Plain Radiographs Research Articles

Size-specific dose estimates calculated using patient size measurements from scanned projection radiograph in high-resolution chest computed tomography.

Size-specific dose estimates (SSDE) are used to assess patient-specific radiation exposure in Computed Tomography (CT), complementing the volume CT dose index (CTDIvol). This study compared SSDE calculated using patient's lateral size from scan projection radiograph (SPR) with SSDE calculated using water equivalent diameter (Dw) from tomographic images in adult chest high-resolution CT (HRCT). In a single-centre study, the CTDIvol and dose-length product (DLP) were recorded from HRCT dose reports of adult patients. Lateral width (SLat), at the centre of the scan range, from the SPR was measured and the SSDE (SSDER) was calculated using conversion factors related to SLat. Average CT number, area of the slice, and lateral size of the patient (AxLat) were measured on the middle slice. The Dw and SSDE from Dw (SSDEW) were calculated. SSDER and SSDEW were compared using Wilcoxon signed rank test. Correlation between patient size and dosimetry parameters were investigated using Spearman Correlation test with statistical significance at P < 0.05. Bland-Altman plot was also used to test agreement between the two SSDE values. Median CTDIvol, DLP, SSDER and SSDEW were 11.0 mGy, 372 mGy.cm, 11.6 mGy and 12.9 mGy, respectively. Small but statistically significant differences (P < 0.03) were found between SLat and AxLat as well as between SSDER and SSDEW. Bland-Altman analysis resulted in borderline agreement between SSDE values. Moderate correlations were observed between dosimetry quantities and patient size measurements (ρ > 0.640; P < 0.001). SSDEw showed statistically significant correlation (ρ = 0.587 and P < 0.001) with SSDER. SSDER may be used to assess patients' absorbed radiation dose, before the scan, in adult chest HRCT. The median value of SSDER was about 10% lower than the median value SSDEW. However, the SSDEW should be used after the scan to establish effective dose and radiation risk to the patient.

Computer diffraction tomography: a comparative analysis of the use of controlled and wavelet filters for image processing

The paper provides digital processing of 2D X-ray projection images of a Coulomb-type point defect in a Si(111) crystal recorded by a detector against the background of statistical Gaussian noise. A managed filter and a wavelet filter with a 4th-order Daubechies function are used. The efficiency of filtering 2D images is determined by calculating the relative quadratic deviations of the intensities of filtered and reference (noiseless) 2D images averaged over all points. A comparison of the calculated values of the relative deviations of the intensities shows that the considered methods work quite well and both, in principle, can be effectively used in practice for noise processing of X-ray diffraction images used for 3D reconstruction of nanoscale defects of crystal structures.

Ferroelectric Smectic C Liquid Crystal Phase with Spontaneous Polarization in the Direction of the Director.

In the previous study, the existence of an unidentified ferroelectric smectic phase is demonstrated in the low-temperature region of the ferroelectric smectic A phase, where the layer spacing decreases with decreasing temperature. In the present study, the phase is identified by taking 2D X-ray diffraction images of a magnetically oriented sample while allowing it to rotate and constructed a 3D reciprocal space with the sample rotation angle as the third axis for the whole picture of the reciprocal lattice vectors originating from the smectic structure. Consequently, circular diffraction images are obtained when the reciprocal lattice vectors are evenly distributed on the conical surface at a certain inclination angle in the reciprocal space. This result provides clear evidence that the phase in question is smectic C. The polarization properties also showed that the observed smectic C phase has spontaneous polarization in the direction parallel to the director and is identified as ferroelectric smectic C. These results provide a new type of classification for liquid crystalline phases that has been established over many years and is a significant contribution to the basic science of soft matter research.

Acromion Fracture in Children (About a Case)

The shoulder trauma in children frequently results in injuries to the clavicle, while acromion fractures remain a rare occurrence. We report a case of an acromion fracture in an 11-year-old child following a road traffic accident (motorcycle passenger struck by a car). The anteroposterior shoulder X-ray revealed an oblique fracture of the distal end of the posterolateral portion of the acromion. Treatment involved immobilization with an arm-to-body sling, and the follow-up was uncomplicated. We emphasize the importance of detecting this rare fracture in the context of any shoulder trauma.

Successful management of megaoesophagus associated with hypothyroidism in a dog: A case report

A seven-year-old male Dachshund was presented with a history of chronic regurgitation and weight loss for two months. On clinical examination, dry and rough hair coat with alopecia on nose bridge and rat tail appearance were observed. Elevated rectal temperature and increased respiratory rate were noticed. Auscultation of lung field revealed mild crackles. Leucocytosis and mild anaemia were evident on complete blood count. Hypercholesterolaemia, hypertriglyceridaemia and elevation of Lactate dehydrogenase (LDH) and Alkaline phosphatase (ALP) were observed in serum biochemistry. The total T4 (TT4) value was low and canine-specific thyroid stimulating hormone (cTSH) was elevated. Megaoesophagus was confirmed by plain radiography. Barium contrast radiograph revealed generalised dilatation with pooling of barium in the oesophagus. The animal was treated with levothyroxine sodium at 0.02 mg/kg BW PO BID and bethanechol at 10 mg PO TID. Supportive therapy included antibiotics, antacids and antiemetics. Elevated feeding was advised. The animal had no episodes of regurgitation even after one month Keywords: Megaoesophagus, hypothyroidism, bethanechol, elevated feeding

Do we need an image quality evaluation system in conventional radiography?

Cilj: Ovim radom nastoji se ukazati na važnost uspostave sustava za ocjenu kvalitete radiološke slike u konvencionalnoj radiografiji. Metode: Studija je provedena retrospektivno, usporedbom kvalitete radiološke slike i načina dobivanja radiološke slike. Ocijenjeno je 20 radioloških slika zdjelice, a ocjena je provedena prema europskim kriterijima za kvalitetu radiološke slike zdjelice. Kvalitetu slike su ocjenjivali radiolog, radiološki tehnolog i student radiološke tehnologije. Usporedbom s istim kriterijem analiziran je i način rada pri oslikavanju zdjelice u 3654 pacijenta te srca i pluća u 57758 pacijenata. Analizirana je i praksa sužavanja rendgenskog snopa na područje od interesa za 50 radioloških slika srca i pluća. Rezultati: Samo jedna slika zdjelice ocijenjena je najvećom mogućom ocjenom od strane sva tri ocjenitelja. Subjektivne procjene ocjenitelja vezano uz odabir parametara ekspozicije razlikovale su se u većini ocjenjivanih slika zdjelice. Naponi na rendgenskoj cijevi korišteni pri oslikavanju zdjelice većinom su bili u preporučenom rasponu, dok su za srce i pluća u većini slučajeva bili manji od preporučene vrijednosti. Zdjelice su većinom oslikavane korištenjem udaljenosti žarišta rendgenske cijevi od prijemnika slike koje su bile u prihvatljivom rasponu osim u slučaju onih pacijenata koji su za vrijeme oslikavanja stajali. U slučaju oslikavanja srca i pluća ove su udaljenosti uglavnom bile u prihvatljivom rasponu osim u slučaju ležećih pacijenata kada je veći broj pacijenata oslikan korištenjem manjih udaljenosti. Svih 50 analiziranih radioloških slika srca i pluća bilo je uređeno na način da su po provedenom oslikavanju uklonjeni rubni dijelovi slike. Zaključci: Rezultati provedene analize ukazuju na potrebu uspostave i provedbe sustava za ocjenu kvalitete radiološke slike koji bi uključivao i analizu načina rada.

Modular Synthesis of Monoanionic PN Ligands Leads to Unexpected Structural Diversity in Lanthanum Chemistry.

We report a new synthetic entry to a series of N-substituted anilidophosphine ligands (short HPNR, R = pTol (HPNTol), 3,5-dimethylphenyl (HPN3,5Me), 3,5-bis(trifluoromethyl)phenyl (HPN3,5CF3), 2-methoxyphenyl (HPNOMe), diisopropylphenyl (HPNDipp), and adamantyl (HPNAd)), allowing a detailed tuning of their steric (and electronic) properties. HPNR could be converted into their lithium salts LiPNR, which are effective precursors for salt metathesis reactions. The new ligands are used for the synthesis of an array of lanthanide complexes using LaCl3(THF)1.2 as a precursor. Depending on the steric bulk of the anilidophosphine ligand, either chloride-bridged dimers of the general formula [(PNR)2La(μ-Cl2)La(PNR)2] (R = pTol (3f), 3,5-dimethylphenyl (3d) and adamantyl (3a)) or mononuclear complexes of the general formula (PNR)2LaCl (R = diisopropylphenyl (3e)) are observed, if the complexation reaction is carried out in toluene. Contrary, if salt metathesis reactions are carried out in dimethoxyethane (DME) as a coordinating solvent, -ate complexes of the general formula [(PNR)2La(μ-Cl2)Li(DME)] (R = Adamantyl (4a) and R = 2-methoxyphenyl (4d)) or [Li(DME)3][(PNR)2LaCl2] (R = 3,5-bis(trifluoromethyl)phenyl (4b), R = pTol (4f) and R = 3,5-dimethylphenyl (4d)) are observed. All ligands and complexes have been thoroughly characterized by 1D and 2D NMR spectroscopy, IR, and X-ray crystallography. Finally, the steric demand of the new anilidophosphine ligands is evaluated using SambVca simulations.

Predicting acetabular version in native hip joints through plain x-ray radiographs: a comparative analysis of convolutional neural network model and the current gold standard, with insights and implications for hip arthroplasty.

This study presents the development and validation of a Deep Learning Convolutional Neural Network (CNN) model for estimating acetabular version (AV) from native hip plain radiographs. Utilizing a dataset comprising 300 participants with unrelated pelvic complaints, the CNN model was trained and evaluated against CT-Scans, considered the gold standard, using a 5-fold cross-validation. Notably, the CNN model exhibited a robust performance, demonstrating a strong Pearson correlation with CT-Scans (right hip: r = 0.70, p < 0.001; left hip: r = 0.71, p < 0.001) and achieving a mean absolute error of 2.95°. Remarkably, over 83% of predictions yielded errors ≤5°, highlighting the model's high precision in AV estimation. The model holds promise in preoperative planning for hip arthroplasty, potentially reducing complications like recurrent dislocation and component wear. Future directions include further refinement of the CNN model, with ongoing investigations aimed at enhancing preoperative planning potential and ensuring comprehensive assessment across diverse patient populations, particularly in diseased cases. Additionally, future research could explore the model's potential value in scenarios necessitating minimized ionizing radiation exposure, such as post-operative evaluations.

Comparison of elastic properties of periodic and aperiodic porous structures produced by additive methods

The aim of this work was to design, print, and examine elastic properties of porous structures with various parameters and beam distributions. These structures, generated using an algorithm, featured three types of lattices: octet, cubic, and Voronoi diagram-based, with different porosities (40 %, 60 %, 80 %) and beam sizes (0.45 mm, 0.66 mm). They were printed using Direct Light Processing and examined using X-ray computed microtomography. Compression tests were conducted to determine the Young’s modulus. The results were compared with computer simulations performed using Abaqus. The tools used, such as 3D printing and X-ray computed microtomography, were described, and the results and conclusions of the tests were presented. As a result, comparable outcomes were obtained for structures with higher beam diameter, while significantly different results were observed for structures with lower beam diameter.

Three-dimensional MRI analysis of elbow anatomy and kinematics in children with ulnar dimelia.

Ulnar dimelia often presents with restricted elbow movement. To develop a treatment strategy to improve elbow mobility, a detailed understanding of the skeletal deformity is needed. We created 3-D models of the cartilage and bone in the elbows of four children with ulnar dimelia by segmentation of MRI scans. We analysed the anatomy and performed a kinematic analysis. In all four children, the distal humerus was triangular in shape and consisted of a medial epicondyle, an enlarged lateral epicondyle and an anterior epicondyle. By comparing the 3-D images with conventional radiographs, we found that the projection of the enlarged lateral epicondyle created two longitudinal lines, which is a radiographic hallmark feature of the triangular-shaped distal humerus. In addition, during elbow flexion, the radial forearm bone slides along the lateral trochlea rather than rotates. This knowledge can aid surgeons to plan treatment for improving elbow mobility in ulnar dimelia.Level of evidence: IV.

Computed tomography of acute orbital trauma in children: a retrospective study

INTRODUCTION: Orbital injuries account for 36 to 64% of all blunt trauma to the facial bones. Diagnosis of orbital wall fractures is carried out using conventional radiography in several projections and computed tomography; magnetic resonance imaging is less commonly used. Often, due to the small displacement of orbital bone fragments, X-ray diagnosis is difficult. Multislice CT with reconstruction of sagittal, coronal projections and 3D in the bone window in such cases is the best visualization method. However, there are still no clear indications for the use of each method and there is no complete view of the CT characteristics of orbital damage.OBJECTIVE: To study the diagnostic value of computed tomography of orbital fractures in pediatric patients with acute trauma.MATERIAL AND METHODS: Retro- and prospectively analyzed the results of CT scans of 94 patients with facial fractures from 01/01/2023 to 09/01/2023 to assess combined orbital injuries. Orbital fractures were detected in 63 children (67.0%). There were 44 boys (69.84%), 19 girls (30.15%) aged from 7 months to 17 years 10 months (average age 10.3). Statistics: For statistical analysis, the method of calculating the nominal correlation using the Kramer coefficient (V) using the IBM SPSS Statistics software package was used.RESULTS: Concomitant injury was observed in 30 (47.6%); isolated 33 (52.36%). The number and frequency of fractures observed were as follows: superior wall of the orbit — 39 (61.9%); zygomatic complex — 19 (30.1%); lower wall of the orbit — 43 (68.2%); nasal bone — 17 (26.9%); lower jaw — 6 (9.5%); medial wall of the orbit — 28 (44.4%); upper jaw — 27 (42.8%); alveolar process — 6 (9.5%); isolated zygomatic arch — 14 (22.2%); Le Fort type I — 1 (1.5%); Le Fort type II — 2 (3.1%); and Le Fort type III — 0 (0%). Orbital hematomas were found in 25 patients (39.6%). It was revealed a strong correlation between the presence of contiguous skull fractures and multiple skull fractures (V=0.878, p&lt;0.001), frontal sinus fractures and frontal sinus hemosinus (V=0.69, p&lt;0.001).CONCLUSION: Orbital fractures are a frequent type of facial fracture occurring in children with blunt isolated and combined trauma. In children with blunt trauma, head CT combined with clinical examination is currently the optimal tool for diagnosing clinically significant orbital injuries. There is a strong correlation between orbital hematomas and orbital vault fractures, orbital hematomas and lattice fractures, adjacent skull and orbital vault fractures, and adjacent skull and lattice fractures. CT examination should include multiplanar (in coronal and sagittal planes) and 3D reconstructions, which help to assess the extent of the fracture, the presence of diastasis, the degree of muscle impingement. Based on the data obtained, the clinician determines the need for surgical intervention.

The Long-Term Clinical and Radiographic Outcomes of Cerclage Cable Fixation for Displaced Acetabular Fractures Using a Posterior Approach: A Retrospective Cohort Study.

Background and Objectives: Cerclage cable fixation with 2 mm multiple-braided cables for displaced acetabular fractures has shown good midterm functional and radiographic outcomes. We retrospectively evaluated the clinical and radiographic outcomes of cerclage cable fixations over ten years. Materials and Methods: We extracted data for patients who underwent cerclage cable fixation for acetabular fractures at a single institution from 2007 to 2012. We adopted this procedure for acetabulum fractures with posterior column fractures. Postoperative reduction quality, complications, reoperations, and Japanese Orthopedic Association (JOA) hip objective functional scores were analyzed. Postoperative reduction quality was classified using plain radiography and computed tomography. Results: We evaluated nine patients with a mean follow-up period of 14.1 ± 2.6 years (range: 10.8-18.1 years). The mean age was 47.1 ± 15.5 years old (range: 28-74 years); the mean injury severity score was 13.6 ± 4.7 (range: 9-22). The most frequent type of fracture was a both-column fracture. Anatomical reduction quality was achieved in five cases. Four patients had hip osteoarthritis at the last follow-up; among them, one patient had worsening hip arthritis > 5 years after surgery, and one patient developed osteoarthritis > 10 years after surgery. Their postoperative reduction quality was worse than their anatomical reduction quality, and both engaged in physical labor. None of the patients underwent revision total hip arthroplasty. The mean JOA hip score was 90.9 ± 7.9 (range: 74-100); seven patients scored >90 at the last follow-up. Conclusions: Cerclage cable fixation showed satisfactory postoperative reductions and favorable long-term clinical outcomes. Long-term follow-up might be necessary for patients whose postoperative reduction is not anatomical to detect late occurrence of hip osteoarthritis, even if osteoarthritis is not evident during short-term follow-up periods.

Mechanical Performance of Cellulose Nanocrystal and Bioceramic-Based Composites for Surgical Training.

This study evaluated the mechanical performance of a cellulose nanocrystal (CNC)-based composite, consisting of hydroxyapatite and natural fibers, mimicking the mechanical properties of real bone. The effect of natural nanofibers on the cutting force of the composite was evaluated for suitability in surgical training. Although hydroxyapatite has been extensively studied in bone-related applications, the exploration of epoxy-based composites incorporating both hydroxyapatite and CNC represents a novel approach. The evaluation involved a load cell with an oscillating saw. The uniform distribution of CNCs within the composite was assessed using 3D X-ray imaging. The cutting force was found to be 4.005 ± 0.5469 N at a feed rate of 0.5 mm/s, comparable to that required when cutting real bone with the osteon at 90°. The 90-degree orientation of the osteon aligns with the cutting direction of the oscillating saw when performing knee replacements on the tibia and femur bones. The addition of CNCs resulted in changes in fracture toughness, leading to increased material fragmentation and surface irregularities. Furthermore, the change in the cutting force with depth was similar to that of real bone. The developed composite material enables bone-cutting surgeries using bioceramics and natural fibers without the risks associated with cadavers or synthetic fibers. Mold-based computed tomography data allows for the creation of various bone forms, enhancing skill development for surgeons.

Effects of Different Fields of View and Rotation Angles on Radiation Doses to Highly Radiosensitive Organs in Children Using Dental Cone Beam Computed Tomography

Dental cone beam computed tomography (CBCT) is a diverse 3D X-ray imaging technique that has enabled clear visualization of the teeth and surrounding structures. The most common diagnostic purpose of dental CBCT examination in children is ectopic eruption and impacted teeth, and a small field of view (FOV) is often used. Since it is difficult for children to control their body movements, reducing the rotation angle is effective. However, no studies have examined the effects of different rotation angles on radiation doses to highly radiosensitive organs in children using small FOVs. The purpose of this study was to examine the effects of small FOVs (4 × 4 cm and 6 × 6 cm) and rotation angles (360° and 180°) on doses that highly sensitize organs in children using dental CBCT. The entrance surface doses to lenses, thyroid lobes, parotid glands, and sublingual glands of a pediatric whole-body phantom were measured. By reducing the FOV from 6 × 6 cm to 4 × 4 cm, the dose to the sublingual gland could be significantly decreased. Additionally, by reducing the rotation angle from 360° to 180°, the lens dose can be decreased significantly. As the rate of dose reduction varies among organs, it is important to consider the relative positions of different organs with respect to the FOV and the trajectory of the X-ray tube.

A framework for three-dimensional statistical shape modeling of the proximal femur in Legg-Calvé-Perthes disease.

The pathomorphology of Legg-Calvé-Perthes disease (LCPD) is a key contributor to poor long-term outcomes such as hip pain, femoroacetabular impingement, and early-onset osteoarthritis. Plain radiographs, commonly used for research and in the clinic, cannot accurately represent the full extent of LCPD deformity. The purpose of this study was to develop and evaluate a methodological framework for three-dimensional (3D) statistical shape modeling (SSM) of the proximal femur in LCPD. We developed a framework consisting of three core steps: segmentation, surface mesh preparation, and particle-based correspondence. The framework aims to address challenges in modeling this rare condition, characterized by highly heterogeneous deformities across a wide age range and small sample sizes. We evaluated this framework by producing a SSM from clinical magnetic resonance images of 13 proximal femurs with LCPD deformity from 11 patients between the ages of six and 12 years. After removing differences in scale and pose, the dominant shape modes described morphological features characteristic of LCPD, including a broad and flat femoral head, high-riding greater trochanter, and reduced neck-shaft angle. The first four shape modes were chosen for the evaluation of the model's performance, together describing 87.5% of the overall cohort variance. The SSM was generalizable to unfamiliar examples with an average point-to-point reconstruction error below 1mm. We observed strong Spearman rank correlations (up to 0.79) between some shape modes, 3D measurements of femoral head asphericity, and clinical radiographic metrics. In this study, we present a framework, based on SSM, for the objective description of LCPD deformity in three dimensions. Our methods can accurately describe overall shape variation using a small number of parameters, and are a step toward a widely accepted, objective 3D quantification of LCPD deformity.

ANALYZING THE RELATIONSHIP AMONG CLINICAL SYMPTOMS, X-RAY RESULTS, AND CARTILAGE WEAR PATTERNS IN KNEE OSTEOARTHRITIS USING T2 MAPPING MRI

Objectives: Osteoarthritis (OA) is a condition that causes joint pain, varying degrees of functional limitations, and a decrease in overall quality of life. The purpose of this study was to examine the progression of cartilage degeneration in knees affected by symptomatic OA and determine its relationship with X-ray and T2 map MRI findings. Methods: This study was conducted at a Tertiary Care Teaching Institute in India and involved 40 patients. It was an observational type of study. For our assessment, we utilized the Western Ontario and McMaster University (WOMAC) osteoarthrosis index to evaluate function, quality of life, and joint pain. Medical imaging technique A standing AP view of the affected knee joint was taken using plain radiographs. Once the X-rays were obtained, they were graded using the Kellgren–Lawrence Classification, which ranges from 0 to 4 grades. Results: Out of the total patients, 6.0% were &lt;40 years old, 21.2% were between 41 and 50 years old, 27.2% were between 51 and 60 years old, 39.3% were between 61 and 70 years old, and 6.0% were above 70 years old. In this study, there were 21 females (63.6%) and 12 males (36.4%). In this study, the researchers found that there was no distinction between the sides of the limb affected. Both the left and right sides were involved in 13 cases each, accounting for 39.39% of the total cases. In addition, 7 cases, or 21.21%, reported experiencing bilateral knee pain. Merchant grade reported that out of the knees examined, 17.5% had Grade 0, 45% had Grade 1, 27.5% had Grade 2, 10% had Grade 3, and none had Grade 4. Conclusion: The findings of this study suggest that T2 map MRI has the ability to accurately measure abnormal cartilage changes in conditions that affect the mechanical properties of the knee joint. It is crucial to have non-invasive methods that can assess early cartilage matrix changes. These methods are important for initiating early treatment, monitoring disease progression, planning operative procedures, and following up on operative cartilage repair.

3D X-ray microscope acts as an accurate and effective equipment of pathological diagnosis in craniofacial imaging

Craniofacial structure and dental hard tissue used to be researched on by traditional imaging tools such as light microscope, electron microscope and micro-CT. Due to the limitations of imaging principle, resolution and 3D rendering reconstruction technique, traditional imaging tools are constrained for presenting fine structure and precise measurements. Here a brand-new imaging equipment–3D X-ray microscope is introduced to realize a more efficient scanning by demonstrating the comparison of the craniofacial structures and dental hard tissue of diabetes and normal DBA mouse. To explore a higher resolution, more efficient imaging measurement and 3D reconstruction method on craniofacial structure and dental hard tissue. The study included 12 DBA mice which were divided into two groups (control group and diabetes group). The heads were separated and scanned by 3D X-ray microscope, after which regions of interest were selected, followed by measurement and 3D reconstruction based on microscope attached software Dragonfly pro©. Hemi-mandibles were collected for enamel mineral density assessment supported by QRM-MicroCT-HA phantom. Data was submitted to paired t-tests at a 95% confidence level. The automatic assessed enamel thickness of diabetes mice decreased on average, whereas the rest of manual measurements and automatic assessed density showed no statistical difference. We constructed HA phantom assisted enamel density procedure in Dragonfly software. Craniofacial structure and dental hard tissue were well-presented both in 2D slide and 3D reconstruction viewport by 3D X-ray microscope which can be routinely used as craniofacial structure and dental hard tissue imaging tool.

Artificial intelligence in commercial fracture detection products: a systematic review and meta-analysis of diagnostic test accuracy

Conventional radiography (CR) is primarily utilized for fracture diagnosis. Artificial intelligence (AI) for CR is a rapidly growing field aimed at enhancing efficiency and increasing diagnostic accuracy. However, the diagnostic performance of commercially available AI fracture detection solutions (CAAI-FDS) for CR in various anatomical regions, their synergy with human assessment, as well as the influence of industry funding on reported accuracy are unknown. Peer-reviewed diagnostic test accuracy (DTA) studies were identified through a systematic review on Pubmed and Embase. Diagnostic performance measures were extracted especially for different subgroups such as product, type of rater (stand-alone AI, human unaided, human aided), funding, and anatomical region. Pooled measures were obtained with a bivariate random effects model. The impact of rater was evaluated with comparative meta-analysis. Seventeen DTA studies of seven CAAI-FDS analyzing 38,978 x-rays with 8,150 fractures were included. Stand-alone AI studies (n = 15) evaluated five CAAI-FDS; four with good sensitivities (> 90%) and moderate specificities (80–90%) and one with very poor sensitivity (< 60%) and excellent specificity (> 95%). Pooled sensitivities were good to excellent, and specificities were moderate to good in all anatomical regions (n = 7) apart from ribs (n = 4; poor sensitivity / moderate specificity) and spine (n = 4; excellent sensitivity / poor specificity). Funded studies (n = 4) had higher sensitivity (+ 5%) and lower specificity (-4%) than non-funded studies (n = 11). Sensitivity did not differ significantly between stand-alone AI and human AI aided ratings (p = 0.316) but specificity was significantly higher the latter group (p < 0.001). Sensitivity was significant lower in human unaided compared to human AI aided respectively stand-alone AI ratings (both p ≤ 0.001); specificity was higher in human unaided ratings compared to stand-alone AI (p < 0.001) and showed no significant differences AI aided ratings (p = 0.316). The study demonstrates good diagnostic accuracy across most CAAI-FDS and anatomical regions, with the highest performance achieved when used in conjunction with human assessment. Diagnostic accuracy appears lower for spine and rib fractures. The impact of industry funding on reported performance is small.

Geometry-Aware Attenuation Learning for Sparse-View CBCT Reconstruction.

Cone Beam Computed Tomography (CBCT) plays a vital role in clinical imaging. Traditional methods typically require hundreds of 2D X-ray projections to reconstruct a high-quality 3D CBCT image, leading to considerable radiation exposure. This has led to a growing interest in sparse-view CBCT reconstruction to reduce radiation doses. While recent advances, including deep learning and neural rendering algorithms, have made strides in this area, these methods either produce unsatisfactory results or suffer from time inefficiency of individual optimization. In this paper, we introduce a novel geometry-aware encoder-decoder framework to solve this problem. Our framework starts by encoding multi-view 2D features from various 2D X-ray projections with a 2D CNN encoder. Leveraging the geometry of CBCT scanning, it then back-projects the multi-view 2D features into the 3D space to formulate a comprehensive volumetric feature map, followed by a 3D CNN decoder to recover 3D CBCT image. Importantly, our approach respects the geometric relationship between 3D CBCT image and its 2D X-ray projections during feature back projection stage, and enjoys the prior knowledge learned from the data population. This ensures its adaptability in dealing with extremely sparse view inputs without individual training, such as scenarios with only 5 or 10 X-ray projections. Extensive evaluations on two simulated datasets and one real-world dataset demonstrate exceptional reconstruction quality and time efficiency of our method.

Correlation of Necrotizing Enterocolitis (Nec) on Radiology Examination of Plain Abdomen Photo and Ultrasonography (USG)

Introduction: Necrotizing enterocolitis (NEC) is an inflammatory condition caused by infectious agents with a background of immaturity of local defense mechanisms and hypoxic-ischemic damage to the intestinal mucosa. Plain abdominal radiography can be used to examine this condition. The results of diagnostic imaging of the neonatal gastrointestinal tract have relatively limited accuracy, and limit improvements in diagnostic efforts and determine the severity. The results of the examination can also be used with ultrasound. This study aims to analyze the correlation of NEC examination using plain radiography and ultrasound. Methods: This type of research uses a retrospective cohort study. The subjects of the study were 39 patients who underwent plain radiography and ultrasound examinations related to NEC conditions. The data source for this study is secondary data obtained through an intermediary media, namely PACS. The secondary data source for this study is data that has been recorded at the Radiology Installation of Hasan Sadikin Hospital in the period January 2023-June 2024. The Spearman correlation test was used to test the hypothesis of a correlation between NEC examinations using plain radiography and ultrasound. Results: The results of the Spearman correlation test showed no significant correlation between NEC examination using plain radiographs and USG with a correlation coefficient value of 0.138. The findings that can be taken from this study are that there is an increase in grade in patients who undergo USG examination. This finding proves the importance of conducting USG examination to confirm NEC conditions more accurately. Conclusion: There is no significant correlation between NEC examination using plain radiographs and USG. Examination using USG can confirm NEC more accurately, as evidenced by an increase in grade in 43.58% of study subjects.