CT In Identification Research Articles

A novel parameter derived from post-processing procedure of dual energy CT for identification of gout

ROI analysis is frequently used for obtaining acid content on rapid-kV-switching dual energy CT (DECT), providing inadequate accuracy. A new parameter derived from post-processing procedure, maximum lower limit with stain visible (MLLSV), was used by us to diagnose gout. 30 gout patients and 20 healthy volunteers were analyzed by using MLLSV. MLLSV was defined as the maximum lower limit of display window allowing only one stained site visible. Radiologists were asked to continuously increase the lower limit of display window of uric acid to decrease number of stained sites until the last stained site disappeared. MLLSV obtained by this way was compared between gout patients and volunteers. Receiver operating characteristic (ROC) curve was used to determine the performance. MLLSV of gout patients was significantly higher than that of volunteers (1373.3 ± 23.0 mg/cm3 vs. 1315.4 ± 20.7 mg/cm3, p = 0.000). The area under ROC curve of MLLSV was 0.993 in identifying gout. When using the optimal cutoff of 1342 mg/cm3, the sensitivity and specificity of MLLSV in identification of gout were 96.7% and 95% respectively. MLLSV derived from post-processing procedure of DECT is useful in discriminating gout patients from healthy people.

Forensic postmortem computed tomography in suspected unnatural adult deaths

PurposeOur study sought to evaluate validity of forensic postmortem CT in establishing cause of death (COD) in suspected unnatural adult death based on the reference standard of autopsy. MethodsIn our prospective, single-center study, 64 of 94 consecutive corpses (70.7 % male, mean age: 47.4 years) who underwent CT and autopsy between November 2013 and April 2019 were included in the analysis. Primary objective was agreement between CT and autopsy on primary COD using kappa statistics. Secondary objectives were competing COD and specific pathological findings. ResultsAgreement on primary COD between forensic CT and autopsy without or in consideration of toxicological and histological findings was strong (85.9 % [55 of 64 corpses]; κ = 0.83 [95 %CI: 0.74 to 0.93] and 95.3 % [61 of 64 corpses]; κ = 0.94 [95 %CI: 0.84–1.04], respectively, McNemar p = 0.03). Sensitivity and specificity of CT in identification of acute heart failure, intracranial bleeding, burns and heat shocks, gunshot wounds, polytrauma, cranio-cerebral trauma, and strangulation or hanging was 100 %, each. Acute respiratory failure was detected with a sensitivity and specificity of 100 % and 96.8 %, cuts and stab wounds with 95.2 % and 100 %, and intoxication, pneumonia, or gastrointestinal bleeding with 60.0 % and 100 %, respectively. Agreement on competing COD was moderate (51.6 %, [33 of 64 corpses]; κ = 0.47 [95 %CI: 0.40 to 0.53], p < 0.001). ConclusionsForensic postmortem CT, complemented by external, toxicological, and histological examination was sufficiently valid to assess primary COD in the majority of suspected unnatural deaths with few restrictions.

03:18 PM Abstract No. 124 Utility of Emboguide with cone-beam CT in identification and navigation of prostatic arteries in prostate artery embolization compared with conventional 2D fluoroscopy with overlay technique: a prospective study

To evaluate the role of embolization guidance software (Emboguide) with cone-beam CT in identifying prostatic arteries and assisting in endovascular navigation compared to conventional 2D angiogram with overlay technique for prostate artery embolization (PAE). IRB-approved prospective study (ClinicalTrials.gov Identifier: NCT03164629) was conducted, enrolling 50 patients undergoing PAE for benign prostatic hyperplasia or urinary retention, aged 50-79 with mean age of 65.7 years. 25 patients underwent PAE using Emboguide and 25 patients were treated with conventional 2D fluoroscopy with overlay. 300-500μm Embospheres were used in both groups. The primary outcome measurement was time to prostatic artery catheterization, which was defined as Emboguide display to catheter in prostate artery for the study group and display of 2D angiogram overlay to catheter in the prostatic artery for the control group. Prostatic arteries were identified in all 50 cases. Technical success (bilateral embolization) was achieved in 24/25 cases in both groups. Time to catheterization was 3 mins for the control group and 4.6 mins for the Emboguide group on the right (p<0.32) and 2.8 mins for the control group and 2.9 mins for the Emboguide group on the left (p<0.95). Fluoroscopy time was 44.5 mins for the control group and 33.0 mins for the Emboguide group (p<0.019). Total procedure time was 129.4 mins for control group and 84.6 mins for the Emboguide group (p<0.003). For additional parameter results, please refer to the table. Time to catheterization was not statistically significantly different between the 2 groups, however, Emboguide significantly reduced mean total procedure time and fluoroscopy time compared to conventional 2D fluoroscopic technique (p <0.05). These findings suggest Emboguide may be an additive tool for prostate artery identification, catheterization and can lead to reduced fluoroscopy and procedure times.Tabled 1Control Group vs Emboguide (with P Values)Parameter (mean)ControlEmboguideT-testProstate size (g)105.7109.80.814Time to catheterization (R) (min)3.04.60.32Time to catheterization (L) (min)2.82.90.95Fluoro time (min)44.5330.019Total procedure time (min)129.484.60.003Dose area product (mGy.cm2)30564255650.292Skin dose (mGy)251622720.628Contrast volume (mL)111.21290.064 Open table in a new tab

CT Scanning in Identification of Sheep Cystic Echinococcosis.

Objective We aim to determine the efficiency of CT in identification of cystic echinococcosis in sheep. Methods Fifty-three sheep with liver cysts confirmed by ultrasonography were subject to CT scan to evaluate the number, size, and type of the cysts in liver and lung, confirmed using necropsy. The correlation of numbers between liver cysts and lung cysts was calculated using Pearson analysis. Results Necropsy indicated a 98% consensus on size, location, number, and activity compared with CT scan. The viable cysts were 53.1% and 50.6% in the liver and lung, respectively. Among the cysts in liver, 35.5%, 9.5%, 5.7%, 10.2%, and 39.1% were Types CE1, CE2, CE3, CE4, and CE5, respectively. The cysts in the lungs, 17.4%, 26.9%, 12.1%, 11.6%, and 32.1%, were Types CE1, CE2, CE3, CE4, and CE5, respectively. A significant correlation was noticed between the number of cysts in liver and those in lung (R = 0.770, P < 0.001). Conclusions CT scan is a suitable tool in determining the size and type of cystic hydatid cysts in both liver and lung of sheep. A significant correlation was noticed between the numbers in liver and lung, indicating that lung infection was likely due to the expansion of liver cyst burden pressure.

Trauma to the hyoid bone and laryngeal cartilages in hanging: review of forensic research series since 1856.

Since 1856 lots of forensic reports, concerning trauma to the hyoid bone and laryngeal cartilages in hanging, have been published. Differences in percentage of injured neck complexes ranged from 0 to 83.3%. Simple arguments suggest that the reason for discrepancy is difference in scientific approach (retro- or prospective) and use of various research methods. Comparative analysis of widely used techniques shows considerable variety in their effectiveness. Plain radiography and palpatory method have fairly low sensitivity (33-60% for different elements of the neck complex) with relatively high specificity (89-98.5%). Reported sensitivity of postmortem CT in identification of different lesions (including fractures) in trauma victims for the head/neck region is higher than 53% in different series with possible false-positive findings. In clinical setting the whole-body CT (pan-scanning) in blunt trauma patients showed sensitivity for head and neck injuries at the level of 84.6%, and specificity - 98.9% (Stengel et al., 2012 [68]). Only complete preparation allows to identify all the damages to the laryngopharynx framework, to avoid false diagnostics and ascertain the exact location, morphology, mechanism and intravital nature of the neck trauma. Currently complete preparation can be regarded as the method of "gold standard". Use of this method shows the frequency of discovered injuries in hanging to be about 70% of cases. In practical use, one should consider radiological techniques and palpation as preliminary and orienting methods (rather excluding, than revealing anterior neck trauma).

Comparison of MRI Sequences to CT in Identification of Calcified Subependymal Nodules in Tuberous Sclerosis Patients (P03.134)

Objective: To determine if MRI is as effective as CT in identification of calcified subependymal nodules in tuberous sclerosis (TS) patients, so that the number of CT scans that TS patients undergo may be able to be reduced, leading to less radiation exposure and less cost. Background CT has been used to look for calcifications in TS patients, especially if they have enlarging subependymal nodules concerning for subependymal giant cell astrocytomas. However, CT has been found to be a source of significant radiation, and MRI techniques have advanced. Design/Methods: TS patients who underwent both a CT and MRI within a 120 day period were evaluated. CT and MR studies from the same patient were compared. CT was considered the gold standard in identification of calcification. Calcification on CT was considered a true positive (TP). Results: Neuroimaging from 9 patients has been reviewed. Patient ages ranged from 2 months to 7 7/12 years, with an average of 3.9 years. Only 2 patients had SWI sequences, which was a limitation of this study. Fifty-five subependymal nodules were identified. MRI overall detected 52 of 55 lesions. The sensitivity for detecting subependymal nodules was 94.5% for T2-weighted imaging, 85% for B0 sequences, and 87% for SWI. The overall sensitivity of CT for detecting subenpendymal nodules was 94.5%; however, most of the lesions were calcified. The sensitivity of CT for uncalcified subependymal nodules was 25%. Among the MRI sequences, the sensitivity for detecting calcifications on T2-weighted sequences was 78%, B0 sequences was 82%, and SWI was 87%. Conclusions: CT is more sensitive than MRI at detecting calcified subependymal nodules. However, it is not sensitive for uncalcified nodules. Traditional MRI (without SWI) tended to underestimate calcified subependymal nodules. However, addition of SWI, which appeared to be the most sensitive MRI sequence to calcification, may allow closer approximation to CT findings. Disclosure: Dr. McGregor has received royalty payments from MedHumor Publishing. Dr. Caron has nothing to disclose. Dr. Perkins has nothing to disclose. Dr. Wheless has received personal compensation for activities with Abbott, UCB, GSK, Novartis, Ortho-McNeil, Cyberonics, Abbott, Cyberonics, Inc., Novartis, Ovation Pharmaceuticals, Marinus Pharmaceuticals, Questcor, Valeant, Pfizer Inc as a consultant and/or participant on an advisory board. Dr. Wheless has received research support from Abbott Laboratories, Cyberonics, Inc., Ortho-McNeil Pharmaceuticals, Novartis, UCB Pharma and Ovation Pharmaceauticals. Dr. Choudhri has nothing to disclose.

Multidetector CT in identification of an anomalous left main coronary artery and a small septal branch

Anomalous origin of the coronary arteries is a rare congenital abnormality that can be associated with increased risk of sudden death. Multidetector CT is now becoming a useful tool in defining coronary anatomy. We present a case of a 41-year-old male with an anomalous left main coronary artery and a small septal branch further identified using multidetector CT.