mm as mean displacement of DRTu is expectable and should be respected when using this approach for surgical planning. Tractographic renditions of the DRTx on the single subject level seem to be still illusive.

scholarly journals Brain atrophy and clinical characteristics predicting SDMT performance in multiple sclerosis: A 10-year follow-up study

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199239
Author(s):  
Cecilie Jacobsen ◽  
Robert Zivadinov ◽  
Kjell-Morten Myhr ◽  
Turi O Dalaker ◽  
Ingvild Dalen ◽  
...  
Keyword(s):  
Clinical Data ◽  
Grey Matter Volume ◽  
Lesion Volume ◽  
Information Processing Speed ◽  
Disability Status ◽  
Mri Scans ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri ◽  
Specific Volumes

Objectives To identify Magnetic Resonance Imaging (MRI), clinical and demographic biomarkers predictive of worsening information processing speed (IPS) as measured by Symbol Digit Modalities Test (SDMT). Methods Demographic, clinical data and 1.5 T MRI scans were collected in 76 patients at time of inclusion, and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. For the primary outcome of analysis, SDMT was used. Results Worsening SDMT at 5-year follow-up was predicted by baseline age, Expanded Disability Status Scale (EDSS), SDMT, whole brain volume (WBV) and T2 lesion volume (LV), explaining 30.2% of the variance of SDMT. At 10-year follow-up, age, EDSS, grey matter volume (GMV) and T1 LV explained 39.4% of the variance of SDMT change. Conclusion This longitudinal study shows that baseline MRI-markers, demographic and clinical data can help predict worsening IPS. Identification of patients at risk of IPS decline is of importance as follow-up, treatment and rehabilitation can be optimized.

scholarly journals Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

2021 ◽  
Author(s):  
Martina Pecoraro ◽  
Stefano Cipollari ◽  
Livia Marchitelli ◽  
Emanuele Messina ◽  
Maurizio Del Monte ◽  
...  
Keyword(s):  
Chest Ct ◽  
Ct Scans ◽  
Imaging Biomarker ◽  
Cross Sectional ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Sectional Analysis ◽  
Ct And Mri ◽  
Interlobular Septal Thickening

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

scholarly journals 3D-Volume Rendering of the Pelvis with Emphasis on Paraurethral Structures Based on MRI Scans and Comparisons between 3D Slicer and OsiriX®

2021 ◽  
Vol 45 (3) ◽  
Author(s):  
C. M. Durnea ◽  
S. Siddiqi ◽  
D. Nazarian ◽  
G. Munneke ◽  
P. M. Sedgwick ◽  
...  
Keyword(s):  
Image Processing ◽  
Secondary Analysis ◽  
Three Dimensional ◽  
3D Models ◽  
Clinical Role ◽  
Cross Sectional ◽  
3D Slicer ◽  
Mri Scans ◽  
3D Volume ◽  
Good Agreement

AbstractThe feasibility of rendering three dimensional (3D) pelvic models of vaginal, urethral and paraurethral lesions from 2D MRI has been demonstrated previously. To quantitatively compare 3D models using two different image processing applications: 3D Slicer and OsiriX. Secondary analysis and processing of five MRI scan based image sets from female patients aged 29–43 years old with vaginal or paraurethral lesions. Cross sectional image sets were used to create 3D models of the pelvic structures with 3D Slicer and OsiriX image processing applications. The linear dimensions of the models created using the two different methods were compared using Bland-Altman plots. The comparisons demonstrated good agreement between measurements from the two applications. The two data sets obtained from different image processing methods demonstrated good agreement. Both 3D Slicer and OsiriX can be used interchangeably and produce almost similar results. The clinical role of this investigation modality remains to be further evaluated.

scholarly journals Magnetic resonance imaging (MRI) scans in patients with dorsal root ganglion stimulation

Pain Practice ◽  
2021 ◽  
Author(s):  
Marco Reining ◽  
Dirk Winkler ◽  
Joachim Boettcher ◽  
Juergen Meixensberger ◽  
Michael Kretzschmar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Resonance Imaging ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

scholarly journals Electrical stimulation to clinically identify position of the lingual nerve: results of 50 subjects with reliability and correlation with MRI

2021 ◽  
Author(s):  
Sanaa Aljamani ◽  
Callum Youngson ◽  
Fadi Jarad ◽  
Francis O’Neill
Keyword(s):  
Third Molar ◽  
Lingual Nerve ◽  
Observer Agreement ◽  
Electrical Nerve Stimulation ◽  
The Third ◽  
Mri Scans ◽  
Tingling Sensation ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Determination

Abstract Purpose Recently we described mapping of the lingual nerve clinically in patients using electrical nerve stimulation. This paper reports results of a larger study with inter- and intra-observer reliability and comparison with positional measurements from magnetic resonance imaging (MRI). Methods In 50 healthy participants, measurements were taken when subjects felt a tingling sensation in the tongue induced by a stimulation probe over the lingual nerve. Three positions were measured in relation to the third molar. Measurement reliability was tested for both inter-observer and intra-observer agreement and positional data of the lingual nerve measured clinically was also compared with nerve position as measured from MRI scans. Results Out of 50 participants, 96 nerves (49 = left/47 = right) were included in the study. The lingual nerve was identified in 90% (87) of this sample. The mean of height of the nerve in points A, B and C were 9.64 mm, 10.77 mm and 12.34 respectively. Inter-and intra-observer agreement was considered to be good to excellent (ICC = 0.8–0.96). Agreement between nerve mapping measured values and MRI measured values was good (ICC < 0.6). Conclusion This technique may prove useful for the clinical determination of lingual nerve position prior to procedures in the third molar region.

scholarly journals Multifocal glioblastoma multiform with “encephalitis-like presentation” : a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Issam Sa’adeh ◽  
Mohamed Jamal Saadh
Keyword(s):  
Vasogenic Edema ◽  
Neurological Deficits ◽  
Herpes Simplex Virus 1 ◽  
Glioblastoma Multiform ◽  
Atypical Clinical Presentation ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
Simplex Virus ◽  
Multifocal Glioblastoma

Abstract Background Glioblastoma multiform is the most common and aggressive type of primary malignant tumor that affects the central nervous system in adults. It clinically presents with seizures, headache, and/or progressive focal neurological deficits. Radiologically, glioblastoma multiform appears as a single distinguishable, large heterogeneous lesion affecting the cerebrum with characteristic central necrosis, marginal enhancement, and surrounding vasogenic edema. This article describes a patient that exhibited an atypical clinical presentation of multifocal glioblastoma multiform with misleading early radiological features that simulated herpetic encephalitis. Results A 66-year-old female that presented with left-sided hemiparesis and left partial motor seizures underwent multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) scans. A cerebrospinal fluid (CSF) polymerase chain reaction (PCR) test was also performed to screen for herpes simplex virus 1 (HSV-1). Conclusions The early stages of glioblastoma may manifest as symptoms typical to encephalitis, which can delay diagnosis and treatment. Therefore, early diagnosis and identification of atypical glioblastoma multiform presentations, as reported in this article, are essential.

scholarly journals Image processing pipeline for synchrotron-radiation-based tomographic microscopy

2010 ◽  
Vol 17 (4) ◽  
pp. 550-559 ◽  
Author(s):  
C. Hintermüller ◽  
F. Marone ◽  
A. Isenegger ◽  
M. Stampanoni
Keyword(s):  
Image Processing ◽  
Synchrotron Radiation ◽  
Processing Pipeline
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