Imaging Examination Method Research Articles

Diagnostic value of contrast-enhanced CT in clear cell renal cell carcinoma: a systematic review and meta-analysis

ObjectiveContrast-enhanced computed tomography (CECT) improves lesion contrast with surrounding tissues through the injection of contrast agents. This enhancement allows for more precise lesion characterization, aiding in the early diagnosis of clear cell renal cell carcinoma (ccRCC). This meta-analysis aims to assess the diagnostic efficacy of CECT in ccRCC and to provide an ideal imaging examination method for the preoperative diagnosis of ccRCC.MethodsWe conducted a comprehensive search across six major online databases: PubMed, Web of Science, Cochrane Library, WANFANG DATA, China National Knowledge Infrastructure, and Chinese BioMedical Literature Database (CBM). The objective was to collate and analyze studies that evaluate the diagnostic utility of CECT in the identification of ccRCC. Meta-disc 1.4 and Stata 16.0 were used to conduct a meta-analysis and evaluate the diagnostic accuracy of CECT for ccRCC.ResultsThe meta-analysis included 17 relevant studies investigating the diagnostic value of CECT for ccRCC. The combined sensitivity and specificity of CECT were 0.88 (95% confidence interval: 0.83–0.91) and 0.82 (95%CI: 0.75–0.87), respectively. Positive diagnostic likelihood ratio = 4.87 (95%CI: 3.47–6.84), negative diagnostic likelihood ratio = 0.15 (95%CI: 0.11–0.21), and diagnostic odds ratio = 32.67 (95%CI: 18.21–58.61). In addition, the area under the ROC curve was 0.92 (95%CI: 0.89–0.94), indicating that CECT has a decent discriminative ability in diagnosing ccRCC.ConclusionsCECT is recognized as a highly effective imaging tool for diagnosing ccRCC. It provides valuable guidance in the preoperative assessment and planning of surgical strategies for patients with ccRCC.

Cervical vertigo due to rotational fixation of atlantoaxial joint combined with benign paroxysmal positional vertigo: A case report and literature review.

Vertigo is the most common clinical complaint, misdiagnosed patients are not rare, so it is very important to exclude and identify vertigo. For vertigo caused by multiple causes, including cervical vertigo with atlantoaxial rotation fixation combined with benign paroxysmal positional vertigo (BPPV), tuina can correct joint misalignment. The reduction technique will return the fallen otolith to the correct position. The use of massage and reduction can improve clinical symptoms and improve quality of life and may be a simple, safe, and effective treatment strategy for this disease. We report on a patient with both cervical vertigo due to atlantoaxial rotational fixation and BPPV, including his imaging examination, clinical manifestations, and treatment methods. Cervical vertigo (atlantoaxial rotatory fixation) and BPPV. Tuina combined with atlantoaxial directional inverted reduction technique and reduction manipulation. The patient's vertigo symptoms improved significantly, nystagmus disappeared, cervical occipital pain, nausea, head distension, and other symptoms disappeared, and cervical motion rotation reached 60°. This study proved the effectiveness of massage combined with a reduction in the treatment of cervical vertigo and BPPV, as well as the importance of vertigo diagnosis and differential diagnosis, and provided a new treatment idea for the future diagnosis and treatment of vertigo caused by a variety of causes.

Bone Marrow Disseminated Tumor Cell Detection Is Beneficial for the Early Finding of Bone Metastasis and Prognosis.

Disseminated tumor cells (DTCs) are thought to be the initiators of tumor recurrence and metastasis. However, based on the current imaging examination methods, early detection of DTCs is extremely difficult due to their small number and dormant state. We used the SE-iFISH approach to detect bone marrow DTCs (mDTCs) in patients with breast or prostate cancer, and compared it with various imaging examination methods to explore its role in predicting metastasis and prognosis. Fifteen patients were enrolled in this study. Among them, 11 patients showed imaging-confirmed bone metastases in different sites of the body, of which seven patients had iliac mDTCs and signs of iliac bone metastases on imaging. For the remaining four patients, imaging confirmed that the bone metastatic foci were far from the ilium, but in one patient, mDTCs were detected in the ilium. Interestedly, iliac mDTCs were also detected in two out of four patients who had no sign of bone metastases on imaging. Furthermore, the epithelial marker, CK18, was ubiquitously expressed in mDTCs, but its expression was very low in peripheral circulating tumor cells (pCTCs). The Kaplan-Meier plot suggested that CK18+ mDTCs ≥ 5 was related to poor overall survival (OS) compared with that of CK18+ mDTCs < 5 in breast cancer patients (median OS: 22.1 vs. 46.9 months; log-rank, p = 0.035). SE-iFISH examination for mDTCs is more sensitive than the conventional methods used for detecting bone metastases. mDTC detection facilitated the early finding of tumor cells in the bone marrow and ≥5 CK18+ mDTCs was associated with a poor prognosis in breast cancer patients.

The painful knee in children

Knee pain is one of the most common reasons for medical consultation for musculoskeletal problems in the paediatric population. The aetiology is of very variable origin and necessitates aprecise assessment. In addition to athorough anamnesis, clinical and imaging examination methods, as well as laboratory diagnostics are of utmost importance to establish aproper diagnosis and an adequate treatment regimen. This chapter summarises the current diagnostic algorithm for dealing with knee pain in children and adolescents.

Comparative evaluation of imaging methods for prognosis assessment in esophageal squamous cell carcinoma: focus on diffusion-weighted magnetic resonance imaging, computed tomography and esophagography.

To identify the most sensitive imaging examination method to evaluate the prognosis of esophageal squamous cell carcinoma (ESCC). Thirty patients with esophageal squamous cell carcinoma (ESCC) participated in the study and underwent chemoradiotherapy (CRT). They were divided into two groups based on their survival status: the survival group and non-survival group. The diagnostic tests were utilized to determine the most effective imaging examination method for assessing the prognosis. 1. There were no significant differences in tumor length shown on esophagography or computed tomography (CT) or the maximal esophageal wall thickness shown on CT at the specified time points between the two groups. 2. The tumor length on diffusion-weighted imaging (DWI) in the survival group was significantly lower than in the non-survival group at the end of the sixth week of treatment (P=0.001). The area under the ROC curve was 0.840 (P=0.002), and the diagnostic efficiency was moderately accurate. 3. The apparent diffusion coefficient (ADC) values of the survival group were significantly higher than those in the non-survival group at the end of the fourth week and sixth week of treatment (both P<0.001). Areas under the curve were 0.866 and 0.970, with P values of 0.001 and <0.001 and good diagnostic accuracy. Cox regression analyses indicated the ADC at the end of the sixth week of treatment was an independent risk factor. Compared with esophagography and CT, DW-MRI has certain advantages in predicting the prognosis of ESCC.

The value of multi-modal ultrasound in the assessment of sarcopenia in maintenance hemodialysis patients

IntroductionSarcopenia is one of the common complications in maintenance hemodialysis (MHD) patients and is associated with poor prognosis. We aimed to study the validity and reliability of ultrasound in the assessment of sarcopenia in MHD patients. MethodsMHD patients were categorized into the sarcopenia group and the non-sarcopenia group according to the diagnostic criteria of the Asian Working Group on Sarcopenia (AWGS) 2019. Ultrasonography of the left medial head of the gastrocnemius muscle was performed in MHD and healthy controls to obtain muscle thickness (MT), pinnation angle (PA), fascicle length (FL), cross-sectional area (CSA), echo intensity (EI), elastic modulus (E), shear wave velocity (SWV), and microvascular velocity (MV). Compare the differences in ultrasound parameters among different groups, and determine the cut-off values suitable for diagnosing sarcopenia in MHD patients. ResultsThe MT, CSA, PA, and MV in the sarcopenia group were lower than those in the non-sarcopenia group and the control group; while the EI was higher, the FL of the sarcopenia group was lower than that of the non-sarcopenia group, while the E and SWV of the sarcopenia group were higher than those of the control group. Receiver operating characteristic curve analyses indicated that ultrasound combined index had a good diagnostic value, model Y = 13.511−0.121*MT-0.609*CSA-0.172*PA+0.011*EI-2.205*MV(P < 0.05), with a cut-off value of 0.69. ConclusionsMulti-modal ultrasound is a safe, non-invasive, and real-time imaging examination method, and can provide information on muscle structure, stiffness, and perfusion, which is expected to be a promising potential tool for predicting sarcopenia in MHD patients.

Valor de la ecografía multimodal en la evaluación de la sarcopenia en pacientes en hemodiálisis de mantenimiento

IntroductionSarcopenia is one of the common complications in maintenance hemodialysis (MHD) patients and is associated with poor prognosis. We aimed to study the validity and reliability of ultrasound in the assessment of sarcopenia in MHD patients. MethodsMHD patients were categorized into the sarcopenia group and the non-sarcopenia group according to the diagnostic criteria of the Asian Working Group on Sarcopenia (AWGS) 2019. Ultrasonography of the left medial head of the gastrocnemius muscle was performed in MHD and healthy controls to obtain muscle thickness (MT), pinnation angle (PA), fascicle length (FL), cross-sectional area (CSA), echo intensity (EI), elastic modulus (E), shear wave velocity (SWV), and microvascular velocity (MV). Compare the differences in ultrasound parameters among different groups, and determine the cut-off values suitable for diagnosing sarcopenia in MHD patients. ResultsThe MT, CSA, PA, and MV in the sarcopenia group were lower than those in the non-sarcopenia group and the control group; while the EI was higher, the FL of the sarcopenia group was lower than that of the non-sarcopenia group, while the E and SWV of the sarcopenia group were higher than those of the control group. Receiver operating characteristic curve analyses indicated that ultrasound combined index had a good diagnostic value, model Y=13.511-0.121*MT-0.609*CSA-0.172*PA+0.011*EI-2.205*MV (p<0.05), with a cut-off value of 0.69. ConclusionsMulti-modal ultrasound is a safe, non-invasive, and real-time imaging examination method, and can provide information on muscle structure, stiffness, and perfusion, which is expected to be a promising potential tool for predicting sarcopenia in MHD patients.

Breast cancer lesion segmentation based on co-learning feature fusion and Transformer

The PET/CT imaging technology combining positron emission tomography (PET) and computed tomography (CT) is the most advanced imaging examination method currently, and is mainly used for tumor screening, differential diagnosis of benign and malignant tumors, staging and grading. This paper proposes a method for breast cancer lesion segmentation based on PET/CT bimodal images, and designs a dual-path U-Net framework, which mainly includes three modules: encoder module, feature fusion module and decoder module. Among them, the encoder module uses traditional convolution for feature extraction of single mode image; The feature fusion module adopts collaborative learning feature fusion technology and uses Transformer to extract the global features of the fusion image; The decoder module mainly uses multi-layer perceptron to achieve lesion segmentation. This experiment uses actual clinical PET/CT data to evaluate the effectiveness of the algorithm. The experimental results show that the accuracy, recall and accuracy of breast cancer lesion segmentation are 95.67%, 97.58% and 96.16%, respectively, which are better than the baseline algorithm. Therefore, it proves the rationality of the single and bimodal feature extraction method combining convolution and Transformer in the experimental design of this article, and provides reference for feature extraction methods for tasks such as multimodal medical image segmentation or classification.

Clinical, functional and imaging parallels in the objective status of patients after community-acquired COVID-19-associated pneumonia

OBJECTIVE. To determine the dynamics of clinical symptoms in patients with community-acquired COVID-19-associated pneumonia, imaging and functional examination methods in the early post-acute period of the disease, establishing clinical, functional and imaging parallels in the objective status of patients.&#x0D; MATERIALS AND METHODS. We examined 56 patients after coronavirus disease (COVID-19). The severity of dyspnoea, anamnesis, objective status, pulse oximetry, lung ultrasound (LUS), computed tomography (CT) data, spirometry, body plethysmography, lung diffusion capacity were assessed. Non-parametric methods were used.&#x0D; RESULTS AND DISCUSSION. According to LUS 6 (10.7 %) patients had no pathological changes. Other patients had changes ranging from 3 to 11 points; 24 (48.0 %) had mild interstitial lung lesions, other – moderate. Every second patients showed signs of interstitial inflammation (single, multifocal, confluent B-lines), no more than three segments. Almost all patients (98.0 %) had single A-lines. LUSS was “recruited” mainly due to the LUS-pattern of consolidation (76.0 %) or thickened/ uneven pleura (90.0 %). The area of lung lesions on CT correlated with LUS (r=0.79; p&lt;0.001).&#x0D; CONCLUSIONS. LUS is a highly sensitive method for visualising interstitial changes in the lungs in the post-acute period after COVID-19-associated pneumonia. Most often, there are no impairments in lung ventilation function, but about 20 % of patients require further examination.

Comparison of three dimensional CT venography and ascending phlebography based on propensity score matching in the evaluation of recurrent varicose veins

Objective: To compare the efficacy of lower extremity three dimensional CT venography (CTV) and lower extremity ascending phlebography in evaluating recurrent varicose veins. Methods: A retrospective analysis was conducted on clinical data from 235 patients with unilateral recurrent varicose veins who were treated at the Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University, between January 2015 and December 2020.There were 112 males and 123 females, with an age of (62.5±11.4)years (range:24 to 75 years).Patients were stratified into two groups based on preoperative imaging examination:the CTV group (utilizing lower extremity venous ultrasound+lower extremity CTV) and the control group (employing lower extremity venous ultrasound+lower extremity ascending phlebography).The two groups were matched in a 1∶1 ratio using propensity score matching, resulting in 43 cases per group.Comparative analyses between the groups at the one-year postoperative follow-up were performed using independent sample t tests, Wilcoxon rank-sum tests, χ2 tests, and linear regression analysis. Results: One year post-surgery,the CTV group exhibited a lower venous clinical severity score (VCSS) compared to the control group(M(IQR),3.0(4.3) vs.4.0(5.8),Z=-2.038,P=0.040).Additionally, the chronic venous insufficiency patients' quality of life questionnaire (CIVIQ-20) scores were significantly higher in the CTV group than in the control group (89.0(8.0) vs.82.5(17.0), Z=-2.627, P=0.010).Patients in the CTV group also experienced a shorter ulcer healing time compared to the control group (4.0(4.0) weeks vs.12.0(7.0) weeks, Z=-3.217,P<0.01).Both groups showed no clinically symptomatic recurrent varicose veins or ulcers.However, they exhibited ultrasound-detectable varicose vein recurrence, with no statistically significant difference (χ2=0.453,P=0.500).The number of diseased vessels requiring management based on ultrasound supplemented by CTV was 16, while the number supplemented by ascending phlebography was 7,with a statistically significant difference (χ2=4.800,P=0.030).Linear regression analysis demonstrated that clinical-etiology-anatomy-pathology clinical grading and the preoperative imaging examination method exerted independent influences on VCSS and CIVIQ-20 during the one-year postoperative assessment. Conclusions: CTV-assisted ultrasound enables a direct and comprehensive evaluation and localization of diseased veins in patients with recurrent varicose veins.The utilization of lower extremity vein ultrasound combined with CTV-guided management of lower extremity vessels in minimally invasive treatment significantly improves patient prognosis, surpassing the assessment provided by ascending phlebography.

Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity (2023 edition)

Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors. With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity (CTR-CVT) in tumor patients, noninvasive imaging technologies play pivotal roles in the risk stratification, early diagnosis, monitoring and follow-up for CTR-CVT. In recent years, the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies, with several pertinent guidelines and expert consensus documents issued in China and abroad. However, there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology. Therefore, the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology, the Ultrasound Branch of the Chinese Medical Association, and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity". Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad, and in conjunction with data derived from evidence-based medical research in China, this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT, aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.

Research advances in imaging techniques related to the diagnosis of pneumoconiosis

Occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) is the most harmful occupational disease in China. According to the current standard GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis, pneumoconiosis is mainly diagnosed and staged by high kilovolt or digital radiography. Chest radiography in pneumoconiosis is the most widely studied and mature imaging technique in the diagnosis of pneumoconiosis. However, this technique has some limitations in the screening of some early pneumoconiosis and occupational health examination, and there is a certain risk of missed diagnosis and misdiagnosis. With the continuous development of imaging examination technology, computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography and artificial intelligence technology as auxiliary imaging examination methods have shown different diagnostic values in the research of auxiliary diagnosis of pneumoconiosis. This paper summarizes the advantages and problems in the application of various kinds of imaging techniques, which provides a direction for the future research of imaging techniques related to the diagnosis of pneumoconiosis.

Hyaline and Cystic Degeneration of Uterine Leiomyomas: CT and MR Imaging with Histopathological Sample Analyses.

Leiomyomas are the most common solid benign uterine neoplasms; they are usually asymptomatic and are identified incidentally. Yet, responsive to stimulation by estrogens, leiomyomas may expand, potentially outgrowing their blood supply to undergo hemorrhage, fibrosis, calcification, and atrophy. These pathologic mechanisms commonly lead to leiomyomas degeneration, i.e., red, hyaline, cystic, or myxoid. Magnetic resonance (MR) imaging is the most accurate imaging technique for the characterization of leiomyomas. In cases of degeneration, variable features on T2-weighted and contrast-enhanced images can be found. With no recent radiologic pathologic correlation literature available on this matter, herewith, we provide computed tomography (CT)/MR imaging along with histopathological specimens of two young women who were diagnosed with hyaline or hyaline and cyst degeneration of uterine leiomyomas at our university hospital. We report on the imaging features of uterine leiomyomas using CT and MR imaging and discuss the available literature on imaging signs that may be suggestive of hyaline or cyst degeneration using either of the imaging examination methods.

Imaging features of concurrent scirrhous hepatocellular carcinoma and primary clear cell carcinoma of the liver: A case report and literature review

Multiple lesions commonly appear in the liver of patients with hepatocellular carcinoma (HCC), and the prognosis is associated with the subtype. However, simultaneous occurrence of scirrhous HCC (SHCC) and primary clear cell carcinoma of the liver (PCCCL) has not been reported to date. The diagnosis of SHCC and PCCCL is uncommon using the traditional imaging examination methods such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging. We herein summarize the imaging features of SHCC and PCCCL to provide a reference for accurate preoperative diagnosis and appropriate treatment. A 55-year-old male was diagnosed with two hepatic tumors by the US examination. On the 2nd day after the US examination, he was diagnosed with HCC with intrahepatic metastasis by enhanced CT examination. His alpha-fetoprotein level was 3272 ng/mL (reference range, 0–7 ng/mL). Two weeks after enhanced CT examination, the patient underwent hepatectomy and cholecystectomy. Pathological examination showed that the tumor in liver segments 2 and 3 was SHCC and that the tumor in liver segment 4 was PCCCL. One year postoperatively, digital subtraction angiography showed no obvious tumor staining. Five years postoperatively, enhanced CT examination showed no recurrence or metastasis. Radiologists usually diagnose multiple tumors in the liver as malignant tumors with intrahepatic metastasis. Simultaneous occurrence of SHCC and PCCCL in the liver is occasionally found. The US imaging features, CT enhancement types, and location of the tumors can help radiologists to accurately diagnose SHCC and PCCCL, allowing clinicians to choose appropriate treatment.

Clinicopathological features and differential diagnosis of gastric metastases

ObjectiveDue to the rarity and non-specificity of symptoms, gastric metastases are often misdiagnosed, and patients are not treated promptly. The aim of this study was to study the clinicopathological features and differential diagnosis of gastric metastases.MethodsFrom 2004 to 2021, 14 patients were diagnosed with gastric metastases not resulting from direct invasion (GMNDI) in our hospital, and their imaging and clinicopathological features were analyzed.ResultsPET-CT examination showed hypermetabolic nodules in the stomach. Under gastroscopy, GMNDI showed eminence, nodular or vegetable pattern mass, and ulcer. Microscopically, GMNDI showed similar pathological features and immunophenotypes to the primary tumor. In our study, the most common primary tumors were malignant melanoma (4 cases), small cell lung cancer (3 cases), and hepatocellular carcinoma (3 cases). Immunohistochemistry contributed to the pathological diagnosis and differential diagnosis of gastric metastases. Malignant melanoma expressed HMB45, MelanA, and S-100; small cell lung cancer expressed TTF-1, CD56, and CgA; hepatocellular carcinoma expressed GPC-3, hepatocyte, and Sall4. In a few cases, tumor cells may lose immune markers during metastasis. Therefore, it is necessary to combine medical history, imaging examination, and other clinical diagnosis methods in the pathological diagnosis.ConclusionAn in-depth understanding of GMNDI is conducive to better diagnosis and treatment planning for gastric metastases and subsequent improvement in patient prognosis.

OrthopedVR: clinical assessment and pre-operative planning of paediatric patients with lower limb rotational abnormalities in virtual reality

Rotational abnormalities in the lower limbs causing patellar mal-tracking negatively affect patients’ lives, particularly young patients (10–17 years old). Recent studies suggest that rotational abnormalities can increase degenerative effects on the joints of the lower limbs. Rotational abnormalities are diagnosed using 2D CT imaging and X-rays, and these data are then used by surgeons to make decisions during an operation. However, 3D representation of data is preferable in the examination of 3D structures, such as bones. This correlates with added benefits for medical judgement, pre-operative planning, and clinical training. Virtual reality can enable the transformation of standard clinical imaging examination methods (CT/MRI) into immersive examinations and pre-operative planning in 3D. We present a VR system (OrthopedVR) which allows orthopaedic surgeons to examine patients’ specific anatomy of the lower limbs in an immersive three-dimensional environment and to simulate the effect of potential surgical interventions such as corrective osteotomies in VR. In OrthopedVR, surgeons can perform corrective incisions and re-align segments into desired rotational angles. From the system evaluation performed by experienced surgeons we found that OrthopedVR provides a better understanding of lower limb alignment and rotational profiles in comparison with isolated 2D CT scans. In addition, it was demonstrated that using VR software improves pre-operative planning, surgical precision and post-operative outcomes for patients. Our study results indicate that our system can become a stepping stone into simulating corrective surgeries of the lower limbs, and suggest future improvements which will help adopt VR surgical planning into the clinical orthopaedic practice.

Clinical Comparative Study of Different Fundus Imaging Methods in the Acute Phase of Vogt-Koyanagi-Harada Disease.

Background The diversification of follow-up ophthalmic imaging examination methods, and whether there are differences in clinical characteristics of VKH at the acute stage under different images. Our study aims to compare the imaging characteristics of the acute phase of Vogt-Koyanagi-Harada disease (VKH) under different fundus imaging methods to deepen clinical knowledge. Methods A retrospective case study was performed on fundus images of 62 eyes from 31 patients with acute phase VKH and a disease duration ≤2 months who were treated at Ganzhou People's Hospital from January 2013 to December 2020. Fundus photography (FP), optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) were performed on all 62 eyes. The fundus presentations were divided into an optic disc swelling (ODS) group, a serous retinal detachment (SRD) group, and a mixed type (MT) group (both ODS and SRD), and the proportions of patients in these groups and the coincidence rate of ODS, SRD, and MT identified by the three fundus imaging modes were determined. Results The proportion of patients with ODS was highest under FP, and the proportion of patients with MT was highest under OCT. The proportions of patients with ODS and MT in the three fundus imaging modes differed significantly (P < 0.05), while the proportion of patients with SRD did not (P > 0.05). The proportion of patients with subretinal fluid with positive OCT results was significantly higher than those with positive FFA results (81.08% vs. 59.46%) (P < 0.05). Conclusion Clinically significant positive signs could be obtained for acute VKH under different imaging methods. However, compared with FP and FFA, OCT tomography is more intuitive for the observation of lesions.

Deep Learning for Bone Mineral Density and T-Score Prediction from Chest X-rays: A Multicenter Study.

Although the number of patients with osteoporosis is increasing worldwide, diagnosis and treatment are presently inadequate. In this study, we developed a deep learning model to predict bone mineral density (BMD) and T-score from chest X-rays, which are one of the most common, easily accessible, and low-cost medical imaging examination methods. The dataset used in this study contained patients who underwent dual-energy X-ray absorptiometry (DXA) and chest radiography at six hospitals between 2010 and 2021. We trained the deep learning model through ensemble learning of chest X-rays, age, and sex to predict BMD using regression and T-score for multiclass classification. We assessed the following two metrics to evaluate the performance of the deep learning model: (1) correlation between the predicted and true BMDs and (2) consistency in the T-score between the predicted class and true class. The correlation coefficients for BMD prediction were hip = 0.75 and lumbar spine = 0.63. The areas under the curves for the T-score predictions of normal, osteopenia, and osteoporosis diagnoses were 0.89, 0.70, and 0.84, respectively. These results suggest that the proposed deep learning model may be suitable for screening patients with osteoporosis by predicting BMD and T-score from chest X-rays.

Image Recognition of Pediatric Pneumonia Based on Fusion of Texture Features and Depth Features.

Pneumonia is one of the diseases that seriously endangers human health, and it is also the leading cause of death of children under the age of five in China. The most commonly used imaging examination method for radiologists is mainly based on chest X-ray images. Still, imaging errors often result during imaging examinations due to objective factors such as visual fatigue and lack of experience. Therefore, this paper proposes a feature fusion model, FC-VGG, based on the fusion of texture features (local binary pattern LBP and directional gradient histogram HOG) and depth features. The model improves model performance by adding detailed information in texture features to the convolutional neural network while making the model more suitable for clinical use. We input the X-ray image with texture features into the modified VGG16 model, C-VGG, and then add the Add fusion method to C-VGG for feature fusion so that FC-VGG is obtained, so FC-VGG has texture features detailed information and abstract information of deep features. Through experiments, our model has achieved 92.19% accuracy in recognizing children's pneumonia images, 93.44% average precision, 92.19% average recall, and 92.81% average F1 coefficient, and the model performance exceeds existing deep learning models and traditional feature recognition algorithms.

Clinical epidemiological survey of primary liver cancer in Yunnan province from 2005 to 2014

Objective: To investigate the clinical characteristics and changing trends of primary liver cancer in Yunnan province from 2005 to 2014, in order to provide theoretical basis for the prevention and treatment of liver cancer in this region. Methods: A retrospective survey was used to select inpatient cases of liver cancer who were initially diagnosed and treated in our hospital from 2005 to 2014 with simple random sampling. Patients socio-demographic and clinicopathological characteristics were extracted by a unified and standardized questionnaire, and the data were statistically analyzed. Results: A total of 1000 cases with liver cancer were included, aged (53.2±11.2) years, with a male-to-female ratio of 5.99/1.00. There was no significant change in the gender and age composition ratio of patients in the past 10 years. The proportion of patients with lower education level (primary or junior high school) were increased from 21.8% to 23.4%, and the proportion of patients with relatively higher education level were decreased from 58% to 38.2% (P<0.001). Smokers and non-smokers patients were decreased and increased from 58.8% to 44.4%, and 41.2% to 55.6% (P<0.001). The proportion of drinker patients were decreased from 46.4% to 35.2%. The proportion of patients with advanced liver cancer (stage C and D) were increased, while the proportion of patients with stage A and B showed a downward trend (P<0.001). The proportion of HBsAg-positive patients showed an upward trend, that is, rising from 69% in 2005 to 82% in 2014 (P=0.043). The proportion of HBeAg-positive patients showed a steady trend (P=0.008). The use rate of ultrasound examination in patients with liver cancer were decreased from 91.0% to 58.0% (P=0.001), while the use rate of computed tomography (CT), MRI, and PET/CT examinations were increased from 81.0% to 84.0% (P=0.05), 0 to 22% (P<0.001), and 0 to 3% (P=0.026) between 2005 to 2014. The proportion of surgical patients were increased (P=0.005), but the proportion of interventional patients did not change significantly (P=0.590). Surgery and interventional therapy were the most common treatment methods, and the proportion of patients treated with surgery over the past 10 years showed an upward trend (P=0.005), while the proportion of interventional therapy remained at a high level with no significant change (P=0.590). Conclusion: In Yunnan province, the incidence of liver cancer increases with age, and the proportion of male with liver cancer is almost six times that of women. Moreover, the low positive rate of alpha-fetoprotein levels and advanced clinical stage in this region are presently the main challenges against the liver cancer prevention and treatment. The application scope of CT, magnetic resonance imaging, PET-CT and other examination methods has gradually expanded, but the treatment methods are still mainly surgery and interventional therapy.