Cross-sectional Imaging Research Articles

CTRing: An R package to extract wood density profiles from computed tomography images of discs and logs

Accurately determining the position of pith and accessing tree-ring density profiles, including intra-ring variations, is important for both the forest industry and dendroclimatology. Although several available methods exist for acquiring this information, such as X-ray computed tomography (CT), micro-CT, and X-ray films, the availability of open-source programs for extracting data remains limited. The CTRing package in the R environment integrates a series of functions to detect precisely the pith and tree-ring boundaries and generate tree-ring density profiles using CT images of tree cross sections. Before processing, grey values are transformed into density using a calibration function. Pith position is then detected by combining an adapted Hough Transform method and a one-dimensional edge detector. Tree-ring profiles along the pith-to-bark path of interest are inspected visually, and tree-ring boundaries can be easily added or removed manually via a graphical user interface. After correcting for tree-ring boundaries, the inflection points of a 3rd-degree polynomial obtained from density profiles are used to delimit the earlywood–latewood transition. We tested this package using 60 CT-scanned images of white spruce (Picea glauca (Moench) Voss) discs collected at various tree heights (0 %, 25 %, 50 % and 75 % of the total tree height as well as at 1.3 m). The pith detection function had an average mean error of 0.72 mm with 95 % of the automatically detected pith locations that differed by less than 2 mm from their manually located positions. Error decreased toward the apex of the tree. The functions of the CTRing package are flexible and can be easily implemented or adapted. The package could also be used with simple images of discs to obtain ring-width time series; however, this use must be evaluated further. Future work with this package involves assessing the use of low-quality images and ring-porous species.

Exploring the Role of Intracorporeal Ultrasound in Partial Nephrectomies: A Systematic Review.

Renal cell carcinoma accounts for the sixth most common cancer in the United Kingdom. With the increasing application of cross-sectional imaging, the frequency of incidental renal masses has increased over time. Laparoscopic and robot-assisted partial nephrectomy has become the standard of care in the management of size and stage-appropriate renal masses. The objective of this systematic review was to analyse the surgical outcomes when intracorporeal ultrasound was utilised as an adjunct in partial nephrectomy. A comprehensive search in PubMed and Google Scholar was performed in July 2024 for publications in the English language. The primary endpoint was to evaluate the role of intracorporeal ultrasound as an adjunct in robotic partial nephrectomies and its impact on tumour clearance. After identifying 609 records, 52 records were screened and 44 records were sought for retrieval. Eight publications were included in this systematic review comprising 765 patients. Seven of the eight studies reported outcomes from single centres. The mean percentage of negative surgical margins was 97.6% (range = 92.1-100%). The use of intracorporeal ultrasound as an adjunct in partial nephrectomy for T1 renal cell cancer has proven to improve the rates of negative surgical margins thereby reducing the incidence of local recurrence and distant metastasis.

Alloplastic Vascular Grafts for Venous Interposition in Pancreatic Surgery: Readily Available and Reliable.

To investigate patency and clinical outcomes of alloplastic and other venous interposition graft materials in pancreatic surgery. Vascular pancreatic surgery is increasingly performed for locally advanced pancreatic neoplasms. Different than other centers, we prefer to use alloplastic vascular graft materials for superior mesenteric vein and portal vein interposition in pancreatic surgery. Advantages are off-the-shelf availability at any customizable length, different diameters, and ring-enforcement but proposed concerns are their thrombogenicity and fatal complications. Patients who underwent elective pancreatic resections with mesoportal venous interposition grafts (ISGPS type 4) between 2003-2022 were identified from the institutional pancreatectomy registry. Alloplastic vascular grafts imply synthetic materials, either based on polytetrafluorethylene (PTFE) or polyethylene terephthalate (PET). Surgical details, clinicopathological, and follow-up data were analyzed. The patients were followed for graft patency by cross-sectional imaging. In this study, 201 patients with venous interposition grafts were included (23% simultaneous arterial resections). Total pancreatectomy (41%) and pancreatoduodenectomy (35%) were the most frequent procedures. Vascular graft materials were alloplastic in 180 patients (83% PTFE and 17% PET) with a median diameter of 10mm and a median length of 33mm (measurement by CT scan). Patency rates among all graft materials at 7-, 30-, and 90-days were 99%, 93%, and 87%. Alloplastic grafts demonstrated superior patency over other materials (hazard ratio 2.7, P=0.009), and PTFE reached a 1-year patency of 78%. The all-cause 90-day mortality rate was 10%. No graft infection occurred. Alloplastic venous vascular grafts are safe and readily available tools in pancreatic surgery, especially for long-segmental mesoportal venous reconstructions.

Neuroendocrine tumours and pregnancy: Real-world data from an European Neuroendocrine Tumour Centre of Excellence.

Neuroendocrine neoplasms (NENs) arise from the diffuse endocrine system and have been considered to be rare. However, the incidence and prevalence of these tumours have increased in recent years, and they are being seen in younger patients including women in the reproductive age group. Due to the paucity of data, diagnostic and therapeutic strategies in managing such tumours during pregnancy can be challenging to both treating physicians and patients. This article describes the experience and outcomes of managing pregnant women with NEN at a European Neuroendocrine Tumour Society (ENETS) Centre of Excellence. In this retrospective analysis, we evaluated a total of 22 pregnancies in 18 pregnant women with concurrent diagnoses of NENs who were managed at Royal Free Hospital ENETS Centre of Excellence throughout their pregnancy. These were identified from our tumour registry of 3500 NEN patients between 2015 and 2023. Cross-sectional imaging (computed tomography (CT)/magnetic resonance imaging (MRI)), pre- and post-pregnancy, for each patient was reviewed by an experienced radiologist. Tumour growth rate (TGR) was calculated using the formula: TGR = 100 × [exp (TG) - 1]; TG. [3 × log (D2/D1)]/time (months), where D1 is the tumour size at date 1; D2 is the tumour size at date 2; and time (months) = (Date 2 - Date 1 + 1)/30.44. Tumour growth rate pre-conception (TGRpc) and tumour growth rate post-partum (TGRpp) were calculated for each patient. In a sub-group of patients, positivity for oestrogen and progesterone receptors were analysed on the tumour tissue to evaluate whether the presence of these receptors affected tumour progression during the pregnancy. We also reviewed the pregnancy outcome in patients treated with somatostatin analogues during pregnancy. We analysed the data of a total 22 pregnancy encounters in 18 women: 15 pregnancies (68%) preceded the diagnosis of the NEN, whereas the diagnosis of NEN was made during pregnancy or in the post-partum period in 5 (23%) and 2 (9%) pregnancies respectively. Eight patients (44%) had a diagnosis of a pancreatic NEN, whereas 5 (28%) were diagnosed with mid-gut NENs, and a further 5 at other sites. The majority of the patients (n = 12, 67%) had evidence of metastatic disease at the time of diagnosis. Most pregnancies had a successful outcome (n = 19, 86%), whereas 3 patients (14%) had miscarriages in the 1st trimester. Five patients in total of 6 pregnancies were treated with somatostatin analogues as monotherapy during the pregnancy, and all of them had stable disease after pregnancy. All of them delivered healthy babies without any side effects or complications due to therapy. The average TGRpc was -0.8% (n = 5) and the average TGRpp was +0.96% (n = 6); 2 patients who did not have suitable targets for calculation of TGRpc developed new lesions suggesting disease progression. Moreover, 2 of the 4 patients who have had both pre-conception and post-pregnancy scans showed an increase in TGRpp compared to TGRpc. The management of NENs during pregnancy should be multidisciplinary with an individualised approach to each patient. Somatostatin analogues appear to be safe during pregnancy, though further robust studies are needed. Pregnancy per se may accelerate tumour progression, and patients should be counselled regarding this possibility.

Paraganglioma With Intracranial Invasion Demonstrated on 68Ga-DOTATATE PET/CT.

68Ga-DOTATATE PET/CT demonstrates superior sensitivity compared with other cross-sectional and functional imaging techniques in detecting head and neck paragangliomas. It is the primary recommended imaging modality for the evaluation of head and neck paragangliomas, especially in patients suspected of having locally aggressive, multifocal, or metastatic disease, as well as those being considered for targeted peptide-receptor therapy. Herein, we demonstrate the 68Ga-DOTATATE PET/CT findings of a skull base paraganglioma with extensive local invasion and intracranial extension.

Sociodemographic predictors of imaging utilization in children with right lower quadrant pain.

Inequities in health care access lead to inequities in outcome. In recent years, health outcome disparities have been documented in children with acute appendicitis and sociodemographic predictors of imaging utilization have not been adequately assessed. The purpose of our study is to assess sociodemographic predictors for the diagnostic imaging of children with right lower quadrant (RLQ) pain. Our hypothesis is that disparities exist in imaging utilization. Our nationwide retrospective cohort study of the Pediatric Health Information System (PHIS) database queried emergency department encounters for children aged 0-18years presenting with RLQ pain (ICD code CM R10.31) between January 2018 and September 2023. Primary exposures included neighborhood-level sociodemographic metrics as measured by Child Opportunity Index, race/ethnicity, and insurance status. Outcomes included no diagnostic imaging, diagnostic imaging with radiography alone, ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). Multivariable logistic regression analyses assessed modality usage with respect to the primary exposures after controlling for demographic (age, gender) and additional (hospital geographic region, time of imaging) covariates. To avoid the perpetuation of bias, reference categories were determined by the lowest numerical value for each covariate. In total, 100,161 patient encounters met inclusion criteria (mean patient age 11.2years ± 3.9; 59.3%, n = 59,416 females). Imaging utilized was US (78.0%; n = 78,115), CT (16.4%, n = 16,405), no imaging (13.9%, n = 13,894), radiography alone (4.4%, n = 4,429), and MRI (3.1%, n = 3,148). The most predictive factors for no imaging were moderate, low, and very low Child Opportunity Index (aOR 1.25, 1.17, and 1.18 [95% CI 1.10-1.33] compared to very high Child Opportunity Index); Black race/ethnicity (aOR 1.26 [95% CI 1.11-1.44] compared to White or Asian race/ethnicity); and public or other insurance (aOR 1.23 and 1.32 [95% CI 1.18-1.41] compared to commercial insurance). The most predictive factors for radiography alone were Black race/ethnicity (aOR 1.30 [95% CI 1.17-1.45] compared to Hispanic race/ethnicity) and public or other insurance (aOR 1.26 [95% CI 1.11-1.44] compared to commercial). The most predictive factors for US were very-high Child Opportunity Index (aOR 1.16 [95% CI 1.09-1.22] compared to very low Child Opportunity Index); Asian, NH-White, or Hispanic race/ethnicity (aOR 1.33, 1.31, 1.30 [95% CI 1.18-1.40] compared to Black race/ethnicity); and commercial insurance (aOR 1.20 [95% CI 1.16-1.25] compared to public insurance). The most predictive factor for CT was White race/ethnicity (aOR 1.26 [95% CI 1.11-1.43] compared with Asian race/ethnicity) and the most predictive factor for MRI was Hispanic race/ethnicity (aOR 1.49 [95% CI 1.17-1.61] compared with Black race/ethnicity). The greatest predictor of cross-sectional imaging was a hospital's region, with CT most likely in southern hospitals (aOR 4.09 [95% CI 2.17-7.70] compared with northeast hospitals). Patient Child Opportunity Index did not predict the likelihood of cross-sectional imaging with CT or MRI in tertiary pediatric centers. Sociodemographic disparities exist in the imaging of children presenting to tertiary pediatric hospitals with RLQ pain. Future studies are needed to analyze the causes of such disparities both on hospital and departmental levels.

Effect of Microstructure on Chemo-Mechanical Damage Evolution in Aluminum Foil Anodes for Lithium-Ion Batteries

Aluminum-based foil anodes could enable lithium-ion batteries with high energy density comparable to silicon and lithium metal. However, mechanical pulverization and lithium trapping within aluminum tend to cause capacity fading. The complex interplay between these damage modes is not well understood, as well as the role of microstructure on reaction front evolution. Here, we investigate aluminum foils with different compositions and processing conditions to understand how microstructure influences chemo-mechanical degradation. Backscattered electron imaging of ion-milled foil cross sections is used to visualize reaction front evolution and chemo-mechanical degradation. We find that the shape of the reaction front during lithiation is strongly affected by foil composition, defect distribution, and grain size, which, in turn, affects the evolution of chemo-mechanical damage within the foils. Furthermore, a key finding is that the extent of fracture upon delithiation is inversely related to lithium trapping, with foil compositions that exhibit uniform lithiation, and therefore, less fracturing showing greater lithium trapping. Nonreactive precipitate inclusions within alloy foils are also found to induce void formation. This work shows that material design strategies designed to overcome the inverse fracture-lithium trapping relationship could be useful for improving performance. Published by the American Physical Society 2024

Blue light reflectance imaging in non-perfusion areas detection: insights from multimodal analysis

DesignA retrospective, cross-sectional image analysis using a convenience sample.SubjectsFive cases selected based on the availability of comprehensive imaging data.MethodsThis study involved a retrospective review of images from five cases, focusing on the use of retinal monochromatic blue light reflectance (BLR) imaging to detect non-perfusion areas. Two cases of sickle-cell retinopathy demonstrated peripheral retinal non-perfusion identified through widefield fluorescein angiography. Three other cases—one with branch retinal vein occlusion, one with branch retinal artery occlusion, and one presenting paracentral acute middle maculopathy showed focal macular non-perfusion detected by structural OCT and OCTA. The areas of nonperfused retinal tissue, confirmed by fluorescein angiography, OCT, and OCTA, were then correlated with findings from the BLR image. This correlation aimed to identify any potential associations between these imaging modalities.Main outcome measuresEnhance understanding of the utilization of retinal monochromatic BLR images as a non-perfusion biomarker.ResultsThe perfusion defects identified through fluorescein angiography were qualitatively correlated with hypo-reflective regions observed in the BLR images. A notable correlation was also observed between the OCTA deep capillary plexus findings and the BLR images. Additionally, areas of retinal thinning identified on structural OCT thickness maps corresponded with the hypo-reflective regions in the BLR images. This indicates the potential of BLR in identifying non-perfused retinal areas.ConclusionsThis study reinforces the evidence, through OCT, OCTA, and angiographic correlation, that the BLR can effectively identify areas of retinal non-perfusion in a non-invasive manner. Further research is warranted to assess the method’s sensitivity, specificity, and limitations. While the interaction of blue light with the retina, leading to specular reflections and scattering, is established, this research represents a pioneering effort in suggesting which specific retinal structures may be implicated in this phenomenon. This novel insight opens avenues for deeper exploration into the underlying mechanisms and potential clinical applications of utilizing the BLR imaging technique for assessing retinal vascular abnormalities.

Anomalous Origin of the Right Subclavian Artery from the Right Pulmonary Artery in a Patient with d-Transposition of the Great Arteries: Diagnosis and Surgical Treatment.

Anomalous origin of the right subclavian artery (AORSA) from the right pulmonary artery is a rare congenital anomaly usually diagnosed by computed tomography, magnetic resonance imaging, or angiography. We present a very rare case of diagnosis and surgical correction of AORSA coexisting with d-transposition of the great arteries in a newborn's first hours of life. Due to the critical local hospital and patient conditions, additional cross-sectional imaging was not feasible. The diagnosis was suspected by clinical signs, confirmed by transthoracic echocardiogram, and the patient was urgently taken to the operating room. We discuss clinical and echocardiographic signs of this child with d-transposition of the great arteries and AORSA from the right pulmonary artery.

Anatomic Distribution and Clinical Presentation of Pulmonary Carcinoids: A Single-institutional Study

BackgroundPulmonary carcinoid tumors (PCTs) have historically manifested predominantly as central lung lesions causing postobstructive symptoms. However, nearly all case series of PCTs to date evaluate cohorts in years before 2010. Because an increased volume of cross-sectional imaging studies results in more frequent detection of incidental lung nodules, we sought to evaluate whether the nature of this cancer’s clinical characteristics may be evolving by studying a contemporary series of patients. MethodsThe study analyzed all patients with a diagnosis of PCT at Thomas Jefferson University Hospital (Philadelphia, PA) between 2006 and 2020. The study evaluated tumor location within the bronchial tree (ie, central or peripheral), the presence or absence of symptoms at diagnosis, patient demographics, and nodule characteristics on computed tomography. ResultsA total of 73 PCTs were analyzed in 72 patients. Most PCTs were detected incidentally (48 of 72; 95% CI: 55%-77%) and located peripherally (41 of 67; 95% CI: 49%-73%). Logistic regression analysis demonstrated that the likelihood of PCTs’ having these features increased over the study period. ConclusionsPCTs manifested predominantly as peripheral lung lesions detected incidentally on computed tomography, which contrasts with the existing literature. This may reflect the changing nature of PCT diagnosis as cross-sectional imaging volume has increased. Clinicians should be mindful that incidental solitary pulmonary nodules detected on chest imaging may represent PCT, especially if the lesions are slow growing.

Imaging of the Inferior Mesenteric Vasculature.

The inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV) supply and drain blood from the distal colon and rectum, respectively. Routinely imaged at cross-sectional imaging of the abdomen and pelvis, these vessels play a vital role in gastrointestinal tract health but may be neglected due to their diminutive caliber relative to other mesenteric vessels and potential lack of inclusion in routine search patterns. The authors describe and illustrate normal and abnormal appearances of the IMA and IMV and findings that are diagnostic of primary vascular abnormalities or can offer diagnostic clues. After the embryologic features, normal anatomy, and anatomic variants of the IMA and IMV are reviewed, various manifestations of IMA and IMV abnormalities, such as aneurysm and pseudoaneurysm, stenosis, occlusion, dissection, hemorrhage, arteriovenous malformations and fistulas, tumoral invasion, vasculitis, and perivascular lymphatic dilatation, are explored with use of case examples. The role of the IMA and IMV as collateral vasculature, including the clinical scenarios of superior mesenteric arterial occlusion, aortic endoleak, and portosystemic venous shunt, are discussed. Finally, diagnostic clues that the inferior mesenteric vessels and adjacent soft tissues can provide, including mesenteric venous gas, compression or displacement from bowel volvulus or internal hernias, lymphadenopathy, and venous flow artifacts, are highlighted. The authors provide a comprehensive reference for radiologists who evaluate the IMA and IMV on cross-sectional images and shine a spotlight on these neglected but important vessels. ©RSNA, 2024 Supplemental material is available for this article.

Evaluation of coarse aggregate properties in hardened concrete based on segment anything model (SAM)

The applicability of the segment anything model (SAM) algorithm, a novel technique for analyzing the characteristics of coarse aggregate from RGB images of concrete cross-sections, was evaluated. Unlike traditional deep learning method, the SAM algorithm effectively and clearly separates coarse aggregate and mortar without requiring a large database, extensive pre-training, conversion of RGB images to grayscale, or manual threshold setting. Additionally, a new technique was applied to separate the pores recognized as aggregates by using the image difference according to the change in vertical and side lighting. Consequently, the area ratio of coarse aggregate, after the separation and removal of pores from the aggregate area, exhibited an error of approximately 7.0 % when compared to the actual volume ratio of the aggregate. However, in contrast to the calculation of the area ratio of coarse aggregate, the SAM algorithm demonstrated significant errors in size analysis, leading to distortions in the sieve curve. Nevertheless, the SAM algorithm indicates potential for application in various concrete-related fields of concrete in the future.

Watchful waiting in laryngo-tracheobronchial amyloid: A case report.

We report the long term follow up of a now 66-year-old male with laryngo-tracheobronchial amyloidosis. The patient initially presented with dysphonia and dyspnoea. He was diagnosed with laryngeal reflux and asthma. Seven years later, the patient underwent cross sectional thoracic imaging showing diffuse thickening of the distal trachea and proximal main bronchi. The patient's FEV1 and FVC remained stable over 13 years and no intervention was required.

P39 Primary antiphospholipid syndrome before development of severe systemic lupus erythematosus – a case report

Abstract Introduction Antiphospholipid syndrome (APS) has long been associated with systemic lupus erythematosus (SLE). Graham Hughes first reported APS in 1983 in cohorts of SLE patients with recurrent thrombosis. We present a case of a young man who developed severe manifestations of SLE 7 years after the diagnosis of primary APS and we look at the literature for predictors in primary APS to develop into SLE. Case description A 28 year old Caucasian male with Turkish ancestry was diagnosed with triple positive primary APS at the age of 21 when he presented with bilateral pulmonary embolisms. He was stable on warfarin with target INR between 3-4. He had been having occasional mouth ulcers, lethargy, mild paraesthesia of his feet and headaches for 2 months. He then presented in February 2024 with short history of pleuritic chest pain and marked breathlessness. Initial cross sectioning imaging did not reveal pulmonary embolism. A week later, echocardiogram demonstrated large global pericardial effusion and small pleural effusions. Ejection fraction was preserved. Interval MRI scan showed pericarditis without evidence of myocarditis. Almost 600 mls of heavily blood stained pericardial fluid was drained. Analysis of the pericardial fluid showed inflammatory processes with macrophages, neutrophil and lymphocytes. Culture was negative including for tuberculosis and cytology negative for malignancy. Immunology revealed ANA 1:160, ENA normal, dsDNA was initially negative but upon interval testing was high at 27.5 IU/mL, IgG 13.1 g/L, C3 1.2 g/L, C4 <0.1 g/L, CRP 143, ESR 30. He had anaemia, lymphopenia and positive direct antiglobulin test. ANCA and rheumatoid factor were unremarkable. Renal and joints were unaffected. Due to his Turkish ancestry, he was extensively investigated for the possibility of Behcet’s with normal femoral vein ultrasound and negative HLA-B51 genotype. His manifestations fulfilled the SLICC criteria to be diagnosed with SLE. His response to intravenous methylprednisolone infusions and subsequent oral steroid was marked. He was initiated on dual treatment of hydroxychloroquine and mycophenolate mofetil and is currently recovering. Discussion We relooked at this immunology when he was first diagnosed with primary APS in 2017. He was strongly positive for ANA at titre of 1:640 but did not have manifestations of SLE then. We researched literature on the predictors for primary APS to develop into SLE. Both disease spectrums have several overlapping manifestations including haemolytic anaemia, thrombocytopenia, lymphopenia, neurological symptoms, renal manifestations and livedo reticularis. Freire et al (1) retrospectively analysed 80 patients with primary APS and found 14 (17.5%) progressed to develop APS-SLE in 5.2 +/- 4 years. ANA positivity was found in 100% those who eventually developed APS-SLE. Other specific autoantibodies including anti-dsDNA, anti-ribosomal P, anti-Ro, anti-La and anti-U1RNP are found more commonly in the cohort too. In their APS-SLE cohort, they also found a correlation with younger age at the time of diagnosis of APS and the duration of the disease. Andreoli L et al (2) demonstrated anti-nucleosome antibody (anti-NCS) was frequently found in their cohort of APS-SLE patients but no relationship between clinical-serological was found, except for a weak correlation between anti-dsDNA antibodies. 2 of their primary APS who developed severe SLE had displayed high titres of anti-NCS years before. Tarr T et al (3) found 4 of their primary APS who developed SLE all presented with cerebrovascular events as the thrombotic manifestation. Key learning points • Primary APS has been associated with the development of SLE • Certain antibody profile such as ANA, anti-nucleosome antibody may predict the development of SLE in primary APS patients • Younger age, cerebrovascular events as thrombotic manifestation at diagnosis of primary APS and the length of duration of primary APS may be associated with the development of SLE at a later stage

Limited Effectiveness in Early Human Clinical Experience with Pulsed Electrical Field Ablation

PurposeTo evaluate oncological outcomes, abscopal effect, and adverse events of pulsed electrical field (PEF) ablation of tumors in the chest, abdomen, and pelvis. Materials & MethodsPEF ablations performed at an academic medical center between May 2023 - January 2024 were retrospectively analyzed . 11 patients (male/female: 4/7, age:58 ± 19) underwent 11 PEF sessions targeting 13 tumors (lung metastasis from solitary fibrous tumor (n=3) and colorectal carcinoma(CA) (n=1), osteosarcoma pleural metastases (n=2), hepatocellular CA (n=2),liver metastasis from colorectal CA (n=1)and leiomyosarcoma (n=1), metastatic melanoma to pancreas (n=1), metastatic retroperitoneal lymph node from endometrial CA(n=1), recurrence of endometrial CA in vaginal cuff(n=1)) with the goal of complete coverage (n=11/13) or debulking (n=2/13). The mean tumor diameter was 1.9 ± 1.0 cm (range, 0.4 – 3.3 cm). Cross-sectional imaging follow-up was 5.3 ± 2.2 months (range, 1.9 - 7.9 months). Oncological outcomes, abscopal effect, and adverse events categorized according to SIR guidelines were reported. ResultsOf 11 tumors underwent ablation for complete coverage, complete coverage was achieved for 1 (9%) and residual detected in 9 (81%). 10 of 11 patients (91%) showed either residual, local or distant progression within a median of 3 months. No abscopal effect was observed. There were 2 mild and 2 severe adverse events. ConclusionsPEF ablation showed a low rate of complete coverage (9%) and a high rate (91%) of residual, local or distant progression. No abscopal effect was observed within a median of 5.1 months after the ablation.

Bilateral Adrenal Tumors: A Visual Case Series

Adrenal incidentalomas are increasingly diagnosed with the widespread use of cross-sectional imaging modalities. Though these are often unilateral, bilateral adrenal masses uncommonly occur and can be of similar or different origins. While the majority of adrenal masses are benign, bilateral masses are more likely to be associated with hormonal disturbances. These range from syndromes of hormone excess, such as mild autonomous cortisol secretion, to primary adrenal insufficiency due to gland infiltration or destruction. Bilateral masses may herald the diagnosis of germline pathogenic variants, hereditary tumor predisposition syndromes, malignancy, or even infection. In many cases, imaging characteristics play an important role in making the diagnosis in addition to biochemical evaluation. Herein, we present various imaging findings of 10 patients with bilateral adrenal masses as evaluated with computed tomography, magnetic resonance imaging, and positron emission tomography scans.

3D Landmark scout imaging accurately assesses presence and extent of coronary calcification with lower radiation exposure

BackgroundCardiac CT for coronary artery calcium (CAC) scoring exposes patients to 1 ​mSv of radiation. A new CT scout method utilizing ultra-low dose CT (3D Landmark) offers tomographic cross-sectional imaging, which provides axial images from which CAC can be estimated. The purpose of our study is to analyze the association between estimated CAC burden on 3D Landmark scout imaging vs dedicated ECG-gated CACS. MethodsConsecutive patients over a 9-month period undergoing non-contrast ECG-gated CACS planned with 3D Landmark scout imaging were included. Extent of CAC on 3D Landmark scout imaging was scored from 0 to 3 (none, mild, moderate, severe). Agatston CACS was converted to an ordinal score from 0 to 3, corresponding to absent (0), mild (1–99), moderate (100–400), or severe (>400). Fischer's exact test, weighted kappa coefficient, and paired t-tests were used for analysis. ResultsOf 150 patients, 51.3% were female with mean age 49.0 ​± ​16.8 and BMI 28.6 ​± ​12.3. Sensitivity of 3D Landmark in identifying calcium was 96.2%, with specificity of 100%. There was strong interrater agreement between 3D Landmark calcium scoring and CACS, with weighted kappa coefficient 0.97 ​± ​0.01(CI 0.95–0.99).Radiation dose-length-product was significantly lower for 3D Landmark imaging vs. dedicated ECG-gated CACS (9.7 ​± ​3.6 vs 43.8 ​± ​26.4 ​mGy ​cm, p ​< ​0.001) despite longer scan length (465.0 ​± ​160.8 vs 123.0 ​± ​12.7 ​mm, respectively). ConclusionEstimated coronary artery calcium on 3D Landmark scout images correlates strongly with Agatston CACS, demonstrating utility in assessing cardiovascular risk without introducing additional radiation or costs.

Transfer learning-based techniques for efficient 3D-reconstruction of functionally graded materials

The various properties and phenomena in materials significantly depend on the high-quality three-dimensional (3D) microstructure. This paper proposes a novel method for 3D reconstruction of functionally graded materials (FGMs) using transfer learning techniques to overcome the limitations of experimental 3D microscopy. The approach begins by interpolating 2D cross-sectional images of FGM microstructures through a hybrid deep learning method combining StyleGAN and Gatys techniques, generating intermediate images based on style and content. In the next step, transfer learning is applied using convolutional occupancy networks to reconstruct the 3D microstructure from the 2D image depth layers, with the model trained on point clouds obtained from 2D images. To validate the method, the reconstructed microstructures are compared to actual material images at the same depth using various metrics, including lineal path, two-point correlation, and quality of connection functions. The results show a high degree of accuracy, indicating that the reconstructed images closely match the target microstructures. Finally, to show the application of model the approach is implemented to the functionally graded lanthanum strontium manganite (LSM) and 3D microstructure of this FGM has been extracted using the approach

Evaluating the effects of three anesthetic regimens on retinal structure and function in the living mouse eye using a customized bimodal OCT/ORG system

Abstract Optical coherence tomography (OCT) is a non-invasive imaging technique that generates cross-sectional images of biological tissues at millimeter-level penetration depth with micron-level resolution. In this study, we developed a custom spectral-domain OCT system equipped with a flash stimulus module for dual-modality imaging of mouse retinal structure and function. The axial resolution of the system reached ∼2.7/2 μm in air/tissue following optimization and calibration. We deployed this system to conduct in vivo OCT structural imaging and optoretinography (ORG) functional assessment of mouse retina to investigate the effects of three anesthesia regimens. Statistical analysis of the results indicates that anesthesia results in a smaller relative intensity of inner/outer segment junction and external limiting membrane and a thickening of the outer segment compared to an awake state. Meanwhile, significant differences were observed in the effects on retinal structure and function between isoflurane and tribromoethanol anesthesia, while differences between isoflurane and esketamine+xylazine groups were small. These findings suggest that the type of anesthetic should be taken into account when comparing imaging results across studies reported in the literature.

Unusual Signal of Lymphadenopathy in Children with Nodular Sclerosing Hodgkin Lymphoma.

The current guidelines for initial cross-sectional imaging in pediatric lymphomas involve computed tomography (CT) of the chest, abdomen, and pelvis. However, whole-body magnetic resonance imaging (MRI) can be favored over CT for diagnosing and staging the disease, given its lack of ionizing radiation and its higher tissue contrast. Imaging characteristics of lymphoid tissue on MRI include a high T2/short tau inversion recovery (STIR) signal. A low or intermediate signal of lymphadenopathy on T2 and STIR images is an unexpected finding, noted anecdotally in nodular sclerosing Hodgkin lymphoma. This signal may be characteristic of a histological subtype of the disease and, if confirmed, could potentially be used to avoid biopsy. In this study, we aimed to review signal characteristics of lymphadenopathy in patients with biopsy-confirmed nodular sclerosing Hodgkin lymphoma. We undertook a retrospective review of relevant MR studies of patients with nodular sclerosing Hodgkin lymphoma. Studies were reviewed by an experienced pediatric radiologist regarding lymph node signal, especially on T2/STIR. Eleven children with nodular sclerosing Hodgkin lymphoma were included. Median age at the time of MRI was 14.3 (IQR: 13.9-16.1) years, and nine were boys. Five patients showed some lymphadenopathy with a low T2/STIR signal, and six showed an intermediate T2/STIR signal. Central gadolinium non-enhancement was observed in four patients. All eleven patients (100%) with a diagnosis of nodular sclerosing Hodgkin lymphoma showed some lymphadenopathy with a low or intermediate T2/STIR signal, and five children (45.5%) showed a frank low signal of some lymphadenopathy, a feature which may prove to be a biomarker for this histology.