Computer-assisted Measurement Research Articles

Dependence of Renal Uptake on Kidney Function in [68Ga]Ga-PSMA-11 PET/CT Imaging.

(1) Background: PSMA ligand PET/CT is increasingly important for diagnostics of prostate cancer and other tumor diseases. In particular, the radiopharmaceutical [68Ga]Ga-PSMA-11 is widely used. Besides its tumor-specific binding, the uptake within the kidneys is dominant and seems to visualize the renal cortex specifically. Kidney diseases may alter the uptake of radiopharmaceuticals. Therefore, the correlation between renal uptake in PET/CT imaging and renal function should be investigated. (2) Methods: A group of 103 male patients were retrospectively evaluated for eGFR according to the CKD-EPI equation, tracer uptake intensity (SUVmax, SUVpeak, SUVmean), the molecular volume of the renal cortex, morphological kidney size, and total renal uptake. Manual and three different computer-assisted contouring methods (thresholds at 50% of SUVmax, 30% of SUVmax, and absolute SUV of 20) were used for measurements. Correlations between parameters were calculated using linear regression models. (3) Results: Renal SUVmax, SUVpeak, and SUVmean do not correlate with eGFR for manual or computer-assisted measurements. In contrast, molecular cortex volume shows a moderate correlation with eGFR (R2 = 0.231, p < 0.001), superior to morphological kidney size. A contouring threshold of 30% of SUVmax outperformed the other settings for renal cortex volume and total renal uptake. (4) Conclusions: Renal uptake of [68Ga]Ga-PSMA-11 cannot predict eGFR, but the functional renal cortex can be quantified by PET/CT imaging.

Enhancing Precision and Efficiency in Knee Arthroplasty: A Comparative Analysis of Computer-Assisted Measurements with a Novel Software Tool versus Manual Measurements for Lower Leg Geometry.

(1) Background: The aim of this prospective study was to evaluate measurement software in comparison with manual measurements using inter-observer and intra-observer variability on radiographs in the preoperative planning of total knee arthroplasty. (2) Methods: Two independent observers retrospectively measured the mechanical lateral proximal femoral angle (mLPFA), the mechanical lateral distal femoral angle (mLDFA), the joint line convergence angle (JLCA), the mechanical medial proximal tibial angle (mMPTA), the mechanical lateral distal tibial angle (mLDTA), the hip-knee angle or mechanical tibial-femoral axis angle (HKA), and the anatomical-mechanical angle (AMA) on 55 long-leg anteroposterior radiographs manually twice, followed by measurements using dedicated software. Variability between manual and computer-aided planning was assessed, and all measurements were performed a second time after 14 days in order to assess intra-observer variability. (3) Results: Concerning intra-observer variability, no statistically significant difference was observed regarding the software-based measurements. However, significant differences were noted concerning intra-observer variability when measuring the mLDFA and AMA manually. Testing for statistical significance regarding variability between manual and software-based measurements showed that the values varied strongly between manual and computer-aided measurements. Statistically significant differences were detected for mLPFA, mLDFA, mMPTA, and mLPTA on day 1, and mLPFA, mMPTA, and mLPTA on day 15, respectively. (4) Conclusions: Preoperative planning of leg axis angles and alignment using planning software showed less inter- and intra-observer variability in contrast to manual measurements, and results differed with respect to manual planning. We believe that the planning software is more reliable and faster, and we would recommend its use in clinical settings.

Optic canal: a CT-based morphometric study in north Indian population

BackgroundLesser wing of sphenoid joins the body of sphenoid by two roots which are separated by the optic canal. Optic canal is a communicating channel between orbit and middle cranial fossa, forming a passage for the ophthalmic artery and optic nerve. Considering the delicate neurovascular structure that traverses the narrow confines of the optic canal, knowledge of the morphometry, anatomical variations of this canal and their relations becomes an important part of diagnostic medicine and surgical management.ObjectiveThe aim of the study was to conduct morphometric analysis and document variations of optic canal in north Indian population and study its sexual dimorphism.Material and MethodType of Study Cross-sectional study. Sample size 200 Computerized tomography head axial section scans from picture archiving and communication system. The computer-assisted measurements of optic canal parameters were obtained on both right and left sides. Statistical analysis Unpaired t-test, paired t-test and ANOVA were applied.ResultOptic canal of 110 males, 90 females were examined. The overall cranial opening diameter, orbital opening diameter and length of optic canal in males were 4.34 ± 0.74, 3.17 ± 0.58 and 9.81 ± 1.62 and in females they were 3.99 ± 0.71, 2.97 ± 0.59 and 9.38 ± 2.02 respectively.ConclusionSignificant gender difference is seen in cranial and orbital opening diameter, and distance from midsagittal plane. No statistical significant difference is observed in right and left side parameters. A thorough knowledge of the normal dimensions of optic canal is important for evaluation and management of cases of optic nerve decompression.

Preoperative sarcopenia combined with prognostic nutritional index predicts long-term prognosis of radical gastrectomy with advanced gastric cancer: a comprehensive analysis of two-center study

PurposeThis study aims to investigate the predictive value of the combined index smni(skeletal muscle index (SMI)-prognostic nutrition index(PNI)) for the postoperative survival of patients with advanced gastric cancer(AGC).Methods650 patients with AGC from two centers (290 cases from the First Affiliated Hospital of Dalian University and 360 points from the Fujian Medical University Union Hospital) were selected as the study subjects based on unified screening criteria. Clinical data, preoperative abdominal CT images, results of hematology-related examinations, tumor-related characteristics, and surgical and follow-up data of the patients were collected and organized. The L3 vertebral level muscle area was measured using computer-assisted measurement techniques, and the skeletal muscle index(SMI) was calculated based on this measurement. The prognostic nutrition index (PNI) was calculated based on serum albumin and lymphocyte count indicators. The Kaplan-Meier survival analysis of data from the First Affiliated Hospital was used to determine that SMI and PNI are significantly correlated with the postoperative survival rate of patients with advanced gastric cancer. Based on this, a novel combined index smni was fitted and stratified for risk. Cox proportional hazards regression analysis was used to determine that the index smni is an independent prognostic risk factor for patients with AGC after surgery. The ROC curve was used to describe the predictive ability of the new combined index and its importance and predictive power in predicting postoperative survival of patients with AGC, which was verified in the data of Fujian Medical University Union Hospital.ResultThe Kaplan-Meier curve analysis of the combined indicator smni Is clearly associated with long-term survival(3-year OS (P < 0.001) and DSS (P < 0.001)), univariate analysis and multivariate analysis showed that smni was an independent prognostic risk factor, The ROC curve for the first center 3-year OS(AUC = 0.678), DSS(AUC = 0.662) show good predictive ability and were validated in the second center.ConclusionThe combined index smni has a good predictive ability for the postoperative survival rate of patients with AGC and is expected to provide a new reference basis and more accurate and scientific guidance for the postoperative management and treatment of patients with AGC.

Macerals particle characteristics analysis of tar-rich coal in northern Shaanxi based on image segmentation models via the U-Net variants and image feature extraction

To investigate the particle characteristics of tar-rich coal macerals before separation, this study focuses on the tar-rich coal in northern Shaanxi, China, as the research object. The image segmentation models of U-Net variants (Mobile-Unet, VGG-Unet, Res-Unet, and TransUNet) are combined with OpenCV feature extraction to systematically study the particle morphology, particle size, liberation characteristics, and density separation process of coal macerals. The results indicate that the morphology of vitrinite tends to an olive-like shape as the particle size decreases, whereas the morphology of inertinite is complex and changeable. Further, the particle sizes of raw coal, vitrinite, and inertinite range from 0.09 mm to 0.075 mm, and their morphology uniformity is the best in this range. The statistical difference between the grid calculation point method (GCPM) and the pixel area statistics method (PASM) is mainly due to the particle size uniformity. When the particle size is less than 0.03 mm, the error is less than 3.0 %. By narrowing the range of the liberation densities and separating them preferentially, samples within the range of the unliberated densities are returned to the regrinding process to separate and enrich the vitrinite and inertinite groups in coal, which effectively improves their purity and recovery. In summary, Res-UNet, TransUNet, and the PASM not only have considerable potential for the qualitative analysis of maceral compositions and their liberation types but also provide powerful computer-assisted measurement to achieve reasonable separation and utilization of coal macerals.

Validation of the X-ray microtomography in the assessment of duodenal morphometry and surface area in celiac disease.

BackgroundDuodenal histology remains the diagnostic reference standard in celiac disease. However, traditional methods have suboptimal sensitivity and reproducibility for early mucosal changes and research purposes. We validated a recently introduced micro-CT imaging method for an accurate digital evaluation of duodenal histomorphometry and mucosal surface areas.MethodsEndoscopic biopsies from 58 individuals were utilized for the micro-CT imaging, selecting histological changes ranging from normal to severely damaged mucosa. The imaging protocol was optimized for practicability and resolution. The Bland–Altman method was applied to test intra- and interobserver variations in the blinded measurements.ResultsThe 3D micro-CT reconstructions enabled easy and precise digital cutting with optimal orientation and computer-assisted measurement of the surface area. Intraobserver analysis of morphological measurements showed a mean difference of 0.011 with limits of agreement (LA) from -0.397 to 0.375 and a standard deviation (SD) of 0.197. The corresponding figures for interobserver analysis were 0.080, from -0.719 to 0.537 and 0.320, respectively. The intraclass correlation coefficients (ICC) for the intraobserver and interobserver variations were 0.981 and 0.954, respectively. Intraobserver surface area analysis yielded a mean difference of 0.010, LA from -0.764 to 0.785 and an SD of 0.395, and an interobserver analysis mean difference of 0.028, LA from -0.642 to 0.698 and SD of 0.342. The respective ICCs for the intra- and interobserver variations were 0.963 and 0.972.ConclusionsMicro-CT showed excellent accuracy and reproducibility in the evaluation of mucosal morphometry and surface areas. The improved sensitivity for histological changes is a powerful tool for the diagnosis of celiac disease and for clinical and pharmacological studies.

Data recording of seizures in children with autism spectrum disorder: description and social validation of computer-assisted measurement

Some children with autism spectrum disorder (ASD) experience seizures and associated staring episodes, loss of consciousness, weakened muscle tone, and myoclonic jerking. Data recording of seizure frequency, duration, and co-occurring behavior is necessary to document the effects of anti-epileptic medications, identify contextual influences on seizure expression, and differentiate seizures from other movement disorders. We describe the design and operation of a computer-assisted system for recording seizures among children with ASD in a social validity study that revealed uniform approval and acceptance of the system from practitioners, clinicians, and nurse (N = 22), parents (N = 11), and neurologists (N = 7). The objectives and benefits of targeting the social validity of technology-based seizure tracking are discussed are discussed.

ABC/2 formula for “bedside” postoperative pneumocephalus volume measurement

BackgroundPostoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma (cSDH). However, there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical use. The ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions, such as intracranial hematomas. This study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus, as compared to the gold standard with computer-assisted volumetric analysis.MethodsA total of 141 postoperative computed tomographic (CT) brain scans of cSDH patients with burr-hole drainage were analysed. Pneumocephalus volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric measurement. For the computer-assisted measurement, the volume of the air was semiautomatically segmented and calculated by computer software. Linear regression was used to determine the correlation between the ABC/2 method and computer-assisted measurement.ResultsThe postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage (29.34 ml versus 12.21 ml, p < 0.001). The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique, with r = 0.992 (p < 0.001). The Pearson correlation coefficient is very close to 1, which signifies a very strong positive correlation, and it is statistically significant.ConclusionsAn excellent correlation is observed between the ABC/2 method and the computer-assisted measurement. This study verified that the ABC/2 method is an accurate and simple “bedside” technique to estimate pneumocephalus volume.

Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters.

Stroke in the postoperative time course after heart surgery remains a serious risk. Cranial computer tomography (CCT) is the first line option to detect severe intracranial damage. However, only few data are available to predict neurological outcome. Using visual rating scales (VRSs), this study addresses reliability and effectivity to indicate neurological status and likelyhood of improvement. In a single-center retrospective evaluation, 3719 patients underwent coronary bypass surgery. Because of a delayed recovery phase and neurologic deficits after cardiac surgery 109 patients had a cranial CT scan in the early postoperative period. The incidence of clinically relevant findings within the imaging was rated by an experienced neuroradiologist using two VRS,that is, the age-related white matter changes (ARWMCs) and the Mendes-Ribeiro visual rating scale (MRVRS). Both are computer-assisted measurement schemes to detect stroke-related intracranial damage. Follow-up was investigated with regard to clinical outcome and patient-related risk profiles. Of 109 patients with postoperative cranial CT scans due to prolonged recovery phases or proven neurological damage 44.5% had one cerebral defect in CCT imaging scans only. The others showed multiple defects. During hospital stay,92.3% experienced neurological improvement exposing reduced ARWMC, while 7.1% had no improvement and correlating high scores. Of both scales, the ARWMC-VRS demonstrated superior accuracy and discrimination. The preoperative ejection fraction (EF), arteriosclerotic degeneration of carotid arteries, and reduced glomerular filtration ratewere found to have a high correlation (r = 0.0005) with the latter group. In-hospital mortality of this cohort was 8.18%. Both the ARWMC and MRVRS were found to be appropriate. They reliably discriminate the groups of stroke patients after coronary artery bypass grafting (CABG) in the analysis of CCT images. When applied at the onset of neurological symptoms both scales are able to predict neurological reconvalescence upon hospital dismission. The ARWMC scale appeared superior as it demonstrated better accuracy and discrimination. The use of both VRS in patients with suspected stroke after CABG surgery can give insightful information toward a progression of neurological dysfunction or postoperative improvement.

Extracranial guiding structures for navigation to specific topographical sectors of the equine neopallium: an anatomical investigation performing three-dimensional distance measurements in adult warm-blooded horses.

This basically anatomical study focuses on two items; firstly, the establishment of a system for the cartographic subdivision of the neopallium; secondly, the topographical correlation of extracranial landmarks and intracranial sites on the neopallium. The surface of the neopallium was subdivided into 15 sectors with reference to a newly introduced pattern of Primary Sulci. The topographical link between extracranial landmarks and certain intracranial sites (i.e. neopallium sectors) was elaborated by using a simple stereotactic device and a computer-assisted measurement device. Measurements were performed between points on the head's outer surface and on the isolated brain. The introduction of an anatomical three-dimensional coordinate system was an essential key issue for this investigation. This setting facilitated the measurements and calculations of the so-called indirect distances that were characterised by their alignment along the three orthogonal axes (x, y, z) of the anatomical coordinate system. The inter-individual comparison (16 adult horses [Equus caballus]) of the indirect distances revealed that each sector centre lay within a distinct morphometric residence area. The measured and calculated data also showed that each sector centre could be assigned to its proper extracranial landmark that - in comparison with other landmarks - was best suited for the optimal allocation of the sector centre point.

Coronal knee alignment measurements differ on long-standing radiographs vs. by navigation

BackgroundThe long-standing radiograph (LSR) is the reference tool for assessing knee alignment after total knee arthroplasty (TKA). However, its value is debatable, as many factors can influence measurement accuracy. Computer-assisted surgery (CAS) provides accurate measurements. Few studies have compared LSR and computer-assisted measurements of knee alignment. The objective of this study was to compare hip-knee-ankle (HKA) angle values obtained before and after TKA on LSRs to those obtained during CAS. HypothesisThe HKA angle values measured on LSRs before and after surgery are identical to those measured during CAS. Material and methodsThe HKA angles of 126 knees were measured on bipedal full-weight-bearing LSRs obtained before and 3 months after TKA. The results were compared to the values obtained during CAS. ResultsBefore surgery, the standard deviation was 2.672, with limits of agreement of {−5.391; + 5.082}. The intra-class coefficients were good for the overall measurements (0.9), good for detecting>10° varus (0.89), fair for<10° varus and valgus (0.66 and 0.71, respectively), poor for>10° valgus (0.43) and poor for normal alignment (0). Post-operatively, the standard deviation was 3.113, with limits of agreement of {−6.426; +5.776}. The intra-class coefficient was poor for the overall measurements (0.20), negative for normal alignment (−0.05) and<10° valgus (−0.05), and positive for<10° varus (0.017) and for>10° varus and valgus (0.33). ConclusionBefore TKA, the LSR overestimates the deformity compared to CAS. After surgery, the two methods are not comparable. These findings underline the relevance of routinely obtaining LSRs and for using LSR results to estimate costs for healthcare insurance reimbursement purposes. Level of evidenceIV, retrospective observational cohort study.

Computer-assisted photoreceptor assessment on Heidelberg Engineering Spectralis\u2122 High Magnification Module\u2122 images

PurposeTo evaluate reliability and repeatability of computer-assisted measurements of cone photoreceptor metrics on Heidelberg Engineering Spectralis™ High Magnification Module (HMM™) Automatic Real-time Tracking (ART™) images.MethodsWe analyzed HMM™ images in three separate study arms. Computer-assisted cone identification software was validated using an open-access adaptive optics (AO) dataset. We compared results of the first arm to data from AO and histology. We evaluated intersession repeatability of our computer-assisted cone analysis in the second arm. We assessed the capability of HMM™ to visualize cones in the presence of pathology in the third arm.ResultsWe included 10 healthy subjects in the first arm of our study, 5 additional healthy participants in the second arm and 5 patients in the third arm. In total, we analyzed 225 regions of interest on HMM™ images. We were able to automatically identify cone photoreceptors and assess corresponding metrics at all eccentricities between 2 and 9° from the fovea. Cone density significantly declined with increasing eccentricity (p = 4.890E-26, Friedman test). With increasing eccentricity, we found a significant increase in intercell distance (p = 2.196E-25, Friedman test) and nearest neighbor distance (p = 1.997E-25, Friedman test). Cone hexagonality ranged between 71 and 85%. We found excellent automated intersession repeatability of cone density counts and spacing measurements. In pathology, we were also able to repeatedly visualize photoreceptors.ConclusionComputer-assisted cone photoreceptor analysis on Spectralis™ HMM™ images is feasible, and most cone metrics show excellent repeatability. HMM™ imaging may be useful for photoreceptor analysis as progression marker in outer retinal disease.

Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

PurposeAccurate laparoscopic bowel length measurement (LBLM), which is used primarily in metabolic surgery, remains a challenge. This study aims to three conventional methods for LBLM, namely using visual judgment (VJ), instrument markings (IM), or premeasured tape (PT) to a novel computer-assisted 3D measurement system (BMS).Materials and MethodsLBLM methods were compared using a 3D laparoscope on bowel phantoms regarding accuracy (relative error in percent, %), time in seconds (s), and number of bowel grasps. Seventy centimeters were measured seven times. As a control, the first, third, fifth, and seventh measurements were performed with VJ. The interventions IM, PT, and BMS were performed following a randomized order as the second, fourth, and sixth measurements.ResultsIn total, 63 people participated. BMS showed better accuracy (2.1±3.7%) compared to VJ (8.7±13.7%, p=0.001), PT (4.3±6.8%, p=0.002), and IM (11±15.3%, p<0.001). Participants performed LBLM in a similar amount of time with BMS (175.7±59.7s) and PT (166.5±63.6s, p=0.35), but VJ (64.0±24.0s, p<0.001) and IM (144.9±55.4s, p=0.002) were faster. Number of bowel grasps as a measure for the risk of bowel lesions was similar for BMS (15.8±3.0) and PT (15.9±4.6, p=0.861), whereas VJ required less (14.1±3.4, p=0.004) and IM required more than BMS (22.2±6.9, p<0.001).ConclusionsPT had higher accuracy than VJ and IM, and lower number of bowel grasps than IM. BMS shows great potential for more reliable LBLM. Until BMS is available in clinical routine, PT should be preferred for LBLM.Graphical abstract

Computer-assisted measurements of the histological structure of the tibial nerve and its terminal branches.

The aim of this study was to analyse the histological structure (cross-sectional area [CSA] and number of nerve bundles) of the distal part of the tibial nerve and its terminal branches (medial plantar nerve, lateral plantar nerve) using computer-assisted image analysis. The tibial nerve and its distal branches (medial and lateral plantar nerves) were dissected from the fresh cadavers. Each nerve was harvested 5 mm proximally and respectively 5 mm distally from the tibial nerve bifurcation, marked, dehydrated, embedded in paraffin, sectioned at 2 μm slices and stained with haematoxylin and eosin. Then photographed and analysed using Olympus cellSens software. The studied group comprised 28 female and 32 male feet (mean age 68.1 ± 15.2 years). The mean CSA and the number of nerve bundles were respectively 17.86 ± 4.57 mm2, 33.88 ± 6.31 for the tibial nerve, 9.58 ± 1.95 mm2, 23.41 ± 7.37 for the medial plantar nerve and 7.17 ± 2.36 mm2, 15.06 ± 5.81 for the lateral plantar nerve in males and 12.27 ± 2.45 mm2, 26.32 ± 8.87 for the tibial nerve, 7.81 ± 1.41 mm2, 17.71 ± 5.28 for the medial plantar nerve and 5.83 ± 1.25 mm2, 11.50 ± 3.72 for the lateral plantar nerve in females. Both CSA and number of nerve bundles of the tibial, medial plantar and lateral plantar nerves revealed no statistical differences when comparing foot side of the individual. The statistical difference was related to the gender, showing significantly bigger CSA and number of nerve bundles in males (CSA: p = 0.000, p = 0.000, p = 0.016; number of nerve bundles: p = 0.01, p = 0.003, p = 0.004, respectively). A positive correlation was found between the donor age and the tibial nerve CSA (r = 0.44, p = 0.000). A significant statistical difference was found between the medial and lateral plantar nerves both in CSA and number of nerve bundles (p < 0.001, p < 0.001, respectively). The CSA and the number of nerve bundles in the distal part of the tibial nerve and its branches are significantly larger in males with no differences between right and left foot of the individual. The tibial nerve shows increasing CSA with advanced age. The medial plantar nerve has larger CSA and more nerve bundles than the lateral plantar nerve.

Investigating the reliability and sex differences of digit lengths, ratios, and hand measures in infants

Hands and digits tend to be sexually dimorphic and may reflect prenatal androgen exposure. In the past years, the literature introduced several hand and digit measures, but there is a lack of studies in prepubertal cohorts. The available literature reports more heterogeneous findings in prepubertal compared to postpubertal cohorts. The comparability of the available studies is further limited by the study design and different measurement techniques. The present study compared the reliability and sex differences of available hand and digit measures, namely digit lengths of 2D, 3D, 4D, 5D, digit ratios 2D:4D, 2D:5D, 3D:4D, 3D:5D, 4D:5D, relative digit lengths rel2, rel3, rel4, rel5, directional asymmetry of right and left 2D:4D (Dr-l), hand width, length, and index of 399 male and 364 female 6-month-old German infants within one study using only indirect and computer-assisted measurements. The inter-examiner reliability was excellent while the test-retest reliability of hand scans was only moderate to high. Boys exhibited longer digits as well as wider and longer hands than girls, but smaller digit ratios, with ratios comprising the fifth digit revealing the largest effect sizes. Other hand and digit ratios revealed sex differences to some extent. The findings promote the assumption of sexual dimorphic hand and digit measures. However, by comparing the results of the available literature, there remains an uncertainty regarding the underlying hypothesis. Specifically in prepubertal cohorts, i.e. before the influence of fluctuating hormones, significant effects should be expected. It seems like other factors than the influence of prenatal androgens contribute to the sexual dimorphism in hand and digit lengths.

A CT Study to examine Morphometry and anatomical Variations of Foramen Ovale

Introduction The foramen ovale (FO) is located in the greater wing of sphenoid, posterolateral to foramen rotundum and transmits the mandibular nerve. Other structures passing through it are accessory middle meningeal artery, lesser petrosal nerve and emissary veins. A comprehensive knowledge of the anatomy of this area is crucial for accurate interpretation and delineation of pathology. Aim and Objectives 1. To study the anatomic variations of foramen ovale. 2. To record and analyze the metric and non metric data of foramen ovale. Material & Method Type of Study Retrospective observational. Sample size 200 Computerized tomography (CT) head axial section scans with no evidence of disease that might alter foraminal anatomy, from picture archiving & communication system (PACS). The Computer-assisted measurements of foraminal parameters were obtained on both right and left sides. Statistical tests applied unpaired t-test, paired t-test, ANOVA. Result Foramen ovale of 110 males, 90 females were examined. Shapes oval (84%), almond (12.5%), round (1%), slit- like (2%) and irregular (0.5%).In 0.5%, it was open postero-medially. In rest of the cases, it was closed on all sides. Septation observed in 2% cases. Morphometry The mean length, breadth, distance from mid-sagittal plane & size in males were 7.75± 1.16, 3.98±0.91,21.40±1.75 & 30.94±8.79, and in females, measurements were 6.90±0.78, 3.57±1.04,20.36±1.62 & 24.86 ± 9.08 respectively. The mean area in males is 30.22 mm2 (R) and 31.72 mm2 (L) and in females it is 24.00 mm2 (R) and 22.90 mm2 (L). Conclusion Significant difference is seen between males and females, and right and left side in all four parameters. Variations in the shapes of the FO are found due to developmental reasons, which may affect clinical and diagnostic procedures. While undergoing invasive procedures like microvascular decompression by percutaneous biopsy of cavernous sinus tumors, or for a CT guided transfacial fine needle aspiration technique through the FO, a thorough knowledge of the normal anatomy of the foramen ovale and variations may help in diagnosis and management of neuralgia, nerve compression diseases and for novel microsurgical techniques.

Quantitative periapical radiography using computer-assisted measurement for intraoral projections

Background: Quantitative evaluation of radiolucent and radiopaque is difficult for intraoral radiography. Aims: This study was designed to estimate quantitative periapical radiography using computer-assisted measurement for intraoral projections. Materials and Methods: Ten patients with periapical inflammatory disease of the mandibular molar region were analyzed using a computer-assisted measurement for intraoral projections. The system measures the image density and calculates the bone mineral density (BMD) of an optional region. The periapical region of mandibular molars was compared to the sclerotic bone reaction resulting from the periapical inflammatory disease with the normal periapical region. P

Telemedicine-Based Specialized Care Improves the Outcome of Anticoagulated Individuals with Venous Thromboembolism-Results from the thrombEVAL Study.

Venous thromboembolism (VTE) is a life-threatening disease with risk of recurrence. Oral anticoagulation (OAC) with vitamin K antagonists (VKA) is effective to prevent thromboembolic recurrence. We aimed to investigate the quality of OAC of VTE patients in regular medical care (RMC) compared to a telemedicine-based coagulation service (CS). The thrombEVAL study (NCT01809015) is a prospective, multi-center study to investigate OAC treatment (recruitment: January 2011–March 2013). Patients were evaluated using clinical visits, computer-assisted personal interviews, self-reported data and laboratory measurements according to standard operating procedures. Overall, 360 patients with VTE from RMC and 254 from CS were included. Time in therapeutic range (TTR) was higher in CS compared to RMC (76.9% (interquartile range [IQR] 63.2–87.1%) vs. 69.5% (52.3–85.6%), p < 0.001). Crude rate of thromboembolic events (rate ratio [RR] 11.33 (95% confidence interval [CI] 1.85–465.26), p = 0.0015), clinically relevant bleeding (RR 6.80 (2.52–25.76), p < 0.001), hospitalizations (RR 2.54 (1.94–3.39), p < 0.001) and mortality under OAC (RR 5.89 (2.40–18.75), p < 0.001) were consistently higher in RMC compared with CS. Patients in RMC had higher risk for primary outcome (clinically relevant bleedings, thromboembolic events and mortality, hazard ratio [HR] 5.39 (95%CI 2.81–10.33), p < 0.0001), mortality (HR 5.54 (2.22–13.84), p = 0.00025), thromboembolic events (HR 6.41 (1.51–27.24), p = 0.012), clinically relevant bleeding (HR 5.31 (1.89–14.89), p = 0.0015) and hospitalization (HR 1.84 (1.34–2.55), p = 0.0002). Benefits of CS care were still observed after adjusting for comorbidities and TTR. In conclusion, anticoagulation quality and outcome of VTE patients undergoing VKA treatment was significantly better in CS than in RMC. Patients treated in CS had lower rates of adverse events, hospitalizations and lower mortality. CS was prognostically relevant, beyond providing advantages of improved international ratio (INR) monitoring.

Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 2-year results of an RCT using 3D digital measuring for volumetric comparison of gingival dimensions.

The aim of this randomized clinical trial was to compare clinical and volumetric outcomes of tunnel technique (TUN) with subepithelial connective tissue graft (CTG) versus coronally advanced flap (CAF) with enamel matrix derivate (EMD) 2years after gingival recession (GR) treatment. Twenty-three patients contributed 45 Miller class I or II GR. At baseline and follow-up examinations, study models were collected. Their three-dimensional scans allowed precise computer-assisted measurement of recession depth (REC), complete root coverage (CRC), percentage of root coverage (RC), pointwise (pTHK) and mean areal (aTHK) marginal soft tissue thickness. Clinical examination delivered probing depths (PPD) and height of keratinized tissue. 24months after surgery, digitally evaluated CRC was present in 60.0% of the TUN+CTG and 0.0% of the CAF+EMD-treated sites (p<.0001), meaning a certain relapse of the gingival margin ragarding both approaches. RC amounted to 94.0% (TUN+CTG) and 57.3% (CAF+EMD), respectively (p<.0001). REC reduction (RECred) was significantly higher for TUN+CTG (1.81±0.56mm) than for CAF+EMD (0.90±0.45mm) (p<.0001). pTHK and aTHK values were significantly greater in the TUN+CTG group (1.41±0.35mm and 1.11±0.26mm) than in the CAF+EMD group (0.78±0.32mm and 0.60±0.26mm) (p<.0001). Statistical analysis detected positive correlations between THK and both RC and RECred (p<.001). Two years post-operatively, CTG showed better clinical and volumetric outcomes than EMD. Increased THK values were associated with improved outcomes regarding RC and RECred.

Computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs: Preliminary study on comparison between men and women in young adults

Background: As bone mineral is one of the major determinants of bone strength, its exact measurement should be useful for the diagnosis of osteoporosis, as well as for the prediction of fracture risk and monitoring of therapeutically response. Aims: The aim of this study was to investigate computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs, especially comparison between men and women in young adults. Materials and Methods: Forty-two patients in young adults (20 men and 22 women; age 22–25 years; and mean age 23.2 years) of the mandibular premolar region who underwent intraoral radiographs with imaging plate (IP) detector and computer analysis system “DentalSCOPE” were included in this study. The DentalSCOPE had a special X-ray beam indicator in which a special calcium carbonate reference object was embedded. IP-based digital X-ray images were input into the DentalSCOPE system. The DentalSCOPE software measured the image density of the reference object automatically and calculated the mineral density value of an arbitrary region of interest (ROI). The mineral density of a rectangular ROI in the periapical region of mandibular premolars was evaluated. The age and alveolar bone density were compared between men and women using the Mann–Whitney U-test. P