Diagnostic Imaging Modalities Research Articles

Optic neuritis: a review of diagnostic imaging modalities and effective management approaches

Optic neuritis (ON) is a medical condition characterized by an acute inflammation of the optic nerve, usually caused by multiple sclerosis (MS). However, there are other causes such as infectious diseases, granulomatous disease, paraneoplastic disorders, and demyelination disorders. Usually, the commonest presentation is unilateral painful loss of vision. This study aimed to review the diagnostic imaging modalities and effective management approaches of ON. ON can be diagnosed through different modalities such as magnetic resonance imaging, which is the modality of choice to assess ON, providing crucial insights into the structural and functional changes within the optic nerve. In ON, the retrobulbar intra-orbital segment of the optic nerve often exhibits noticeable characteristics, including swelling and a high T2 signal. In addition, optical coherence tomography is a new, noninvasive tool for direct visualization of the head of the optic nerve that can detect thinner retinal nerve fiber layers diagnosing ON. In treating ON and MS, the main aim is to reduce the recurrence and severity of the attacks to minimize the subsequent disability. The utilization of disease-modifying drugs contributes to delaying the onset of subsequent episodes, reducing the occurrence of MS relapses, and minimizing the formation of demyelinating lesions.

Exploring Recent Advancements in Rotator Cuff Injury Rehabilitation: A Narrative Review

Rotator cuff injuries are prevalent musculoskeletal injuries that may impair quality of life and function. This narrative review covers current rotator cuff injury rehabilitation breakthroughs and provides insights into evidence-based techniques that improve patient outcomes. Recent advances in evaluation and rehabilitation are the topic of this narrative review. It covers the newest diagnostic techniques and imaging modalities for better diagnosis and patient stratification. It also examines how wearable gadgets and tele rehabilitation might improve recovery. Recent exercise prescription and progression advances include eccentric training, isometric movements, and neuromuscular re-education for rotator cuff repair and function. It emphasises patient-specific rehabilitation procedures and the growing significance of regenerative treatments and biologics in rotator cuff injury treatment. This evaluation also stresses patient education and collaborative decision-making for rehabilitation success. Managing rotator cuff injuries psychologically involves treating pain, fear avoidance, and psychosocial concerns. In conclusion, this narrative review summarises the latest rotator cuff injury rehabilitation techniques and modalities. Rotator cuff injury patients may benefit from these advances in outcomes, recurrence rates, and quality of life. This narrative review helps physicians, researchers, and healthcare workers treating rotator cuff injuries keep current.

Imaging approach to prosthetic joint infection.

The diagnosis of prosthetic joint infection (PJI) remains challenging, despite multiple available laboratory tests for both serum and synovial fluid analysis. The clinical symptoms of PJI are not always characteristic, particularly in the chronic phase, and there is often significant overlap in symptoms with non-infectious forms of arthroplasty failure. Further exacerbating this challenge is lack of a universally accepted definition for PJI, with publications from multiple professional societies citing different diagnostic criteria. While not included in many of the major societies' guidelines for diagnosis of PJI, diagnostic imaging can play an important role in the workup of suspected PJI. In this article, we will review an approach to diagnostic imaging modalities (radiography, ultrasound, CT, MRI) in the workup of suspected PJI, with special attention to the limitations and benefits of each modality. We will also discuss the role that image-guided interventions play in the workup of these patients, through ultrasound and fluoroscopically guided joint aspirations. While there is no standard imaging algorithm that can universally applied to all patients with suspected PJI, we will discuss a general approach to diagnostic imaging and image-guided intervention in this clinical scenario.

A deep learning‐based x‐ray imaging diagnosis system for classification of tuberculosis, COVID‐19, and pneumonia traits using evolutionary algorithm

AbstractTo aid in detection of tuberculosis, researchers have concentrated on developing computer‐aided diagnostic technologies based on x‐ray imaging. Since it generates noninvasive standard‐of‐care data, a chest x‐ray image is one of the most often used diagnostic imaging modalities in computer‐aided solutions. Due to their significant interclass similarities and low intra‐class variation abnormalities, chest x‐ray pictures continue to pose difficulty for proper diagnosis. In this paper, a novel automated framework is proposed for the classification of tuberculosis, COVID‐19, and pneumonia from chest x‐ray images using deep learning and improved optimization technique. Two pre‐trained convolutional neural network models such as EfficientB0 and ResNet50 have been utilized and fine‐tuned based on the additional layers. Both models are trained with fixed hyperparameters on the selected datasets and obtained newly trained models. A novel feature selection technique has been proposed that selects the best features. In the novel version, distance and update position formulation has been modified. The selected features are further fused using a novel technique that is based on the serial and standard deviation threshold function. The experimental process of the proposed framework is conducted on three datasets and obtained an accuracy of 98.2%, 99.0%, and 98.7%, respectively. In addition, a detailed Wilcoxon signed‐rank analysis is conducted and shows the proposed method significance performance. Based on the results, it is concluded that the proposed method accuracy is improved after the fusion process. In addition, the comparison with recent techniques shows the proposed method as more significant in terms of accuracy and precision rate.

Biliary Complications After Liver Transplantation

Liver transplantation continues to be an optimal treatment choice for end-stage liver disease, acute liver failure, and primary liver cancer. An understanding and anticipation of potential complications of liver transplantation is integral to the medical and interventional management of these postoperative patients. Complications related to the biliary system are the most common posttransplant complications. Potential complications include biliary strictures, leakage, intraductal stone/sludge, and biliary cast syndrome. Multiple diagnostic imaging modalities are available including ultrasound, CT angiography, and hepatobiliary iminodiacetic acid scanning for evaluation of the biliary system and associated complications. The approach of interventional access to the biliary system after surgery is tailored based on surgical transplantation techniques. Endoscopic retrograde cholangiopancreatography remains the imaging modality of choice for evaluation and potential therapeutic intervention. If the biliary tree is not accessible by endoscopy due to postsurgical anatomy changes, interventional radiology may play a vital role in complication management and can provide percutaneous transhepatic cholangiography as a less invasive alternative to surgical intervention.

Neuroforaminal Stenosis in the Lumbosacral Spine: A Scoping Review of Pathophysiology, Clinical Manifestations, Diagnostic Imaging, and Treatment

OBJECTIVE To conduct the first scoping review of lumbosacral neuroforaminal stenosis with respect to the pathophysiology, symptomatic manifestations, diagnostic imaging, and treatment options. METHODS A scoping literature review was conducted in accordance with the recommendations set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with English language restrictions stipulated to include articles pertaining to lumbosacral neuroforaminal stenosis. Databases maintained by PubMed, National Library of Medicine, Cochrane Central Register of Controlled Trials (Ovid), Scopus (Elsevier), Web of Science (Thomson Reuters), and Google Scholar were queried from their inception date through December 2022. SUMMARY OF THE EVIDENCE A total of 276 articles were reviewed and 29 articles were included within the study. Within these articles, the anatomic origins of neuroforaminal stenosis were reviewed in detail and the resulting clinical manifestations were discussed. Recent studies evaluating the efficacy of existing diagnostic imaging modalities were summarized, along with potential future methods to improve sensitivity for detecting this entity and measuring foraminal stenosis via novel imaging techniques. Based on the literature, the conservative management and surgical treatment of lumbosacral foraminal stenosis were discussed. CONCLUSIONS Lumbar neuroforaminal stenosis represents a significant source of radicular pain that is often compounded by delayed diagnosis and incomplete treatment. This article represents the first scoping review of lumbosacral neuroforaminal stenosis with focus on diagnosis, management, and treatment for associated radicular pain. The goal is to reduce the incidence of untreated or unrecognized neuroforaminal stenosis in the setting of a complex decompression and fusion, as well as to promote minimally invasive surgery to address radicular pain from neuroforaminal stenosis. Recent advances in diagnostic imaging and surgical techniques have the potential to improve the timeliness and durability of patients’ treatment options. Future directions for the diagnostic imaging of foraminal stenosis include efforts aimed at developing the nascent field of computerized mapping to reliably quantify stenosis and its impact on the exiting nerve root and associated dorsal root ganglia.

Focal Congenital Hyperinsulinism (CHI) Due To Paternally Inherited Variant in ABCC8 Gene: Importance of Genetic Testing & PET Imaging in Stratification & Management of Diazoxide Unresponsive CHI

Congenital Hyperinsulinism (CHI) may be transient or permanent and inherited either in autosomal recessive or dominant forms. Variants in ABCC8 and KCNJ11 genes coding for Sulphonyl Urea Receptor (SUR1) and potassium channel subunit (Kir6.2) respectively, account for 82% cases of diazoxide-unresponsive patients and 45% of all cases of CHI. The histology of CHI is classified into focal and diffuse. Approximately half of all cases can be classified as diffuse, 40 % as focal, and 10% of cases are considered atypical. We report a 1 month old male with recurrent hypoglycemia detected with focal congenital hyperinsulinism secondary to a paternally inherited heterozygous ABCC8 gene mutation. Focal disease results due to inheritance of a monoallelic recessive paternal ABCC8 or KCNJ11 variant together with somatic Loss of Heterozygosity (LOH) of the maternal allele at 11p15 within a pancreatic progenitor cell. Infants & children with focal disease may be cured by resection of their hyperplastic lesion and the risk for postoperative diabetes is significantly lower as compared to that following pancreatectomy for diffuse CHI. The report describes molecular mechanisms underlying CHI & emphasises the need of genetic testing and diagnostic functional imaging modalities in diazoxide unresponsive CHI to guide management and improve clinical outcomes.

Enhancement of Optical Coherence Tomography for Early Diagnostics Through Ag-Decorated ZnO Quantum Dots-Induced Motion Analysis

Optical Coherence Tomography (OCT) stands as a pivotal imaging modality in medical diagnostics, providing intricate insights into microstructural alterations within biological tissues. This research delves into the augmentative impact of nanostructures on OCT, with a specific emphasis on their potential applications in early diagnostic scenarios. The article introduces a novel composite material, Silver-Zinc Oxide (Ag-ZnO) nano-structures, synthesized through the amalgamation of zinc oxide (ZnO) quantum dots and silver (Ag) particles. The study scrutinizes the enhancement effect of these nanostructures on the depth imaging capability and diagnostic precision of OCT. Employing the finite difference time domain method, the research simulates and calculates the extinction spectrum enhancement effect of Ag-ZnO quantum dots in OCT. Comparative analyses are conducted to evaluate the effectiveness and diagnostic accuracy of OCT imaging when enhanced with Ag-ZnO quantum dots against Magnetic Resonance Imaging (MRI) technology. The outcomes manifest a noteworthy improvement in diagnostic accuracy with the integration of Ag-ZnO quantum dots in OCT, underscoring their efficacy in heightening imaging depth and diagnostic precision for early diagnostic applications. This study not only accentuates the pivotal role played by quantum dots in amplifying the capabilities of OCT but also paves the way for the advancement of sophisticated diagnostic tools within the realm of medical imaging.

Effectiveness Management of Radiation Protection Program: A Short Review

An effective radiation protection program requires an effective oversight and feedback mechanism to management. A main objective of the radiation protection program is to decrease radiation doses wherever and whenever reasonably possible, hence lowering the health risk that is thought to be proportionate to the radiation dosage. Justification of operations requiring radiation exposure, as well as the use of minimal radiation exposure simply adequate for diagnostic and interventional procedures, should all be part of a radiation protection policy. National authorities must support the development and implementation of radiological safety and security in organisations that employ radiation sources. Maintaining a high level of competence is critical for the development of future safe ionizing radiation applications. Patients, physicians, and employees across many departments, including radiology, interventional cardiology, and surgery, are concerned about radiation safety. Radiation released during fluoroscopic operations is the source of the highest radiation dosage for healthcare workers. Radiation from diagnostic imaging modalities such as computed tomography, mammography, and nuclear imaging are minimal factors to healthcare personnel's cumulative dose exposures. Radiation exposure, on the other hand, poses a risk to both patients and healthcare professionals. The medical use of ionizing radiation is a huge and growing global activity. While the use of ionizing radiation in medicine provides enormous advantages to the worldwide population, the inherent hazards owing to stochastic and deterministic effects necessitate the need to safeguard patients from potential injury. Current issues in radiation protection of patients include not only the rapidly increasing collective dose to the global population from medical exposure, but also the fact that a significant percentage of diagnostic imaging examinations are unnecessary, and the cumulative dose to individuals from medical exposure is increasing.

Pengaruh Variasi Window Width Dan Window Level Pada Lung Window Terhadap Kualitas Citra CT Scan Thorax Dengan Klinis Tumor Paru Di Rumah Sakit TK II Pelamonia Makassar

Background: Lung tumors are the growth of abnormal lumps in lung tissue which can be benign or malignant. One diagnostic imaging modality that is more supportive of lung disorders is by using a Computed Tomography Scan examination. Image manipulation can be done to improve the appearance of the image. One of the most common image processing techniques is called windowing. This technique allows the technology to change the contrast of the displayed image by adjusting the window width (Window Width) and window level (Window Level). Method: The type of research used in this research is quantitative research with a quasi-experimental approach, which aims to determine the effect of variations in window width and window level on image quality in CT scans of the Thorax with clinical lung tumors. Using variations of Window Width and Window Level WW 1000 and WL -500, -600, -700, WW 1250, WL -500, -600, -700 and WW 1550, WL -500, -600, -700. The author took CT scan data of the Thorax with clinical lung tumors in 4 samples. Then an assessment was carried out in the form of a check list by respondents, namely 3 radiographers and 1 radiologist. The data is then processed using SPSS. Results & Conclusions: There is an influence of WW 1000 and WL -500, -600, -700, WW 1250 and WL -500, -600, -700 and WW 1550 and WL -500, -600, -700 on image quality, namely artifacts and noise on Thorax CT Scan examination with lung tumor cases, the conclusion was obtained from the results of the Friedman test which showed a p.value value of <0.001 or smaller than 0.05 so that H0 was rejected and Ha was accepted. From the results of the mean rank Friedman test, it is known that the value of image quality is artifacts and noise in Thorax CT scans with lung tumor cases. Variations in window width 1550 and window level 500 are able to produce the best image quality with minimal artifacts and noise. Thorax CT scan examination in lung tumor cases.

Comparing the Diagnostic Accuracy of Ultrasonography, CT, MRI, and PET/CT in Cervical Lymph Node Metastasis of Oral Squamous Cell Carcinoma.

(1) Background: In oral cancer staging, ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) are routinely used in clinical practice. The present study is a retrospective examination of the diagnostic accuracy of cervical lymph node metastasis using US, CT, MRI, and PET/CT, with histopathological diagnosis as a reference, to compare the different diagnostic imaging modalities. (2) Methods: The participants included 16 patients with oral squamous cell carcinoma who underwent US-, CT-, MRI-, and PET/CT-based preoperative diagnostic imaging and simultaneous primary lesion resection and neck dissection, including 82 level regions and 424 lymph nodes. We compared the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of each imaging modality based on the imaging results and the pathology results of metastasis. (3) Results: Of the four diagnostic imaging modalities, PET/CT exhibited the highest sensitivity but the lowest specificity and accuracy. US, CT, and MRI had high specificities. Comparing each level region and lymph node showed that differences were observed in PET/CT. (4) Conclusions: PET/CT to diagnose lymph node metastasis requires a comprehensive evaluation because it produces more false positives than other diagnostic imaging modalities. Using US, CT, and MRI, which have excellent spatial resolution, improves diagnostic accuracy at the lymph node level.

An in-Depth Review of Dercum’s disease: Aetiology, Epidemiology, and Treatment

The purpose of the present review is to proffer a comprehensive overview of Dercum's disease (DD), a rare medical condition typified by the presence of excruciating subcutaneous adipose tissue deposits. The ambit of this exposition encompasses the delineation of the clinical features, diagnostic criteria, and treatment options for DD. DD is a complex and poorly understood ailment, thereby rendering its diagnosis a daunting task, primarily on account of the indeterminate character of its symptoms. Nonetheless, the timely identification of DD is crucial to stave off its advancement and ameliorate the standard of living of those afflicted by it. Diagnostic criteria have been posited for DD, and diagnostic imaging modalities, such as magnetic resonance imaging (MRI), have proven efficacious in facilitating the diagnosis of this malady. The treatment of DD is primarily palliative, geared toward assuaging pain and enhancing the overall quality of life. Therapeutic options comprise the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, local anesthetics, weight management strategies, and alterations to lifestyle choices.

Abstract 17372: Cardiac Magnetic Resonance in Takotsubo Disease: Impact on Outcomes and Resource Utilization

Introduction: Takotsubo cardiomyopathy (CM), characterized by transient left ventricular dysfunction, presents diagnostic and management challenges. The utility of cardiac magnetic resonance (CMR) in Takotsubo CM is uncertain. We investigate CMR's impact on outcomes and resource utilization in Takotsubo CM. Methods: A retrospective analysis was conducted with TriNetX. Two cohorts with Takotsubo CM, with and without CMR within 1 month of diagnosis, were matched for lipidemias, hypertension, diabetes, sarcoidosis, and heart diseases (n=1,422 per cohort), Risks assessed 30-day, 1- and 5-year outcomes, resource utilization, and medication/procedure usage. Results: The CMR group had 3.9% (1.5% vs 5.4%, p=0.000) lower risk of mortality within 30 days and 2.6% (4.6% vs 7.2%, p=0.003) lower risk between 1 and 5 years. Hospitalization rates were similar, while complication risks (cardiomyopathy, heart failure) were higher in the CMR group at 1 and 5 years. The CMR group had higher utilization of GDMT, with similar usage for some treatments. Risk of pacemaker or implantable defibrillator usage were 4.9% higher within 30 days (5.8% vs 0.8%, p=0.000) and 5.8% higher within 1 year (8.2% vs 2.5% p=0.000) in the CMR group. Conclusions: Takotsubo patients undergoing CMR exhibited increased risk of concomitant diagnoses of CM/heart failure/pericarditis, received treatments earlier in the disease course, and experienced lower risk of mortality. These results support utilization of CMR as a routine diagnostic imaging modality in patients with suspected Takotsubo CM for comprehensive evaluation to guide treatment decisions and improve patient prognosis.

Profile of Pediatric Neurosurgery in Nigeria from 1962 to 2021: A Systematic Review

This study aims to provide a comprehensive overview of pediatric neurosurgery in Nigeria, since 1962, by assessing epidemiological data, management strategies, and case outcomes. A systematic bibliometric review of Nigerian neurosurgical literature was reported with the PRISMA guidelines. The Risk of Bias Assessment Tool was applied to all nonrandomized studies, and a descriptive analysis was performed for all variables. We identified 12,295 pediatric patients from 196 published studies. Most publications (72.4%) occurred in the recent 2decades, of which 40.3% were observational case reports/series. The patients were predominantly male (57.2%) and aged 0-18years, with the majority (66.1%) belonging to the 0-5 age range. Most patients (63.4%) presented between 1-12months. The most common presenting feature was altered consciousness (7.7%), with computed tomography (38.8%) being the most frequently utilized diagnostic imaging modality. The diagnoses with the greatest prevalence (60.2%) were congenital abnormalities such as hydrocephalus and neural tube defects. 57.5% of cases received surgical therapy, with ventriculoperitoneal shunt placement being the most noticeable procedure performed (36.4%). Complications were identified in 9.5% of cases, with a 4.5% death rate. The Glasgow Outcome Score (95.7%) was the primary outcome measure utilized, with positive outcomes reported in 59.3% of cases. This review provides significant epidemiological data which emphasizes the country's enormous burden of pediatric neurosurgical cases. The findings can help guide clinical decisions as well as future research and policy development.

The role of high-resolution ultrasound and MRI in the evaluation of peripheral nerves in the lower extremity.

Lower extremity peripheral neuropathy is a commonly encountered neurologic disorder, which can lead to chronic pain, functional disability, and decreased quality of life for a patient. As diagnostic imaging modalities have improved, imaging has started to play an integral role in the detection and characterization of peripheral nerve abnormalities by non-invasively and accurately identifying abnormal nerves as well as potential causes of neuropathy, which ultimately leads to precise and timely treatment. Ultrasound, which has high spatial resolution and can quickly and comfortably characterize peripheral nerves in real time along with associated denervation muscle atrophy, and magnetic resonance neurography, which provides excellent contrast resolution between nerves and other tissues and between pathologic and normal segments of peripheral nerves, in addition to assessing reversible and irreversible muscle denervation changes, are the two mainstay imaging modalities used in peripheral nerve assessment. These two modalities are complimentary, and one may be more useful than the other depending on the nerve and location of pathology. Imaging must be interpreted in the context of available clinical information and other diagnostic studies, such as electrodiagnostic tests. Here, we offer a comprehensive overview of the role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of the peripheral nerves of the lower extremity and their associated neuropathies.

Assessment of the effectiveness of Saba shielding with the composition of Cu–Bi in neck CT imaging: a phantom and patient study

The use of computed tomography (CT) is a very well-established medical diagnostic imaging modality, however, the high radiation dose due to this imaging method is a major concern. Therefore, dose reduction methods are necessary, especially for superficial radiosensitive organs like the thyroid. The aim of this study is to construct and assess a CT shield with composition of 90% Cu and 10% Bi (Saba shield) with regard to dose reduction and image quality. The efficiency of the constructed shields for dose reduction was assessed by measuring entrance skin dose (ESD), using thermoluminescence dosimeters placed on an anthropomorphic phantom. Image quality was assessed quantitatively based on image noise and CT number accuracy by drawing regions of interest on CT images of the anthropomorphic phantom. Image quality was further investigated qualitatively in a patient study. Application of the Saba shield and 100% Bi shield with the thickness of one thickness (1T) reduced ESD by 50.2% and 51.7%, respectively, and using a three-fold thickness reduced ESD by 64.6% and 65.1%, respectively. Saba shield with thickness of 1T had no significant change in image noise in the anterior part, and image noise and mean CT number in the posterior part (P > 0.05). The statistical analysis performed did not find any meaningful difference between the study and control groups in image quality assessment of the patient study (P > 0.05). The 1T Saba shield reduced thyroid dose efficiently during neck CT imaging without causing unwanted effects on image quality.

The barriers, motives, perceptions, and attitudes toward research among radiology practitioners and interns in Saudi Arabia: a cross-sectional study.

Research and the use of evidence-based practices are imperative to the advancement of diagnostic imaging modalities. The aim of this study was to assess the perceptions and attitudes of radiology practitioners (i.e., Technicians, Technologists or Specialists, and Senior Specialists) and interns in King Abdulaziz Medical Cities (KAMCs), Kingdom of Saudi Arabia, toward research, and to explore the various barriers and obstacles that hinder their research efforts. A cross-sectional descriptive investigation was carried out from December 2022 to March 2023 among 112-KAMCs' radiology practitioners and interns, using previously developed and validated questionnaire comprised of five distinct sections, each serving a specific purpose, and with a non-probability convenient sampling technique. Descriptive statistics were generated for participants' demographics, and chi-square and fisher's exact tests were used to examine the association between participants' demographics and their involvement in research. Among the 137 KAMCs' radiology practitioners and interns who were invited to participate, 112 responded and completed the questionnaire, resulting in an overall response rate of 81.75%. Radiology practitioners and interns from various medical imaging subspecialties were found to be involved in research to the extent of 83%, with nearly half (40.9%) of them have had publications, and 53.3% of these publications being either cross-sectional studies or retrospective clinical studies. A lack of time (66.1%), a lack of a professional supervisor support program (50.9%), and deficiency in research skills (45.5%) were common obstacles that may impede the participants' ability to conduct research. The most common motives for participants to conduct research were the desire to improve their resumes (69.6%), get accepted into postgraduate radiology programs (58%), and improve their research skills (52.7%). KAMCs' radiology practitioners and interns have a positive attitude toward performing research. Despite the high percentage (83%) of those involved in research, the number of publications remains low. A crucial step to advancing the profession's evidence base is engaging radiology practitioners and interns in research and encouraging radiology practitioner-led research. The study findings can serve as a valuable basis for designing developmental programs aimed at overcoming research obstacles among healthcare professionals in Saudi Arabia.

The use of artificial intelligence tools in cancer detection compared to the traditional diagnostic imaging methods: An overview of the systematic reviews.

In comparison to conventional medical imaging diagnostic modalities, the aim of this overview article is to analyze the accuracy of the application of Artificial Intelligence (AI) techniques in the identification and diagnosis of malignant tumors in adult patients. The acronym PIRDs was used and a comprehensive literature search was conducted on PubMed, Cochrane, Scopus, Web of Science, LILACS, Embase, Scielo, EBSCOhost, and grey literature through Proquest, Google Scholar, and JSTOR for systematic reviews of AI as a diagnostic model and/or detection tool for any cancer type in adult patients, compared to the traditional diagnostic radiographic imaging model. There were no limits on publishing status, publication time, or language. For study selection and risk of bias evaluation, pairs of reviewers worked separately. In total, 382 records were retrieved in the databases, 364 after removing duplicates, 32 satisfied the full-text reading criterion, and 09 papers were considered for qualitative synthesis. Although there was heterogeneity in terms of methodological aspects, patient differences, and techniques used, the studies found that several AI approaches are promising in terms of specificity, sensitivity, and diagnostic accuracy in the detection and diagnosis of malignant tumors. When compared to other machine learning algorithms, the Super Vector Machine method performed better in cancer detection and diagnosis. Computer-assisted detection (CAD) has shown promising in terms of aiding cancer detection, when compared to the traditional method of diagnosis. The detection and diagnosis of malignant tumors with the help of AI seems to be feasible and accurate with the use of different technologies, such as CAD systems, deep and machine learning algorithms and radiomic analysis when compared with the traditional model, although these technologies are not capable of to replace the professional radiologist in the analysis of medical images. Although there are limitations regarding the generalization for all types of cancer, these AI tools might aid professionals, serving as an auxiliary and teaching tool, especially for less trained professionals. Therefore, further longitudinal studies with a longer follow-up duration are required for a better understanding of the clinical application of these artificial intelligence systems. Systematic review registration. Prospero registration number: CRD42022307403.

Dual-layer spectral computed tomography aortography using a seventy-five-percent-reduced iodine dose protocol and multiparameter spectral imaging: comparison with conventional computed tomography imaging.

Computed tomography angiography (CTA) is the recommended diagnostic and follow-up imaging modality for acute aortic dissection (AD). However, the high-contrast medium burden associated with repeated CT aortography follow-ups remains a significant concern. This prospective study aimed to assess whether an ultra-low contrast dose (75% cutoff) aortic CTA protocol on dual-layer spectral CT could achieve comparable image quality with the full dose protocol. We also investigated the image quality of the virtual noncontrast (VNC) images derived from the ultra-low dose protocol. This study included 37 consecutive patients who were referred to aortic CTA from May 2022 to August 2022. The enrolled patients underwent full-dose contrast CTA and ultra-low dose (reduced to 25% of conventional) contrast CTA on dual-layer spectral CT in 1 day. Virtual monochromatic images (VMIs) were reconstructed with 40 and 70 keV. The VNC images were reconstructed for both protocols. Objective image quality evaluation, recorded as signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs), was compared between the groups using 1-way analysis of variance and post hoc analysis with Bonferroni correction. Subjective image quality was also compared between the groups. Finally, VNC images derived from the low-dose (VNClow) and full-dose (VNCfull) protocols were compared to the true noncontrast (TNC) images. Neither CNR nor SNR was lower for the 40-keV images reconstructed from the ultra-low dose group compared to the conventional images. Both were significantly higher than those of the 70-keV images. Regarding subjective image quality, vessel enhancement was not significantly different between the 40-keV VMI and full-dose images [ascending aorta (AAO): 4.37±0.46 vs. 4.57±0.48, P=0.096; brachiocephalic arteries: 4.34±0.45 vs. 4.51±0.49, P=0.152; abdominal aortic side branch: 4.42±0.48 vs. 4.51±0.49, P=0.480]. The VNClow images were similar to the TNC images but significantly different from the VNCfull images (P<0.001). Ultra-low contrast aortic CTA with a 75%-reduced iodine dose using dual-layer spectral CT and the derived VNC achieved image quality comparable to that of conventional CTA and TNC images.

Osteoporosis: Molecular Pathology, Diagnostics, and Therapeutics.

Osteoporosis is a major public health concern affecting millions of people worldwide and resulting in significant economic costs. The condition is characterized by changes in bone homeostasis, which lead to reduced bone mass, impaired bone quality, and an increased risk of fractures. The pathophysiology of osteoporosis is complex and multifactorial, involving imbalances in hormones, cytokines, and growth factors. Understanding the cellular and molecular mechanisms underlying osteoporosis is essential for appropriate diagnosis and management of the condition. This paper provides a comprehensive review of the normal cellular and molecular mechanisms of bone homeostasis, followed by an in-depth discussion of the proposed pathophysiology of osteoporosis through the osteoimmunological, gut microbiome, and cellular senescence models. Furthermore, the diagnostic tools used to assess osteoporosis, including bone mineral density measurements, biochemical markers of bone turnover, and diagnostic imaging modalities, are also discussed. Finally, both the current pharmacological and non-pharmacological treatment algorithms and management options for osteoporosis, including an exploration of the management of osteoporotic fragility fractures, are highlighted. This review reveals the need for further research to fully elucidate the molecular mechanisms underlying the condition and to develop more effective therapeutic strategies.