Diagnostic Imaging Research Articles

Incidentally cured psoriasis in a patient with refractory/relapsed diffuse large B-cell lymphoma receiving CD19 CAR-T cell therapy: a case report

Chimeric antigen receptor T (CAR-T) cell therapy is a new treatment for cancers, but reports on curing immune-related skin diseases are limited. We report a case of successful CAR-T-cell therapy in a patient with refractory/relapsed diffuse large B-cell lymphoma (R/R DLBCL) who was incidentally cured of chronic generalized plaque psoriasis. The patient, a 65-year-old male who had a known history of psoriasis for 45 years, did not receive immunotherapy for psoriasis during this period. Imaging, molecular biology and immunology diagnostics confirmed DLBCL. After several weeks of standard-dose R-CHOP chemotherapy, the patient achieved partial remission, but according to CT, the patient relapsed, and there was no significant improvement in her psoriasis symptoms. Subsequently, the patient was enrolled in the CD19 CAR-T-cell therapy group. Four weeks after CAR-T-cell infusion, the patient’s abdominal pain disappeared, and there was a significant improvement in overall skin lesions. One year later, follow-up results indicated complete remission of R/R DLBCL (confirmed by PET-CT), with only minimal residual psoriatic skin lesions limited to the patient’s neck. The results of using CAR-T-cell therapy to achieve an incidental cure for psoriasis highlight the potential for exploring cell-based therapies for complex autoinflammatory skin diseases.

Diagnostic point-of-care ultrasound in obstetric anesthesia and critical care: a scoping review protocol

BackgroundPoint-of-care ultrasound (POCUS) has gained popularity as a bedside diagnostic imaging modality. In obstetrical populations, particularly in acute care settings, POCUS serves as a valuable complement to clinical assessment. Despite its many applications, only a few have been defined and validated in the obstetric population. This scoping review aims to delineate literature on the diagnostic applications of POCUS in obstetric anesthesia and critical care.MethodsThis review will adhere to the Joanna Briggs Institute methodology for scoping reviews, as updated by Arksey and O’Malley and in stages elaborated by Levac et al. Relevant literature will be identified using Medical Subject Headings (MeSH), keyword, and proximity searches and combined using Boolean operators in PubMed, Embase, and Web of Science from January 1, 2000, to the present. Two independent reviewers will screen literature against predefined eligibility criteria in abstract and full-text forms. A third reviewer will be consulted if consensus cannot be reached. Data extraction will be systematic, focusing on pre-specified variables aligned with the review’s aims. Descriptive statistical and thematic analysis will follow data extraction, with findings presented in graphical and tabular forms. The reporting will follow Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR).ConclusionThis review will present the scope of the current literature on diagnostic POCUS in obstetric anesthesia and critical care, highlighting both strengths and gaps in existing knowledge. The insights gained will support future research, knowledge synthesis, and development of educational programs. The findings will be disseminated through peer-reviewed journal publications, conferences, and social media platforms.Systematic review registrationNot applicable.

Castellvi classification of lumbosacral transitional vertebrae: comparison between conventional radiography, CT, and MRI.

The reliability and diagnostic accuracy of commonly used diagnostic imaging modalities in the classification of lumbosacral transitional vertebrae (LSTV) are poorly known, and comparative studies are scarce. To compare the diagnostic performance of conventional radiography (CR), computed tomography (CT), and magnetic resonance imaging (MRI) in classifying LSTVs. In this retrospective cross-sectional study, a total of 852 patients undergoing lumbar imaging studies using all three modalities were initially assessed for the presence of LSTV using CT scans. In total, 100 patients with LSTV anatomy were identified. Four readers performed blinded and independent evaluations of these 100 patients on each modality, and an experienced fellowship-trained radiologist performed a gold standard read using all three modalities. Inter-reader reliability metrics were analyzed in comparison to the gold standard. Statistical software R (4.2.1) was used for the analyses. We found superior diagnostic efficacy for CT: the sensitivity, specificity, accuracy, and balanced accuracy were 76%, 93%, 77%, and 84%, respectively. For MRI, the metrics were 54%, 88%, 56%, and 68%, and for CR 32%, 85%, 42%, and 59%, respectively. Inter-reader reliability was found to be good for CT (κ = 0.63-0.71) and fair for both CR (κ = 0.16-0.32) and MRI (κ = 0.24-0.56). CT had the highest diagnostic performance in all measured metrics with good inter-reader reliability. MRI and CR showed fairly poor sensitivity and accuracy, and thus consideration should be used when classifying LSTVs with these two modalities.

An Effective Liposome-Based Nanodelivery System for Naphthalene Derivative Polyamines with Antitumor Activity

This study focuses on the development of a novel liposome-based nanodelivery system designed to encapsulate polyamine-1, a compound with potential anti-tumor properties. The main objective of this work was to enhance the therapeutic and imaging potential of polyamine-1 by incorporating it into liposome-based nanoparticles, which were functionalized with a gadolinium complex for imaging purposes and a fluorescent phospholipid for tracking applications. These nanoparticles were characterized by measuring their size, shape, polydispersity index, zeta potential and encapsulation efficiency. In vitro experiments were conducted to evaluate the antitumor activity, specifically determining the cytotoxicity of both free and encapsulated polyamine-1 in cancerous and non-cancerous cell lines. Additionally, the study shows the enhanced signal intensity of gadolinium-loaded liposomes by T1-weighted MRI, highlighting their imaging potential. The experimental results suggest that this liposome-based nanodelivery system not only has therapeutic potential in targeted cancer therapy but also could be advantageous for diagnostic imaging, particularly in MRI applications.

Unnecessary diagnostic imaging requested by medical students during a first day of residency simulation: an explorative study

BackgroundPhysicians’ choice of appropriate tests in the diagnostic process is crucial for patient safety. The increased use of medical imaging has raised concerns about its potential overuse. How appropriately medical students order diagnostic tests is unknown. We explored their ordering behavior of diagnostic imaging during a simulated first day of residency.MethodsIn total, 492 undergraduate medical students participated in the simulation. After history taking with simulated patients, the students used an electronic system for requesting diagnostic tests. The analysis focused on 16 patient cases, each managed by at least 50 students. We calculated the total number of ordered images and unnecessary radiation exposure in millisievert per patient and performed one sample t-tests (one tailed) with an expected mean of zero on a Bonferroni-corrected alpha level of 0.003 for the independent variable of unnecessary radiation exposure.ResultsUnnecessary diagnostic imaging was ordered across all patient cases. Ultrasound, especially abdominal ultrasound, X-rays of the thorax, and abdominal CTs were notably overused in 90.9%, 80.0%, and 69.2% of all patient cases, respectively. Unnecessary requests of imaging related to radiation resulted in radiation over-exposure for nearly all patients, with 37.5% of all patients being exposed to a significant radiation overdose on average.ConclusionMedical students’ overuse of diagnostic imaging can be explained by patient-related factors like anxiety and medical factors like missing clinical information leading to cognitive biases in patient workup. This suggests the need for interventions to improve students’ clinical decision-making and reduce cognitive biases. Investigating student-specific factors being associated with overuse of diagnostic imaging would be of additional interest.

Dentigerous cysts in horses: A retrospective study

SummaryBackgroundDentigerous cysts are well‐known congenital defects in horses, and the literature on this condition is extensive. Recently, a third type of dentigerous cyst, associated with an exostosis arising from the temporal bone, has been described. Today, computed tomography (CT) is often available and provides detailed information about the exact location and extent of dentigerous cysts, allowing for the description of new findings.Study designThis is a case series outlining the clinical, radiographic and computed tomographic features of dentigerous cysts in seven horses presented to the Equine Clinic at the Vetsuisse Faculty, University of Zurich, Switzerland.ObjectivesThe aim of this case series was to describe the radiographic and computed tomographic findings, and the occurrence of exostoses arising from the temporal bone, in horses with dentigerous cysts.MethodsThe medical records of the Equine Hospital at the University of Zurich were reviewed for horses admitted with dentigerous cysts between 2007 and 2023. Data collected and analysed included patient signalment, clinical history, clinical signs and their duration prior to referral, diagnostic imaging results, treatment and outcomes.ResultsThe most common location for the cysts was the base of the ear, although in one case, the maxillary sinus was involved. Of the seven cases, four were Icelandic horses. CT proved superior to standard radiography for determining the extent and precise location of the cysts, as well as for identifying dental material and exostoses in the temporal region. CT also facilitated detailed surgical planning. All cysts were surgically removed with good long‐term outcomes.Main limitationsOverall, the incidence of dentigerous cysts in horses was low. The relatively high occurrence of dentigerous cysts in Icelandic horses in this study is an interesting finding, though the small sample size calls for further research.ConclusionsTwo of the cases in this series were similar to a recently described variant of a ‘temporal dentigerous cyst associated with an exostosis in the temporal region’ and were closely connected to the bony structure and draining tract.

Canadian Association of Radiologists Spine Imaging Referral Guideline.

The Canadian Association of Radiologists (CAR) Spine Expert Panel is made up of physicians from the disciplines of radiology, emergency medicine, neurology, neurosurgery, physiatry, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 10 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 23 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 22 recommendation statements across the 8 scenarios (one scenario points to the CAR Trauma Referral Guideline and one scenario points to the CAR Musculoskeletal Guideline). This guideline presents the methods of development and the referral recommendations for myelopathy, suspected spinal infection, possible atlanto-axial instability (non-traumatic), axial pain (non-traumatic), radicular pain (non-traumatic), cauda equina syndrome, suspected spinal tumour, and suspected compression fracture. Spondyloarthropathies and spine trauma point to other CAR Diagnostic Imaging Referral Guidelines, Musculoskeletal and Trauma, respectively.

Double innominate vein in a case with double aortic arch: a case report

BackgroundDouble aortic arch (DAA) is a type of vascular ring, causing stridor and dysphagia owing to compression of the trachea and esophagus. In contrast, double innominate veins, which is a relatively rare venous anomaly, usually does not cause symptoms or require intervention.Case presentationA 2 month-old boy presented with mild stridor and a hoarse voice while crying, and was diagnosed as having DAA, small atrial septal defects and double innominate vein. The double innominate veins, crossing over and underneath the ascending aorta, did not contribute to airway compression. To release the narrow vascular ring caused by the DAA, surgical resection of the atretic side of the arch was performed by lateral thoracostomy at 4 months of age, before the appearance of signs of bronchomalacia. The double innominate veins were left untouched, and open-heart surgery was avoided.ConclusionsDAA should be suspected if airway symptoms are present in early infancy, particularly if a right aortic arch is noted. It is important not to hesitate to perform diagnostic imaging and release the DAA, as this might prevent or minimize airway complications. However, for double innominate veins, operative release is not necessary unless it interferes with surgical procedures or is causing symptoms.

A month of diagnostic imaging studies in an acute supportive/palliative care unit.

The aim was to assess the characteristics of patients who required imaging studies during admission to an acute supportive palliative care unit (ASPCU). A consecutive number of patients who performed imaging studies during ASPCU admission in a month period were assessed. Epidemiological data, ongoing anticancer treatment, cancer diagnosis, reasons for admission, referral, and type of imaging study were recorded. Indications, findings, consequent actions for treatment, prognosis, and discharge were also collected. Twenty-one of 56 patients admitted to ASPCU in the period taken into consideration were assessed. Pain and deterioration of the general condition were the most frequent indications for admission. Computed tomography (CT) was the most frequent imaging study performed. Indications for performing imaging studies depended on individual clinical needs. Findings suggested different clinical decisions, after a comprehensive oncological and palliative care assessment and family conference, the most frequent of which was to withdraw oncological treatments. The majority of patients underwent transition to palliative care and were discharged home or to hospice. Imaging studies were of paramount importance for clinical treatment and decision-making process in an intensive ASPCU. There is the need to explore the need and the possible outcomes of imaging studies, as well cost-effectiveness in any ASPCU.

Traumatic brain injury (TBI): Is there anything we can do? A review

Introduction Traumatic brain injury (TBI) is considered a global health crisis. It results in injury to the brain from an external impact leading to severe disability, with higher incidence statistics recently observed in young adults and elderly individuals. Purpose The review aims to analyze current research findings explaining the prevalence, incidence, and demographics of such injuries stressing the need for enhanced prevention and management techniques. The pathophysiology involves a complex cascade of biochemical and cellular events, which results in necrotic-apoptotic neuronal cell death. Method The review synthesizes current research on TBI, highlighting epidemiological data, advanced diagnostics, and effective rehabilitation strategies like physical and cognitive therapy. Findings Traumatic Brain Injury is an important public health issue with high morbidity and mortality rates causing extreme damage to a person, such as comas, catatonic states for various years, or lifelong injury or demolition. Early diagnostic imaging techniques include CT, MRI, advanced neuroimaging methods, and blood-based biomarkers. In the acute setting, initial management is directed toward stabilizing and preventing secondary injuries and early mobilization. The goals of rehabilitation are to promote the highest level of functional independence and physical function, cognitive functions, and social integration. Conclusion This review highlights that the use of new rehabilitation technologies, such as VR-based and robot-assisted therapies, might lead to improved recovery. Long-term supportive care combined with community integration is mandatory for enhancing quality of life. A systematic multidisciplinary team approach and family support are needed for traumatic brain injury survivors.

Mortality trends, gender, and racial disparities in older adults due to abdominal aortic aneurysm: A nationwide cross-sectional analysis

Abdominal aortic aneurysms (AAAs) are a significant vascular pathology in older adults, often asymptomatic but with high mortality upon rupture. Despite advancements in diagnostic imaging and surgical interventions, AAAs remain a public health concern. This research letter analyzed CDC WONDER data on AAA-related deaths (ICD-10 I71.3 and I71.4) among US adults aged 65+ from 1999 to 2020. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, gender, age group, race/ethnicity, geography, and urbanization status. Between 1999 and 2020, there were 180,037 reported deaths in older adults due to AAA. The overall AAMR decreased from 32.6 to 13.2 per 100,000, with a significant decline from 2014 to 2020 (APC: −1.66; 95% CI: −2.48 to −0.48). Older men had a significantly higher AAMR than older women (31.2 vs. 12). Among racial and ethnic groups, Non-Hispanic (NH) Whites had the highest AAMR at 21.7, followed by NH American Indian or Alaska Native (14.5), NH Black (12.6), NH Asian or Pacific Islander (10.1), and Hispanic populations (8.4). Additionally, non-metropolitan areas exhibited higher AAMRs compared to metropolitan areas (23.9 vs. 18.7). While mortality rates have declined, disparities remain, with higher rates among older men, NH Whites, and non-metropolitan residents, highlighting the need for targeted and equitable interventions.

Bilateral Adrenal Hemorrhage in a Patient Anticoagulated with Apixaban for Antiphospholipid Syndrome (APS): A Rare Case Report

Context: Adrenal hemorrhage is a recognized yet rare complication associated with antiphospholipid syndrome (APS), an autoimmune disorder characterized by the presence of antiphospholipid antibodies that increase the risk of thrombosis. The incidence of adrenal hemorrhage in patients with APS has a diagnostic yield of approximately one-third, indicating that it may often go unrecognized in clinical practice. Traditionally, the management of APS has relied on anti-vitamin K therapy, such as warfarin. However, the advent of direct oral anticoagulants (DOACs) has prompted discussions about their use as an alternative. Recent clinical guidelines, however, strongly advise against the use of DOACs in patients with APS due to concerns over their safety and efficacy in preventing thromboembolic events. Case Presentation: This case study describes a 53-year-old woman with a history of venous thromboembolism who was treated with apixaban, a direct oral anticoagulant. She presented with acute abdominal pain and symptoms suggestive of adrenal insufficiency. Initial evaluations revealed significant changes in her clinical condition, leading to further diagnostic imaging. A CT scan demonstrated bilateral adrenal hemorrhage, which was a surprising finding given her anticoagulation therapy. Subsequent laboratory tests indicated a positive triple antibody profile, confirming a diagnosis of primary antiphospholipid syndrome. This case is particularly noteworthy as there have been limited documented instances of adrenal hemorrhage in patients receiving chronic anticoagulation with apixaban. The presentation of bilateral adrenal hemorrhage in the context of APS adds a crucial dimension to the understanding of the disease and its management. Conclusion: This case highlights the potential for serious complications, such as adrenal hemorrhage, in patients with antiphospholipid syndrome, particularly those treated with direct oral anticoagulants. It underscores the necessity for clinicians to remain vigilant for such rare yet significant events in the management of APS. Additionally, this case raises important questions regarding the appropriateness of DOACs in this patient population, especially given the latest recommendations against their use. Increased awareness and further investigation into the implications of anticoagulation strategies in APS patients are warranted to improve patient outcomes and safety.

Hip joint rice body bursitis combined with hip dysplasia and pelvic fracture: a case report

BackgroundRice body formation is an uncommon, nonspecific inflammatory process. Certain clinical features, such as chronic synovitis associated with rheumatoid arthritis, tuberculous arthritis, and osteoarthritis, can induce a non-specific response that may lead to the development of rice bodies. Currently, the etiological and prognostic significance of rice bodies remains unknown. Magnetic resonance imaging (MRI) is the preferred diagnostic imaging modality for evaluating rice body formation.Case presentationThe patient, a 44-year-old female, presented with bursitis of the hip joint and the presence of numerous rice bodies. This case is exceptionally rare and unusual as it involves a combination of hip dysplasia and pelvic fracture. The patient underwent a one-stage resection of the rice body, internal fixation of the acetabular fracture, and two-stage total hip arthroplasty, resulting in an immediate improvement in her symptoms. We reviewed the relevant literature and observed that the majority of rice bodies were predominantly found within the capsules of the shoulder and knee joints, while instances of hip joint rice body bursitis were relatively infrequent. To our knowledge, there have been no previous reports documenting a case of hip joint rice body bursitis in conjunction with hip dysplasia and pelvic fracture.ConclusionThis paper presents the rare case of hip joint rice body bursitis combined with hip dysplasia and pelvic fracture, and is one of the highlights.

Clinical signs, diagnostic imaging, histopathology and outcome in a dog with meningoencephalomyelitis of unknown origin and concurrent involvement of the cauda equina and left sciatic nerve

AbstractA 3‐year‐old, female, neutered toy poodle dog was presented with generalised tremors, neck pain and obtundation. Neurological examination revealed a multifocal localisation (brainstem and cervical spinal cord). Magnetic resonance imaging findings and cerebrospinal fluid tap were consistent with meningoencephalomyelitis of unknown origin. After immunosuppressive treatment, the dog improved, but while tapering experienced two relapses. During the second relapse, clinical presentation revealed multifocal clinical signs affecting the brainstem, the lumbosacral spinal cord and the left sciatic nerve. Magnetic resonance imagings of the brain, lumbosacral spinal cord and the left sciatic nerve, cerebrospinal fluid analysis and histopathology of the left sciatic nerve confirmed a recurrence of a meningoencephalomyelitis of unknown origin involving the central nervous system and the peripheral nervous system. Immunosuppressive treatment was re‐instituted, with improvement of clinical signs. At 1‐year follow‐up, the dog remains clinically stable with no treatment.

2. Measurement Division, Diagnostic Imaging Division, Medical Informatics Division, Radiation Protection Division

2. Measurement Division, Diagnostic Imaging Division, Medical Informatics Division, Radiation Protection Division

Image-Guided Breast Conserving Surgery

Background: Breast-conserving surgery (BCS) has gained wide acceptance as the treatment of choice for early-stage breast cancer. One of the primary goals of BCS is to obtain tumor-free resection margins. In practice, the excision of a palpable breast carcinoma is guided by preoperative diagnostic images and the intraoperative tactile skills of the surgeon. The somewhat ‘blind’ approach of using palpation-guided surgery is known to be highly inaccurate, with studies worldwide reporting positive resection margins in up to 41% of patients. In recent years, ultrasonography has emerged as an effective guidance tool during surgery and ultrasound-guided surgery has been introduced into breast cancer surgery as a method of excising nonpalpable breast cancer. Objective: The aim of this study is comparing ultrasound-guided vs palpation-guided conservative breast surgery in obtaining tumor-free resection margins. Methods: This study was a prospective randomized controlled clinical trial where patients with early breast cancer (T1-T2) and eligible for breast conserving surgery are randomly assigned (1:1) into two arms. Arm A: included the patients who will undergo ultrasound-guided breast conserving surgery. Arm B: included the patients who will undergo the conventional palpation-guided breast conserving surgery. Results: Overall, 142 patients undergoing breast conserving surgery were enrolled: 71 were allocated to the Ultrasound-guided (US) group (Arm A) and 71 to the Palpation-guided (PG) group (Arm B). Patient and tumor characteristics were comparable between the two groups. Age, Body mass index, tumor laterality, tumor location and tumor stage were comparable in both groups and statistically insignificant. Despite that the final tumor size was comparable between both groups, IOUS significantly reduced the main specimen volume and the least negative margin width (p<0.001). The median operative time was significantly longer in the US group bey around 27 min than in the PG group and this was statistically significant in favor of the PG surgery (p<0.001). The involved resection margin rate was significantly higher in the PG group and thus the need for reoperation (p<0.001). Conclusion: IOUS is the only method allowing a true real-time visualization and continuous control of resection margins during all phases of BCS. In our single-institution study, IOUS demonstrated clear superiority over palpation-guided surgery in both oncological and surgical outcomes except for the operative time (smaller excision volume yet, with optimum resection margins). IOUs provides much better tumor localization in small breasts with dense fibroadenosis. Since all the other available localization techniques (including palpation) limit the surgeon’s visual guidance during BCS, IOUS could be regarded as one of the most significant modern technological innovations in the field of breast cancer surgery, restoring sight to the breast surgeon. Our findings strongly suggests that the integration of IOUS in breast conserving surgery could be regarded as a highly beneficial surgical approach.

Brain Tumor Detection through Image Fusion Using Cross Guided Filter and Convolutional Neural Network

This Data fusion has become a significant issue in diagnostic imaging, particularly in medical applications like radiation and guided image surgery. Medical image fusion aims to enhance the precision of tumor diagnosis, by preserving the salient information and characteristics of the original images in the fused image. It has been shown that guided filters are capable of maintaining edges well. In this paper, we propose a novel cross-guided filter-based fusion approach for multimodal medical images utilizing convolutional neural networks. The cross-guided filter is used in the proposed algorithm to extract the detailed features from the source images. Convolutional neural networks are used to generate the feature weights of source images derived from the detail layers. The weighted average rule is used to merge the source images based on these weights. We used thirty distinct types of medical images from diverse sources to compare the effectiveness of the proposed strategy to that of existing methods, both numerically and visually. The experimental findings demonstrated that, in terms of both objective evaluation and qualitative image quality, the suggested system performs better than other standard methods already in use. The quantitative results show that compared to existing methods under consideration for comparison, the proposed algorithm improves mutual information by 25%, image entropy by 9.5%, spatial frequency by 21%, standard deviation by 18.1%, structural similarity index by 30%, and edge strength of the fused image by 39%.

Serum metabolite and metal ions profiles for breast cancer screening

Enhancing early-stage breast cancer detection requires integrating additional screening methods with current diagnostic imaging. Omics screening, using easily collectible serum samples, could serve as an initial step. Alongside biomarker identification capabilities, omics analysis allows for a comprehensive analysis of prevalent histological types—DCIS and IDC. Employing metabolomics, metallomics, and machine learning, could yield accurate screening models with valuable insights into organism responses. Serum samples of confirmed breast cancer patients were utilized to analyze metabolite and metal ion profiles, using two distinct analysis methods, proton NMR for metabolomics and ICP-OES for metallomics. The resulting responses were then subjected to discriminant analysis, progression biomarker exploration, examination of correlations between patients’ metabolites and metal ions, and the impact of age and menopause status. Measured NMR spectra and metabolite relative integrals were used to achieve statistically significant discrimination through MVA between breast cancer and control groups. The analysis identified 24 metabolites and 4 metal ions crucial for discrimination. Furthermore, four metabolites were associated with disease progression. Additionally, there were important correlations and relationships between metabolite relative integrals, metal ion concentrations, and age/menopausal status subgroups. Quantified relative integrals allowed for discrimination between studied subgroups, validated with a holdout set. Feature importance and statistical analysis for metabolomics and metallomics extracted a set of common entities which in combination provides valuable insights into ongoing molecular disturbances and disease progression.

Management of penetrating arrow injury of the maxillofacial region, case report

An arrow maxillofacial penetrating injury is an unusual traumatic injury sometimes encountered in developing countries. This rare injury has the potential to be dangerous because the arrow is deeply lodged in maxillofacial region crossed by major vessels, and because damage to one of these vessels should always be suspected. Furthermore, removal of a foreign body may result in complications such as massive bleeding or iatrogenic injury to adjacent structure and complications should always be considered in maxillofacial region. We describe a case of a patient who presented with maxillofacial penetrating arrow injury and analyze the problems faced in its management with emphasis on diagnostic imaging, on surgical planning and on careful surgery management.

Awareness About Artificial Intelligence Among Dental Practitioners And Dental Students

BACKGROUND Artificial intelligence (AI) is defined as acquisition of intelligence by computers or machines to perform complex tasks that generally require human intelligence. Nowadays usage of AI in various fields is appreciated because of its time effectiveness and less laborious.In dentistry, AI has been trending, specifically in diagnostic imaging and early detection of diseases,benefiting both dental graduates and practitioners. AIM The main aim is to assess the awareness of Artificial intelligence as an effective tool among dental trainees and dental practitioners. MATERIALS AND METHOD An online cross-sectional survey was conducted among dental trainees and dental practitioners in various institutions. A Google questionnaire form was developed and circulated to assess participant’s awareness about Artificial intelligence in dentistry. Data were collected in Microsoft excel and statistical analysis were performed. RESULTS More than 60% of the participants showed confidence about their familiarity towards AI in dentistry (p<0.01197). Among those, 60.5% answered that they are well aware of ChatGPT and 28% of them to Microsoft Bing (p<0.04395). 53% answered that machine learning is an important form of AI (p<0.00216). Over the advantages of AI, 43% believed AI can improve diagnostics, access to disease screening, cost effectiveness, reduced treatment time (p<0.0001) and 53% agreed that AI can be useful in day-to-day dental practices (p<0.0001). CONCLUSION The present study shows that awareness of AI among the dental fraternity is satisfactory. The field of AI is emerging rapidly and various other new applications in AI are being utilised. AI could act as a valuable tool in supporting clinicians delivering effective dental care and supplementing education for dental trainees. To enhance the future of AI in dentistry, the present curriculum needs to be approachable enough and various hands-on-training are essential. KEYWORDS:artificial intelligence, chatbots, dental caries, radiographic diagnosis, teledentistry.