To investigate changes in the fatty acid composition of the lumbar vertebral bone marrow in patients with Crohn's disease (CD) and its relationships with disease activity and complex disease behavior. This study, designed as a single-center, cross-sectional, and prospective trial, was conducted between September 2023 and February 2025, with 83 CD patients and 70 healthy individuals. Disease activity was evaluated using the CD activity index (CDAI). Disease behavior was recorded based on the Montreal classification. Quantitative analysis of saturated, unsaturated, monounsaturated, and polyunsaturated fatty acids (SFA, UFA, MUFA, and PUFA) for lumbar vertebrae by using a two-dimensional bipolar multi-echo 3-T MRI. Spearman correlation and logistic regression analyses were employed. PUFA was significantly lower, whereas MUFA was significantly higher in the CD than in the control group (p = 0.03 and 0.04, respectively). CDAI was positively correlated with UFA and PUFA (r = 0.30 and 0.47; p = 0.01 and p < 0.001, respectively), and negatively correlated with SFA (r = -0.29, p = 0.01). The complicated disease behavior negatively correlated with PUFA only (r = -0.31; p = 0.01). Regression analysis showed that PUFA was an independent risk factor for CDAI (p = 0.01). PUFA and disease duration were independent impact factors for complicated disease behavior (p = 0.02 and 0.01, respectively). CD patients exhibited alterations in bone marrow fatty acid composition compared to healthy controls. Bone marrow PUFA was a potential predictor of disease activity state and complicated disease behavior. Questions What was the relationship of bone marrow fatty acids with disease activity and complex disease behavior in patients with Crohn's disease (CD)? Findings Alterations in bone marrow fatty acid composition were found in CD. Polyunsaturated fatty acids were related to disease activity and complex disease behavior. Clinical relevance Non-invasive MRI imaging assessment of bone marrow fatty acids in vivo has the potential to monitor disease activity and treatment response, which may provide a new imaging marker for insight into the inflammation in CD.

Objective Airway foreign body (AFB) in adults remains a potentially life-threatening emergency, which lacks standardized clinical pathways of management. This review aims to synthesize current evidence on the clinical recognition, imaging work-up, and bronchoscopic management of AFB in adults and to propose a practical, stepwise algorithm, enabling interventional pulmonologists to establish a systematic retrieval framework as early as possible and thereby optimize care for adult patients. Methods A narrative review was conducted by searching PubMed for studies focusing on the bronchoscopic management of AFB in adults. The emphasis is on the tool selection, critical techniques, and procedural nuances for AFB retrieval. Personal clinical experience also informed the interpretation and contextualization. Results Adult AFB typically presents with chronic cough, dyspnea, wheeze, or recurrent post-obstructive pneumonia. Computed tomography (CT) is the first-line imaging modality (pooled sensitivity 98.8%, specificity 96.6%), but radiolucent organic material may yield false-negative results; therefore, high clinical suspicion warrants direct bronchoscopy. The right main bronchus is the most common site because of its anatomical features. Pre-intervention planning matches AFB characteristics (site, size &amp;amp; shape, and substance) with patient status to decide between rigid and flexible scopes and to select retrieval accessories. Flexible bronchoscopy under general anesthesia via laryngeal mask airway achieves &amp;gt; 90% success in adults, which is preferred for peripheral items, whereas rigid bronchoscopy remains the gold standard for large, sharp, or proximal AFBs. Tool choice follows an object-specific strategy: forceps for metal/bone, snare for bulky, irregular items, basket for smooth, round seeds, balloon for impacted distal AFBs after dilation, and cryoprobe for semisolid, water-rich material (blood clot, mucus plug, food). Complication rates are lowest when dislodgement and extraction are performed as a single, controlled maneuver under continuous visualization; hybrid rigid–flexible approaches further improve safety. Conclusions Consider AFB in adults with unexplained chronic respiratory symptoms. CT guides but does not replace bronchoscopy. An individualized strategy—flexible scope first (in patients with stable status), rigid scope reserved for selected complex cases—combined with object-tailored tools optimizes successful AFB retrieval while minimizing morbidity. Maintaining both rigid and flexible systems, trained multidisciplinary teams, and strict manometric monitoring are essential components of AFB retrieval.

Ongoing active monitoring (AM) trials for women with ductal carcinoma in situ (DCIS) are investigating the safety and efficacy of monitoring DCIS lesions vs the current standard of care (surgical treatment). The frequency of upgrade in women undergoing AM for DCIS remains unknown. To evaluate the frequency of upgrade of DCIS at core-needle biopsy to invasive carcinoma at surgical excision among women who meet eligibility criteria for AM trials. A retrospective review between 2010 and 2023 was performed of women at an National Cancer Institute-designated comprehensive cancer center with a diagnosis of DCIS at core-needle biopsy who underwent subsequent surgical excision. Medical records were reviewed for clinical presentation, imaging findings, core biopsy, and final surgical pathology. Each patient was evaluated for AM trial eligibility based on published criteria for the LORD, LORIS, and COMET trials. Fisher's exact test compared proportions, with a P-value <.05 considered statistically significant. Of 264 women, 10/264 (3.8%) were eligible for the LORD trial, 24/264 (9.1%) for the LORIS trial, and 64/264 (24.2%) for the COMET trial. Invasive carcinoma was found at surgical excision in 1/10 (10%) patients eligible for the LORD trial, 2/24 (8.3%) for the LORIS trial, and 9/64 (14.1%) for the COMET trial. All occult invasive carcinomas detected at surgical excision in trial-eligible patients were node-negative, with a median size of invasive cancer measuring 3.5 mm (interquartile range, 1-7 mm). A subset of women who meet eligibility criteria for DCIS AM trials are at risk for occult invasive carcinoma, with frequency of upgrade ranging from 8% to 14%. More precise criteria and predictive biomarkers are needed to better stratify DCIS lesions and exclude women harboring invasive carcinomas from AM regimens.

Objective.While photon-counting computed tomography (PCCT) improves image quality and reduces radiation dose, artifacts induced by cardiac and respiratory motion is still a challenge. The purpose of this work is to evaluate the potential of an image-domain motion-artifact-correction method based on a deep-learning model that incorporates spectral information (material basis images).Approach.We simulated PCCT imaging of five XCAT phantoms, and used these for training two deep neural networks-one with and one without spectral information-to map two motion-corrupted virtual monoenergetic images to corresponding motion-free images. Using images from another simulated XCAT phantom, we calculated the CT number error on five regions of interest and 10 segmented organs. The method was also evaluated visually on clinical cardiac PCCT images. Stretch quantification of endocardial engraved zones was used to calculate regional wall motion and mechanical delay. The results were compared with the motion-free image using a paired t-test.Main results.Out of 45 regions and organs, the CT number accuracy is improved in 41 regions (91%). Among these, the best accuracy is obtained with spectral information in 25 regions (61%). Both models, in particular the one with spectral information, improves visual image quality in simulated and clinical images. The model significantly (P< 0.01) improved estimation of the regional wall motion and assessment of mechanical delay of the left ventricle, but no significant difference was observed between models with and without spectral information.Significance.Our approach, validated on simulated datasets, shows that quantitative cardiac CT imaging can be improved by deep-learning motion correction and that spectral information substantially improves performance.

GloW-VSNet: A scribble-based weakly supervised framework for global-view vitiligo lesion segmentation.

Agent-MIRA: AI-orchestrated medical imaging agent for PET image retrieval and assistance.

Interstitial lung disease (ILD) is a diverse group of pulmonary disorders characterized by inflammation and fibrosis of the lung parenchyma. Previous studies have linked acute exacerbation (AEx) events in patients with idiopathic pulmonary fibrosis to frequent hospitalizations, increased health care resource utilization (HCRU), and high mortality. However, limited information exists regarding the impact of AEx in other forms of fibrosing ILD. To assess HCRU and the associated costs of managing AEx in patients within a large population of patients with fibrosing ILD. This retrospective cohort study used a large US claims database to identify adults (aged ≥18years) with fibrosing ILD who experienced at least 1 AEx event between January 2017 and September 2022. AEx events were identified using an algorithm based on clinical guidelines, symptoms, imaging, and prescriptions. Using propensity score matching, patients with AEx were matched to those without AEx. Baseline data were evaluated for 12 months before the date of first AEx or assigned proxy equivalent (index date), with follow-up until death, loss to follow-up, or study conclusion. Outcomes included health care costs, inpatient stay frequency and length, emergency department and outpatient visits, and prescriptions. Two-part regression models compared health care utilization and costs during follow-up. A total of 8,929 patients were identified as having at least 1 qualifying AEx event. After matching for clinical and demographic characteristics, 8,104 were retained in both the AEx and comparator cohorts (average age, 63years; average Charlson Comorbidity Index, 8.18-8.33). An evaluation of postmatch baseline characteristics indicated cohorts to be well-balanced. Patients were followed for a mean of 616 days in the AEx group and 648 days in the comparator group. Regression analysis found all-cause inpatient HCRU to be 53% (risk ratio [95% CI] = 1.53 [1.45-1.62]) and outpatient HCRU to be 13% (risk ratio 1.13 [1.09-1.17]) higher for AEx cohort patients. For ILD-related utilization, the inpatient and outpatient rates were 98% and 63% higher, respectively, in the AEx cohort. Total per-patient per-month health care costs were $17,549 for AEx and $11,715 for comparator cohorts (P < 0.001). Per-patient per-month outpatient pharmacy costs were not significantly different between the cohorts ($1,327 vs $1, 302). This study found that patients with ILD experiencing AEx events incur significantly greater health care utilization and total costs than matched patients without AEx events. This study fills a key gap in understanding the broader health care burden of AEx beyond idiopathic pulmonary fibrosis.

Kartagener's Syndrome (KS), a rare autosomal recessive disorder and a subset of Primary Ciliary Dyskinesia (PCD), is characterized by chronic sinusitis, bronchiectasis, and, in approximately 50% of cases, situs inversus. This condition arises from genetic mutations that impair motile cilia function, leading to defective mucociliary clearance, recurrent respiratory infections, and progressive lung damage. While KS is typically diagnosed in childhood, its recognition in adults is often delayed due to symptom overlap with common respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), or cystic fibrosis. This case report describes a 40-year-old male who presented with a 10-12-day history of productive cough, intermittent left-sided chest pain, and a longstanding history of recurrent respiratory infections and chronic sinusitis. Diagnostic imaging, including chest X-rays and computed tomography (CT) scans, revealed bilateral bronchiectasis, right lung atelectasis, and isolated dextrocardia, with all other organs maintaining normal anatomical positions (situs solitus), an atypical presentation of KS. Laboratory findings indicated mild neutrophilic leukocytosis, and sputum cultures confirmed Pseudomonas aeruginosa infection, a common pathogen in bronchiectasis. The patient was managed with inhaled bronchodilators, corticosteroids, targeted antibiotic therapy, and chest physiotherapy to enhance mucociliary clearance. A multidisciplinary team, including pulmonologists and cardiologists, was engaged to address the complex, multisystem nature of KS and provide long-term care. This case underscores the diagnostic challenges of identifying KS in adults, particularly with atypical features like isolated dextrocardia, and emphasizes the critical need for comprehensive clinical evaluation, advanced imaging, and consideration of rare genetic disorders in patients with chronic respiratory symptoms.

As total ankle arthroplasty becomes an increasingly common treatment for end-stage ankle arthritis, managing failing implants is becoming a growing challenge for orthopaedic surgeons. The UK National Joint Registry reports a 13-year cumulative revision rate of 17.01% in patients aged under 65 years, and 3.22% in those aged over 75 years. These complex cases are challenging to manage and require a structured, multidisciplinary approach. Key factors influencing management include implant and hindfoot alignment, infection, bone stock, and implant stability. Recent advances in implant design, imaging methods, surgical planning, and revision techniques have expanded the armamentarium available to orthopaedic surgeons. This article aims to provide an overview of the algorithmic assessment and management of the failing ankle arthroplasty, highlighting the importance of thorough clinical evaluation, appropriate imaging, and early identification or exclusion of periprosthetic joint infection, along with tailored treatment strategies for each underlying pathology.

Cowden syndrome (CS) is a rare autosomal-dominant inherited variant of PTEN (phosphatase and tensin homolog gene) hamartoma tumor syndrome caused by mutations to the PTEN tumor suppressor gene, leading to activation of the PI3K/AKT/mTOR intracellular signaling pathway. Patients with this syndrome present with multisystem hamartomatous lesions and are particularly predisposed to developing malignancies, including breast, thyroid, renal, endometrial, and colorectal malignancies. Mucocutaneous lesions, especially trichilemmomas, and macrocephaly are commonly seen in the 2nd decade of life and usually manifest before the development of malignancies. In children, clinical manifestations such as intellectual disability and gastrointestinal polyps may arise and may prompt early investigation and diagnosis. Major features of CS include Lhermitte-Duclos disease, breast cancer, endometrial cancer, thyroid carcinoma, macrocephaly, and gastrointestinal hamartomas. Other features that are considered part of the minor clinical diagnostic criteria include colorectal cancer, esophageal glycogenic acanthosis, lipomas, renal cell carcinoma, testicular lipomatosis, and vascular anomalies. Comprehensive evaluation including clinical and genetic assessment and imaging is essential for early diagnosis and management. Given the increased risk of developing malignancies, surveillance strategies have been routinely updated and recommended by the National Comprehensive Cancer Network. Important cancer surveillance imaging strategies include mammography, MRI of the breast, and US of the thyroid and kidneys, although other manifestations are routinely assessed with CT and MRI. In this article, the genetics and molecular pathogenesis, clinical manifestations, imaging features, and most up-to-date surveillance recommendations of CS are reviewed. ©RSNA, 2026 Supplemental material is available for this article.

Alterations of static and dynamic brain functional network connectivity in preschool children with autism spectrum disorder.

Neural mechanisms of response inhibition impairments in patients with perimenopausal insomnia.

Calcium Pyrophosphate Dihydrate (CPPD) deposition disease, also known as pseudogout, is a crystal-induced arthropathy that primarily affects larger, weight-bearing joints such as the knees, hips, and shoulders. CPPD can present with a wide spectrum of clinical manifestations, ranging from asymptomatic chondrocalcinosis to acute inflammatory arthritis. CPPD in the spine is rare and can lead to calcification of the ligamentum flavum, potentially causing spinal cord compression, myelopathy, and significant neurological impairment. The absence of chondrocalcinosis on imaging does not rule out the diagnosis of spinal CPPD. On microscopy, CPPD is characterised by rhomboid-shaped, positively birefringent crystals, in contrast to the needle-shaped, negatively birefringent crystals observed in gout. The present case report of a 78-year-old female highlights a rare and isolated clinical presentation of CPPD causing lumbar spine myelopathy, which was discovered incidentally on histopathology after spinal decompression and discectomy surgery. Although imaging modalities may raise suspicion for CPPD by revealing chondrocalcinosis, they often lack the specificity to differentiate it from other degenerative or inflammatory conditions. Histopathological analysis and polarised microscopic examination remain the cornerstones in diagnosing CPPD, even in atypical clinical presentations or ambiguous imaging findings. This underscores the importance of including pseudogout in the differential diagnosis of lumbar myelopathy, particularly in elderly patients, to provide early, targeted treatment and prevent severe irreversible neurological deficits.

DVAP-Reg: Dual-view anatomical prior-driven cross-dimensional registration for spinal surgery navigation.

Dissecting the clinical and pathophysiological complexity of fundus tessellation.

&lt;span lang="EN-US"&gt;Tuberculosis is one of the biggest threats that has been remaining a contagious disease since its discovery, posing a significant risk to millions of lives. Many people yield to TB because of incomplete treatments or the lack of preventive measures. An effective pulmonary TB diagnostic system has remained a big challenge. As it is a contagious disease, it mainly affects the lungs and other vital organs of the human body. We find DL as a subset of ML that runs an incurable disease diagnostic system with multi-neural architectures. In recent ages, a neural model can detect more accurately and quickly resulting in classified labels as normal and positive TB cases. It helps medical practitioners to identify bacterial infections in the early stage. It has also enabled proper diagnosis and treatment for pulmonary tuberculosis. Through this paper, an enhanced detection model to classify TB and non-TB cases using clinical X-ray images has been proposed. The augmented histogram equalized X-rays were applied to top state-of-the-art classifiers. The evaluation matrics have been compared with and without histogram equalization and a comparative study is done to find the best CNN classifiers. The Resnet 50 and ResNet169 have shown the higest accuracy on preprocessed chest X-rays with 99.6% and 99.48% respectively. &lt;/span&gt;

Chondroid lipoma is a rare benign soft-tissue tumour characterised by the presence of both mature adipose and chondroid-like extracellular matrix components. We present the case of a 34-year-old male who reported a slow-growing, painless swelling on the plantar aspect of the right foot evolving over two years, with a history of preceding trauma. The swelling was associated with sharp, pricking pain exacerbated by walking and relieved on rest in the last eight months. The patient had no similar lesions elsewhere and was newly diagnosed with diabetes without other comorbidities. Clinical evaluation and imaging are crucial for diagnosis, given the rarity and non-specific presentation of this tumour, especially at the uncommon plantar foot location, which can mimic other soft tissue masses. Magnetic Resonance Imaging (MRI) plays a significant role in delineating the tumour's extent and composition, aiding in surgical planning. Histopathological examination confirms the diagnosis by revealing a biphasic pattern of mature adipocytes mixed with chondroid areas devoid of malignant features. Complete surgical excision is the treatment of choice, with an excellent prognosis and a low likelihood of recurrence. This case underscores the importance of considering chondroid lipoma in the differential diagnosis of slow-growing, painful swellings in the foot, especially post-trauma, to avoid misdiagnosis and ensure appropriate management. Awareness of this rare entity enables clinicians to differentiate it from more aggressive neoplasms and tailor treatment accordingly, leading to better patient outcomes.

Analysis of prognostic factors in acute encephalopathy with biphasic seizures and late reduced diffusion: a retrospective study on MRI findings and the treatments.

Association between disability and alexithymia in lumbar disc herniation: A cross-sectional study.

Calcified chronic subdural hematoma (CCSDH) is a rare neurosurgical entity. Due to limited reported cases, its diagnosis and management remain poorly understood. This study aims to enhance the understanding of CCSDH and improve familiarity with its clinical presentation, imaging features, and treatment strategies. A comprehensive search was performed using PubMed, Scopus, DOAJ (Directory of Open Access Journals), BASE (Bielefeld Academic Search Engine), and ScienceDirect with the keyword "calcified chronic subdural hematoma," without date restrictions. Out of 354 articles initially identified, 163 unique records remained after merging duplicates. Following abstract and full-text screening, 76 articles describing 93 cases were included. One additional case from our institution was added, resulting in 94 cases reviewed. The average patient age was 41.88 years, with a strong male predominance (sex ratio 4.53). No past medical history was noted in 24 cases; ventriculoperitoneal shunt was present in 33 cases. While 14% were asymptomatic, 34% presented with intracranial hypertension, 12.5% with altered consciousness, 33% with motor deficits, and 25.5% with seizures. Bilateral CCSDH was observed in 21 patients, totaling 115 hematomas. Imaging showed: capsule-only calcification (52%), total (28%), or partial (20%) calcification. Hematoma shapes were biconvex (37%), concave (29%), bean-like (20%), irregular (7%), and thin lamina (6%). Computed tomography (CT) was used in 90.5%, and magnetic resonance imaging in 43.6%. Twenty-seven were visible on plain X-ray. Twenty cases were managed conservatively; two later required surgery. About 70 surgical procedures were performed: 60 via craniectomy, 9 burr holes procedures, and 1 via twist drill. Outcomes were favorable in 75% of conservatively treated cases and 87.5% of craniectomy cases. Six surgical deaths occurred. CCSDH primarily affects young males, often with a history of shunting. CT remains the imaging modality of choice. Conservative treatment is suitable for noncompressive, asymptomatic cases, while surgical evacuation via craniectomy offers the best outcomes when intervention is required.