scholarly journals Geometric and Volumetric Measurements of Orbital Structures in CT Scans in Thyroid Eye Disease Classification

2021 ◽  
Vol 11 (11) ◽  
pp. 4873
Author(s):  
Yuekun Bao ◽  
Zhihui Zhang ◽  
Cheng Li ◽  
Huan Ma ◽  
Pan Yin ◽  
...  
Keyword(s):  
Extraocular Muscle ◽  
Soft Tissues ◽  
Population Distribution ◽  
Ct Images ◽  
Thyroid Eye Disease ◽  
Ct Scans ◽  
Eye Disease ◽  
Orbital Apex ◽  
The Mean ◽  
Volumetric Measurements

This study examines the usefulness of both geometric and volumetric measurements of orbital soft tissues on CT scans to provide quantitative diagnostic guidance in image reading of thyroid eye disease (TED). Computed tomography (CT) images were obtained from 92 orbits and were classified as impaired motility (TED-IM) and normal motility (TED-NM). The TED-IM group was further divided into dysthyroid optic neuropathy (DON) and non-DON groups. There were 5 volumetric, 2 angular, and 3 ratio parameter measurements acquired from CT images to examine their feasibility in TED classification. We found that the mean volumes of extraocular muscle and retroorbital fat and their ratio to the orbital volume were significantly different between the two motility groups. The mean ratio of extraocular muscle volume in orbital apex and orbital apex volume (EMV-OA/OAV) was significantly larger in DON than non-DON patients (p < 0.05). The population distribution among TED-NM, non-DON, and DON groups significantly varied for different angles between the optic nerve and medial rectus and lateral rectus. In conclusion, geometric and volumetric measurements using CT scans help to quantitatively classify TED.

Correlation Between Extraocular Muscle Size and Motility Restriction in Thyroid Eye Disease

2011 ◽  
Vol 27 (2) ◽  
pp. 102-110 ◽  
Author(s):  
Lora R. Dagi ◽  
Christopher I. Zoumalan ◽  
Hindola Konrad ◽  
Stephen L. Trokel ◽  
Michael Kazim
Keyword(s):  
Extraocular Muscle ◽  
Thyroid Eye Disease ◽  
Muscle Size ◽  
Eye Disease

scholarly journals Extraocular muscle problems in thyroid eye disease

Eye ◽  
1994 ◽  
Vol 8 (5) ◽  
pp. 497-505 ◽  
Author(s):  
Peter Fells ◽  
Linda Kousoulides ◽  
Anastasia Pappa ◽  
Peter Munro ◽  
Joanna Lawson
Keyword(s):  
Extraocular Muscle ◽  
Thyroid Eye Disease ◽  
Eye Disease

scholarly journals A Case of Thyroid Eye Disease Revealed During Secondary Adrenal Insufficiency

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A910-A910
Author(s):  
Amira Ibrahim ◽  
Victoria Loseva
Keyword(s):  
Adrenal Insufficiency ◽  
Extraocular Muscle ◽  
Early Recognition ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Secondary Adrenal Insufficiency ◽  
Movement Restriction ◽  
Free T4 ◽  
Muscle Movement ◽  
Graves Orbitopathy

Abstract Introduction: Thyroid eye disease (TED) or Graves’ orbitopathy (GO) is an autoimmune disease of the retro-orbital tissues. GO is mostly associated with hyperthyroidism in 90% of patients; however, it may coexist with hypothyroid conditions in 5% of cases. Clinical Case: A 56-year-old male with a past medical history of autoimmune diseases including hypothyroidism and Ulcerative Colitis on chronic steroid therapy presented to the emergency department with nausea, fatigue, weight loss, and muscle weakness. The patient stated that his glucocorticoids were abruptly discontinued a month prior to his current presentation. On examination, vitals were stable. The patient was somnolent with a depressed mood. He had bilateral periorbital edema and bilateral eyeball protrusion, left more pronounced than right. Extraocular muscle movement revealed a delay in the lateral movement of the left eye causing double vision on exam. He had no starring look or lid lag. The thyroid gland was normal in size and contour. Initial Laboratories revealed a white blood cell count of 6.7 K/mcL (4-10 K/mcL) with 18% eosinophil count (0-5%). Cortisol at 8 AM was 2.9 mcg/dL (4.3 -22.4 mcg/dl). The patient was managed for secondary adrenal insufficiency and restarted immediately on Prednisone. A review of a recent CT scan of the head revealed bilateral proptosis with no signs of compressing lesions. Further thyroid studies revealed TSH of 2.9 mcIU/mL (0.3-3.7 mcIU/mL), free T4 of 0.8 ng/dL (0.75-2.0 ng/dL), free T3 of 1.6 ng/dL (2.4-4.2 ng/dL), TPO antibodies &lt;0.3 IU/mL (0.0-9.0 IU/mL) and TSH receptor antibodies 0.90 IU/L (reference range &lt;1.75 IU/L). The patient was then diagnosed with Hypothyroid Grave’s ophthalmopathy with negative antibodies given the evidence of proptosis on CT and exam revealing extraocular muscle movement restriction causing diplopia. The patient had a unique presentation of TED with hypothyroidism and asymmetric ophthalmic signs that were only manifested after the patient discontinued the prednisone and therefore unmasking the underlying disorder. Fortunately, in June of 2020, the US Food and Drug Administration (FDA) approved Teprotumumab (an insulin-like growth factor 1 [IGF-1] receptor inhibitor) for the treatment of Graves’ orbitopathy based on the findings from two 24-week trials comparing teprotumumab with placebo in 171 patients with active, moderate-to-severe orbitopathy. (1) Our patient was started on Levothyroxine along with Prednisone and referred for ophthalmology evaluation for possible qualification for Teprotumumab treatment. Conclusion: Clinician awareness of the unusual presentations of TED would allow for early recognition and prevention of progression, especially with the recently approved treatment modality. References: (1) Teprotumumab for Thyroid-Associated Ophthalmopathy. Smith TJ Et al. N Engl J Med. 2017;376(18):1748.

False diagnosis of orbital apex tumor by CAT scan in thyroid eye disease

1977 ◽  
Vol 1 (4) ◽  
pp. 397-398 ◽  
Author(s):  
John O. Susac ◽  
Albert N. Martins ◽  
Bernard Robinson ◽  
Domenic F. Corrigan
Keyword(s):  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Orbital Apex ◽  
Cat Scan ◽  
False Diagnosis

scholarly journals Teprotumumab for the treatment of chronic thyroid eye disease

Eye ◽  
2021 ◽  
Author(s):  
Shoaib Ugradar ◽  
Julia Kang ◽  
Andrea L. Kossler ◽  
Erin Zimmerman ◽  
Jenna Braun ◽  
...  
Keyword(s):  
Volumetric Analysis ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Soft Tissue Volume ◽  
Before And After ◽  
The Mean ◽  
Clinically Significant ◽  
Fat Volume ◽  
Post Therapy ◽  
Orbital Soft Tissue

Abstract Background Teprotumumab, a novel IGF-1R antibody was recently shown to significantly reduce the signs of active Thyroid eye disease (TED). The current study reviews its efficacy in chronic TED. Methods In this retrospective review, consecutive patients with chronic stable TED (>2 years), who had received ≥3 infusions of teprotumumab were included. All patients had measurements of proptosis, and calculation of the CAS and diplopia scores before and after therapy. Five-point strabismus scores were also calculated. Patients who had imaging within 4 months prior to therapy and 6 weeks post therapy underwent orbital 3D volumetric analysis. Results Thirty-one patients met the inclusion criteria. The mean (SD) duration of TED was 81 months (56) and the mean (SD) number of infusions received by each patient was 7 (2). Mean (SD) reduction in proptosis for each study orbit was 3.5 mm (0.4) and 3 mm (0.3) for the fellow orbit. The CAS response was 90% for the study orbit and 87% for the fellow orbit. Of the 15 patients who had diplopia at baseline, 67% had a clinically significant response, while 47% had complete resolution following treatment. Following teprotumumab, mean (SD) reduction of muscle tissue was 2011 mm3 (1847) in the study orbit and 1620 mm3 (1759) in the fellow orbit. The mean (SD) reduction of fat volume was 2101 mm3 (1681) in the study orbit and 1370 mm3 (1181) in the fellow orbit. Conclusion Teprotumumab significantly reduces proptosis, inflammation, diplopia, strabismus and orbital soft tissue volume in patients with chronic TED.

scholarly journals Brain CT registration using hybrid supervised convolutional neural network

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hongmei Yuan ◽  
Minglei Yang ◽  
Shan Qian ◽  
Wenxin Wang ◽  
Xiaotian Jia ◽  
...  
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Soft Tissues ◽  
Ct Images ◽  
Registration Accuracy ◽  
Visual Evaluation ◽  
Normalized Mutual Information ◽  
Brain Ct ◽  
Visual Spatial ◽  
The Mean

Abstract Background Image registration is an essential step in the automated interpretation of the brain computed tomography (CT) images of patients with acute cerebrovascular disease (ACVD). However, performing brain CT registration accurately and rapidly remains greatly challenging due to the large intersubject anatomical variations, low resolution of soft tissues, and heavy computation costs. To this end, the HSCN-Net, a hybrid supervised convolutional neural network, was developed for precise and fast brain CT registration. Method HSCN-Net generated synthetic deformation fields using a simulator as one supervision for one reference–moving image pair to address the problem of lack of gold standards. Furthermore, the simulator was designed to generate multiscale affine and elastic deformation fields to overcome the registration challenge posed by large intersubject anatomical deformation. Finally, HSCN-Net adopted a hybrid loss function constituted by deformation field and image similarity to improve registration accuracy and generalization capability. In this work, 101 CT images of patients were collected for model construction (57), evaluation (14), and testing (30). HSCN-Net was compared with the classical Demons and VoxelMorph models. Qualitative analysis through the visual evaluation of critical brain tissues and quantitative analysis by determining the endpoint error (EPE) between the predicted sparse deformation vectors and gold-standard sparse deformation vectors, image normalized mutual information (NMI), and the Dice coefficient of the middle cerebral artery (MCA) blood supply area were carried out to assess model performance comprehensively. Results HSCN-Net and Demons had a better visual spatial matching performance than VoxelMorph, and HSCN-Net was more competent for smooth and large intersubject deformations than Demons. The mean EPE of HSCN-Net (3.29 mm) was less than that of Demons (3.47 mm) and VoxelMorph (5.12 mm); the mean Dice of HSCN-Net was 0.96, which was higher than that of Demons (0.90) and VoxelMorph (0.87); and the mean NMI of HSCN-Net (0.83) was slightly lower than that of Demons (0.84), but higher than that of VoxelMorph (0.81). Moreover, the mean registration time of HSCN-Net (17.86 s) was shorter than that of VoxelMorph (18.53 s) and Demons (147.21 s). Conclusion The proposed HSCN-Net could achieve accurate and rapid intersubject brain CT registration.

scholarly journals Minimization of Extraocular Muscle Damage in Thyroid Eye Disease Patients Following Surgery Based on Computerized Biomechanics

2021 ◽  
Author(s):  
Byeong-Cheol Jeong ◽  
Chi-Seung Lee ◽  
Dong-man Ryu ◽  
Jungyul Park
Keyword(s):  
Finite Element ◽  
Stress Reduction ◽  
Extraocular Muscle ◽  
Reduction Rate ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Element Analysis ◽  
Orbital Wall

Abstract Background To evaluate the risk of general orbital decompression in patients with thyroid eye disease (TED).Methods In this study, we replicated the behavior of intraorbital tissue in patients with TED based on finite element analysis. The orbit and intraorbital tissues of TED patient who underwent orbital decompression were modeled as finite element models. The stress was examined at a specific location of the removed orbital wall of a patient with TED who had undergone orbital decompression, and its variation was investigated and analyzed as a function of the shape and dimension (to be removed).Results In orbital decompression surgery which removes the orbital wall in a rectangular shape, the stress at the orbital wall decreased as the width and depth of the removed orbital wall increased. In addition, the stress of the non-chamfered model (a form of general orbital decompression) was higher than that of the chamfered model. Especially, in the case of orbital decompression, it can be seen that the chamfered model compared to the non-chamfered model have the stress reduction rate from 11.08% to 97.88%.Conclusions It is inferred that if orbital decompression surgery considering the chamfered model is performed on an actual TED patient, it is expected that the damage to the extraocular muscle caused by the removed orbital wall will be reduced.

Extraocular Muscle Volumetry for Assessment of Thyroid Eye Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Georgios Bontzos ◽  
Efrosini Papadaki ◽  
Michael Mazonakis ◽  
Thomas G. Maris ◽  
Nikolaos G. Tsakalis ◽  
...  
Keyword(s):  
Extraocular Muscle ◽  
Thyroid Eye Disease ◽  
Eye Disease
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