Contrast Enhancement Research Articles

CIC/ATXN1-rearranged tumors in the central nervous system are mainly represented by sarcomas: A comprehensive clinicopathological and epigenetic series.

CIC fusions have been described in two different central nervous system (CNS) tumor entities. On one hand, fusions of CIC or ATXN1 genes belonging to the same complex of transcriptional repressors, were reported in the CIC-rearranged, sarcoma (SARC-CIC). The diagnosis of this tumor type, which was recently added to the World Health Organization (WHO) Classification of CNS tumors, is difficult mainly because the data concerning its histopathology (as compared to its soft tissue counterpart), immunoprofile, and clinical as well as radiological characteristics are scarce in the literature. On the other hand, a recent study, based on DNA-methylation profiling, has identified a novel high-grade neuroepithelial tumor characterized by recurrent CIC fusions (HGNET-CIC). The aim of this multicentric study was to characterize a cohort of 15 primary CNS tumors harboring a CIC or ATXN1 fusion in terms of clinical, radiological, histopathological, immunophenotypical, and epigenetic characteristics. According to the integrated diagnoses, 14/15 tumors corresponded to SARC-CIC, and only one to HGNET-CIC. The tumors showed similar clinical (mainly pediatric), radiological (mostly supratentorial, cystic, and contrast enhancing), immunophenotypical (common expression of glioneuronal markers), and genetic (similar spectrum of fusions) profiles but their histopathological appearance was clearly distinct. Moreover, we found a novel fusion transcript (CIC::EWSR1) in a SARC-CIC. Most DNA methylation profiles using the Heidelberg Brain Tumor Classifier (v12.8) annotated the samples to the methylation class "SARC-CIC" (9/14 tumors with available data). By using uniform manifold approximation and projection analysis, four other samples were classified as SARC-CIC and another clustered within the methylation class of HGNET-CIC. Our findings confirm that CNS CIC-fused tumors do not represent a single molecular tumor entity. Further analyses are needed to characterize HGNET-CIC in more detail. These results may help to refine the essential diagnostic criteria for SARC-CIC and their terminology (with a suggested consensual name of sarcoma, CIC/ATXN1-complex rearranged).

Evaluation of Selected MRI Parameters in the Differentiation of Mucinous Ovarian Carcinomas and Metastatic Ovarian Tumors.

Introduction: Analysis of selected MRI parameters in initial MRI for the characterization of ovarian masses enables differentiation between mucinous ovarian carcinoma and metastatic ovarian tumors. Material and Methods: A prospective analysis of contrast-enhanced MRI of patients with suspected ovarian masses diagnosed in ultrasound and CT examination. Morphological criteria, such as the size of lesion, bilateral location, presence of "mille-feuille sign", so-called Seidman criteria, as well as the diffusion weighted imaging and dynamic contrast enhancement of each lesion, were evaluated. Patients were allocated into two groups; the first group contained patients with mucinous ovarian cancer, and the second group contained patients with metastatic ovarian tumors. Results: A total of 35 patients were enrolled into the study. Median age was 49 in the first group and 59 in the second group of patients (p = 0.04). In the first group, all patients (100%) had unilateral lesions, and in the second group, 94% had bilateral tumors (p < 0.000001). In the first group, a tumor size equal or greater than 10 cm was present in 80% of patients, and the same was true for 21% of patients in the second group. The mille-feuille sign was present in 30% of patients from the first group and in 64% of patients from the second group. In the first group of patients, TTP was 410 and Perf.Max Enhancement was 141; in the second group, they were, respectively, 154 and 167 (p = 0.0001 and p = 0.5). Median ADC values in the first group were significantly higher in the first group than in the second group (p < 0.01). Conclusions: Significant differences in TTP and ADC values as well as in Seidman criteria enable reliable differentiation between the analyzed groups of tumors.

Contrast enhancement after mechanical thrombectomy: clinical correlations and impact on outcomes.

Contrast enhancement (CE) after mechanical thrombectomy (MT) remains a subject of investigation, with a reported prevalence ranging from 31 to 88%. We examined our patients to identify predictors of CE and its impact on outcomes, an aspect that remains understudied. We retrospectively analyzed 106 patients who underwent MT at our hospital between 2018 and 2022. The inclusion criteria involved patients who underwent two head CT scans: one immediately after the procedure and a repeat scan within 24h. This study compared demographic, clinical, laboratory, neuroimaging, and procedure-related variables between patients with CE and those without hyperdensity. Regression analysis was employed to determine the associations between CEs and significant variables. Among the analyzed patients, 32.1% had CE. Hyperlipidemia was more prevalent in the CE group. CE correlated with an increase in the National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 within 24h, intracerebral hemorrhage (ICH) incidence, elevated NIHSS score, and a decreased rate of modified Rankin scale (mRS) 0-3 upon discharge. The adjusted model demonstrated a significant association between CE and the incidence of hyperlipidemia and ICH, with an increase in NIHSS score ≥ 4 within 24h of ICH and a lower mRS score of 0-3 upon discharge. CE is associated with hyperlipidemia, ICH, early neurological deterioration, and poor functional outcomes upon discharge. However, no similar association was shown for long-term outcomes. Further studies are required to clarify the pathophysiology of CE and its implications for optimizing stroke care.

Thoracolumbar Paravertebral Intramuscular Myxoma Presenting With Mechanical Back Pain: A Case Report and Review of the Literature

Background and Aim: Intramuscular myxomas are uncommon benign tumors that are rarely seen in the paraspinal musculature. They might present with neurological symptoms if situated near the spinal cord or may present with nonspecific symptoms such as back pain. Case Presentation: The case of this study was a 46-year-old female presented with back pain that was exacerbated with movement. A thoracolumbar magnetic resonance imaging revealed a T2 hyperintense 35x25x85 mm mass that extends craniocaudally within the right-sided paraspinal muscles with heterogeneous contrast enhancement on T1 sequence images. Using a paramedian incision, paraspinal muscles were dissected, and a rubbery mass was palpated within. The tumor was mobilized in all quadrants and removed with its pseudocapsule. The tumor internally had a gel-like substance with rubbery margins. The patient was discharged without complications. Conclusion: To our knowledge, this is the 16th case of paraspinal intramuscular myxoma in the literature. Even though it is a rare entity, one must be vigilant for pathologies within the paraspinal muscles in patients with back pain

Reappraisal of prognostic factors in CNS WHO grade 3 oligodendrogliomas IDH-mutant and 1p/19q co-deleted: lessons from the French POLA cohort.

In POLA cohort, three pathological groups of CNS WHO grade 3 oligodendroglioma IDH-mutant and 1p/19q co-deleted have been described: group 1 (high mitotic count only), group 2 (microvascular proliferation MVP and no necrosis), and group 3 (MVP and necrosis). 494 patients from the POLA cohort, with a median follow up of 96 months were included. To identify the impact of the pathological groups and contrast enhancement in group 1 on overall survival (OS) or progression free survival (PFS), survival curves were obtained (Kaplan-Meier method) and compared (log-rank test). Prognostic value of clinical factors and CDKN2A homozygous deletion HD were also tested. Multivariate analysis was performed. Survival analysis demonstrated that the pathological groups were associated with both progression-free survival (PFS P=0.01) and overall survival (OS P=0.001). In group 1, patients with contrast enhancement (1CE+) had a poorer prognosis compared to those without (OS P=0.028, PFS P=0.006). Further stratification into group 1CE-, group 1CE+, group 2, and group 3 provided clearer prognostic distinctions (OS P=0.002, PFS P<0.0001). Other prognostic factors included age (OS P<0.0001, PFS P=0.002), extent of surgical resection (OS P=0.001, PFS P=0.003), KPS (OS P<0.0001, PFS P=0.002), postoperative treatment (OS P=0.007, PFS P<0.0001), and CDKN2A HD (OS and PFS P<0.0001). The pathological groups remained of prognostic significance for PFS in multivariate analysis. Necrosis and CDKN2A HD are adverse prognostic factors of WHO grade 3 oligodendrogliomas, IDH mutant and 1p/19q co-deleted. Besides, in group 1 patients, lack of contrast enhancement is a factor of better prognosis.

Ultrasound protein-copolymer microbubble library engineering through poly(vinylpyrrolidone-co-acrylic acid) structure

HypothesisWhile albumin-coated microbubbles are routine contrast agents for ultrasound imaging, their short duration of contrast enhancement limits their use, yet can be improved by incorporating protein-copolymer hybrids into microbubble shells. The incorporation of N-vinyl-2-pyrrolidone and acrylic acid copolymer (P(VP–AA)) has been shown to enhance the performance of bovine serum albumin (BSA)-coated microbubbles. However, the impact of the copolymer structural properties on key microbubble characteristics (i.e., concentration, mean diameter and acoustic response) remains poorly understood. Therefore, we hypothesize that the copolymer structure affects its capacity to form micelle-like nanoaggregates, protein-copolymer hybrids, and microbubble shells, ultimately influencing the physicochemical and acoustic properties of the microbubbles. ExperimentsHere we evaluate the production and performance of BSA@P(VP–AA) microbubbles synthesized using a series of P(VP–AA) copolymers with –C8H17 and –C18H37 end groups and molecular weight cutoffs between 3.5 and 15 kDa. Both simulation and experimental data demonstrate that interactions between BSA and the copolymers significantly influence the performance of the resulting microbubbles across the library of 60 formulations. FindingsThe introduction of –C8H17 terminated copolymers into microbubble shells resulted in up to 200-fold higher concentration, 7-fold greater acoustic response, and 5-fold longer ultrasound contrast enhancement compared to plain BSA microbubbles. The enhanced acoustic performance was sustained during in vivo cardiac ultrasound imaging, without altering liver accumulation after copolymer introduction. These findings underscore how optimizing copolymer structure (specifically the terminal end group and molecular weight) can tailor the formation and performance of protein-copolymer-coated microbubbles, offering valuable insights for designing ultrasound contrast agents.

A multi-center, clinical analysis of IDH-mutant gliomas, WHO Grade 4: implications for prognosis and clinical trial design.

Mutations in the Isocitrate Dehydrogenase (IDH) genes, IDH1 or IDH2, define a group of adult diffuse gliomas associated with a younger age at diagnosis and better prognosis than IDH wild-type glioblastoma. Within IDH mutant gliomas, a small fraction of astrocytic tumors present with grade 4 histologic features and poor prognosis. In molecular studies, homozygous deletion of CDKN2A/B is independently predictive of poor prognosis and short survival. As a consequence, 2021 WHO classification now also recognizes this molecular feature, CDKN2A/B deletion, as sufficient for classifying an astrocytoma as IDH-mutant, WHO Grade 4, regardless of histological grading. Here, we investigate outcomes of patients with WHO Grade 4 IDH-mutant astrocytoma both with and without CDKN2A/B deletion, to compare these groups and evaluate clinical and radiographic factors that contribute to survival. We retrospectively identified 79 patients with IDH-mutant astrocytoma with CDKN2A/B deletion detected at initial diagnosis across five international institutions as well as a comparison group of 51 patients with IDH-mutant, astrocytoma, histologically Grade 4 without detectable CDKN2A/B deletion. We assembled clinical and radiographic features for all patients. We find that CDKN2A/B deletion was associated with significantly worse overall survival (OS; p = 0.0004) and progression-free survival (PFS; p = 0.0026), with median OS of 5.0 years and PFS of 3.0 years, compared to 10.1 and 5.0 years for tumors with a grade 4 designation based only on histologic criteria. Multivariate analysis confirmed CDKN2A/B deletion as a strong negative prognosticator for both OS (HR = 3.51, p < 0.0001) and PFS (HR = 2.35, p = 0.00095). In addition, in tumors with CDKN2A/B deletion, preoperative contrast enhancement is a significant predictor of worse OS (HR 2.19, 95% CI 1.22-3.93, p = 0.0090) and PFS (HR = 1.74, 95% CI = 1.02-2.97, p = 0.0420). These findings underscore the severe prognostic impact of CDKN2A/B deletion in IDH-mutant astrocytomas and highlight the need for further refinement of tumor prognostic categorization. Our results provide a key benchmark of baseline patient outcomes for therapeutic trials, underscoring the importance of CDKN2A/B status assessment, in addition to histologic grading, in clinical trial design and therapeutic decision-making for IDH-mutant astrocytoma patients.

An Adaptive Parameter Optimization Deep Learning Model for Energetic Liquid Vision Recognition Based on Feedback Mechanism.

The precise detection of liquid flow and viscosity is a crucial challenge in industrial processes and environmental monitoring due to the variety of liquid samples and the complex reflective properties of energetic liquids. Traditional methods often struggle to maintain accuracy under such conditions. This study addresses the complexity arising from sample diversity and the reflective properties of energetic liquids by introducing a novel model based on computer vision and deep learning. We propose the DBN-AGS-FLSS, an integrated deep learning model for high-precision, real-time liquid surface pointer detection. The model combines Deep Belief Networks (DBN), Feedback Least-Squares SVM classifiers (FLSS), and Adaptive Genetic Selectors (AGS). Enhanced by bilateral filtering and adaptive contrast enhancement algorithms, the model significantly improves image clarity and detection accuracy. The use of a feedback mechanism for reverse judgment dynamically optimizes model parameters, enhancing system accuracy and robustness. The model achieved an accuracy, precision, F1 score, and recall of 99.37%, 99.36%, 99.16%, and 99.36%, respectively, with an inference speed of only 1.5 ms/frame. Experimental results demonstrate the model's superior performance across various complex detection scenarios, validating its practicality and reliability. This study opens new avenues for industrial applications, especially in real-time monitoring and automated systems, and provides valuable reference for future advancements in computer vision-based detection technologies.

Rectangling and enhancing underwater stitched image via content-aware warping and perception balancing

Single underwater images often face limitations in field-of-view and visual perception due to scattering and absorption. Numerous image stitching techniques have attempted to provide a wider viewing range, but the resulting stitched images may exhibit unsightly irregular boundaries. Unlike natural landscapes, the absence of reliable high-fidelity references in water complicates the replicability of these deep learning-based methods, leading to unpredictable distortions in cross-domain applications. To address these challenges, we propose an Underwater Wide-field Image Rectangling and Enhancement (UWIRE) framework that incorporates two procedures, i.e., the R-procedure and E-procedure, both of which employ self-coordinated modes, requiring only a single underwater stitched image as input. The R-procedure rectangles the irregular boundaries in stitched images by employing the initial shape resizing and mesh-based image preservation warping. Instead of local linear constraints, we use complementary optimization of boundary–structure–content to ensure a natural appearance with minimal distortion. The E-procedure enhances the rectangled image by employing parameter-adaptive correction to balance information distribution across channels. We further propose an attentive weight-guided fusion method to balance the perception of color restoration, contrast enhancement, and texture sharpening in a complementary manner. Comprehensive experiments demonstrate the superior performance of our UWIRE framework over state-of-the-art image rectangling and enhancement methods, both in quantitative and qualitative evaluation.

Hybrid modality dual-energy imaging aggregating complementary advantages of kV-CT and MV-CBCT: concept proposal and clinical validation

Megavoltage cone-beam CT (MV-CBCT) is advantageous in metal artifact reduction during Image-Guided Radiotherapy (IGRT), although it is limited by poor soft tissue contrast. This study proposed and evaluated a novel hybrid modality dual-energy (DE) imaging method combining the complementary advantages of kV-CT and MV-CBCT.&#xD;Approach: The kV-CT and MV-CBCT images were acquired on a planning CT scanner and a Halcyon linear accelerator respectively. After rigid registration, images of basis materials were generated using the iterative decomposition method in the volumetric images. The decomposition accuracy was quantitatively evaluated on a Gammex 1472 phantom. The performance of contrast enhancement and metal artifact reduction in virtual monochromatic images were evaluated on both phantom and patient studies.&#xD;Main results: Using the proposed method, the mean percentage errors for RED and SPR were 0.90% and 0.81%, outperforming the clinical single-energy mapping method with mean errors of 1.28% and 1.07%, respectively. The contrasts of soft-tissue insets were enhanced by a factor of 2~3 at 40 keV compared to kV-CT. The standard deviation in the metal artifact area was reduced by ~67%, from 42 HU (kV-CT) to 14 HU (150 keV monochromatic). The head and neck patient test showed that the percent error of soft-tissue RED in the metal artifact area was reduced from 18.1% (HU-RED conversion) to less than 1.0% (the proposed method), which was equivalent to the maximum dosimetric difference of 28.7% based on the patient-specific plan.&#xD;Significance: Without hardware modification or extra imaging dose, the proposed hybrid modality method enabled kV-MV DE imaging, providing improved accuracy of quantitative analysis, soft-tissue contrast and metal artifact suppression for more accurate IGRT.&#xD.

Comparison of computed tomography findings between perianal tumors originating from the anal sacs and perianal glands in dogs.

Tumors originating from the anal sacs and perianal glands are common tumors of the perianal region. However, differentiation of perianal tumors based on CT findings remains challenging because perianal tumors can show overlapping CT characteristics. Therefore, this retrospective, multi-institutional study aimed to identify the CT findings that can differentiate between tumors originating from the anal sacs and perianal glands in canines. Twenty dogs were included, with nine apocrine gland anal sac adenocarcinomas (AGASACAs), six perianal gland adenomas, three perianal gland carcinomas, and two perianal gland epitheliomas. The tumor CT features included the tumor growth pattern, tumor shape, cystic changes within the tumor, contrast enhancement pattern, displacement of the anus, and identification of the anal sacs. The prevalences of suspected metastatic lymphadenopathy of the iliosacral lymph centers and lung metastases were evaluated. The tumor volumes and values normalized to body weight were also assessed. The tumor growth patterns differed significantly between AGASACAs and perianal gland tumors. AGASACAs mostly showed unilateral growth, whereas perianal gland tumors mostly exhibited bilateral growth. CT features, except for the tumor growth pattern, failed to show significant differences between tumors arising from the anal sacs and those arising from the perianal glands. Although histopathological diagnosis remains the gold standard, this study's findings suggest that CT analysis of tumor growth patterns may help differentiate AGASACAs from perianal gland tumors.

Lipoleiomyoma of the uterus in a woman of reproductive age (clinical case)

Uterine lipoleiomyoma is one of the variants of uterine leiomyoma, which is histologically represented by the presence of mature fat and smooth muscle cells. The relevance of the coverage of this clinical case is determined by the extreme rarity of the development of uterine lipoleiomyoma in women of reproductive age. The purpose of this work was to record this clinical case in the world statistics of lipoleiomyoma, to evaluate methods of diagnosis and differential diagnosis, to determine the role of early diagnosis of uterine lipoleioma in the subsequent tactics and scope of surgical treatment. Data from the medical records of a 41-year-old inpatient were analyzed. In addition to the generally accepted clinical and biochemical methods of blood and urine examination, electrocardiogram, ultrasound examination of the pelvic organs, the level of ovarian tumor markers in the blood (CA 125, HE4 and the ROMA index) was determined. The diagnosis of the disease was based on the data of pathohistological and immunohistochemical studies. Based on the results of a review of the medical literature, analysis of articles obtained as a result of a search of PubMed, SCOPUS, Web of Science, MedScape databases, the current state of the problem is highlighted, literary data related to the incidence, features of the clinical course, diagnosis and treatment of uterine lipoleiomyoma are summarized. The clinical case presented in the article demonstrates an incidental finding of a uterine lipoleiomyoma in a woman of reproductive age, measuring 30x25x20 cm, originated subserously from the body and cervix of the uterus, in the area of its isthmus. Under this condition, it occupied the entire Douglas space, the area of the sacro-uterine ligaments and the parietal peritoneum, intimately adjacent to the sigmoid and rectum, to the ureters and iliac vessels. The peculiarity of this clinical case is that sonographically uterine lipoleiomyoma was hidden under the "mask" of a dermoid cyst of the right ovary. Macroscopically, it differed from a typical lipoleiomyoma by the purple-bluish color of its outer surface and soot-colored, fine-lobed spongy structure on the section. The diagnosis of uterine lipoleiomyoma was verified only on the basis of pathohistological and immuno­histochemical research. Microscopically, the lipoleiomyoma had a mesenchymal structure with a pronounced vascular component and consisted of mitotically inactive bundles of smooth muscle cells and mature adipocytes. Im­munohistochemically, a positive reaction for caldesmon, desmin, smooth muscle actin alpha of tumor cells and for S.100 (DAKO, polyclonal) fatty cells was detected, which confirmed the hypothesis of direct transformation of smooth muscle cells existing in the leiomyoma of the uterus into fatty cells. This clinical case should complement the global statistical indicators of diagnosis of uterine lipoleiomyoma in women of reproductive age. Lipoleiomyoma should be considered as the primary diagnosis in case of detection of a large uterine tumor in women with excess body weight and be removed immediately after diagnosis, otherwise it is impossible to exclude its malignancy. For the planned diagnosis of neoplasms of the female genital organs, preference should be given to non-invasive research methods: magnetic resonance or computer tomography with contrast enhancement. The problem of these tumors lies in their unpredictable histogenesis, the unexpected presence of fat in the microscopic structure, and in the visual similarity to sarcomas. Verification of the diagnosis is carried out on the basis of pathohistological and immunohistochemical studies of the tumor preparation. Uterine lipoleioma can have a purplie-bluish color and develop by a broad base from the body and cervix of the uterus, as a result of "lipomatous" metaplasia of the uterine leiomyoma existing in a woman. Regular preventive examinations of women of all ages are crucial for timely detection of this rare neoplasm.

Bolus tracking from pulsed x-ray projections: A feasibility study using a five-dimensional cardiac CT contrast dynamics model.

Cardiac computed tomography (CT) exams are some of the most complex CT exams due to the need to carefully time the scan when the heart chambers are near the peak contrast concentration. With current "bolus tracking" and "timing bolus" techniques, after contrast medium is injected, a target vessel or chamber is scanned periodically, and images are reconstructed to monitor the opacification. Both techniques have opportunities for improvement, such as reducing the contrast medium volume, the exam time, the number of manual steps, and improving the robustness of correctly timing the peak opacification. The objective of our study is to (1) develop a novel autonomous cardiac CT clinical workflow to track contrast bolus dynamics directly from pulsed x-ray projections, (2) develop a new five-dimensional virtual cardiac CT data generation tool with programmable cardiac profiles and bolus dynamics, and (3) demonstrate the feasibility of projection-domain prospective bolus tracking using a neural network trained and tested with the virtual data to find the contrast peak. In our proposed workflow, pulsed mode projections (PMPs) are acquired with a wide-open collimator under sparse view conditions (monitoring phase). Each time a new PMP is acquired, the neural network is used to estimate the contrast enhancement inside the target chambers. To train such a network, we introduce a new approach to generate clinically realistic virtual scan data based on a five-dimensional cardiac model, by synthesizing user-defined contrast bolus dynamics and patient electrocardiogram profiles. In this study, we investigated a scenario with one single PMP per rotation. To find the optimal PMP view angle, 20 angles were explored. For each angle, 300 virtual exams were generated from 115 human subject datasets and divided into training, validation, and testing groups. Twenty neural networks were trained and evaluated in total to find the optimal network. Finally, a simple bolus peak time estimation algorithm was developed and evaluated by comparing to the ground truth bolus peak time. To evaluate the accuracy of a bolus time-intensity curve estimated by the network, the cosine similarity between the estimation and the ground truth was computed. The cosine similarity was larger than 0.97 for all projection angles. A view angle corresponding to the x-ray tube at 30 degrees from vertical (left-anterior of subject) showed the lowest errors. The amplitude of the estimated bolus curves (in Hounsfield Units) was not always correctly predicted, but the shape was accurately predicted. This resulted in an RMSE of 1.23s for the left chambers and 0.78s for the right chambers in the contrast peak time estimation. In this study, we proposed an innovative real-time way to predict the contrast bolus peak in cardiac CT as well as an innovative approach to train a neural network using virtual but clinically realistic data. Our trained network successfully estimated the shape of the time-intensity curve for the target chambers, which led to accurate bolus peak time estimation. This technique could be used for autonomous diagnostic cardiac CT to trigger a diagnostic scan for optimal contrast enhancement.

Role of Advanced Magnetic Resonance Imaging in Differentiating among Glioma Subtypes and Predicting Tumor-Proliferative Behavior

Abstract Objective Gliomas are a devastating and heterogeneous group of primary brain tumors. Previously, the source of glioma was undetermined. Recent literature indicates that neural stem cells, or progenitors, are proposed to be the source of glioma. The prognosis of different types of gliomas differs due to their various biological tissue types. Besides the histological grade, the two useful immunohistochemistry markers that show the tumor's biological behavior are isocitrate dehydrogenase (IDH) labeling and the Ki-67 labeling index. We sought to determine the magnetic resonance imaging (MRI) characteristics associated with IDH mutational status and ascertain whether MRI combined with IDH mutational status, can better predict the clinical outcomes of gliomas. Materials and Methods This period study was conducted in the Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India for 5 years (May 2016–May 2021). The study cohort included 30 patients diagnosed with gliomas who underwent preoperative MRI followed by surgical resection and histopathological examination. Preoperative MRI images were done to assess qualitative tumor characteristics such as location, margin of tumor, extent, cortical involvement, cystic component, mineralization or hemorrhage, and contrast enhancement. Discussion Differences in MRI features between IDH-mutant (MT) and IDH-wild-type (WT) groups were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Statistical analysis was conducted using SPSS software. Results Among the 30 patients evaluated, 18 had IDH-WT and 12 had IDH-MT type gliomas. Male predominance (73.33%) was noted in our study. Brainstem location, indistinct borders (83.33%), less cortical involvement (72.22%), less cystic changes (88.89%), more area of necrotic component (44.44%), significantly increased choline/creatine (Cho/Cr) ratio, and choline/N-acetyl aspartate (Cho/NAA) ratio favors IDH-WT tumors. Positive T2-fluid-attenuated inversion recovery mismatch sign is more frequently seen in IDH-MT (7/12; 58.33%) tumors than in IDH-WT (4/18; 22.22%) tumors. Whereas well-defined contours (66.67%), more cortical involvement (83.33%), more cystic changes (58.33%), and less area of necrotic component favor IDH-MT type tumors. Conclusion MRI is a very promising and valuable tool for differentiating among glioma subtypes and predicting tumor-proliferative behavior in glioma cases. The combination of MRI characteristics with IDH mutation status enhances the predictive accuracy for clinical outcomes in glioma patients. This approach could potentially guide treatment planning and improve prognostic assessments.

ASSOCIATIONS BETWEEN AORTIC DIAMETER AND ANTHROPOMETRIC MEASURES IN MEN: A CT STUDY

Cardiovascular diseases are a leading cause of death globally, with Ukraine experiencing a mortality rate of 64.3% in 2019, predominantly affecting men. Aortic aneurysms, assessed by aorta diameter, are significant among these diseases. While computed tomography (CT) is the gold standard for diagnosing aortic syndromes, there's a lack of comprehensive data on aortic morphometrics in Ukraine, particularly in men. This research aims to bridge this gap by analyzing CT-derived data on the ascending aorta in Ukrainian men. Aim. To enhance diagnostic accuracy and guide treatment strategies, including surgical interventions, by understanding the correlation between aortic morphology, age, and anthropometric variables in this high-risk demographic. Materials and methods. The study used DICOM images from computed tomography angiography of the aorta with contrast enhancement and ECG synchronization. Methods included anthropometric assessments, CT imaging, and statistical analysis. The study involved 62 male subjects without heart or ascending aorta pathology. Data included age, body length, and weight, which were used to calculate BMI and BSA. Diameter measurements of the aorta were taken at specific levels: the aortic ring, aortic sinus, sinotubular junction, maximum diameter of the ascending aorta, mid-section of the ascending aorta, and just before the brachiocephalic trunk departure. Statistical analyses employed the Student's t-test and Pearson's correlation analysis, with a significance level of p&lt;0.05. Results. The study encompassed 62 male subjects without cardiovascular pathology, with an average age of 52.56±13.52 years, average body length of 1.76±0.07 m, average body weight of 84.74±14.14 kg, average BMI of 27.54± 4.74 kg/m², and BSA of 2.03±0.18 m². A moderate positive correlation between age and aortic diameter was observed, ranging from +0.35 for the average diameter of the aorta at the aortic ring level to +0.57 for the maximum diameter of the aorta (p&lt;0.05). However, no significant correlations were found between aortic diameters and body height in men (p&gt;0.05). Notably, a moderate positive correlation was observed between body weight and aortic diameter at the sinotubular junction level (r=+0.61, p&lt;0.001) and the aortic sinus level (r=+0.34, p= 0.027). Furthermore, an increase in aortic diameter at the sinotubular junction level was significantly correlated with an increase in BMI (r=+0.59, p&lt;0.001) and BSA (r=+0.57, p&lt;0.001). Additionally, body surface area demonstrated a significant positive correlation with an aortic diameter at the aortic sinus level, exhibiting a moderate positive correlation (r=+0.35, р=0.023). Men with a BMI of 25 kg/m² or higher (n=45) showed significantly larger aortic diameters at almost all levels (excluding the aortic ring diameter) compared to those with lower BMIs (р&lt;0.05). Conclusions. CT-morphometric indicators of the diameter of the aorta in men normally increase with age. Body weight is directly correlated with the diameter of the aorta at the level of the sinotubular junction and aortic sinuses. In men with excess body weight and obesity, larger values of the diameters of the aorta were established at all studied levels, except for the level of the sinotubular junction.

A controlled study of MR DWI, FS-PDW, and CE-T1W imaging for the evaluation of the internal opening of anal fistulas.

Anal fistula (AF) is an abnormal tunnel under the skin connecting the anal canal in the colon to the skin of buttocks. Fat-suppressed (FS) proton density-weighted (PDW) imaging is mainly used for the diagnosis of diseases involving bones and joints. Until now, its value in the diagnosis of anal fistula has been rarely reported. To compare three magnetic resonance imaging (MRI) sequences - diffusion-weighted imaging (DWI), FS-PDW), and contrast-enhanced (CE) T1-weighted (T1W) imaging - for the diagnostic value of the internal opening of AF. MRI scans of 132 patients suspected of having AF between December 2021 and April 2023 were retrospectively analyzed. In total, 65 patients who underwent preoperative MRI and were treated surgically were included. The lesion conspicuity and accuracy for featuring AF were calculated by evaluating the three imaging datasets DWI, FS-PDW, and CE-T1W imaging, with surgical findings serving as the reference standard for the presence of fistulas. The statistical analysis included the application of the chi-square test and Kruskal-Wallis test. In 65 patients with AF, 87 internal openings of AF were confirmed. In terms of the diagnostic accuracy of the internal openings, both FS-PDW and CE-T1W imaging sequences were significantly better than DWI sequences, and the difference was statistically significant (P < 0.05). The FS-PDW imaging sequence showed comparable diagnostic performance of the internal opening of AF to CE-T1W imaging, which can provide an important diagnostic basis for clinical procedures.

Operando lateral state-of-charge inhomogeneity mapping via wavelength-resolved neutron imaging

The continuous advancement in battery technology requires the development of robust and more precise diagnostic tools for the characterization of commercial-scale battery cells. In this work, operando Bragg edge imaging (BEI), based on a time-of-flight approach, provides spatially resolved state-of-charge (SoC) mapping of a commercial-size pouch cell. The changes in the position and intensity of Bragg edges are used to track the Li intercalation into the graphite, thereby identifying the spatial distribution of various lithiation stages and the corresponding SoC. The operando wavelength-resolved BEI assessment revealed an inhomogeneous Li+ intercalation, dependent on the distance to the electrical tabs, effectively identifying features that contribute to the overall loss of performance and the accelerated degradation of battery materials. The presented results demonstrate the potential of advanced wavelength-resolved neutron imaging to be used as a diagnostic tool for commercial battery cells in a configuration without special casings or isotopes for enhancement of imaging contrast. It thus highlights its applicability for operando characterization of future batteries for portable and automotive applications.

Hypophysitis in COVID-19: a systematic review.

This systematic review aims to collect and examine recent research findings regarding hypophysitis in COVID-19 patients. We conducted a comprehensive literature review in English on the topic "Hypophysitis in COVID-19," using the MEDLINE (PubMed) database in July 2024. The selected articles were systematically tabulated and we have assessed in this review patient demographics, symptom presentation, imaging results, diagnosis, clinical management, and outcomes. Seven reported cases of post-COVID-19 hypophysitis were identified, comprising 4 (57%) females and 3 (43%)males, with a median age of 37 years. The interval between COVID-19 infection symptoms and the onset of hypophysitis ranged from 2 to 3 weeks. Initial symptoms included frontal headache in 4 (57%) cases and polyuria and polydipsia in 3 (43%)cases. Anterior or posterior hypopituitarism was observed in 6 (85%)patients. Radiological findings varied: 2 (28.5%) cases showed panhypophysitis, 3 (43%) cases exhibited gland enlargement with homogeneous contrast enhancement on magnetic resonance imaging (MRI), 1 case involved the loss of the posterior pituitary bright spot, and 1 case involved pituitary apoplexy/enlargement of the gland and infundibulum. No pituitary biopsies were performed. Four (57%) patients received glucocorticoid (GC) treatment. Long-term follow-up was documented in only one case, a 16-year-old female followed for 2 years reporting complete clinical and radiological resolution. Although rare, hypophysitis related to COVID-19 is documented in the literature exhibiting distinct characteristics such as a homogeneous gender prevalence, an average age of onset around 35 years, and primary symptoms of headache, polyuria, and polydipsia which are indicative of angiotensin-vasopressin deficiency. This is in contrast with primary autoimmune hypophysitis characterized by a female prevalence and typical symptoms with headache and visual impairment. Longer-term follow-up of these patients is needed to better understand the potential lasting impact on pituitary function and radiological improvement. Future research should also explore the presence of anti-pituitary antibodies and the other possible pathophysiological mechanisms potentially involved in these cases.

Fine-grained relation contrast enhancement of knowledge graph for recommendation

Fine-grained relation contrast enhancement of knowledge graph for recommendation

Performance of dual-energy subtraction in contrast-enhanced mammography for three different manufacturers: a phantom study

BackgroundDual-energy subtraction (DES) imaging is critical in contrast-enhanced mammography (CEM), as the recombination of low-energy (LE) and high-energy (HE) images produces contrast enhancement while reducing anatomical noise. The study's purpose was to compare the performance of the DES algorithm among three different CEM systems using a commercial phantom.MethodsA CIRS Model 022 phantom, designed for CEM, was acquired using all available automatic exposure modes (AECs) with three CEM systems from three different manufacturers (CEM1, CEM2, and CEM3). Three studies were acquired for each system/AEC mode to measure both radiation dose and image quality metrics, including estimation of measurement error. The mean glandular dose (MGD) calculated over the three acquisitions was used as the dosimetry index, while contrast-to-noise ratio (CNR) was obtained from LE and HE images and DES images and used as an image quality metric.ResultsOn average, the CNR of LE images of CEM1 was 2.3 times higher than that of CEM2 and 2.7 times higher than that of CEM3. For HE images, the CNR of CEM1 was 2.7 and 3.5 times higher than that of CEM2 and CEM3, respectively. The CNR remained predominantly higher for CEM1 even when measured from DES images, followed by CEM2 and then CEM3. CEM1 delivered the lowest MGD (2.34 ± 0.03 mGy), followed by CEM3 (2.53 ± 0.02 mGy) in default AEC mode, and CEM2 (3.50 ± 0.05 mGy). The doses of CEM2 and CEM3 increased by 49.6% and 8.0% compared with CEM1, respectively.ConclusionOne system outperformed others in DES algorithms, providing higher CNR at lower doses.Relevance statementThis phantom study highlighted the variability in performance among the DES algorithms used by different CEM systems, showing that these differences can be translated in terms of variations in contrast enhancement and radiation dose.Key PointsDES images, obtained by recombining LE and HE images, have a major role in CEM.Differences in radiation dose among CEM systems were between 8.0% and 49.6%.One DES algorithm achieved superior technical performance, providing higher CNR values at a lower radiation dose.Graphical