Visual classification of three computed tomography lung patterns to predict prognosis of COVID-19: a retrospective study

Background Quantitative evaluation of radiographic images has been developed and suggested for the diagnosis of coronavirus disease 2019 (COVID-19). However, there are limited opportunities to use these image-based diagnostic indices in clinical practice. Our aim in this study was to evaluate the utility of a novel visually-based classification of pulmonary findings from computed tomography (CT) images of COVID-19 patients with the following three patterns defined: peripheral, multifocal, and diffuse findings of pneumonia. We also evaluated the prognostic value of this classification to predict the severity of COVID-19. Methods This was a single-center retrospective cohort study of patients hospitalized with COVID-19 between January 1st and September 30th, 2020, who presented with suspicious findings on CT lung images at admission (n = 69). We compared the association between the three predefined patterns (peripheral, multifocal, and diffuse), admission to the intensive care unit, tracheal intubation, and death. We tested quantitative CT analysis as an outcome predictor for COVID-19. Quantitative CT analysis was performed using a semi-automated method (Thoracic Volume Computer-Assisted Reading software, GE Health care, United States). Lungs were divided by Hounsfield unit intervals. Compromised lung (%CL) volume was the sum of poorly and non-aerated volumes (− 500, 100 HU). We collected patient clinical data, including demographic and clinical variables at the time of admission. Results Patients with a diffuse pattern were intubated more frequently and for a longer duration than patients with a peripheral or multifocal pattern. The following clinical variables were significantly different between the diffuse pattern and peripheral and multifocal groups: body temperature (p = 0.04), lymphocyte count (p = 0.01), neutrophil count (p = 0.02), c-reactive protein (p < 0.01), lactate dehydrogenase (p < 0.01), Krebs von den Lungen-6 antigen (p < 0.01), D-dimer (p < 0.01), and steroid (p = 0.01) and favipiravir (p = 0.03) administration. Conclusions Our simple visual assessment of CT images can predict the severity of illness, a resulting decrease in respiratory function, and the need for supplemental respiratory ventilation among patients with COVID-19.

Evaluation of Safety for Scanning Carbon-Ion Radiotherapy in Hemodialysis Patients with Prostate Cancer

Background/Aim The efficacy and safety of carbon-ion radiotherapy (CIRT) for prostate cancer have already been demonstrated. The number of hemodialysis (HD) patients is increasing. Although the toxicity of CIRT in HD patients may be more severe, it has been insufficiently investigated. Therefore, we retrospectively analyzed the safety of CIRT for HD patients with prostate cancer in the present study. Materials and Methods Five HD patients with prostate cancer who underwent CIRT at the Kanagawa Cancer Center during November 2015–2020 were included in this study. CIRT was delivered by the raster scanning method (sCIRT). Adverse events were assessed using the CTCAE v5.0. The dose-volume histogram (DVH) parameters of the target volume and normal organs were evaluated between initial planning computed tomography (CT) and in-room CT images. Results In the acute phase, Grade 1 genitourinary toxicity was recorded in 1 patient. In the late phase, Grade 1 genitourinary toxicity was recorded in 2 patients. No gastrointestinal toxicities were noted during the follow-up period. In-room CT analysis revealed no significant differences among all DVH parameters of the target volume and normal organs when compared with the treatment plan dose. Conclusions The safety of sCIRT for prostate cancer in HD patients was investigated in the present study. In-room CT analysis suggested the robustness of the treatment plan. According to the present results, sCIRT for prostate cancer can be safely performed in HD patients.

Layered Clay–Graphene Oxide Nanohybrids for the Reinforcement and Fire-Retardant Properties of Polyurea Matrix

Nanostructures are more and more evolved through extensive research on their functionalities; thus, the aim of this study was to obtain layered clay–graphene oxide nanohybrids with application as reinforcing agents in polyurea nanocomposites with enhanced thermal–mechanical and fire-retardant properties. Montmorillonite (MMT) was combined with graphene oxide (GO) and amine functionalized graphene oxide (GOD) through a new cation exchange method; the complex nanostructures were analyzed through FTIR and XPS to assess ionic interactions between clay layers and GO sheets by C1s deconvolution and specific C sp3, respective/ly, C-O secondary peaks appearance. The thermal decomposition of nanohybrids showed a great influence of MMT layers in TGA, while the XRD patterns highlighted mutual MMT and GO sheets crystalline-structure disruption by the d (002) shift 2θ = 6.29° to lower values. Furthermore, the nanohybrids were embedded in the polyurea matrix, and the thermo-mechanical analysis gave information about the stiffness of MMT–GO nanocomposites, while GOD insertion within the MMT layers resulted in a 30 °C improvement in the Tg of hard domains, as shown in the DSC study. The micro CT analysis show good dispersion of inorganic structures within the polyurea, while the SEM fracture images revealed smooth surfaces. Cone calorimetry was used to evaluate fire-retardant properties through limiting the oxygen index, and MMT–GOD based nanocomposites showed a 35.4% value.

X-ray CT Analysis of the Cross-Section of a 3D-Printed Deformed Layer

In this study, we experimentally analyzed the deformation shape of stacked layers developed using three-dimensional (3D) printing technology. The nozzle traveling speed was changed to 80, 90, 100, and 110 mm/s when printing the layers to analyze its effect on layer deformation. Furthermore, the cross-sectional area and the number of layers were analyzed by printing five layers with overall dimensions of 1000 (w) × 2200 (l) × 50 (h) mm (each layer was 10 mm high) using Vernier calipers. Moreover, we analyzed the interface and cross-sectional area of layers that are difficult to confirm visually using X-ray computed tomography (X-ray CT) analysis. As a result of measuring the deformation at the center of the layer, it was confirmed that the deformation was greater for lower nozzle traveling speeds. Consequently, the X-ray CT analysis verified that the layer had the same cross-sectional area irrespective of the layer printing order at the same nozzle travel speed, even if the layer was deformed.

Experimental Investigation on the Effect of Converter Slag Aggregate for Blended Mortar Based on CT Scanning

This study investigated the air aging converter (Basic Oxygen Furnace, BOF) slag aggregate mortar with pulverized fly ash (PFA) and ferronickel slag (FNS). The chemical composition and mineralogical constituents of BOF incorporated mortar were analyzed. Setting time, flowability, compressive strength, and length change were measured to evaluate the fundamental properties of BOF mortar. The X-ray CT analysis was employed to observe the effect of converter slag in the cement matrix visually. The results showed that the hydration of BOF generated a pore at the vicinity of the aggregate, which decreased the compressive strength and increased the length change of mortar. However, the PFA or FNS incorporation of PFA or FNS can decrease the alkalinity of pore solution and subsequently reduce the reactivity of BOF aggregate. Thus, the incorporation of PFA and FNS can be a way to eliminate the disadvantage of BOF, such as volume expansion.

Cone Beam CT Analysis of Haller Cells: Prevalence and Relationship with Orbital Floor Dehiscence

Background and aim: Haller cells arise from anterior ethmoid air cells and are located in the medial orbital floor, lateral to the maxillary infundibulum. The aim of this cross-sectional study was to determine the prevalence of the Haller cells and its relationship with orbital floor dehiscence on cone beam CT images. Materials and Methods CBCT images of 120 patients were interpreted in coronal plane for the presence of Haller cells and orbital floor dehiscence. The prevalence of Haller cell, presence of dehiscence, unilateral or bilateral frequency were assessed. In addition, the size were categorized in three groups of small, medium and large. Chi-square and Cochran-Mantel-Haenszel tests were used for statistical analysis of the data and p<0.05 was considered to be significant. Results A total of 51 male and 69 female with Mean±SD age of 38.84±68.14 were assessed. The overall prevalence of Haller cells was 56.7%, of which 44 (64.7%) were unilateral and 24 were bilateral (35.3%). The majority of the cells (70.7%) were seen in medium (2-4mm) sized. There was a significant association between Haller cells and orbital floor dehiscence (p=0.002). Conclusion The prevalence of Haller cells was remarkably high and presence of Haller cells was strongly associated with ipsilateral orbital floor dehiscence. Based on the findings of this study, CBCT can be useful in delineation of the bony anatomy of sinonasal complex.

Analysis of Clinical Profiles, Deformities, and Plantar Pressure Patterns in Diabetic Foot Syndrome

Diabetic foot syndrome refers to heterogeneous clinical and biomechanical profiles, which render predictive models unsatisfactory. A valuable contribution may derive from identification and descriptive analysis of well-defined subgroups of patients. Clinics, biology, function, gait analysis, and plantar pressure variables were assessed in 78 patients with diabetes. In 15 of them, the 3D architecture of the foot bones was characterized by using weight-bearing CT. Patients were grouped by diabetes type (T1, T2), presence (DN) or absence (DNN) of neuropathy, and obesity. Glycated hemoglobin (HbA1c) and plantar lesions were monitored during a 48-month follow-up. Statistical analysis showed significant differences between the groups for at least one clinical (combined neuropathy score, disease duration, HbA1c), biological (age, BMI), functional (joint mobility, foot alignment), or biomechanical (regional peak pressure, pressure-time integral, cadence, velocity) variable. Twelve patients ulcerated during follow-up (22 lesions in total), distributed in all groups but not in the DNN T2 non-obese group. These showed biomechanical alterations, not always occurring at the site of lesion, and HbA1c and neuropathy scores higher than the expected range. Three of them, who also had weight-bearing CT analysis, showed >40% of architecture parameters outside the 95%CI. Appropriate grouping and profiling of patients based on multi-instrumental clinical and biomechanical analysis may help improve prediction modelling and management of diabetic foot syndrome.