Quantitative Assessment of Iodine Intensity of Different Types of Lesions in the Low-Energy (LE) Images of Contrast-Enhanced Spectral Mammography (CESM)

Purpose: To assess the iodine enhancement intensity of breast lesions in low energy (LE) images obtained in contrast-enhanced spectral mammography (CESM) with different tissue compositions. Materials and Methods: A 50 mm dedicated phantom with different lesion insert and iodine insert were used to assess the enhancement intensity quantitatively. The target slab of the phantom consists of three lesions + iodine inserts together and 100% adipose equivalent,100% glandular equivalent inserts alone to mimic the adipose and glandular lesion without contrast-enhancement. Each iodine inserts having a concentration of 0.5 mgI/cm3, 1.0 mgI/cm3, 2.0 mgI/cm3. The phantom was exposed under semiautomated function at 28 kV, 30 kV, and 32 kV with Mo/Rh target/filter combination. Iodine intensity was estimated for three types of lesions at three breast equivalent compositions. Results: Lesions with fatty tissue had high intensity while lesions with glandular tissues had the minimum intensity. Among fatty lesions, highest mean intensity value (0.972±0.003) observed with minimum iodine concentration (F + 0.5 mgI/cm3). The highest mean intensity value (0.882±0.001) was found related to the glandular lesion with maximum iodine concentration (G + 2.0 mgI/cm3). The one-way ANOVA statistical test confirmed that mean intensity values were significantly varied among different lesions (P < 0.05). Conclusion: LE images obtained in CESM can be used to identify the different types of lesions without performing the full field digital mammography (FFDM) as an additional examination prior to the CESM procedure.

Radiological Correlation of Negative Appendectomies: A Clinical Audit

Introduction: Appendectomy is the most common surgical emergency and negative appendectomy is a one of recognized consequence of appendectomy. Recently an increased use of radiology is seen in diagnosing appendicitis and it has significantly decreased the rate of negative appendectomy. Every effort should be made to establish an exact diagnosis. If, however, this is impossible and a suspicion of appendicitis exists, exploration is mandatory. It is far better to subject a moderate number of patients to a theoretically unnecessary operation than to let one patient suffer perforation. Aim: Recently we have seen an increased use of radiology in our department for diagnosing appendicitis. The idea of conducting this audit was to calculate our negative appendectomy rate by correlating it with use of radiology and to compare it with international figures and to set up guidelines for use of radiology in diagnosing appendicitis on basis of results of our audit. Methods: Records of all patients who underwent appendectomy in Dubai Hospital, UAE from Jan 2018 to Jan 2019 were retrospectively analysed using electronic record system. Clinical diagnosis and radiological findings were compared with histopathology as gold standard for negative appendectomy rate. The sensitivity and specificity of different radiological procedures was calculated as well. Results: Total 165 patients underwent appendectomy in specified duration. Overall negative appendectomy rate was 17% with male being 9.7% and female rate 31%. CT scan was found to be 100% specific and 91.4% sensitive in diagnosing appendicitis while clinical diagnosis was accurate in 88.5% cases.

Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography

Background: Dual-energy contrast-enhanced spectral mammography (CESM) is one of the latest methods for breast lesions characterization, where structural and functional (i.e., vascularization) assessment are combined. Nowadays an interpretation of contrast-enhanced images is based only on the degree of contrast enhancement, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Purpose: To evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) using the contrast enhancement patterns in malignant and benign lesions. Material and Methods: Study included 332 women examined from February 2018 to June 2020. The mean age of the women was 50 years. Of 428 lesions totally revealed, 172 (40.2%) were histologically verified as malignant and 256 (59.8%) as benign. We proposed 9 types of contrast enhancement patterns to describe lesions: reticular, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results: We showed that diagnostic performance of CESM increased sensitivity if an additional diagnostic feature of contrast enhancement pattern was used: sensitivity increased from 79.7% to 94.8% (p = 0.26), specificity from 82.4% to 95.3% (p = 0.013) and accuracy from 81.3 to 95.1% (p = 0.004), in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: Thus, using contrast enhancement pattern allows to increase the efficiency of CESM in breast cancer detection.

A Short Review of Benefits of Using Chest CT Characteristics for Early diagnoses to Corona Virus Disease 2019 (COVID-19)

In 21st century, the year 2020 was expected with much development in India as well many other countries. But unfortunately, the world is facing many natural calamities. World is taking steps towards rescue mission of the disasters. Among of those calamities, deadly Corona Virus remains still all over the world as pandemic disease. Even the developed countries are struggling to come back to its normal routine. India is a country with developing technologies. Vaccines are yet to be developed for treatment of this Novel Corona Virus. As a diagnostic tool, Nasopharyngeal and Oropharyngeal swabs are taken from the person and tested using RT-PCR. This test is not 100 percent accurate. Confirmed COVID patients after few days are undergoing the medical imaging. This diagnostic imaging technique helps in showing the progression of this virus spread in Upper and Lower respiratory system. Chest Radiography is low cost modality but its sensitivity towards observation is 69%. Lung Ultrasound is used in Intensive Care patients and not used for routine diagnosing purpose. Computed Tomography plays a crucial role in three-dimensional chest imaging of COVID-19 patients. The sensitivity of CT is 98%. The aim of this paper is to consider CT as a tool for diagnosing COVID-19 patient than using the standard tool RT-PCR. A brief knowledge about imaging modality like X-ray, Ultrasound and Computed Tomography when used against COVID patient is explained. This paper gives reason for the ideal use of CT diagnosis for COVID 19.

Dissolution, Mechanical Properties, and Thermal Stability of Microparticles Containing Radioactive Cesium on Plant Litter Derived from the Fukushima Daiichi Nuclear Power Plant Accident

Most of the radioactive cesium (134Cs and 137Cs), which originated from the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, has remained in the soil and on plants as water-insoluble microparticles (termed as CsMPs) and maintained relatively high radioactivity levels in the district. However, it has been reported that the radioactive Cs has been absorbed by plants. To interpret this phenomenon, the authors investigated CsMPs to determine if they become soluble during filtration and dialysis experiments. Moreover, other physical properties, such as mechanical properties and thermal stability, were observed during the course of the relevant experiments. These properties can be obtained by using carbonized charcoal litter with CsMPs.

Cardiac Magnetic Resonance Imaging in Patients with COVID-19

In the beginning of December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was determined in Wuhan, Hubei, China. Besides its predominant respiratory system-related symptoms, cardiovascular involvement has also been described in adults with direct and indirect cardiac injury. Pre-existing cardiovascular disease and cardiac risk factors have been shown to increase the risk of cardiac complications of COVID-19 infection. However, it is also known that healthy and asymptomatic COVID-19 survivors suffer cardiac damage-related complications. Cardiac Magnetic Resonance Imaging (CMRI) is known to be the reference non-invasive standard to present cardiac function and tissue characterization. It is recommended as an effective and efficient diagnostic imaging choice to obtain critical information for clinical diagnosis and decision-making. In this article, we sought the usefulness of CMRI in cardiovascular complications related to COVID-19.

Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

When students learn radiographic positioning during radiography practical training in educational institutions, they adjust the angle of the body using positioning aids and angle gauges. In contrast, radiologic technologists position patients using their own hands in clinical environments. In recent years, virtual simulations have been used to help students improve their clinical skills. However, because the existing simulations use computer-generated virtual environments, students cannot actually position human bodies or anthropomorphic phantoms. Therefore, we developed a simulation using augmented reality to teach radiographic positioning. This simulation allows learners to simulate angle placement by using both hands without positioning aids and angle gauges by looking at a virtual object that demonstrates the angle. The objective of this study was to investigate whether this simulation can be applied as a learning tool for radiography practical training and to examine future development directions for this simulation. We introduced the simulation in radiography practical training. The lumbar spine oblique projection was chosen as a learning task in this study, and an anthropomorphic phantom was used for practice. A questionnaire survey was conducted to collect feedback from the students at the end of the semester (n = 41). The survey results indicated that the students could practice positioning the angle of the body using only their own hands, demonstrating that the simulation could be applied as a learning tool in radiography practical training. Ongoing work will be conducted to develop a simulation in which students can practice with a human body.

Speckle Track Analysis of Ultrasound Images Produce Reliable Measures of Supraspinatus Tendon Strain During a Maximal Isometric Contraction

Introduction: Ultrasound speckle tracking is an emergent method in studying musculoskeletal physiology and disease. The precision and reliability of supraspinatus tendon strain measurements have not been explored. The purpose of this study was to examine the reliability of speckle tracking to measure supraspinatus tendon strain. Methods: Forty-two (42) participants participated in this study. Five (5) ultrasound images of the participant’s right shoulder supraspinatus tendon were collected during a maximal voluntary isometric abduction contraction. Cine loop video files of the 5 imaging trials were imported into Ncorr software for speckle track analysis. Axial and longitudinal strain measurements were made for the bursal side, midsubstance, and joint side of the thickest portion of the supraspinatus tendon. Reliability of the strain measures was determined using interclass correlation coefficients (ICC). Bland-Altman plots were created in order to explore systematic error. Results: Mean strain of the supraspinatus tendon ranged from 1.791 to -2.120 %. ICC values for the longitudinal and axial strains of both within and between images were high (>0.9) for all locations of the tendon, demonstrating very good reliability. The 95% for the MDC was large for all measurements of strain, except the axial strain at the mid-substance demonstrating poor precision. Conclusion: The results of the investigation show evidence of very good reliability, poor precision, and some evidence of systematic error. The very good ICC values support the hypothesis that speckle tracking does produce reliable strain measurements. The large MDC values do not support the hypothesis that speckle tracking produces precise strain measurements. Improvements in ultrasound image quality and the shoulder stabilization process need to be made before ultrasound speckle tracking will be a viable research method for the supraspinatus tendon.

Entrapment of the Basilar Artery into the Sphenoid Sinus, With CSF Fistula, without Ischaemic Stroke: A Case Report

The basilar artery herniation into the sphenoid sinus secondary to skull base fracture is a rare condition. There have been few cases described worldwide. This entity carries a potential risk of basilar artery stenosis or occlusion, resulting in ischaemia and infarction of the brainstem and cerebellum. Images study such as computed tomography (CT) and MRI plays a crucial role in diagnosing this condition. We report a rare case that shows entrapment of the basilar artery into the sphenoid sinus, after a traumatic skull base fracture, without infarction of the brainstem and cerebellum, with CSF fistula.

Breast Uptake of Radio-iodine in Differentiated Thyroid Cancer

Radioiodine is often seen to accumulate within breast tissue in patients with differentiated thyroid cancer. Although the risk of secondary breast malignancy in patients with differentiated thyroid cancer treated with radioiodine is controversial, the identification and reduction of this uptake is prudent to minimize the radiation absorbed dose to the breast tissue. This article reviews the literature describing the etiology, frequency and patterns of radioiodine uptake in breast tissue. Approaches and techniques to help minimize the radioiodine uptake in lactating and nonlactating breasts are presented.