radiological imaging
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2022 ◽  
Vol 15 (1) ◽  
pp. 101279
Martin Metzenmacher ◽  
Balazs Hegedüs ◽  
Jan Forster ◽  
Alexander Schramm ◽  
Peter A. Horn ◽  

Angelo Della Corte ◽  
Ettore Di Gaeta ◽  
Stephanie Steidler ◽  
Francesco De Cobelli

Cholangiocarcinoma (CC) is a malignancy with a very heterogeneous spectrum of morphopathological and prognostic characteristics. Diagnostic imaging is fundamental for early detection, preoperative staging, and resectability assessment, as well as early recognition of prognostic factors. Radical surgical treatment is limited by disease stage and technical feasibility. Interventional radiology has acquired a critical function in addressing disease control and survival improvement through loco-regional therapies, specifically in the setting of intrahepatic CC. In this review, we will describe the current state of art of diagnostic imaging, focusing on intrahepatic CC and proximal extrahepatic CC, and delineate the available loco-regional therapies strategies for unresectable intrahepatic CC.

Dawood Ahmad Dar

Abstract: COVID-19 seems to be the most devastating and lethal illness characterized by an unique coronavirus for the human body. Coronavirus, which is considered to have originated in Wuhan, China, and is responsible for a huge number of deaths, spread swiftly around the world in December 2019. Early discovery of COVID-19 by proper diagnosis, especially in situations with no evident symptoms, could reduce the death rate of patients. The primary diagnostic tools for this condition are chest Xrays and CT scans. COVID-19 may be detected using a machine vision technique from chest X-ray pictures and CT scans, according to this study.The model's performance was evaluated using generalised data throughout the testing step. According to recent studies gained using radiological imaging techniques, such images convey crucial data about the COVID-19 virus. This proposed approach, which makes use of modern artificial intelligence (AI) techniques, has shown to be effective in recognising COVID-19, and when combined with radiological imaging, can aid in the correct detection of this disease. The proposed approach was created in order to provide accurate assessments for COVID and non-COVID patients.The results demonstrate that VGG-16 is the best architecture for the reference dataset, with 98.87 percent accuracy in network evaluations and 95.91 percent success in patient status identification. Convolutional layers were developed, with distinct filtering applied to each layer. As a result, the VGG-16 design performed well in the classification of COVID-19 cases. Nevertheless, by modifying it or adding a preprocessing step on top of it, this architecture allows for significant gains. Our methodology can be used to help radiologists validate their first screenings and can also be used to screen patients quickly via the cloud.

Martina Schmidbauer ◽  
Lars Grenacher ◽  
Markus S. Juchems ◽  
Erik Memmel ◽  
Thomas Lauenstein ◽  

Purpose To analyze the impact of the COVID-19 pandemic in 2020 on the radiological imaging volume in Germany. Materials und Methods In this retrospective multicenter study, we analyzed CT and MRI examinations of 7 radiology institutes across Germany from January to December 2020. The imaging volume was compared to 2019 (Wilcoxon-Mann-Whitney test). Modality, patient service locations, and examined body parts were assessed in consideration of time periods of the pandemic. In addition, correlation with the incidence of SARS-CoV-2 cases and associated death was performed (Spearman-test). Results In total, in 2020, imaging volume declined by 4 % (n = 8314) compared with 2019 (p < 0.05). The hard lockdown during the first pandemic wave (calendar week 12–16, March 22 – April 19) revealed the highest decrease with 29 % (n = 894, p < 0.01), with the greatest decrease in CT (36 % vs. MRI 26 %), outpatients (38 %, p < 0.01), and imaging of the spine and extremities (51–72 %, < 0.05 – p < 0.01). Examinations referred from the emergency department (–13 %, p < 0.05) and CT of the chest (–16 %, p < 0.05) were least affected. With the end of the first wave, gradual normalization of the imaging volume was observed and persisted until the end of the observation period. A reduction of imaging volume negatively correlated with the incidence of SARS-CoV-2-positive cases and associated deaths (r = 0.28 and 0.49, p < 0.05 and p < 0.001). Conclusion The COVID-19 pandemic was associated with a significant temporary decline in imaging volume. After the first lockdown period, a quick recovery was observed with radiologic imaging examinations steadily approaching prior-year figures. Key points:  Citation Format

2021 ◽  
pp. 089686082110658
K Muthucumarana ◽  
P Howson ◽  
S Burrows ◽  
S Swaminathan ◽  
A Irish

Background: In peritoneal dialysis-related peritonitis (peritonitis), delayed antibiotic therapy is associated with adverse outcomes. Identifying barriers to timely treatment may improve outcomes. Aim: To determine the impact of radiological investigations on treatment delay and predictors of hospitalisation and length of stay (LOS). Methods: Retrospective review of patients with presumed peritonitis in Western Australia. Results: In 153 episodes of peritonitis, 79 (51.6%) resulted in admission with a median LOS of 3 days (Q1, Q3: 1, 6). In a multivariable model, significant predictors of admission were abnormal exit-site (odds ration (OR) 5.7; 95% confidence interval (CI): 1.4, 23.6; p = 0.02), failure to detect a cloudy bag (OR 11.9; 95%CI: 3.2, 44.7; p < 0.001), female sex (OR 3.3; 95% CI: 1.4, 9.7; p = 0.027), radiological imaging within 24 h (OR 8.8; 95% CI: 2.2, 34.8; p = 0.002) and contact with ambulant care facility (OR 0.32, 95% CI: 0.11, 0.98; p = 0.04). Imaging within 24 h of presentation occurred in 41 (27%) episodes of peritonitis, mostly plain X-rays (91%), of which 83% were clinically irrelevant. Imaging performed within 24 h of presentation increased the median time to antibiotic treatment (2.9 h (Q1, Q3: 1.6, 6.4) vs 2.0 h (Q1, Q3: 1, 3.8; p = 0.046)). Imaging performed prior to administering antibiotics significantly increased the median time to treatment (4.7 h (Q1, Q3: 2.9, 25) vs 1.5 h (Q1, Q3: 0.75, 2.5; p < 0.001)) in those where imaging followed antibiotic treatment. Conclusions: Half of all presentations with peritonitis result in hospital admission. Radiological imaging was associated with an increased risk of hospitalisation, potentially contributes to treatment delay, and was mostly clinically unnecessary. When required, imaging should follow antibiotic therapy.

S. Varsha ◽  
C. Bhavya Sree ◽  
Karthik Krishna Ramakrishnan ◽  
Seena Cheppala Rajan ◽  
Muthiah Pichandi

Introduction: Primary Ovary Neoplasms are the most frequent tumors showing epithelial differentiation. Tumour Marker CA-125, glycoprotein synthesized mainly by neoplastic cells with epithelial differentiation. Serum Level of CA-125 has a biological potential of these lesions. This study is mainly done to evaluate the association between serum CA-125 levels and imaging findings and to predict malignancy in various ovarian lesions. Objectives: To evaluate the capacity of CA125 and Imaging findings to predict malignancy in various ovarian pathologies. Materials and Methods: Study area: Department of Radiology, Saveetha Medical College and Hospital, Chennai, Study design: Retrospective study. Study period: 6months. Study population: Patients with history and clinical symptoms of ovarian lesions and USG detected ovarian lesions confirmed on Radiological Imaging. Sampling method: Purposive sampling Sample size: 30. Inclusion criteria: Patients with clinically suspected ovarian lesions or indeterminate ovarian lesions on USG who underwent Radiological imaging and CA-125 estimation. Exclusion criteria: Children less than 12years of age are excluded from this study. Results: Among 30 cases, 19(63.33%) were benign and 2(6.67%) were borderline and 9(30%) were malignant lesion in the present study. Ovarian pathologies is mostly seen in women of age above 25 yrs(86.67%). In this study Ovarian lesions are more commonly seen in married women(86.67%) and menstruating women(56.67%). Out of 30 Cases, Serum CA-125 level <35IU/ml is seen among 13(43.33%) and level >35IU/ml is seen among 17(56.67%). Out of 17 women with CA-125 level >35IU/ml, 9 had malignant lesions on histopathology while 7 women had benign lesions and 1 women had borderline lesion. Conclusion: The present study shows significant association of Serum CA-125 levels with mixed solid cystic ovarian lesions ill defined margins (possible Malignant Ovarian lesions) (p<0.05) especially in Post-menopausal women.

2021 ◽  
Vol 11 (12) ◽  
pp. 1351
Fabiana Gregucci ◽  
Ilaria Bonaparte ◽  
Alessia Surgo ◽  
Morena Caliandro ◽  
Roberta Carbonara ◽  

Aim: To test inter-fraction reproducibility, intrafraction stability, technician aspects, and patient/physician’s comfort of a dedicated immobilization solution for Brain Linac-based radiation therapy (RT). Methods: A pitch-enabled head positioner with an open-face mask were used and, to evaluate inter- and intrafraction variations, 1–3 Cone-Beam Computed Tomography (CBCT) were performed. Surface Guided Radiation Therapy (SGRT) was used to evaluate intrafraction variations at 3 time points: initial (i), final (f), and monitoring (m) (before, end, and during RT). Data regarding technician mask aspect were collected. Results: Between October 2019 and April 2020, 69 patients with brain disease were treated: 45 received stereotactic RT and 24 conventional RT; 556 treatment sessions and 863 CBCT’s were performed. Inter-fraction CBCT mean values were longitudinally 0.9 mm, laterally 0.8 mm, vertically 1.1 mm, roll 0.58°, pitch 0.59°, yaw 0.67°. Intrafraction CBCT mean values were longitudinally 0.3 mm, laterally 0.3 mm, vertically 0.4 mm, roll 0.22°, pitch 0.33°, yaw 0.24°. SGRT intrafraction mean values were: i_, m_, f_ longitudinally 0.09 mm, 0.45 mm, 0.31 mm; i_, m_, f_ laterally 0.07 mm, 0.36 mm, 0.20 mm; i_, m_, f_ vertically 0.06 mm, 0.31 mm, 0.22 mm; i_, m_, f_ roll 0.025°, 0.208°, 0.118°; i_, m_, f_ pitch 0.036°, 0.307°, 0.194°; i_, m_, f_ yaw 0.039°, 0.274°, 0.189°. Conclusions: This immobilization solution is reproducible and stable. Combining CBCT and SGRT data confirm that 1 mm CTV-PTV margin for Linac-based SRT was adequate. Using open-face mask and SGRT, for conventional RT, radiological imaging could be omitted.

Immunotherapy ◽  
2021 ◽  
Maria Gemelli ◽  
Marco Carbone ◽  
Maria I Abbate ◽  
Maddalena Mancin ◽  
Nicola Zucchini ◽  

PD-1/PD-L1 inhibitors demonstrate high efficacy in non-small-cell lung cancer and are now routinely used in clinical practice. Severe immune-related adverse events are reported in about 5% of patients, requiring hospitalization and possibly leading to death. We present a rare case of vanishing bile duct syndrome that arose a few days after the first pembrolizumab infusion. Laboratory tests and radiological imaging studies were performed to orient diagnosis and monitor the disease, while the evidence of ductal loss on the histological sample was pathognomonic for vanishing bile duct syndrome. High-dose steroid therapy and immunosuppressors were administered, resulting in scarce efficacy. Prompt recognition and management of similar conditions is crucial to avoid fatal events. Further studies are needed to investigate new drugs for steroid-refractory conditions.

Sanjanaa Srikant ◽  
Darshit Dave ◽  
Dhara Dave

Pneumatocele may complicate the course of SARS-CoV2 infection. Our article exhibits the value of early radiological imaging for the timely diagnosis and management of COVID-19 and its complications. Conservative management is the mainstay of treatment of pneumatoceles however prompt surgical intervention is imperative for complicated pneumatoceles.

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