Characterization Of Lesions Research Articles

Comparison of Performance in Diagnosis and Characterization of Breast Lesions: Contrast-Enhanced Mammography Versus Breast Magnetic Resonance Imaging

IntroductionIn contemporary medical practice, magnetic resonance imaging (MRI) is the most sensitive modality for detecting breast cancer. Contrast-enhanced mammography (CEM), a relatively recent technology, represents another contrast-enhanced imaging technique that has the potential to serve as an alternative to breast MRI. Our main goal is to compare the diagnostic accuracy including assessment of sensitivity and specificity of these 2 contrast-enhanced breast imaging methods, CEM and MRI, in the diagnosis and characterization of breast lesions. Material and methodsOur prospective study included patients who were clinically suspected of malignancy and/or had suspicious findings detected by mammography or ultrasound. A total of 116 patients were included, and both CEM and MRI examinations were performed on all patients. All CEM examinations were conducted at our institution, while 56.89% of all MRI examinations were carried out at external centers. While histopathological results were accessible for all malignant lesions, the final diagnosis for 80.5% of benign lesions was established through typical imaging findings and adequate follow-up. ResultsThis study encompassed a total of 219 lesions, with 125 out of 219 (57.07%) malignant lesions and 94 out of 219 (42.92%) benign lesions. The sensitivity and specificity values were 98.40% and 81.91%, respectively, for CEM, and 100% and 75.33%, respectively, for MRI. Moreover, CEM showcased comparable performance to MRI in evaluating women with dense breasts. ConclusionCEM and MRI were compared for breast lesion diagnosis, with MRI showing higher sensitivity and CEM higher specificity; however, the differences were not statistically significant.

Discrepancies in hidradenitis suppurativa lesion characterization by providers and patients.

The hidradenitis suppurativa (HS) clinical response (HiSCR) has come under scrutiny as several HS clinical trials failed to meet primary endpoints with high placebo responses. This may be due to limitations of the tool and raters' ability to accurately characterize and count lesions, rather than lack of efficacy of the studied drug. Due to HS lesion complexity and potential differences in rater training, it was hypothesized that there would be discrepancies in how providers characterize and count lesions for HS clinical trials. To evaluate how HS providers and patients name and count HS lesions and to identify discrepancies among providers to initiate the development of consensus-driven guidance for HS rater training. An online survey was distributed to the members of HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). Respondents were asked to classify lesion images composed of multiple and different morphology types and answer questions regarding inclusion of associated dermatological conditions. Forty-seven HISTORIC members responded (29 providers; 18 patients). There was variability in how respondents classified HS lesions. Of 12 questions containing images, four had ≥50% of respondents choosing the same answer. With an image of a lesion composed of different morphologies, 45% of providers counted it as a single lesion and 45% counted it as multiple distinct lesions. With an image of multiple interconnected draining tunnels, 7% of providers classified it as a single draining tunnel while 79% categorized it as multiple draining tunnels with the number estimated by visual inspection. There was also variability in deciding whether lesions occurring in associated conditions should be considered separately or included in HS lesion counts. Patient responses were also variable. The result of the current study reaffirms the gap in how providers characterize and count HS lesions for clinical trials and the need to develop consensus-driven rater training related to HS outcome measures.

“Open Your Mouth and Stick out Your Tongue:” Revisiting Static and Dynamic Maneuvers in Head and Neck CT

The head and neck region has a complex anatomy, making assessing lesion extension challenging. Current CT technology has not been able to overcome these challenges. Both static and dynamic maneuvers have been developed to better evaluate some areas where mucosal apposition prevents appropriate lesion characterization. Static maneuvers do not require modification of the breathing pattern and can be performed during quiet breathing acquisition. Dynamic maneuvers require an extra acquisition, with increased radiation exposure; thus, patients and scanning areas should be carefully selected. The purpose of this article is to describe these maneuvers, how to perform them, and their clinical application.Learning Objective: To describe useful dynamic and static maneuvers in head and neck diagnostic imaging and recognize the structures that may be better assessed by performing them

Comprehensive review of imaging modalities for diagnosis and characterization of focal liver lesions

Comprehensive review of imaging modalities for diagnosis and characterization of focal liver lesions

El análisis cuantitativo de las imágenes potenciadas en difusión (DWI) mejora la precisión diagnóstica del sistema de puntuación O-RADS RM en lesiones anexiales indeterminadas

IntroductionDespite the overall high accuracy of the O-RADS MRI scoring system for characterization of indeterminate adnexal lesions, a non-negligible percentage of adnexal lesions remains indeterminate. Given this, the main objective of this study was to evaluate the value of adding quantitative diffusion-weighted imaging (DWI) to Ovarian-Adnexal Reporting and Data System (O-RADS) MRI to improve the diagnostic accuracy of the scoring system in a cohort of indeterminate adnexal lesions according to International Ovarian Tumor Analysis Group Simple Rules (IOTA-SR). Methods and materialSeventy-nine women with 81 pelvic lesions classified as indeterminate according to IOTA-SR underwent 3-Tesla MRI with a conventional multiparametric protocol. DWI was quantitatively analyzed. Lesions were surgically removed or followed-up, according to a local protocol. Sensitivity, specificity, positive and negative predictive values and accuracy were determined for conventional multiparametric MRI and quantitative DWI-derived data. ResultsTwenty masses in 72 patients (27.8%) were malignant. An apparent diffusion coefficient (ADC) cut-off value of 1.30×10-3mm2/s had 89% sensitivity and 80% specificity for malignancy. Overall, adding quantitative DWI to O-RADS MRI increased the specificity (98.08%, P<.001), positive predictive value (94.12%, P<.001), and accuracy (93.06%, P=.05). In the specific O-RADS MRI score 4 subgroup, an ADC cut-off value of 1.22×10-3 mm2/s had 86% sensitivity and 67% specificity for distinguishing benign from malignant lesions. ConclusionIn IOTA-SR indeterminate adnexal lesions, quantitative DWI significantly improves the diagnostic performance of conventional multiparametric MRI in all O-RADS MRI score groups.

A rare case of dysplastic cerebellar gangliocytoma - Lhermitte Duclos Disease

Lhermitte–Duclos disease (LDD), also known as dysplastic cerebellar gangliocytoma, is an uncommon hamartomatous lesion found in the cerebellar cortex. First described by French physicians Lhermitte and Duclos in 1920, this condition involves enlarged cerebellar folia containing abnormal ganglion cells. Clinical manifestations typically include headaches, visual disturbances, and cerebellar dysfunction. While imaging techniques like computed tomography (CT) scans may indicate the presence of mass lesions, magnetic resonance imaging (MRI) is crucial for accurate delineation of the lesion's boundaries and characterization of tissue involvement. Surgical intervention, typically in the form of respective surgery, remains the cornerstone of treatment for LDD. Despite advancements in imaging technologies and surgical techniques, the management of LDD remains fraught with complexities. The prognosis can be variable, and in some cases, despite appropriate therapeutic interventions guided by MRI-assisted surgical planning and confirmation through CT screening, the outcome may be unfavorable, as observed in this instance with the demise of the 50-year-old male patient. Further research and a deeper understanding of the pathophysiology underlying LDD are imperative to enhance diagnostic accuracy, refine treatment modalities, and potentially improve patient outcomes. This case underscores the challenges in managing this rare neurological condition and highlights the need for continued exploration into more effective therapeutic avenues.

Quantitative time intensity curve analysis of contrast-enhanced ultrasound (CEUS) examinations for the assessment of focal liver lesions.

Contrast enhanced ultrasound (CEUS) is well-established for the characterization of focal liver lesions (FLLs). By using intravenous ultrasound contrast agents, followed by specific low mechanical index examinations, CEUS enables a high spatial and temporal resolution as well as a dynamic assessment of macro- and microvascularization down to the capillaries. Nevertheless, CEUS has the disadvantage of being examiner-dependent, so quantitative analysis of time-intensity curves in dynamic CEUS (D-CEUS) could provide further information. The aim of this article is to provide a general review of the current literature regarding the usefulness of D-CEUS in the assessment of FLLs.

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare benign focal liver lesion, part I.

Improved detection and characterization of common focal liver lesions (FLL) are the main topics of the World Federation for Ultrasound in Medicine and Biology (WFUMB) guidelines on the use of contrast-enhanced ultrasound (CEUS). On stateof-the-art CEUS imaging, to create a library of rare FLL, especially concerning their atypical imaging characteristics, might be helpful for improving clinical diagnostic efficiency. In this review, we aim to summarize the ultrasound and CEUS features of rare benign FLL. Currently there are limited reports and images published.

Induced saturation transfer recovery steady states (iSTRESS) for proton exchange rate mapping with CEST MRI, a preliminary study

Proton exchange underpins essential mechanisms in diverse MR imaging contrasts. Omega plots have proven effective in mapping proton exchange rates (kex) in live human brains, enabling the differentiation of MS lesion activities and characterization of ischemic stroke. However, Omega plots require extended saturation durations (typically 5 to 10 s), resulting in high specific absorption rates (SAR) that can hinder clinical feasibility. In this study, we introduce a novel kex mapping approach, named induced Saturation Transfer Recovery Steady-States (iSTRESS). iSTRESS integrates an excitation flip angle pulse prior to chemical exchange saturation transfer (CEST) saturation, effectively aligning the magnetization with its steady-state value. This innovation reduces saturation times and mitigates SAR concerns. The formula for iSTRESS-based kex quantification was derived theoretically, involving two measurements with distinct excitation flip angles and saturation B1 values. Bloch-McConnell simulations confirmed that iSTRESS-based kex values closely matched input values (R2 > 0.99). An iSTRESS MRI sequence was implemented on a 9.4 T preclinical MRI, imaging protein phantoms with pH values ranging from 6.2 to 7.4 (n = 4). Z-spectra were acquired using excitation flip angles of 30° and 60°, followed by CEST saturation at powers of 30 and 120 Hz respectively, with a total saturation time of <1 s, resulting in two iSTRESS states for kex mapping. kex maps derived from the phantom study exhibited a linear correlation (R2 > 0.99) with Omega plot results. The developed iSTRESS method allows for kex quantification with significantly reduced saturation times, effectively minimizing SAR concerns.

Highly Sensitive Detection of Melanin in Melanomas Using Multi-harmonic Low Frequency EPR

PurposeLow frequency EPR can noninvasively detect endogenous free radical melanin in melanocytic skin lesions and could potentially discriminate between benign atypical nevi and malignant melanoma lesions. We recently succeeded in demonstrating the ability of clinical EPR to noninvasively detect the endogenous melanin free radical in skin lesions of patients. However, the signal-to-noise ratio (SNR) was extremely low warranting further research to boost the sensitivity of detection. In the present study, we assessed the performance of a clinical EPR system with the capability to perform multi-harmonic (MH) analysis for the detection of melanin.ProceduresThe sensitivity of MH-EPR was compared with a classical continuous wave (CW)-EPR (1st harmonic) detection in vitro in melanin phantoms, in vivo in melanoma models with cells implanted in the skin, in lymph nodes and having colonized the lungs, and finally on phantoms placed at the surface of human skin.ResultsIn vitro, we observed an increase in SNR by a factor of 10 in flat melanin phantoms when using MH analysis compared to CW combined with an increase in modulation amplitude. In B16 melanomas having grown in the skin of hairless mice, we observed a boost in sensitivity in vivo similar to that observed in vitro with the capability to detect melanoma cells at an earlier stage of development. MH-EPR was also able to detect non-invasively the melanin signal coming from melanoma cells present in lymph nodes as well as in lungs. We also observed a boost of sensitivity using phantoms of melanin placed at the surface of human skin.ConclusionsOverall, our results are paving the way for new clinical trials that will use MH clinical EPR for the characterization of pigmented skin lesions.

Malignancy diagnosis of liver lesion in contrast enhanced ultrasound using an end-to-end method based on deep learning

BackgroundContrast-enhanced ultrasound (CEUS) is considered as an efficient tool for focal liver lesion characterization, given it allows real-time scanning and provides dynamic tissue perfusion information. An accurate diagnosis of liver lesions with CEUS requires a precise interpretation of CEUS images. However,it is a highly experience dependent task which requires amount of training and practice. To help improve the constrains, this study aims to develop an end-to-end method based on deep learning to make malignancy diagnosis of liver lesions using CEUS.MethodsA total of 420 focal liver lesions with 136 benign cases and 284 malignant cases were included. A deep learning model based on a two-dimensional convolution neural network, a long short-term memory (LSTM), and a linear classifier (with sigmoid) was developed to analyze the CEUS loops from different contrast imaging phases. For comparison, a 3D-CNN based method and a machine-learning (ML)-based time-intensity curve (TIC) method were also implemented for performance evaluation.ResultsResults of the 4-fold validation demonstrate that the mean AUC is 0.91, 0.88, and 0.78 for the proposed method, the 3D-CNN based method, and the ML-based TIC method, respectively.ConclusionsThe proposed CNN-LSTM method is promising in making malignancy diagnosis of liver lesions in CEUS without any additional manual features selection.

Pathological characterization of pulmonary lesion and identification of associated bacteria and parasite infection in sheep and goat slaughtered at Dessie municipal abattoir, North-East Ethiopia

BackgroundLung is susceptible and vulnerable to many infectious and non-infectious agents. From this, a large number of specific and nonspecific diseases conditions can be diagnosed. A cross-sectional study design was conducted from December 2022 to May 2023 on major pulmonary lesion of sheep and goat slaughtered at Dessie municipal abattoir with the objective of characterizing the pulmonary pathological lesions, and isolating and identifying potential aerobic bacteria and parasite from pneumonic lung.Materials and MethodsA total of 420 (302 sheep and 118 goats) were examined for gross lung lesions and histopathological investigation using standard techniques. Additionally, detailed pathological investigation was conducted on purposively selected lung lesions. Besides, pneumonic lesions were subjected to routine bacteriological and parasitological analysis.ResultsThe overall abattoir prevalence of pulmonary abnormalities in sheep and goat was 81.2% (341/420). The common gross lesions encountered were Pneumonia (55.5%), emphysema (7.1%), atelectasis (3.3%), Hydatid cyst (4.3%), congestion (2.4%), haemorrhage (3.1%), Anthracosis (0.9%), adhesion (0.7%), and Bronchoectasis (0.7%) respectively. Pneumonia, hydatidosis, and pulmonary emphysema were significantly associated (p < 0.05) with animal age groups. Pneumonia was the most common disorder, accounting for 233 (55.5%). Dictyocaulus filaria (47.7%), Mullerius capillaries (23.2%) and Protostrongylus rufescens (17.16%) were isolated lung worm parasites; whereas E. coli (20.6%), Klebsiella Pneumoniae (12.7%), Mannheimia haemolytica (10.8%), Streptococcus species (4.9%), Staphylococcus aurous (7.8%) and Pasteurella multocida (2.9%), Pseudomonas (6.9%), Proteus (1.9%) and Cornybacterium (1%) were the isolated bacteria. Moreover, 18 (4.3%) Hydatid cysts were identified by cyst viability test. The pulmonary disorder of sheep and goats in the study are relatively high prevalent and posing great health and economic impacts.ConclusionPulmonary infection with different agents is very common in the study areas. Feasible and affordable control measures and using latest diagnostic techniques like molecular detections of bacteria, viruses, and fungi, is necessary.

Bone Reporting and Data System (Bone-RADS) and Other Proposed Practice Guidelines for Reporting Bone Tumors.

The purpose of this article is to review the different bone tumor radiology reporting systems [Bone Reporting and Data System (Bone-RADS), Osseous Tumor Reporting and Data System (OT-RADS), Solitary Bone Tumor Imaging Reporting and Data System (BTI-RADS), and Radiological Evaluation Score for Bone Tumors (REST)] and summarize their advantages and disadvantages. A selective search of PubMed was performed for literature regarding the definition and discussion of bone tumor reporting systems. No time frame was selected, but the search was particularly focused on current literature on musculoskeletal radiology lexicon. To date, four major reporting systems has been proposed to standardize and systematize the reporting of imaging studies of bone tumors: Bone-RADS, OT-RADS, BTI-RADS, and REST. Both Bone-RADS and OT-RADS aid in the characterization and management of bone lesions on CT and MRI. OT-RADS and REST can be applied to MRI and radiography, respectively. Radiologists play a central role in the detection and characterization of asymptomatic (or incidentally detected) and symptomatic bone tumors. There are several existing bone tumor reporting systems with various advantages and disadvantages including emphasis on lesion characterization as well as management of incidentally detected bone lesions. · Four bone tumor reporting systems have been proposed thus far.. · Bone-RADS guides management of incidental bone lesions on CT and MRI.. · OT-RADS guides management of bone lesions on MRI with high accuracy.. · BTI-RADS classifies bone tumors on CT and MRI..

In silico annotation of follicular thyroid neoplasm associated metabolic pathways and involved biomarkers: An aid to diagnosis

The follicular thyroid neoplasm (FTN) is like an unsolved puzzle at some stage in preoperative diagnosis. Usually, for preliminary characterization of thyroid lesions, clinicians depend much on fine-needle aspiration cytology (FNAC). However, in the case of FTN, FNAC cannot distinguish between benign and malignant entities, as both are exhibiting predominant follicular architecture. Cytological/ architectural/ or cellular criteria alone is not enough to differentiate Follicular adenoma (FA), Follicular thyroid carcinoma (FTC), Follicular variant of papillary thyroid carcinoma (FVPTC) together with Non-Invasive Follicular variant of Papillary Thyroid Carcinoma (NIFTP), Encapsulated FVPTC (EFVPTC) and well-differentiated neoplasm of uncertain malignant potential. Thus, the genetic analysis can be used as a novel diagnostic approach that should be applied with the traditional method for easy diagnosis of follicular thyroid neoplasm, which reduces the risk of unnecessary surgeries. This present study tried to explore the current genetic assessment of FTN through review of the genetics of FTN studied from 2009 to 2019 which showed the characterization of differential gene expression in these follicular neoplasms some extent. Also, pathway analysis has potentially implemented to minimize the diagnosis dilemma. In addition to the previously identified pathways and associated target genes, some novel endocrine cancer-related pathways with putative target genes of FTN have been remoted from characterizing tumor with follicular pattern. The observed genes might be considered as diagnostic biomarker in the respective FTN associated metabolic pathways.

As how artificial intelligence is revolutionizing endoscopy.

With incessant advances in information technology and its implications in all domains of our lives, artificial intelligence (AI) has emerged as a requirement for improved machine performance. This brings forth the query of how this can benefit endoscopists and improve both diagnostic and therapeutic endoscopy in each part of the gastrointestinal tract. Additionally, it also raises the question of the recent benefits and clinical usefulness of this new technology in daily endoscopic practice. There are two main categories of AI systems: computer-assisted detection (CADe) for lesion detection and computer-assisted diagnosis (CADx) for optical biopsy and lesion characterization. Quality assurance is the next step in the complete monitoring of high-quality colonoscopies. In all cases, computer-aided endoscopy is used, as the overall results rely on the physician. Video capsule endoscopy is a unique example in which a computer operates a device, stores multiple images, and performs an accurate diagnosis. While there are many expectations, we need to standardize and assess various software packages. It is important for healthcare providers to support this new development and make its use an obligation in daily clinical practice. In summary, AI represents a breakthrough in digestive endoscopy. Screening for gastric and colonic cancer detection should be improved, particularly outside expert centers. Prospective and multicenter trials are mandatory before introducing new software into clinical practice.

Artificial Intelligence-assisted colonoscopy and colorectal cancer screening: Where are we going?

Colorectal cancer is a significant global health concern, necessitating effective screening strategies to reduce its incidence and mortality rates. Colonoscopy plays a crucial role in the detection and removal of colorectal neoplastic precursors. However, there are limitations and variations in the performance of endoscopists, leading to missed lesions and suboptimal outcomes. The emergence of artificial intelligence (AI) in endoscopy offers promising opportunities to improve the quality and efficacy of screening colonoscopies. In particular, AI applications, including computer-aided detection (CADe) and computer-aided characterization (CADx), have demonstrated the potential to enhance adenoma detection and optical diagnosis accuracy. Additionally, AI-assisted quality control systems aim to standardize the endoscopic examination process. This narrative review provides an overview of AI principles and discusses the current knowledge on AI-assisted endoscopy in the context of screening colonoscopies. It highlights the significant role of AI in improving lesion detection, characterization, and quality assurance during colonoscopy. However, further well-designed studies are needed to validate the clinical impact and cost-effectiveness of AI-assisted colonoscopy before its widespread implementation.

Pathological Characterization and Risk Factors of Splenic Nodular Lesions in Dogs (Canis lupus familiaris).

In dogs, the spleen is a secondary lymphoid organ that can be affected by both neoplastic and non-neoplastic nodules. In general, few studies relate histopathological diagnosis to tumor size and the number of nodules in spleen biopsies. Some of these studies are inconclusive regarding the difference between neoplastic and non-neoplastic lesions and have small sample sizes or do not consider all splenic lesions. This study aimed to characterize splenic masses and determine risk factors for spleen tumors in dogs. A total of 507 histological reports corresponding to the diagnosis of splenic lesions in dogs from a private laboratory of animal pathology in the Metropolitan Region, Chile, were used. Data were analyzed by descriptive statistics and multiple logistic regression. The most frequent neoplastic and non-neoplastic diagnoses were hemangiosarcoma and hyperplasia, respectively. Most of the cases occurred in male (265 cases, 52.3%), senior (421 cases, 83%), and purebred individuals (342 cases, 67.5%). The most affected breeds were the Cocker Spaniel, German Shepherd, and Labrador Retriever. The most frequent lesion was a single nodule. The variables that exhibited a greater risk for the presentation of splenic neoplasia were male sex (odds ratio (OR) = 16.21; 95% confidence interval (CI) 1.741-150.879; p = 0.014), the presence of two or more splenic nodules (OR = 3.94; 95% CI 2.168-7.177; p < 0.001), an increase in nodule size greater than 2 cm (OR for quartiles 2, 3 and 4 of 2.2; 95% CI 1.036-4.941; p = 0.041, 2.9; 95% CI 1.331-6.576; p = 0.008, and 3.6; 95% CI 1.562-8.499; p = 0.003, respectively), and increasing age (OR = 1.23; 95% CI 1.048-1.436; p = 0.011). On the other hand, males exhibited a lower risk as age increases (OR = 0.76; 95% CI 0.615-0.928; p = 0.008). In conclusion, this study identified that males, multinodular presentation, nodule size, and age are risk factors for the occurrence of splenic neoplasia in dogs, knowledge that will contribute to the diagnostic management of dogs with spleen lesions.

Ultrasound assessment of ovarian lesions: O-RADS approach

Lesions of ovarian or adnexal origin are common in all age groups, but there is significant variability in the interpretation of the words, definitions, and morphologic descriptions by the radiologists and the clinicians. There has also been a paradigm shift in the diagnosis and management of ovarian lesions during the last 20 years. Ovarian-Adnexal Reporting and Data System (O-RADS) by the American College of Radiology (ACR) was introduced in 2018. ORADS US (ultrasonography) serves as a tool to simplify the characterization of adnexal lesions, minimize the use of misleading terminology, and aid in the management of such lesions. It maintains the six risk assessment categories (O-RADS US 0–5) with an increasing predicted risk of malignancy from O-RADS US 1 to 5. In this pictorial essay, we briefly summarize the O-RADS and its descriptors, followed by representative ultrasound images to help clinicians understand what the O-RADS descriptors in the ultrasound report would mean.

Feasibility of the application of deep learning-reconstructed ultra-fast respiratory-triggered T2-weighted imaging at 3 T in liver imaging

ObjectiveThe evaluate the feasibility of a novel deep learning-reconstructed ultra-fast respiratory-triggered T2WI sequence (DL-RT-T2WI) In liver imaging, compared with respiratory-triggered Arms-T2WI (Arms-RT-T2WI) and respiratory-triggered FSE-T2WI (FSE-RT-T2WI) sequences. Methods71 patients with liver lesions underwent 3-T MRI and were prospectively enrolled. Two readers independently analyzed images acquired with DL-RT-T2WI, Arms-RT-T2WI, and FSE-RT-T2WI. The qualitative evaluation indicators, including overall image quality (OIQ), sharpness, noise, artifacts, lesion detectability (LC), lesion characterization (LD), cardiacmotion–related signal loss (CSL), and diagnostic confidence (DC), were evaluated in two readers, and further statistically compared using paired Wilcoxon rank-sum test among three sequences. Results176 lesions were detected in DL-RT-T2W and Arms-RT-T2WI, and 175 were detected in FSE-RT-T2WI. The acquisition time of DL-RT-T2WI was improved by 4.8–7.9 folds compared to the other two sequences. The OIQ was scored highest for DL-RT-T2WI (R1, 4.61 ± 0.52 and R2, 4.62 ± 0.49), was significantly superior to Arms-RT-T2WI (R1, 4.30 ± 0.66 and R2, 4.34 ± 0.69) and FSE-RT-T2WI (R1, 3.65 ± 1.08 and R2, 3.75 ± 1.01). Artifacts and sharpness scored highest for DL-RT-T2WI, followed by Arms-RT-T2WI, and were lowest for FSE-RT-T2WI in both two readers. Noise and CSL for DL-RT-T2WI scored similar to Arms-RT-T2WI (P > 0.05) and were significantly superior to FSE-RT-T2WI (P < 0.001). Both LD and LC for DL-RT-T2WI were significantly superior to Arms-RT-T2WI and FSE-RT-T2WI in two readers (P < 0.001). DC for DL-RT-T2WI scored best, significantly superior to Arms-RT-T2WI (P < 0.010) and FSE-RT-T2WI (P < 0.001). ConclusionsThe novel ultra-fast DL-RT-T2WI is feasible for liver imaging and lesion characterization and diagnosis, not only offers a significant improvement in acquisition time but also outperforms Arms-RT-T2WI and FSE-RT-T2WI concerning image quality and DC.

Characterisation, prevalence and severity of skin lesions caused by ophidiomycosis in a population of wild snakes

Ophidiomycosis is an emerging infectious disease affecting wild snakes in the Northern Hemisphere. Recently confirmed in Great Britain, the prevalence, severity and significance of ophidiomycosis has yet to be characterised in free-living snakes at a population level in Europe. Therefore, a population of barred grass snakes (Natrix helvetica) in eastern England was monitored for three seasons (May 2019 to October 2021), to investigate the prevalence (25.5%; 191/750 snakes) and severity of skin lesions and their aetiology. The most frequently observed skin lesion characteristics were changes in scale colour, crusting, and scale margin erosion. The majority of such lesions (96.9%; 185/191 snakes) was observed on the ventral surface along the length of the body. The severity of skin lesions was considered mild in more than half of the cases (53.1%; 98/191 snakes). Predominantly, skin lesions were observed in adult snakes (72.8%; 139/191 snakes). Combined histological examinations and qPCR tests of skin lesions from N. helvetica sloughs and/or carcasses confirmed a diagnosis of ophidiomycosis. Further targeted surveillance, supported by molecular and histological examinations to confirm skin lesion aetiology, is required to determine the extent to which our findings reflect the occurrence of ophidiomycosis in populations within wider landscapes.