Imaging Appearance Research Articles

Non-mass enhancement on breast MRI: Clues to a more confident diagnosis

BackgroundNon-mass enhancement (NME) seen on dynamic contrast enhanced breast MRI (DCE-MRI) may be caused by benign, high risk or malignant lesions. Making a clear distinction between these lesions is challenging due to the significant overlap in their imaging appearance. Our study aims to assess the various patterns of distribution, internal enhancement patterns (IEPs) and kinetics of NME using the BI-RADS lexicon fifth edition with histopathologic correlation to aid in making a more confident recommendation regarding clinical management.ResultsSixty-six female patients with NME on DCE-MRI were included. Thirty-four lesions (51.5%) were histopathologically proven to be benign and 32 (48.5%) were malignant. Segmental distribution was the most common pattern and was found in 22 cases (33.3%), 14 of them were malignant with p-value < 0.05. Linear distribution was reported in 14 cases, (21.2%), five of which were malignant, with p-value > 0.05. Thirteen cases (19.7%) had focal distribution, only two of them were malignant with p-value < 0.05. Twelve cases (18.2%) were of regional distribution, seven of which were malignant. Multiregional and diffuse distribution were the least common and were found in 3% and 4.5% of cases respectively. As for the enhancement pattern, 30 cases (45.5%) had heterogeneous enhancement. Nineteen of which were malignant with a p-value < 0.05. Clumped enhancement was found in 24 cases (36.4%); 12 cases were found to be malignant. Nine cases (13.6%) were of homogeneous enhancement, all of them were benign and three cases (4.5%) were of clustered ring enhancement with p-value > 0.05. Restricted diffusion value was detected in 75% of malignant cases with p-value < 0.05. In terms of kinetic curve, the most frequent curve was found to be type II plateau curve (26 cases, 39.4%), 15 cases were of benign pathology and the other 11 cases were proven to be malignant. Followed by type III washout curve which was detected in 25 cases (37.9%), 20 cases were malignant and five cases were benign. And type I persistent curve was found in 15 cases (22.7%); 14 cases were histopathologically proven to be benign, and only one case was of malignant pathology, with a total p-value < 0.05.ConclusionsOur study found that the most common distribution pattern was segmental distribution, being statistically significant with p-value < 0.05, being more common among malignant lesions. As for the enhancement pattern, heterogeneous enhancement was the most common pattern, mainly detected in malignant lesions, with p-value < 0.05. The most common type of kinetic curve was type II curve.

Abstract PS05-03: MagSense® HER2, a Molecularly Targeted Magnetic Resonance Imaging Agent for the Detection of Axillary Nodal Metastasis in Subjects with Human Epidermal Growth Factor Receptor 2 Positive (HER2+) Breast Cancer

Abstract Background Precise nodal staging is critical in guiding systemic and regional treatments including surgery in the management of breast cancer. Regional nodal assessment includes axillary imaging (mostly by ultrasound) and lymph node sampling. Since imaging findings suggestive of nodal metastasis are based on size and morphologic changes and not specific to tumor type, pathologic confirmation through either biopsy or removal of sentinel lymph node (SLN) remains the gold standard. Imagion is developing the MagSense® HER2 Imaging Agent (MSH2IA), an anti-human epidermal growth factor receptor 2 (HER2) conjugated with iron oxide nanoparticles, for the detection of nodal metastasis in HER2+ breast cancer patients. MSH2IA is currently being investigated in a first-in-human phase 1 study (ACTRN12621000126819) in HER2+ breast cancer patients who are diagnosed to have suspicious nodes by conventional imaging. Methods The key objectives of the phase 1 study are safety and tolerability of MSH2IA and confirmation that MSH2IA drains to the axillary lymph nodes. The study also explores MSH2IA’s ability to detect metastatic nodes when used with magnetic resonance imaging (MRI), with tumor status assessed by standard tissue histopathology. All eligible subjects receive a 22.5 mg (iron equivalent) subareolar or peritumoral injection of MSH2IA. MRI of the axilla are obtained before and 24 to 72 hours after MSH2IA injection. Core biopsy or dissection of a node suspicious by ultrasound is obtained for histopathology assessments. After completing the first cohort of 6 subjects, the protocol was amended to include the insertion of an MRI compatible clip in a node suspicious by ultrasound to localize the suspicious node for core biopsy and postdose MRI scan. Review of MRI scans and histopathology are performed in respective central laboratories. Results Thirteen participants with HER2+ breast cancer have completed the study. MSH2IA appears safe and well tolerated. The imaging agent, as administered, is detectable by MRI and pathology, confirming that MSH2IA drains to the lymph nodes via the chosen route of administration. In postdose MRI scans, study central radiologists reported distinct and differentiable MRI appearance in morphologically normal and suspicious nodes. The presence of a distinct postdose MR image appearance was confirmed by a group of independent radiologists in a separate blinded review. While normal nodes appeared with homogeneous hypointensity, morphologically suspicious nodes showed partial irregular darkening and/or speckled heterogeneous hypointensity. In evaluable subjects, histopathology of the core biopsies obtained from the clipped nodes confirmed the presence of HER2+ nodal metastasis, providing preliminary evidence for node-level concordance between MRI vs pathology observations. Safety, imaging, and pathology results from all available subjects will be presented. This phase 1 study in Australia will be closing enrollment by July 31, 2023. A phase 2 study in the United States and elsewhere is being planned with the objectives of optimizing dose, schedule, and imaging parameters for best diagnostic performance for clinical utility. Conclusion Available data from the ongoing phase 1 study show that MSH2IA appears safe and drains to the axillary lymph nodes. MSH2IA displays a distinct and differentiable MRI appearance in nodes morphologically highly suspicious for tumor, which is confirmed to be HER2+ metastasis by histopathology by node level concordance. This data provides preliminary proof of principle for the mechanism of molecularly targeted MR imaging and suggests that MSH2IA has the potential to provide tumor-specific MR imaging not currently available in conventional axillary imaging. Citation Format: Jane Fox, Shanta Velaiutham, Natalie Yang, Eddie lau, Kowsi Murugappan, Beena Kumar, Alex Laslowski, Koushik Govindarajan, Steven Reich, Stephen Thomas, Nitika Neha, Marie Zhang, Isaac Bright. MagSense® HER2, a Molecularly Targeted Magnetic Resonance Imaging Agent for the Detection of Axillary Nodal Metastasis in Subjects with Human Epidermal Growth Factor Receptor 2 Positive (HER2+) Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS05-03.

Multimodality Imaging of Postmastectomy Breast Reconstruction Techniques, Complications, and Tumor Recurrence.

For women undergoing mastectomy, breast reconstruction can be performed by using implants or autologous tissue flaps. Mastectomy options include skin- and nipple-sparing techniques. Implant-based reconstruction can be performed with saline or silicone implants. Various autologous pedicled or free tissue flap reconstruction methods based on different tissue donor sites are available. The aesthetic outcomes of implant- and flap-based reconstructions can be improved with oncoplastic surgery, including autologous fat graft placement and nipple-areolar complex reconstruction. The authors provide an update on recent advances in implant reconstruction techniques and contemporary expanded options for autologous tissue flap reconstruction as it relates to imaging modalities. As breast cancer screening is not routinely performed in this clinical setting, tumor recurrence after mastectomy and reconstruction is often detected by palpation at physical examination. Most local recurrences occur within the skin and subcutaneous tissue. Diagnostic breast imaging continues to have a critical role in confirmation of disease recurrence. Knowledge of the spectrum of benign and abnormal imaging appearances in the reconstructed breast is important for postoperative evaluation of patients, including recognition of early and late postsurgical complications and breast cancer recurrence. The authors provide an overview of multimodality imaging of the postmastectomy reconstructed breast, as well as an update on screening guidelines and recommendations for this unique patient population. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.

Thymic Imaging Pitfalls and Strategies for Optimized Diagnosis.

Thymic imaging is challenging because the imaging appearance of a variety of benign and malignant thymic conditions are similar. CT is the most commonly used modality for mediastinal imaging, while MRI and fluorine 18 fluorodeoxyglucose (FDG) PET/CT are helpful when they are tailored to the correct indication. Each of these imaging modalities has limitations and technical pitfalls that may lead to an incorrect diagnosis and mismanagement. CT may not be sufficient for the characterization of cystic thymic processes and differentiation between thymic hyperplasia and thymic tumors. MRI can be used to overcome these limitations but is subject to other potential pitfalls such as an equivocal decrease in signal intensity at chemical shift imaging, size limitations, unusual signal intensity for cysts, subtraction artifacts, pseudonodularity on T2-weighted MR images, early imaging misinterpretation, flow and spatial resolution issues hampering assessment of local invasion, and the overlap of apparent diffusion coefficients between malignant and benign thymic entities. FDG PET/CT is not routinely indicated due to some overlap in FDG uptake between thymomas and benign thymic processes. However, it is useful for staging and follow-up of aggressive tumors (eg, thymic carcinoma), particularly for detection of occult metastatic disease. Pitfalls in imaging after treatment of thymic malignancies relate to technical challenges such as postthymectomy sternotomy streak metal artifacts, differentiation of postsurgical thymic bed changes from tumor recurrence, or human error with typical "blind spots" for identification of metastatic disease. Understanding these pitfalls enables appropriate selection of imaging modalities, improves diagnostic accuracy, and guides patient treatment. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.

Advancements in Magnetic Resonance Neurography: Techniques, Sequences, and Standardization

Magnetic resonance neurography requires varying imaging techniques based on the site of imaging and anticipated disease. In assessing the brachial and lumbosacral plexus, a three-dimensional (3D) spin echo method, such as 3D-short tau inversion recovery imaging, is frequently employed. It's beneficial to familiarize oneself with the imaging sequence and understand the appearance of normal images in advance. The imaging parameters used in our institute are provided below as a reference. When interpreting the images, pay close attention to nerve thickening, signal intensity changes, asymmetry between the left and right sides, and irregularities in nerve caliber. Efforts are underway to standardize qualitative assessments and quantify signals through technological advancements.

Twist in the Bowel: A Multimodality Radiological Imaging Spectrum.

Volvulus affecting the gastrointestinal (GI) tract is one of the common causes of recurrent pain in the abdomen, and often, patients present with non-specific abdominal pain associated with nausea and/or vomiting. A high degree of suspicion is required at the clinician's end to suspect this diagnosis, which is usually confirmed by imaging using radiographs, fluoroscopic evaluation, and computed tomography. Familiarity of the clinician and radiologist with the imaging appearances of these emergent conditions on various imaging modalities is quintessential to avoiding life-threatening complications like bowel ischemia or perforation, which are associated with delayed or missed diagnosis. Our article describes the clinical features and classical imaging of the various types of volvulus affecting different bowel segments in the entire GI tract.

Imaging findings of the infective endocarditis with neurological complications

Neurological complications are the most serious extracardiac complications of infective endocarditis. They can be manifested as ischemic stroke, intracranial hemorrhage, mycotic aneurysms, meningitis, cerebritis and abscesses. Avoidance of anticoagulants and antiplatelet agents with early intravenous antibiotic administration is crucial in the management of this condition. MRI of the brain is an important tool for early diagnosis and guiding the treatment decision. The purpose of this article is to review the imaging appearances and the possible mechanisms of the intracranial findings in the patients with neurological complications of infective endocarditis.

Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine contrast-enhanced ultrasound guidelines. Rare pancreatic tumors, imaging features on transabdominal ultrasound and EUS with contrast enhancement: Rare epithelial pancreatic tumors: solid pseudopapillary neoplasm, acinar cell carcinoma, mixed neuroendocrine-non-neuroendocrine neoplasms, some rare subtypes of pancreatic adenocarcinoma and pancreatoblastoma.

Rare malignant pancreatic lesions are systematically reported in this review. The focus is on the imaging appearance of the rare epithelial pancreatic tumors such as the solid pseudopapillary neoplasm, acinar cell carcinoma, rare subtypes of adenocarcinoma, and pancreatoblastoma as seen on ultrasound, EUS, and contrast-enhanced ultrasound or EUS. The present overview summarizes the data and shows that not every pancreatic tumor is likely to be the most common entities of ductal adenocarcinoma or neuroendocrine tumor.

Sarcoma Botryoides a Rare Pediatric Pelvic Tumor: A Case Report and Literature Revue

Sarcoma botryoides, a variant of embryonal rhabdomyosarcoma, represents the predominant malignant tumor affecting the genitourinary (GU) system in children under 15 years of age. Among GU tract malignancies in this age group, the embryonal subtype of habdomyosarcoma is the most prevalent. In young and adolescent individuals, the cervix and uterus are affected; whereas in infants, vaginal lesions are more common. Imaging plays a crucial role not only in the initial diagnosis but also in long‑term follow‑up of genital rhabdomyosarcoma. Although the magnetic resonance imaging features of GU tract rhabdomyosarcomas have been escribed, there have been relatively few radiological reports in the literature regarding the botryoid variant. This article aims to illustrate and describe the imaging appearance of this rare tumor. We present a case of a one-year-old male who presented with a rapidly growing pelvic mass, crying and straining on micturition and difficulty in passing stool and urine. An abdomino-pelvic CT scan and MRI were performed. He had been examinated under anesthesia and biopsy. Histology confirmed sarcoma botryoides.

Safe Communication Using Steganography

This research aims to propose a method of safe communication using steganography, which involves hiding information in other information to conceal the fact that communication is taking place. Digital images are one of the most popular file formats used for steganography due to their frequency on the internet. The project focuses on hiding secret information within images using steganography techniques. Different techniques have their respective strong and weak points, and their application requirements vary. The proposed technique allows users to choose the bits for replacement instead of using the least significant bit (LSB) replacement from the images. In this technique, the sender selects a cover image with the secret text or text file, hides it in the image, and sends it to the receiver through a private or public communication network. The receiver retrieves the secret text hidden in the stego-image using the software. This method provides a secure and user-friendly interface for individuals to exchange confidential messages. It leverages the power of image steganography to address the growing need for privacy and confidentiality in digital communication. By hiding messages within images, it ensures a covert and secure means of transmitting information while maintaining the visual appearance of harmless images. Keywords: Encryption, decryption, steganography, safe communication.

Severity of COVID-19 infection in patients with COVID-19 combined with diabetes

PurposeThis study aimed to analyse the correlation between blood glucose control and the severity of COVID-19 infection in patients with diabetes.MethodsClinical and imaging data of a total of 146 patients with diabetes combined with COVID-19 who visited our hospital between December 2022 and January 2023 were retrospectively collected. The patients were divided into the ‘good blood glucose control’ group and the ‘poor blood glucose control’ group based on an assessment of their blood glucose control. The clinical data, computed tomography (CT) appearance and score and the severity of COVID-19 infection of the two groups were compared, with the severity of COVID-19 infection being the dependent variable to analyse other influencing factors.ResultsThe group with poor blood glucose control showed a higher lobar involvement degree and total CT severity score (CTSS) than the group with good blood glucose control (13.30 ± 5.25 vs. 10.38 ± 4.84, p < 0.05). The two groups exhibited no statistically significant differences in blood lymphocyte, leukocyte, C-reaction protein, pleural effusion, consolidation, ground glass opacity or crazy-paving signs. Logistic regression analysis showed that the total CTSS significantly influences the clinical severity of patients (odds ratio 1.585, p < 0.05), whereas fasting plasma glucose and blood glucose control are not independent factors influencing clinical severity (both p > 0.05). The area under the curve (AUC) of CTSS prediction of critical COVID-19 was 0.895 with sensitivity of 79.3% and specificity of 88.1% when the threshold value is 12.ConclusionBlood glucose control is significantly correlated with the CTSS; the higher the blood glucose is, the more severe the lung manifestation. The CTSS can also be used to evaluate and predict the clinical severity of COVID-19.

Arachnoid cyst in the pediatric patient: What the radiologist needs to know.

Arachnoid cysts are the most common incidentally discovered intracranial lesions on imaging and the most common cystic intracranial lesions. They may be developmental or secondary. A relative lack of recent literature and any comprehensive radiological review on arachnoid cysts has led to a general lack of awareness among radiologists of symptomatic or complicated arachnoid cysts. This is particularly concerning in pediatric patients. While arachnoid cysts are asymptomatic in most cases, they can cause clinical symptoms in a minority of cases, especially when they occur in unusual sites. These include intraventricular locations where they may cause hydrocephalus, the basal cisterns where they may compress cranial nerves, the cerebellopontine angle where they have to be differentiated from a number of cystic lesions, the cavum septum pellucidum or cavum velum interpositum, the choroid fissure where they can entrap the temporal horn and compress the hippocampus, the posterior fossa where they need to be differentiated from other posterior fossa cystic lesions, and within the spinal canal where there is a concern for cord or nerve root compression. Larger cysts are more prone to complications such as mass effect, hemorrhage, and rupture. Hemorrhage and rupture often present with acute symptoms. Ruptured cysts lose their characteristic imaging appearance and can mimic several ominous pathologies. It therefore becomes vital to accurately diagnose these cases as complications of pre-existing arachnoid cysts for appropriate management. A detailed review of all diagnostic imaging aspects of arachnoid cysts will help fill in the existing information void on this important entity.

Absorbable Hemostatic Agents Mimic Gossypiboma or Infected Collection on Imaging

AbstractAbsorbable hemostatic agents are commonly used in clinical practice and their imaging appearance is less known. In our case series, we demonstrate how absorbable hemostatic agents can masquerade as other clinically and medicolegally significant conditions such as gossypiboma and infected collections. Through our report, we aimed to describe the imaging features of absorbable hemostatic agents, to compare them with their imaging mimics, and provide a comprehensive review of the available literature.

Intracranial extra-axial chondromas: clues to computed tomography and magnetic resonance imaging diagnosis.

We aimed to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of intracranial extra-axial chondroma. We retrospectively evaluated the imaging findings of CT and MR examinations of six patients (three men and three women, aged 21-66 years) with histopathological diagnoses of intracranial extra-axial chondroma. Four tumors were located in the frontal region and two in the cavernous sinus. All the tumors showed low signals on diffusion-weighted images and high signals on apparent diffusion coefficient maps without restricted diffusion. There was no perifocal edema in all the tumors. Cavernous sinus chondromas were associated with bone erosion and anterior displacement of the internal carotid arteries, but without calcification. Calcification was present in all frontal chondromas. All the tumors revealed low signals on T1-weighted MR images. Frontal chondromas revealed mixed signals, but cavernous sinus chondromas were brightly hyperintense on T2-weighted MR images. No enhancement was detected in the two chondromas. An intense homogeneous enhancement was detected in a cavernous sinus chondroma. The imaging appearances of frontal extra-axial chondromas and cavernous sinus chondromas may have different imaging appearances. Although there is a wide range of imaging findings, the absence of restricted diffusion, perifocal edema, enhancement, and presence of low signals on T1-weighted MR images in a well-circumscribed calcified extra-axial mass should suggest an intracranial chondroma.

Evaluating the relationship between magnetic resonance image quality metrics and deep learning-based segmentation accuracy of brain tumors.

Magnetic resonance imaging (MRI) scans are known to suffer from a variety of acquisition artifacts as well as equipment-based variations that impact image appearance and segmentation performance. It is still unclear whether a direct relationship exists between magnetic resonance (MR) image quality metrics (IQMs) (e.g., signal-to-noise, contrast-to-noise) and segmentation accuracy. Deep learning (DL) approaches have shown significant promise for automated segmentation of brain tumors on MRI but depend on the quality of input training images. We sought to evaluate the relationship between IQMs of input training images and DL-based brain tumor segmentation accuracy toward developing more generalizable models for multi-institutional data. We trained a 3D DenseNet model on the BraTS 2020 cohorts for segmentation of tumor subregions enhancing tumor (ET), peritumoral edematous, and necrotic and non-ET on MRI; with performance quantified via a 5-fold cross-validated Dice coefficient. MRI scans were evaluated through the open-source quality control tool MRQy, to yield 13 IQMs per scan. The Pearson correlation coefficient was computed between whole tumor (WT) dice values and IQM measures in the training cohorts to identify quality measures most correlated with segmentation performance. Each selected IQM was used to group MRI scans as "better" quality (BQ) or "worse" quality (WQ), via relative thresholding. Segmentation performance was re-evaluated for the DenseNet model when (i) training on BQ MRI images with validation on WQ images, as well as (ii) training on WQ images, and validation on BQ images. Trends were further validated on independent test sets derived from the BraTS 2021 training cohorts. For this study, multimodal MRI scans from the BraTS 2020 training cohorts were used to train the segmentation model and validated on independent test sets derived from the BraTS 2021 cohort. Among the selected IQMs, models trained on BQ images based on inhomogeneity measurements (coefficient of variance, coefficient of joint variation, coefficient of variation of the foreground patch) and the models trained on WQ images based on noise measurement peak signal-to-noise ratio (SNR) yielded significantly improved tumor segmentation accuracy compared to their inverse models. Our results suggest that a significant correlation may exist between specific MR IQMs and DenseNet-based brain tumor segmentation performance. The selection of MRI scans for model training based on IQMs may yield more accurate and generalizable models in unseen validation.

Uncommon Causes of Interlobular Septal Thickening on CT Images and Their Distinguishing Features.

Interlobular septa thickening (ILST) is a common and easily recognized feature on computed tomography (CT) images in many lung disorders. ILST thickening can be smooth (most common), nodular, or irregular. Smooth ILST can be seen in pulmonary edema, pulmonary alveolar proteinosis, and lymphangitic spread of tumors. Nodular ILST can be seen in the lymphangitic spread of tumors, sarcoidosis, and silicosis. Irregular ILST is a finding suggestive of interstitial fibrosis, which is a common finding in fibrotic lung diseases, including sarcoidosis and usual interstitial pneumonia. Pulmonary edema and lymphangitic spread of tumors are the commonly encountered causes of ILST. It is important to narrow down the differential diagnosis as much as possible by assessing the appearance and distribution of ILST, as well as other pulmonary and extrapulmonary findings. This review will focus on the CT characterization of the secondary pulmonary lobule and ILST. Various uncommon causes of ILST will be discussed, including infections, interstitial pneumonia, depositional/infiltrative conditions, inhalational disorders, malignancies, congenital/inherited conditions, and iatrogenic causes. Awareness of the imaging appearance and various causes of ILST allows for a systematic approach, which is important for a timely diagnosis. This study highlights the importance of a structured approach to CT scan analysis that considers ILST characteristics, associated findings, and differential diagnostic considerations to facilitate accurate diagnoses.

A framework for identification of brain tumors from MR images using progressive segmentation

PurposeThis study addresses the critical health issue of brain tumors, focusing on enhancing the accuracy of tumor segmentation from Magnetic Resonance Imaging (MRI) images. The primary research question investigates the effectiveness of a novel Hybrid Watershed–Clustering framework and its underlying Progressive Segmentation of the MR Images using the Radius and Intensity Measure (PS-RIM) algorithm. The aim is to improve the detection and segmentation of brain tumors within MR images, surpassing the efficacy of current methodologies.MethodsThe methodology involves a three-stage process. In the preprocessing stage, noise reduction and intensity normalization techniques are applied to clarify the images. The next stage is region-based segmentation, which includes morphological processing, edge detection, and thresholding to delineate tumor areas accurately. The final post-processing stage enhances segmentation accuracy and reduces false positives by integrating clustering machine learning techniques, specifically the K-Means cluster algorithm, to refine tumor identification.ResultsThe framework's comprehensive evaluation across various MR images shows a significant improvement in accuracy over existing segmentation methods. The PS-RIM algorithm within the framework effectively captures the diverse presentations of tumor appearances in MR images. The research recorded an impressive accuracy rate of 98.11% in tumor detection, demonstrating enhanced identification and segmentation quality.ConclusionsThe study concludes that the proposed Hybrid Watershed–Clustering framework, powered by the PS-RIM algorithm, markedly improves the detection and differentiation of brain tumors in MR images. It exhibits exceptional accuracy, resilience, and computational efficiency. These findings hold substantial potential for advancing computer vision and image analysis in medical diagnostics, which could improve patient outcomes in managing brain tumors.Graphical abstract

Brain functional connectivity correlates of anomalous interaction between sensorily isolated monozygotic twins.

This study examined brain functional connectivity (FC) changes associated with possible anomalous interactions between sensorily isolated monozygotic (MZ) twins. Brain FC was estimated using the Steady State Visual Evoked Potential-Event Related Partial Coherence (SSVEP-ERPC) methodology. Five twin pairs served twice as participants, with an average interval between sessions of 67 days. In each recording session, one twin, the Sender, viewed a randomized set of 50 general images and 50 personally relevant images, while the other twin, the Receiver, viewed a static personally relevant image for the entire duration of the session. Images appeared on the Sender screen for 1.0 s, with the interval between successive images varied randomly between 4.0 and 8.0 s. Receiver FC changes were calculated based on the appearance times of the images as viewed by the Sender. It was hypothesized that anomalous interactions would be indicated by statistically significant Receiver FC changes when those changes are determined using the Sender image appearance times. For each twin serving as Receiver, FC components were separately analyzed for the 50 general and the 50 personal images, yielding 38 observations (19 twin pairs by 2 conditions). The hypothesis was confirmed in that 11 of the 38 observations yielded statistically significant Receiver FC increases or decreases at the p < 0.01 level only when trials were synchronized to the Sender image appearance times. Overall, this effect was significant at the p = 4 × 10-8 Df = 175. To the best of our knowledge, this is the first study reporting statistically significant FC changes indicative of anomalous interactions between two sensorily isolated individuals.

Cross-Sectional Imaging Characteristics of Pancreatic Intraductal Oncocytic Papillary Neoplasms.

Pancreatic intraductal oncocytic papillary neoplasms (IOPN) are rare precursors to pancreatic ductal adenocarcinoma. We report cross-sectional computed tomography and magnetic resonance imaging (where available) findings of pancreatic IOPNs. Consecutive cases of pancreatic IOPNs identified on pathology between 2008 and 2020 at University of Pittsburgh and Johns Hopkins University were included in the study. Cross-sectional imaging of all patients was reviewed by two subspecialty trained abdominal radiologists. Patient demographics, cross-sectional imaging appearances and growth characteristics were evaluated. In this dual-center study, 14 patients with IOPNs were included. Median age was 64 years, and 64% were male. The median size of the lesions was 5.4 cm (range, 1.4-12.3 cm). All patients had either an enhancing mural nodule (93% of patients) and/or thick internal septations (29%). Thin/imperceptible outer wall was seen in 93%. Main duct was involved in 64% of the cases. Only 14% of the cases did not demonstrate abutment of the main duct. Histologic evaluation of surgical specimen showed high-grade dysplasia without invasive carcinoma in 57% and invasive carcinoma in 43% of cases. Lesions with invasive carcinoma were larger (7.1 cm vs 4.3 cm, P = 0.05) and tended to have larger mural nodule (3.7 cm vs 1.8 cm) compared with those without invasive carcinoma. Pancreatic IOPNs are rare cystic premalignant lesions, which among resected cases, are predominantly seen in middle aged men, are often large, have enhancing mural nodules and frequently harbor invasive carcinoma.

Improving Computer Vision-Based Wildfire Smoke Detection by Combining SE-ResNet with SVM

Wildfire is one of the most critical natural disasters that poses a serious threat to human lives as well as ecosystems. One issue hindering a high accuracy of computer vision-based wildfire detection is the potential for water mists and clouds to be marked as wildfire smoke due to the similar appearance in images, leading to an unacceptable high false alarm rate in real-world wildfire early warning cases. This paper proposes a novel hybrid wildfire smoke detection approach by combining the multi-layer ResNet architecture with SVM to extract the smoke image dynamic and static characteristics, respectively. The ResNet model is improved via the SE attention mechanism and fully convolutional network as SE-ResNet. A fusion decision procedure is proposed for wildfire early warning. The proposed detection method was tested on open datasets and achieved an accuracy of 98.99%. The comparisons with AlexNet, VGG-16, GoogleNet, SE-ResNet-50 and SVM further illustrate the improvements.