This study aimed to establish sex-specific cutoff values for sarcopenia based on the muscle parameters skeletal muscle index (SMI) and psoas muscle thickness per height (PMTH) using CT scans in a presumably healthy Caucasian study cohort. In this retrospective, cross-sectional study, CT scans of 350 Caucasian patients (mean age, 32 years ± 8; mean BMI, 23 (women) and 24 kg/m2 (men)) with polytrauma, but otherwise young and presumably healthy, were evaluated. Sex-specific PMTH at the level of the umbilicus (mm/m) and the SMI (cm2/m2) at the level of the L3 vertebral body were calculated from cross-sectional images. Two standard deviations below the mean were considered the cutoff values for sarcopenia according to the recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP). To exclude random outliers, only the 5th-95th percentiles were analyzed. The sex-specific cutoff values for PMTH were 15.7 mm/m for women and 20.2 mm/m for men, while those for SMI were 33.2 and 44.0 cm2/m2, respectively. The intra-rater and inter-rater variabilities were consistently low, indicating the high reliability of the measurement method. This study established sex-specific thresholds for sarcopenia based on two different muscle parameters in a presumably healthy Caucasian study cohort according to EWGSOP recommendations. Question Establishment of sarcopenia cutoff values according to the recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP). Findings Cutoff values for psoas muscle thickness per height (mm/m) were 15.7 (women) and 20.2 (men); for skeletal muscle index (cm2/m2), 33.2 and 44.0, respectively. Clinical relevance These cutoff values for two different parameters that can be determined by CT allow patients with low muscle mass to be objectively identified, thereby revealing those at high risk of manifest sarcopenia.

Operando X-ray transmission microscopy of dynamic concentration change of electrolyte salt in composite electrodes of lithium-ion battery

UVC light-induced metabolic modifications at the level of the plant cells and tissue determined by FTIR and Raman spectralomics.

To assess the prevalence of adrenal vein involvement in primary and metastatic adrenal lesions and to determine if morphological changes in tumor shape precede venous extension. This retrospective, single-center observational study evaluated 102 patients: 28 adrenal cortical carcinoma (ACC) patients, and 74 non-ACC cancer patients that presented adrenal metastasis (82 metastatic adrenal lesions). Two readers reviewed cross-sectional imaging to assess tumor size, laterality, venous invasion, and the presence of the "edge sign." Surgical and histopathological confirmation was the reference standard for ACCs, while for metastases, sequential imaging or PET-CT results showing hypermetabolism were used in 70.7% of cases and histopathology in 29.3% of cases. Of the 28 ACC patients, 82.1% were female, with balanced laterality. Metastases primarily originated from the lung (24.4%), colorectal (13.4%), and breast (12.2%) cancers and had a left-sided dominance (61.7%). Venous extension was present in 14.6% of metastases and 21.4% of ACCs, a non-significant difference (p = 0.40). The "edge sign" was more frequently observed in metastatic lesions than in ACCs, 26.8 × 17.8%, although this difference has not reached statistical significance (p = 0.34). In multivariate analysis, both mean size and the "edge sign" were independent predictors of adrenal and renal vein extension. Interobserver agreement was almost perfect for venous extension (κ = 0.9256) and substantial for the edge sign (κ = 0.7844). Venous extension was less prevalent in metastatic adrenal lesions compared to ACCs. The edge sign may precede venous extension, especially in metastatic cases, indicating the nature of the lesion. These findings potentially may alter disease management, expediting the decision for surgery; however, prospective multicenter studies are needed to confirm their clinical impact. Question What is the prevalence of venous extension in malignant adrenal lesions-whether primary or secondary-and how can early involvement be recognized on imaging? Finding Adrenal vein involvement occurred similarly in ACCs (21.4%) and metastases (14.6%). Early extension may be preceded by the adrenal edge sign in 25% of cases. Clinical relevance Adrenal vein involvement occurs in both primary and metastatic adrenal lesions, with a tendency to be more prevalent in adrenocortical carcinomas. The 'edge sign' may precede venous extension in malignant lesions, aiding both diagnosis and therapeutic planning.

STAGE challenge: Structural-Functional Transition in Glaucoma Assessment.

Femoral version deformities are key in the diagnostic evaluation of young patients with hip pain. While computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used for femoral version assessment, their limitations include a lack of standardized reference values, high costs, and accessibility constraints. An accessible and reproducible alternative is needed, particularly in the context of joint-preserving hip surgery. To evaluate the reliability and reproducibility of femoral version measurements on the modified Budin view, to compare these measurements with 4 established cross-sectional imaging methods (CT or MRI), and to determine the diagnostic accuracy of the modified Budin view in identifying abnormal femoral version. Case series; Level of evidence, 4. The authors retrospectively analyzed the records of 93 patients (107 hips; mean age, 31 ± 9 years [range, 16-55 years]; 43 female hips [40%]) evaluated for joint-preserving hip surgery at a specialized tertiary center. Femoral version was measured using the modified Budin view and compared to 4 cross-sectional imaging methods (CT and MRI) using Bland-Altman analysis and diagnostic accuracy metrics. The mean femoral version measured on the modified Budin view was 13°± 7° (95% CI, 12°-14°). The technique demonstrated excellent intra- and interobserver reliability (ICC, 0.99 and 0.98, respectively). Compared to the Reikerås method, the mean difference was 1°± 4° (95% CI, 0°-2°; P = .042; Bonferroni-corrected significance level, P < .01). The mean differences were 3°± 5° (95% CI, 2°-3°) for the Lee method, 11°± 5° (95% CI, 10°-12°) for the Tomczak method, and 12°± 6° (95% CI, 11°-14°) for the Murphy method (all P < .001). Diagnostic accuracy for detecting abnormal femoral version was high, with an area under the curve ranging from 0.88 to 0.98 and a consistently high negative predictive value (91%-100%). The modified Budin view is a highly reliable and accessible radiographic method for femoral version measurement in young patients undergoing joint-preserving hip surgery. It closely reflects the femoral neck version as measured by the Reikerås method, and demonstrates high diagnostic accuracy for detecting abnormal femoral version, making it a valuable screening tool for femoral version deformities in clinical practice.

Expanded screening with the aldosterone-renin ratio has improved detection of primary aldosteronism, the most common surgically curable cause of arterial hypertension. However, identification of surgically curable primary aldosteronism remains constrained by technical limitations of subtyping by adrenal vein sampling (AVS), as bilateral selectivity often fails. Although alternative biomarkers superior to cortisol may help reduce this rate, currently, the failure to achieve bilateral selectivity precludes calculation of the lateralization index and, thus, diverts patients toward lifelong medical therapy. Recent advances have established the relative aldosterone secretion index (RASI) as a physiologically grounded strategy to interpret partially successful AVS. By quantifying aldosterone secretion from each adrenal gland relative to peripheral values and incorporating contralateral suppression, RASI-based interpretation can rescue many AVS studies by enabling subtyping under unilateral selectivity with 80% concordance with the lateralization index, when available. Postoperative outcomes following RASI-guided adrenalectomy approximate those achieved after fully selective AVS, with biochemical cure rates of 85% to 90% and blood pressure improvement in 65% to 75%. Studies published over the past 3 years have clarified factors influencing RASI performance, including cosyntropin stimulation, variations in aldosterone secretion, and the limited utility of cross-sectional imaging alone for subtype classification. Collectively, the available data support the incorporation of RASI into contemporary AVS interpretation algorithms. As primary aldosteronism management enters a postdetection era, subtyping has emerged as the principal bottleneck to definitive cure. RASI provides a pragmatic, evidence-based means to overcome the imperative dependence on bilateral selectivity while preserving diagnostic accuracy, thereby improving access to adrenalectomy and associated cardiovascular benefits.

Region-Specific Evaluation of Plaque Segmentation in Cross-sectional Projections of Carotid Ultrasound Images Using Deep Learning Models in a Sub-clinical Atherosclerosis Cohort.

Overlapping Mechanisms and Novel Biomarkers Define Asthma and COPD as a Spectrum of Airway Disease.

CEUS provided clinically relevant diagnostic information in neonates, including preterm and critically ill infants and was well tolerated. CEUS was particularly valuable in hepatic vascular tumors, where it could provide a definite diagnosis, enabled hemodynamic assessment, supported treatment decisions, and aided identification of potentially life-threatening complications. Bedside use enabled timely diagnosis without sedation, intubation, or patient transport, thereby supporting minimal handling. In selected cases, CEUS may reduce the need for cross-sectional imaging. Despite off-label use, our findings suggest a beneficial role for CEUS in neonatal imaging, predominantly for hepatic indications. • Contrast-enhanced ultrasound (CEUS) is a radiation-free, bedside-compatible imaging technique with an established safety profile in pediatric patients. • Neonatal CEUS experience is limited to small case series, predominantly reporting cerebral applications. • CEUS was feasible and well tolerated in neonates including preterm infants, with no adverse events in 23 examinations. • CEUS yielded clinically relevant diagnostic information across a range of indications, primarily hepatic, encompassing both focal lesions and perfusion assessment, supporting clinical decision-making in neonatal care.

Portal hypertension leads to the development of a complex and heterogeneous network of portosystemic collateral pathways, which represent adaptive responses to increased portal pressure. Although traditionally considered compensatory mechanisms, growing evidence indicates that Spontaneous Portosystemic Shunts (SPSS) are ineffective in normalizing portal pressure and may contribute to adverse clinical outcomes. In patients with cirrhosis, particularly those with preserved liver function, the presence and extent of SPSS are independently associated with hepatic encephalopathy, variceal bleeding, portal vein thrombosis, and reduced transplant-free survival, highlighting their prognostic relevance. Cross-sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) plays a central role in the noninvasive assessment of portal hypertension by enabling comprehensive mapping of collateral circulation, including shunt size, anatomical course, and drainage pathways. These imaging characteristics are key determinants of clinical impact and therapeutic planning. This pictorial review illustrates the major portosystemic collateral pathways encountered in portal hypertension using representative clinical cases, emphasizing key imaging features and common diagnostic pitfalls, as well as highlighting the clinical significance in each context. Accurate recognition and standardized reporting of SPSS are essential to optimize risk stratification, guide management decisions, and improve outcomes in patients with portal hypertension.

Brain lithium temporospatial kinetics in bipolar disorder: a repeated-measures 7Li MRI study of dosing regimens in Germany.

The renal involvement during lateral lumbar interbody fusion: a radioanatomical study for surgical risk stratification.

A case of a patient with left maxillary molar pain unresponsive to standard dental treatment is presented. Advanced imaging revealed an aggressive lesion in the maxillary sinus with associated bone destruction, soft tissue extension, and diffusion restriction suggestive of malignancy. The lesion was subsequently confirmed as maxillary sinus carcinoma. This case highlights the diagnostic challenges associated with nonspecific temporomandibular disorder-like symptoms and emphasizes the importance of recognizing red flags as prompts for cross-sectional imaging and specialist referral, which are essential for ensuring an accurate diagnosis and improving clinical outcomes in patients with atypical or refractory orofacial pain.

Cervical fusion alters regional biomechanics and increases load transmission through adjacent facet joints, which may produce facet-mediated pain. Cervical medial branch blocks (MBBs) and radiofrequency ablation (RFA) remain highly useful diagnostic and therapeutic interventions, yet surgical approaches used in cervical fusion frequently disrupt the cervical medial branch nerves (MBNs) at treated levels. Identifying which MBNs remain anatomically intact is essential for accurate diagnostic and therapeutic targeting of relevant nerves (and sensate facet joints), and for avoiding unnecessary procedure levels or procedures altogether. To present an approach to determining which cervical medial branches require management after fusion, drawing upon surgical approach, anatomic landmarks, implant trajectory, and cross-sectional imaging. Technical Note. Cervical radiofrequency ablation following spinal fusion surgery. A systematic, anatomy-based method improves diagnostic precision, reduces unnecessary procedures, and helps identify patients most likely to benefit from interventions. Posterior cervical fusion using modern screw and rod instrumentation will essentially always result in denervation of the MBN at the operated level(s). Anterior surgical approaches reliably preserve the MBNs, making them viable targets for cervical RFA.

Ovarian assessment and monitoring are crucial for reproductive management and breeding programs in animal production. Currently, there is a lack of quantitative and non-invasive methods for ovarian assessment and monitoring in crab species. In the present study, magnetic resonance imaging (MRI) was utilized to characterize the ovarian morphology of mud crabs during vitellogenesis. The ovaries exhibited low signal intensity in T2-weighted magnetic resonance images and displayed intermediate signal intensity in T1-weighted magnetic resonance images. The ovarian shape varied topologically among different cross-sectional images and changed considerably across different developmental stages. From the early to late stages, the ovaries increased in size, as determined by MRI measurements at the eyes in the sagittal plane and at the commissure of the ovaries, heart, and flank in the transverse plane, which were positively correlated with values of the gonadosomatic index (GSI). The GSI was well-plotted against MRI measurements using two-variable linear regression. Among them, five regression models appeared promising for estimating GSI values in ovarian assessment of live mud crabs. The growth of the ovaries was documented in three mud crabs through repeated MRI scans, suggesting that this non-invasive method could be employed for longitudinal monitoring. Our findings demonstrate the application of MRI for ovarian assessment and monitoring in mud crabs, providing new insights into assisted reproductive technology in decapods.

Enhanced myometrial vascularity (EMV) is defined as focal myometrial hypervascularity at the former placental implantation site identified after a recent pregnancy. Spectral Doppler imaging shows characteristic high velocity, low resistance flow. Proposed mechanisms underlying prolonged EMV include delayed involution of remodeled uterine arteries and persistent trophoblastic activity with associated neoangiogenesis. EMV may reflect normal involution or subinvolution of the placental site or may be associated with retained products of conception. While often self-limited in asymptomatic patients, EMV in the setting of abnormal uterine bleeding warrants further evaluation and tailored management. Terminological ambiguity persists between EMV and acquired arteriovenous malformation (AVM) or fistula (AVF). Although Doppler findings may suggest arteriovenous shunting, cross-sectional imaging alone cannot reliably distinguish these entities, and catheter angiography remains the reference standard when definitive characterization is required. Importantly, many cases labeled as "acquired AVM" in the postpregnancy setting likely represent EMV related to persistent uteroplacental circulation or subinvolution rather than true vascular malformations. This distinction is clinically important, as true high-flow lesions, though less common, carry a risk of significant hemorrhage and may require uterine artery embolization. EMV may also be seen following intrauterine ectopic pregnancies, most commonly those implanted within a Cesarean scar. Several conditions may mimic EMV, including adenomyosis, pseudoaneurysm, gestational trophoblastic disease, fibroids, polyps, endometrial neoplasm and infection. Management is individualized based on clinical status, imaging findings, and associated conditions. Accurate recognition of EMV and use of this specific terminology as well as differentiation from mimics, is essential to guide appropriate care and avoid unnecessary interventions.

Pancreatic cystic lesions represent an increasingly common clinical finding due to the widespread use of cross sectional imaging, encompassing a heterogeneous spectrum ranging from benign entities to premalignant and malignant neoplasms. Their rising incidence poses significant challenges in diagnosis, risk stratification, and management, requiring a careful balance between avoiding unnecessary interventions and preventing malignant progression. This position paper, developed by an intersocietal multidisciplinary panel of experts in pancreatic disease, aims to provide a comprehensive and evidence-based overview of these lesions. Current classifications, imaging features, and differential diagnosis are discussed, with particular emphasis on the role of magnetic resonance imaging. Key entities including serous cystic neoplasms, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and rarer cystic tumors are analyzed in terms of biological behavior and radiological characteristics. Furthermore, the document reviews available international guidelines and proposes a pragmatic approach to clinical management, including indications for surveillance, endoscopic evaluation, and surgical treatment. Special attention is given to risk stratification based on high-risk stigmata and worrisome features, as well as to individualized patient management. In conclusion, this paper provides a shared expert perspective to support standardized and personalized management of pancreatic cystic lesions in clinical practice.

Precise orientation of symmetry-mismatched epilayers on van der Waals (vdW) substrates via heteroepitaxy has commonly been achieved through surface treatment processes to accommodate weak interlayer registry and bonding strength, thereby limiting the range of material combinations for heterostructure design. In this study, we investigate the influence of lattice instabilities in a structurally modulated vdW TaCo2Te2 substrate on the growth and alignment of a symmetry-mismatched bulk CoxTey epilayer using in situ heating in a transmission electron microscope (TEM). We show that a Peierls-like lattice instability occurs in TaCo2Te2 at a transition temperature of ∼523 K, which was corroborated by phonon calculations. Postheat-treated samples reveal a thermally induced surface diffusion process and the dominant lateral growth of the CoxTey epilayer on the TaCo2Te2 vdW layers, as observed in cross-sectional TEM images. Temperature-dependent selected area electron diffraction (SAED) patterns reveal that the quasi-vdW CoxTey/TaCo2Te2 heterointerface acquires directional locking by aligning larger interlayer lattice mismatch along the lattice instability axis of TaCo2Te2, while preserving a strong lattice matching along the orthogonal direction. This heterostructure exhibits precise interlayer registry with one-dimensional lattice incommensuration along the lattice instability axis, resulting from structural distortion to accommodate lattice-mismatch strain. Moreover, the interfacial reconstruction of TaCo2Te2 back to the distorted phase stabilizes the lattice-locking of the quasi-vdW heterointerface at elevated temperatures. These findings encourage the expansion of material diversity for designing and predicting multidimensional heterostructures by leveraging lattice instabilities to guide epitaxy.

Primary adrenal lymphoma (PAL) is a rare and aggressive extranodal lymphoma that may radiologically mimic primary adrenal carcinoma, often leading to diagnostic uncertainty and potentially unnecessary surgical intervention. Early tissue diagnosis is essential for accurate management. A 71-year-old man was evaluated for persistent left upper quadrant abdominal pain and progressive fatigue. Cross-sectional imaging revealed a large, heterogeneous mass originating from the left adrenal gland with radiologic features suggestive of local invasion. Based on the initial radiologic impression, primary adrenal carcinoma was suspected, and surgical intervention was planned accordingly. However, further review by an experienced radiologist raised suspicion of a lymphoproliferative disorder. A computed tomography-guided core needle biopsy was subsequently performed, and histopathological analysis confirmed the diagnosis of high-grade B-cell lymphoma with a Ki-67 proliferation index of approximately 80%. The patient received six cycles of well-tolerated R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Post-treatment imaging revealed complete resolution of the adrenal mass. At the 24-month follow-up, the patient remained in complete remission, with no evidence of disease recurrence. This case underscores the importance of multidisciplinary assessment and image-guided biopsy in the evaluation of adrenal masses. Avoiding unnecessary surgery through early tissue diagnosis enabled effective systemic treatment. In selected patients, R-CHOP chemotherapy may result in long-term disease control, even in elderly individuals with large unilateral adrenal tumors.