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Yu. N. Vinogradova ◽  
N. V. Ilyin ◽  
M. S. Tlostanova ◽  
A. A. Ivanova

Visual analysis of positron emission tomography/computed tomography (PET/CT) scans and semiquantitative parameter of glucose’s standardized uptake value are used in PET/CT with 18F-fluorodeoxyglucose (18F-FDG). Recently some volumetric parameters, which can evaluate metabolic tumor volume for patients with lymphomas and total lesion glycolysis in the tumor sites are established. In our study this problem was analyzed for different types of lymphomas considering clinical importance of these rates and their bond to known factors of international prognostic index.

2021 ◽  
Vol 22 (1) ◽  
Xiangtian Deng ◽  
Lingzhi Li ◽  
Peng Zhou ◽  
Fuyuan Deng ◽  
Yuan Li ◽  

Abstract Background The purpose of this study was to evaluate the clinical and radiographic outcomes after medial patellofemoral ligament (MPFL) reconstruction combined with supracondylar biplanar femoral derotation osteotomy (FDO) in recurrent patellar dislocation (RPD) with increased femoral anteversion angle (FAA) and genu valgum. Methods Between January 2017 to December 2020, a total of 13 consecutive patients (13 knees, 4 males and 9 females, mean age 18.7 (range, 15–29 years) with RPD with increased FAA (FAA > 25°) and genu valgum (mechanical axis deformity of ≥5°) who underwent supracondylar biplanar FDO using a Tomofix-locking plate combined with MPFL reconstruction in our institution were included. Preoperative full-leg standing radiographs, lateral views, and hip-knee-ankle computed tomography (CT) scans were used to evaluate the mechanical lateral distal femoral angle (mLDFA), anatomical femorotibial angle (aFTA), mechanical axis, patellar height, tibial tubercle-trochlear groove (TT-TG) distance, and torsional angle of the tibial and femoral in the axial plane. Patient reported outcomes were evaluated using the International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score, visual analog scale (VAS), and Tegner score preoperatively and postoperatively. Postoperative CT scans were used to evaluate the changes of FAA and TT-TG, and full-leg standing radiographs was used to evaluate the changes of mLDFA, aFTA, and mechanical axis. Results A total of 13 patients (13 knees) were included with an average follow-up period of 26.7 months (range 24–33). No cases developed wound infection, soft tissue irritation, and recurrent patellar dislocation during the follow-up period after surgery. Bone healing at the osteotomy site was achieved in all cases, and all patients regained full extension and flexion. Clinical outcomes (VAS, Kujala, IKDC, Lysholom, and Tegner scores) improved significantly at the final follow-up after surgery (p < 0.05). The mean mLDFA, aFTA, mechanical axis, and TT-TG distance showed statistically significant improvement following the combined surgery (p < 0.05), while the CDI did not change significantly after surgery (p>0.05). Conclusion MPFL reconstruction combined with supracondylar biplanar FDO showed satisfactory clinical outcomes and radiographic results in the short-term follow-up period.

2021 ◽  
pp. 000348942110606
Mehdi Abouzari ◽  
Brooke Sarna ◽  
Joon You ◽  
Adwight Risbud ◽  
Kotaro Tsutsumi ◽  

Objective: To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize its accuracy compared to computerized tomography (CT) scan. Methods: In a prospective investigational study, NIR and CT images from 65 patients who presented to a tertiary care rhinology clinic were compared to determine the sensitivity and specificity of NIR as an imaging modality. Results: The sensitivity and specificity of NIR imaging in distinguishing normal versus maxillary sinus disease was found to be 90% and 84%, normal versus mild maxillary sinus disease to be 76% and 91%, and mild versus severe maxillary sinus disease to be 96% and 81%, respectively. The average pixel intensity was also calculated and compared to the modified Lund-Mackay scores from CT scans to assess the ability of NIR imaging to stratify the severity of maxillary sinus disease. Average pixel intensity over a region of interest was significantly different ( P < .001) between normal, mild, and severe disease, as well as when comparing normal versus mild ( P < .001, 95% CI 42.22-105.39), normal versus severe ( P < .001, 95% CI 119.43-174.14), and mild versus severe ( P < .001, 95% CI 41.39-104.56) maxillary sinus disease. Conclusion: Based on this data, NIR shows promise as a tool for identifying patients with potential maxillary sinus disease as well as providing information on severity of disease that may guide administration of appropriate treatments.

2021 ◽  
Vol 11 (3) ◽  
pp. 121-128
Omolola Fakunle ◽  
Meet Patel ◽  
Victoria G. Kravets ◽  
Adam Singer ◽  
Robert Hernandez-Irizarry ◽  

Purpose: This study assessed the relationship of core muscle sarcopenia, myosteatosis, and L1 attenuation to the 5-factor modified frailty index (mFI-5), discharge disposition, and post-admission complications in orthopedic and general trauma patients. It was hypothesized that reduced sarcopenia, L1 attenuation, and increased myosteatosis is associated with higher mFI-5 scores (≥ 0.3), discharge into care, and increased post-admission complications.Methods: This prospective cohort study was performed at a Level 1 trauma center. Patients were surveyed and metrics of the mFI-5 were used. Frail was categorized as a mFI-5 score ≥ 0.3. Recent abdominal computed tomography (CT) scans were used to extract radiographical information of total psoas cross-sectional area, psoas myosteatosis, and L1 vertebrae attenuation.Results: There were 140 patients who consented to the study, of which 83 had available abdomen and pelvis CT scans. The mean age was 43.19 (± 17.36), and 65% were male (n = 52). When comparing the frail (16%, n = 13) and not frail (84%, n = 70) patients, there was a significant difference in mean psoas myosteatosis (p < 0.0001) and the attenuation of the L1 vertebrae (p < 0.001). On multivariate analysis when accounting for age, myosteatosis of the psoas muscles was predictive of an mFI-5 score ≥ 0.3.Conclusion: The findings suggest that myosteatosis and L1 attenuation are associated with frailty indices (mFI-5) after traumatic injury. Future studies are needed to prospectively assess the validity of both radiographical and index-based markers of frailty in predicting post-traumatic complications, mortality, and hospital utilization.

2021 ◽  
pp. 000313482110635
Jordan Perkins ◽  
Jacob Shreffler ◽  
Danielle Kamenec ◽  
Alexandra Bequer ◽  
Corey Ziemba ◽  

Background: Many patients undergo two head computed tomography (CT) scans after mild traumatic brain injury (TBI). Radiographic progression without clinical deterioration does not usually alter management. Evidence-based guidelines offer potential for limited repeat imaging and safe discharge. This study characterizes patients who had two head CTs in the Emergency Department (ED), determines the change between initial and repeat CTs, and describes timing of repeat scans. Methods: This retrospective series includes all patients with head CTs during the same ED visit at an urban trauma center between May 1st, 2016 and April 30th, 2018. Radiographic interpretation was coded as positive, negative, or equivocal. Results: Of 241 subjects, the number of positive, negative, and equivocal initial CT results were 154, 50, and 37, respectively. On repeat CT, 190 (78.8%) interpretations were congruent with the original scan. Out of the 21.2% of repeat scans that diverged from the original read, 14 (5.8%) showed positive to negative conversion, 1 (.4%) showed positive to equivocal conversion, 2 (.88%) showed negative to positive conversion, 20 (8.3%) showed equivocal to negative conversion, and 14 (5.8%) showed equivocal to positive conversion. Average time between scans was 4.4 hours, and median length of stay was 10.2 hours. Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.

Yige Peng ◽  
Lei Bi ◽  
Ashnil Kumar ◽  
Michael Fulham ◽  
David Dagan Feng ◽  

Abstract Objective: Positron emission tomography-computed tomography (PET-CT) is regarded as the imaging modality of choice for the management of soft-tissue sarcomas (STSs). Distant metastases (DM) are the leading cause of death in STS patients and early detection is important to effectively manage tumors with surgery, radiotherapy and chemotherapy. In this study, we aim to early detect DM in patients with STS using their PET-CT data. Approach: We derive a new convolutional neural network (CNN) method for early DM detection. The novelty of our method is the introduction of a constrained hierarchical multi-modality feature learning approach to integrate functional imaging (PET) features with anatomical imaging (CT) features. In addition, we removed the reliance on manual input, e.g., tumor delineation, for extracting imaging features. Main results: Our experimental results on a well-established benchmark PET-CT dataset show that our method achieved the highest accuracy (0.896) and AUC (0.903) scores when compared to the state-of-the-art methods (unpaired student’s t-test p-value < 0.05). Significance: Our method could be an effective and supportive tool to aid physicians in tumor quantification and in identifying image biomarkers for cancer treatment.

Xiao-Yan Lv ◽  
Wei-Hong Xing ◽  
Xi Ma ◽  
Li-Hong Xing ◽  
Yu Zhang ◽  

Purpose: To investigate the Computed Tomography (CT) imaging characteristics and dynamic changes of COVID-19 pneumonia at different stages. Methods: Forty-six patients infected with COVID-19 who had chest CT scans were enrolled, and CT scans were performed 4-6 times with an interval of 2-5 days. Results: At the early stage (n=25), ground glass opacity was presented in 11 patients (11/25 or 44.0%) and ground glass opacity mixed with consolidation in 13 (13/25 or 52.0%) in the lung CT images. At the progressive stage (n=38), ground glass opacity was presented in only one patient (1/38 or 2.6%) and ground glass opacity mixed with consolidation in 33 (33/38 or 86.8%). In the early improvement stage (n=38), the imaging presentation was ground glass opacity alone in three patients (3/38 or 7.9%) and ground glass opacity mixed with consolidation in 34 (34/38 or 89.5%). In the late improvement (absorption) stage (n=33), the primary imaging presentation was ground glass presentation in eight patients (8/33 or 24.2%) and ground glass opacity mixed with consolidation in 23 (23/33 or 69.7%). The lesion reached the peak at 4-16 days after disease onset, and 26 (26/38 or 68.4%) patients reached the disease peak within ten days. Starting from 6 to 20 days after onset, the disease began to be improved, with 30 (30/38 or 78.9%) patients being improved within 15 days. Conclusion: COVID-19 pneumonia will progress to the peak stage at a mediate time of seven days and enter the improvement stage at twelve days. Computed tomography imaging of the pulmonary lesion has a common pattern from disease onset to improvement and recovery and provides important information for evaluation of the disease course and treatment effect.

2021 ◽  
Vol 21 (1) ◽  
Fulong Zhang ◽  
Jing Xu ◽  
Yuandong Zhu ◽  
Qianneng Wu ◽  
Xincheng Xie ◽  

Abstract Background IgG4-related disease mainly manifests as organomegaly and is accompanied by tissue fibrosis (Mimori, Mod Rheumatol 29(2):213, 2019) which is frequently confused with tumour (Dawei et al., J Gastroenterol Hepatol 29(12):1375–8, 2020). There are few reports with of IgG4-related disease with the first clinical manifestation involving the stomach. Case presentation We present the case of 46-year-old male patient with a “stomach tumour” as the first manifestation of IgG4-related disease. Gastroscopy showed a mass in the stomach, however, the pathology result was chronic inflammation with IgG4 positivity. CT scans of abdomen showed that the stomach wall was thick, the head of the pancreas was swollen, and retroperitoneal fibrosis was severe.The serum IgG4 level was 75 g/L (normal range 0.03–2.01 g/L).After treatment with methylprednisolone for one month, the symptoms were greatly relieved. Conclusions To reduce the suffering of patients and relieve their financial burden, we should consider the possibility of IgG4-related disease when the initial manifestation is a stomach mass.

2021 ◽  
Vol 12 (1) ◽  
Susann-Cathrin Olthof ◽  
Christian Reinert ◽  
Konstantin Nikolaou ◽  
Christina Pfannenberg ◽  
Sergios Gatidis ◽  

Abstract Background Detection of pulmonary nodules in MRI requires fast imaging strategies without respiratory motion impairment, such as single-breath-hold Cartesian VIBE. As patients with pulmonary diseases have limited breath-hold capacities, this study investigates the clinical feasibility of non-Cartesian Spiral VIBE under free-breathing compared to CT as the gold standard. Methods Prospective analysis of 27 oncological patients examined in PET/CT and PET/MR. A novel motion-robust 3D ultrashort-echo-time (UTE) MR sequence was evaluated in comparison with CT and conventional breath-hold MR. CT scans were performed under breath-hold in end-expiratory and end-inspiratory position (CT ex, CT in). MR data was acquired with non-contrast-enhanced breath-hold Cartesian VIBE followed by a free-breathing 3D UTE Spiral VIBE. Impact of respiratory motion on pulmonary evaluation was investigated by two readers in Cartesian VIBE, followed by UTE Spiral VIBE and CT ex and the reference standard of CT in. Diagnostic accuracy was calculated, and visual image quality assessed. Results Higher detection rate and sensitivity of pulmonary nodules in free-breathing UTE Spiral VIBE in comparison with breath-hold Cartesian VIBE were found for lesions > 10 mm (UTE Spiral VIBE/VIBE/CT ex): 93%/54%/100%; Lesions 5–10 mm: 67%/25%/ 92%; Lesions < 5 mm: 11%/11%/78%. Lobe-based analysis revealed sensitivities and specificities of 64%/96%/41% and 96%/93%/100% for UTE Spiral VIBE/VIBE/CT ex. Conclusion Free-breathing UTE Spiral VIBE indicates higher sensitivity for detection of pulmonary nodules than breath-hold Cartesian VIBE and is a promising but time-consuming approach. However, sensitivity and specificity of inspiratory CT remain superior in comparison and should be preferred for detection of pulmonary lesions.

2021 ◽  
Demir Amanda ◽  
Påhlson Elin ◽  
Norrman Eva ◽  
Erik Stenberg

Abstract Background Abdominal pain after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common and unwanted complication that typically leads to further exploration through radiology. Concerns have been raised regarding the consequences of this radiation exposure and its correlation with the lifetime risk of cancer. The aim of this study was to evaluate the differences in computed tomography (CT) use between LRYGB patients with open and closed mesenteric defects and to assess the radiological findings and radiation doses. Methods This subgroup analysis included 300 patients randomized to either closure (n = 150) or nonclosure (n = 150) of mesenteric defects during LRYGB. The total number of CT scans performed due to abdominal pain in the first 5 postoperative years was recorded together with the radiological findings and radiation doses. Results A total of 132 patients (44%) underwent 281 abdominal CT scans, including 133 scans for 67 patients with open mesenteric defects (45%) and 148 scans for 65 patients with closed mesenteric defects (43%). Radiological findings consistent with small bowel obstruction or internal hernia were found in 31 (23%) of the scans for patients with open defects and in 18 (12%) of the scans for patients with closed defects (p = 0.014). The other pathological and radiological findings were infrequent and not significantly different between groups. At the 5-year follow-up, the total radiation dose was 82,400 mGy cm in the nonclosure group and 85,800 mGy cm in the closure group. Conclusion Closure of mesenteric defects did not influence the use of CT to assess abdominal pain. Graphical abstract

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