Imaging Signs Research Articles

Commodity Wi-Fi-Based Wireless Sensing Advancements over the Past Five Years

With the compelling popularity of integrated sensing and communication (ISAC), Wi-Fi sensing has drawn increasing attention in recent years. Starting from 2010, Wi-Fi channel state information (CSI)-based wireless sensing has enabled various exciting applications such as indoor localization, target imaging, activity recognition, and vital sign monitoring. In this paper, we retrospect the latest achievements of Wi-Fi sensing using commodity-off-the-shelf (COTS) devices from the past 5 years in detail. Specifically, this paper first presents the background of the CSI signal and related sensing models. Then, recent studies are categorized from two perspectives, i.e., according to their application scenario diversity and the corresponding sensing methodology difference, respectively. Next, this paper points out the challenges faced by Wi-Fi sensing, including domain dependency and sensing range limitation. Finally, three imperative research directions are highlighted, which are critical for realizing more ubiquitous and practical Wi-Fi sensing in real-life applications.

A rare case of lumbar facet fracture-dislocation and review of the literature.

Lumbar facet fracture-dislocation is rare, often due to hyperflexion with rotational force. Abnormal scoliosis on radiography is a key sign, prompting further imaging. Facetectomy and laminectomy ensure safe reduction, while instrumented fusion is an effective surgical treatment. Traumatic lumbar facet dislocation is an uncommon condition, particularly when unilateral lumbar facet dislocation is accompanied by a contralateral facet fracture. The patient had a locked facet joint at the left L4-L5, a fracture of the right superior articular process of L5 and a comminuted fracture at the peritrochanteric region of the right femur following a fall. Emergent operation was conducted, starting with open reduction and fixation for the right proximal femur, followed by posterior open reduction and posterolateral fusion with instrumentation, without interbody fusion, for the lumbar spine injury. The patient exhibited positive outcomes throughout the follow-up. This article highlights the trauma mechanism of lumbar facet dislocation, emphasizing hyperflexion with rotational force. Abnormal local scoliosis is a distinctive imaging sign of facet joint dislocation. Facetectomy and laminectomy are recommended for safe reduction and instrumented fusion is considered a safe and effective surgical treatment for facet joint dislocation injuries.

Primary hyperoxaluria type 3: from infancy to adulthood in a genetically unique cohort.

Primary hyperoxaluria type 3 (PH3) is a rare autosomal recessive disorder caused by bi-allelic genetic variants in the 4 hydroxy-2 oxoglutarate aldolase (HOGA-1) gene. We report the natural history of PH3 in a 16-patient cohort, 15 from a unique genetically isolated population. This retrospective single-center study followed PH3 patients between 2003 and 2023 with demographic, clinical, radiographic, genetic, and biochemical parameters. Genetic population screening was performed in four villages to determine carrier frequency and identify couples at risk in a genetically isolated population. Sixteen patients with biallelic (or homozygous) pathogenic variants (PV) in HOGA-1 (c.944_946 del, c.119C > A, c.208C > T) were included in the study, 15 Druze and one Jewish, aged 0-63years at diagnosis (4 adults and 12 pediatric patients). All symptomatic patients had clinical or imaging signs of nephrolithiasis. One developed chronic kidney disease (CKD) stage 5; biopsy showed focal mesangial sclerosis and chronic tubulo-interstitial changes with few oxalate deposits. Two other patients had CKD stage 2 (eGFR 87 and 74mL/min/1.73m2) upon their last visit. The remaining cohort showed preserved kidney function until the latest follow-up. Of 1167 healthy individuals screened, 90 carriers were found, a rate of 1:13 in the genetically unique cohort screened. A high prevalence of PH3 patients was found among a unique cohort, but probably still underdiagnosed due to relatively mild disease course. The carrier rate is high. There is no specific therapy for PH3, but early diagnosis can prevent redundant diagnostic efforts and provide early treatment for kidney stone disease. Even in our homogeneous cohort, kidney stone disease severity and CKD degree were variable, supporting a suspected contribution of yet unknown genetic or environmental factors.

Cardiac magnetic resonance T1 imaging for the diagnosis of cardiac amyloidosis among patients with symptomatic heart failure

Abstract Background Cardiac amyloidosis (CA) is a significant cause of heart failure in elderly patients. However, specific signs in cardiac imaging are lacking, hence bone scintigraphy in combination with screening for monoclonal protein, or myocardial biopsy is required for the diagnosis. Cardiac magnetic resonance (CMR) imaging with T1 mapping is a promising diagnostic tool, which may allow to differentiate causes of left ventricular (LV) hypertrophy, particularly CA. Purpose The aim of this study was to test the diagnostic accuracy of T1 mapping for the diagnosis of CA in elderly patients with symptomatic heart failure and red flags for CA. Methods We prospectively enrolled 120 patients aged above 60 years with symptomatic heart failure NYHA II-IV, LV ejection fraction ≥ 40%, increased LV wall thickness of ≥ 12 mm end-diastolic on echocardiography, and elevated cardiac biomarkers (N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥ 1,000 ng/L, high-sensitivity cardiac troponin T (hs-cTnT) ≥ 14 ng/L). All patients underwent standardized quantitative CMR with a 3.0T scanner. 99mTc-DPD bone scintigraphy, blood screening for monoclonal protein, and, where applicable, cardiac biopsy, were performed as reference methods in all patients. Primary endpoint was diagnostic accuracy of native T1 mapping for the diagnosis of CA. Results 112 patients were included in the final analysis. Median age was 81.0 years (interquartile range 74.0–85.0 years), and 45% were female. CA was diagnosed in 38 patients (34%), of which 32 suffered from a Transthyretin (ATTR) and 6 patients from light chain (AL) amyloidosis. The areas under the receiver operating characteristic curves for native T1 were 0.713, 0.772, 0.836 for global, septal short-axis (SAX), and septal 4-chamber (4Ch) view measurements. The corresponding value of extracellular volume fraction (ECV) was 0.904 (Figure 1). Based on these results, we developed a new diagnostic algorithm for the diagnosis of CA including T1 septal 4Ch and ECV, with a sensitivity and positive predictive value of both 92.9% and a specificity and negative predictive value of 95.8% (Figure 2). Thereby, contrast application can be avoided in 33% of patients. A definite diagnosis could be provided in 81%. Conclusion CMR with T1 imaging provides a high diagnostic accuracy to diagnose CA in patients with symptomatic heart failure at risk for CA. These data may help to identify underlying causes in heart failure which require specific treatment. An earlier diagnosis of CA may improve outcome of these patients.Figure 1Figure 2

Imaging signs of carotid plaque vulnerability predict subclinical neurological events in asymptomatic patients: the carotid artery multi-modality imaging prognostic study

Abstract Background Carotid artery plaques should be considered for invasive treatment if diameter stenoses is ≥60%, in the presence of clinical and/or imaging characteristics associated with an increased risk of ipsilateral stroke, such as intraplaque haemorrhage (IPH) or lipid-rich necrotic core (LRNC). However, little is known about plaque’s characteristics in patients with <60% stenoses. Purpose To evaluate the prevalence and significance of imaging signs of plaque vulnerability in patients with asymptomatic <60% carotid artery stenoses. Methods In the Carotid Artery Multi-modality imaging Prognostic (CAMP) study (granted by Bando Ricerca Salute 2018 - Regione Toscana) we prospectively enrolled 200 patients with asymptomatic, mild/moderate (40-60%) carotid artery stenoses, as assessed at Doppler ultrasound (DUS). All patients were evaluated with multimodality imaging, including computed tomography angiography (CTA), magnetic resonance angiography (MRA) and brain magnetic resonance imaging (MRI), whenever not contraindicated. A subgroup of 75 patients underwent also a 18[F]-fluorodeoxyglucose (FDG) positron emission tomography (PET). A thorough clinical, biochemical, cardiological and neurological evaluation was performed in all patients. Results Imaging signs of plaque vulnerability were frequent (IPH and/or LRNC at MRA were found in 26.3% patients, plaque ulceration at CTA was found in 36.7% of patients). No difference in the prevalence of cardiovascular risk factors was noted in those with and without signs of vulnerability. Subclinical embolic brain infarctions at brain MRI were found in 8.8% of patients at enrollment. These patients had more frequently a LRNC at MRA than patients without subclinical embolic brain infarctions (50% vs 17%, p<0.05), lower estimated glomerular filtration rate (55±8 vs 73±23 mL/min/1.73mq, p<0.001), higher troponin HS values (16±4 vs 12±8 ng/ml, p<0.05). Presence of LRNC at MRA was the only predictor of embolic lesions at MRI (odds ratio 4.86, 95% confidence interval 1.08-21.8, p<0.05). Conclusions Imaging signs of vulnerability are highly prevalent in patients with asymptomatic intermediate carotid artery stenosis. Presence of a LRNC at MRA is associated with subclinical embolic brain infarcts. The use of non-invasive multi-imaging can better characterize carotid plaques, independent of the degree of stenosis, and help identifying a subgroup of patients at higher risk of events.

The polar vessel sign: insights from CT imaging analysis in Asian Indian primary hyperparathyroidism.

Data on the polar vessel sign (enlarged feeding vessel terminating in parathyroid lesions) on four-dimensional computed tomography (4D-CT) is limited. We performed a retrospective analysis to determine the prevalence, predictors, and adjunctive utility of polar vessel sign in pre-operative 4D-CT of patients with primary hyperparathyroidism (PHPT). One radiologist blinded to the patients' details reported the 4D-CT of eighty-four operated patients with histopathology-proven single-gland PHPT. Two protocols were used to obtain arterial-phase images: timed via bolus tracking (n = 41) or fixed at 20 s after contrast injection (n = 43). Seventy-one patients were symptomatic for PHPT, with median serum calcium 12.1 mg/dL. On the arterial phase of 4D-CT, 88.1% of lesions had the polar vessel sign, including 7/9 asymptomatic patients, 6/6 parathyroid carcinomas, and 3/4 ectopic(1:mediastinum, 2:thyro-thymic ligament). Predictors of polar vessel sign were maximum lesion dimension (2.2 vs. 1.4 cm; P = 0.03), solid-cystic CT morphology (47.3% vs. none; P = 0.004), and bolus tracking-timed arterial phase (55.4% vs. none; P = 0.001). Of these, bolus tracking improved the polar vessel's visualization (100% vs. 76.7%; P = 0.001) independent of lesion dimension and solid-cystic morphology. The latter two predicted polar vessel sign in images obtained at a fixed interval (20 s). A significantly lower proportion of bolus tracking-timed scans had lesion percentage arterial enhancement (PAE) < 128.9% (2/41 vs. 9/43; P = 0.04). Even with suboptimal PAE, the polar vessel helped identify 9/11 lesions. The polar vessel sign demonstrated an additive role to PAE during CT reporting. Bolus tracking is valuable in optimizing vessel and tumor arterial enhancement and is easily incorporated into parathyroid 4D-CT protocol.

Clinical characteristics of HIV-associated tracheobronchial Talaromyces marneffei infection in seven patients in Guangxi, China.

Tracheobronchial Talaromyces marneffei (T. marneffei) infections among HIV-infected patients are rare. To improve understanding, we analyzed the clinical features, immune mechanisms, treatment, and prognosis of these patients. We collected clinical information from HIV-positive patients with talaromycosis admitted to the Fourth People's Hospital of Nanning from January 2015 to June 2022. Patients who presented with culture and/or histopathological proof of tracheobronchial T. marneffei infection were included. A total of 108 patients with respiratory infections who underwent bronchoscopy were enrolled. Seven patients with tracheobronchial T. marneffei infection, all of whom were men with a median age of 48 years (range 39-50 years), were analyzed. Cough, sputum, fever, and weight loss were the most common symptoms. The total white blood cell count was normal or decreased, and all lymphocyte counts were decreased. All patients had reduced CD4+ T-cell counts, with values less than 50 cells/µL. The chest CT imaging signs included patchy signals or large areas of exudation, bronchial stenosis and occlusion. This was different from the lack of bronchial involvement. Endoscopically, the trachea and bronchial mucosa showed congestion, edema, surface attachment, nodules, lumen stenosis, obstruction, etc. T. marneffei spores were found via bronchial mucosal pathology in all 7 patients. Five patients were initially treated with intravenous infusion of amphotericin B for 2 weeks, followed by oral itraconazole capsules (200mg) twice daily, and two patients were initially treated with itraconazole. Six patients were remission, and 1 died. The clinical features of trachea invasion and nontracheal invasion are not unique, but chest CT reveals manifestations such as masses, solid shadows, and bronchial stenosis/obstruction. Bronchoscopy should be performed if possible, and the presence or absence of trachea T. marneffei infection should be confirmed. Antiviral therapy combined with antifungal therapy can improve patient prognosis.

Malaysian Sign Language Detection with Convolutional Neural Network for Disabilities

Sign language is the main form of communication used by deaf people. Most of their activities like speaking and learning involved sign language. In Malaysia, instead of a deaf person, only a few people know sign language because it's not part of the co-curriculum. Hence, normal people need to know sign language so that they can communicate with deaf people effectively. However, learning sign language requires a lot of effort and takes years of study. Therefore, this research tends to initiate the sign language image detection system that utilizes the deep learning model. The initial effort involves the development of an image detection system that can identify the alphabet of sign language from A to Z. There will be 26 alphabets that contribute to 26 classes of image detection using the Convolutional Neural Network. 85 images will be collected for each alphabet and the total data will be distributed into 80% and 20% for training and testing the CNN model, respectively. The result showed that the proposed system produced more than 95% detection accuracy of the alphabet based on finger sign gestures. For future works, the proposed system will be evaluated with a more complex dataset in terms of words.

A series of cases of transthyretin amyloid cardiomyopathy with negative bone scintigraphy but a confirmed positive endomyocardial biopsy

BackgroundBone scintigraphy (BS) is established as an accurate, non-invasive method for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). In a real-life setting, however, some patients with no cardiac uptake on BS turn out to have cardiac-biopsy-confirmed ATTR-CM. We retrospectively included all patients diagnosed at the French Referral Center for ATTR-CM and who had data for BS and a cardiac biopsy.ResultsOf 271 patients with positive cardiac biopsy, 14 (5%) had no cardiac uptake on 99mTc-hydroxymethylene diphosphonate BS. Cardiac uptake was found in four of the seven patients who had a second BS assessment with 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD). A retrospective review of the BS data found low cardiac uptake in four patients (two with HMDP and two with both radiotracers). Ultimately, six of the 14 patients with a biopsy-confirmed diagnosis of ATTR-CM did not show any cardiac radiotracer uptake.ConclusionsAn endomyocardial biopsy may be necessary for confirming the diagnosis of ATTR-CM in patients with clinical and imaging signs of cardiac amyloidosis but no cardiac radiotracer uptake in BS.

Pregnancy-related intracranial venous sinus thrombosis secondary to cryptococcal meningoencephalitis: a case report and literature review

BackgroundCerebral venous sinus thrombosis (CVST), a serious cerebrovascular and neurological emergency, is common in pregnant individuals and accounts for approximately 0.5–1.0% of all cerebrovascular diseases. However, CVST with cryptococcal meningoencephalitis in immunocompetent pregnant patients is rare.Case presentationA 30-year-old woman who was 33 weeks pregnant presented with recurrent dizziness, headache, and vomiting as the main clinical manifestations, all of which were initially nonspecific. After assessment of the cerebrospinal fluid, skull computerized tomography, magnetic resonance imaging, and other laboratory and imaging examinations, the patient was diagnosed with secondary pregnancy-related CVST with cryptococcal meningoencephalitis. Despite receiving potent anticoagulant and antifungal treatment, the patient’s condition deteriorated, and the patient’s family opted to cease treatment.ConclusionsWe present a rare case of CVST with cryptococcal meningoencephalitis in an immunocompetent pregnant patient. The difficulty of diagnosing and treating secondary pregnancy-related CVST caused by cryptococcal meningoencephalitis, as well as the great challenges faced at present are highlighted. One crucial lesson from the present case is that when clinical and imaging signs are unusual for CVST during pregnancy, it is essential to account for the possibility of other central nervous system (CNS) diseases, such as CNS infections with Cryptococcus, which may cause CVST.

Enhancing radiologist's detection: an imaging-based grading system for differentiating Crohn's disease from ulcerative colitis

BackgroundDelayed diagnosis of inflammatory bowel disease (IBD) is common, there is still no effective imaging system to distinguish Crohn's Disease (CD) and Ulcerative Colitis (UC) patients.MethodsThis multicenter retrospective study included IBD patients at three centers between January 2012 and May 2022. The intestinal and perianal imaging signs were evaluated. Visceral fat information from CT images was extracted, including the ratio of visceral to subcutaneous fat volume (VSR), fat distribution, and attenuation values. The valuable indicators were screened out in the derivation cohort by binary logistic regression and receiver working curve (ROC) analysis to construct an imaging report and data system for IBD (IBD-RADS), which was tested in the validation cohort.ResultsThe derivation cohort included 606 patients (365 CD, 241 UC), and the validation cohort included 155 patients (97 CD, 58 UC). Asymmetric enhancement (AE) (OR = 87.75 [28.69, 268.4]; P < 0.001), perianal fistula (OR = 4.968 [1.807, 13.66]; P = 0.002) and VSR (OR = 1.571 [1.087, 2.280]; P = 0.04) were independent predictors of CD. VSR improved the efficiency of imaging signs (AUC: 0.929 vs. 0.901; P < 0.001), with a threshold greater than 0.97 defined as visceral fat predominance (VFP). In IBD-RADS, AE was the major criterion, VFP and perianal fistula were auxiliary criteria, and intestinal fistula, limited small bowel disease, and skip distribution were special favoring items as their 100% specificity. Grade 3 to 5 correctly classified most CD patients (derivation: 96.5% (352/365), validation: 98.0% (95/97)), and 98% of those were eventually diagnosed with CD (derivation: 97.8% (352/360), validation: 98.0% (95/97)).ConclusionsIBD-RADS can help radiologists distinguish between CD and UC in patients with suspected IBD.

Imaging characteristics of hip joint microinstability: a case-control study of hip arthroscopy patients.

Hip microinstability is a clinical entity increasingly recognized and treated but challenging to diagnose with a lack of objective criteria. This study assessed the prevalence and diagnostic accuracy of different imaging findings for hip microinstability on radiograph and MR. A retrospective case-control study of 224 hips treated with arthroscopic surgery by a single orthopedic surgeon, 112 hips with clinical microinstability and 112 controls without. Pre-operative radiograph and MRI/MRA imaging were evaluated by two musculoskeletal radiologists to assess morphological parameters and imaging signs reportedly associated with hip microinstability. Four imaging features reached significance as predictors of microinstability via three-step logistic regression: labral hyperplasia and decreased lateral center edge angle on MR (OR 2.45 and 0.93, respectively) and the absence of positive ischial spine sign and absence of osteophytes on radiographs (OR 0.47 and 0.28, respectively). Increased acetabular anteversion and absence of cam lesions were more likely in the microinstability group (p = 0.02 and 0.04, respectively), but not independent predictors. Labral tears, chondral loss, abnormal ligamentum teres, anterior capsule thinning, iliocapsularis to rectus femoris ratio, posterior crescent sign, cliff sign, and femoro-epiphyseal acetabular roof (FEAR) index were not associated with microinstabillity. Imaging features may be predictive of hip microinstability in some cases. Decreased LCEA, increased acetabular anteversion, and labral hyperplasia were associated with microinstability in this study, while many other published imaging findings were not. Imaging remains complementary, but not definitive, in the diagnosis of hip microinstability.

Deep learning-based characterization of pathological subtypes in lung invasive adenocarcinoma utilizing 18F-deoxyglucose positron emission tomography imaging

SummaryObjectiveTo evaluate the diagnostic efficacy of a deep learning (DL) model based on PET/CT images for distinguishing and predicting various pathological subtypes of invasive lung adenocarcinoma.MethodsA total of 250 patients diagnosed with invasive lung cancer were included in this retrospective study. The pathological subtypes of the cancer were recorded. PET/CT images were analyzed, including measurements and recordings of the short and long diameters on the maximum cross-sectional plane of the CT image, the density of the lesion, and the associated imaging signs. The SUVmax, SUVmean, and the lesion's long and short diameters on the PET image were also measured. A manual diagnostic model was constructed to analyze its diagnostic performance across different pathological subtypes. The acquired images were first denoised, followed by data augmentation to expand the dataset. The U-Net network architecture was then employed for feature extraction and network segmentation. The classification network was based on the ResNet residual network to address the issue of gradient vanishing in deep networks. Batch normalization was applied to ensure the feature matrix followed a distribution with a mean of 0 and a variance of 1. The images were divided into training, validation, and test sets in a ratio of 6:2:2 to train the model. The deep learning model was then constructed to analyze its diagnostic performance across different pathological subtypes.ResultsStatistically significant differences (P < 0.05) were observed among the four different subtypes in PET/CT imaging performance. The AUC and diagnostic accuracy of the manual diagnostic model for different pathological subtypes were as follows: APA: 0.647, 0.664; SPA: 0.737, 0.772; PPA: 0.698, 0.780; LPA: 0.849, 0.904. Chi-square tests indicated significant statistical differences among these subtypes (P < 0.05). The AUC and diagnostic accuracy of the deep learning model for the different pathological subtypes were as follows: APA: 0.854, 0.864; SPA: 0.930, 0.936; PPA: 0.878, 0.888; LPA: 0.900, 0.920. Chi-square tests also indicated significant statistical differences among these subtypes (P < 0.05). The Delong test showed that the diagnostic performance of the deep learning model was superior to that of the manual diagnostic model (P < 0.05).ConclusionsThe deep learning model based on PET/CT images exhibits high diagnostic efficacy in distinguishing and diagnosing various pathological subtypes of invasive lung adenocarcinoma, demonstrating the significant potential of deep learning techniques in accurately identifying and predicting disease subgroups.

Inter-rater Reliability of the Reflux Sign Assessment-10 (RSA-10)

ObjectiveTo evaluate the interrater reliability and internal consistency of the Reflux Sign Assessment-10 (RSA-10) among otolaryngologists and speech therapists with various experiences. MethodsSix experts (2 otolaryngologists, 2 speech-therapists, and 2 speech-therapist students) rated 300 clinical images of oral, laryngeal, and pharyngeal signs from patients with LPRD diagnosis at the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring. Interrater reliability and internal consistency were evaluated with Intraclass Correlation (ICC) and Cronbach-α. The severity of scores was compared between judges. The intra-rater (test-retest) reliability was evaluated with the Spearman correlation coefficient. ResultsThe pictures of 40 patients were included. There were 18 females and 22 males. The mean age was 52.6±13.9 years. The Cronbach-α was 0.854, which indicates a high internal consistency between judges. The overall ICC was 0.787 (95% CI: 0.715-0.845; p=0.001). The ICC varied among judges with the highest value for students (ICC=0.960) and SLP seniors versus students (ICC=0.805). The severity of RSA-10 rating scores was influenced by the number of reflux patients seen (rs=-0.941; p=0.001) and the number of fiberscope examinations performed (rs=-0.812; p=0.049). The RSA-10 was more severely scored by speech therapists with the least experience compared to otolaryngologists with the most experience in fiberscope/reflux patient assessment. ConclusionThe RSA-10 demonstrated adequate global ICC and internal consistency among otolaryngologists and speech therapists with various degrees of experience. The assessment of RSA was influenced by the fibroscopy experience, and the number of reflux patients seen.

Ramp Lesions with ACL Injuries Between MRI and Arthroscopic Evaluation.

To compare the accuracy of arthroscopy with MRI in diagnosing ramp lesions associated with anterior cruciate ligament (ACL) injuries. Prospective observational study. Material and Methods: We included 100 patients with complete ACL tear. 1) Partial ACL tear, 2) ACL revision surgery or previous knee surgery, 3) Multi-ligamentous knee injury, 4) Extensive medial meniscus tear. Results: Nine patients were diagnosed with ACL-associated ramp lesions. All nine had magnetic resonance imaging (MRI) signs, but these were not statistically significant ( 2=1.884, FEp=0.348). Mean medial meniscal slope for patients with ramp lesions was 2.88 +- 0.46, without was 2.47 +- 0.55 (T=2.146, P=0.034), implying statistical significance as visualized by arthroscopy. Arthroscopy is superior in diagnosing ramp lesions. Arthroscopy is superior in diagnosing ramp lesions due to cost-effectiveness, direct visualization, and immediate treatment capability. The absence of specific MRI signs for ramp lesions further supports this conclusion.

Prevalence and spectrum of manifestations of tamoxifen retinopathy as assessed by multimodal and ultra-widefield retinal imaging

Background/ObjectivesTamoxifen has well-known retinal toxicity, but the epidemiology of this toxicity is poorly defined. This study aims to 1) evaluate the prevalence of tamoxifen retinopathy in a major northeastern metropolitan area based on multimodal retinal imaging and 2) determine whether the additional peripheral retina captured in ultra-widefield (UWF) imaging aids in the diagnosis of tamoxifen retinopathy. MethodsThis retrospective cohort study examined female patients initiated on tamoxifen for at least 12 months prior to their first retinal exam. Two independent graders performed blinded review of spectral-domain optical coherence tomography (OCT) images for evidence of macular toxicity and UWF images for signs of central and peripheral toxicity. A one-tailed two-proportion Z-test determined whether peripheral pigmentary changes were more prevalent in the tamoxifen cohort than age- and gender-matched controls. Results241 eyes from 123 patients were included in the tamoxifen cohort, and 258 eyes from 132 patients were included in the control cohort. Two patients demonstrated definitive tamoxifen retinopathy, for a prevalence of 1.6%. One patient demonstrated crystalline maculopathy on OCT and UWF imaging, while another demonstrated pseudocystic cavitations on OCT imaging. Neither patient had peripheral findings on UWF imaging. Peripheral pigmentary changes were not significantly more prevalent in the tamoxifen cohort. ConclusionsThese findings suggest that UWF imaging does not contribute to diagnosis of tamoxifen retinopathy, and OCT may be the most valuable tool in diagnosing tamoxifen retinopathy. Our prevalence (1.6%) diverges from higher rates in studies screening with similarly advanced retinal imaging. Further large population studies are needed.

Imaging approach for fungal sinusitis.

This article provides a comprehensive review of the computed tomography (CT) and magnetic resonance (MR) imaging findings of invasive fungal sinusitis with an emphasis on pattern recognition and approach to interpretation. Fungal sinusitis is categorized into invasive (acute, chronic, and granulomatous) and noninvasive forms (allergic fungal sinusitis and mycetoma). CT is superior for detecting bony erosion and hyperdense fungal elements, while MRI excels in evaluating soft tissue and mucosal involvement. Key radiologic signs such as bone destruction, sinus wall thickening, and 'black turbinate sign' aid in early diagnosis, especially in invasive cases. Early imaging signs can be subtle. Early detection is necessary, particularly in immunocompromised patients with acute invasive fungal sinusitis, where rapid intervention is critical. Pattern recognition and adequate interpretation of fungal sinusitis are possible using CT and MRI. Imaging can also help identify complications, aiding with reliable diagnosis and prompt intervention.

Diagnostic Value of Pericholedochal Hypointense Ring Sign in MRI T2W Images in Cases of Pancreatic Ductal Adenocarcinoma.

To determine the value of hypointense pericholedocal ring sign in magnetic resonance imaging (MRI) T2W sequence images in the diagnosis of pancreatic ductal adenocarcinoma (PDA). Retrospective observational study. Place and Duration of the Study: Department of Radiology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkiye, from January 2016 and March 2022. Retrospective analysis of MRI scans was performed on 70 patients with postoperative histopathological confirmation of a diagnosis of periampullary cancer. The patients' demographic information, the results of their histopathological examinations, and the findings of their MRIs were recorded. The results of the MRI were statistically analysed and compared between the PDA and the non-PDA groups. The study included 43 (61.4%) male and 27 (38.5%) female patients, with a mean age of 62.2 ± 8.4 years. The means of Wirsung diameter and tumour diameter were significantly higher in PDA group (p = 0.034, p = 0.010, respectively). A progressive contrast enhancement pattern of 95.3% was observed in PDA group, while 40.7% rapid contrast enhancement pattern was observed in the non-PDA group. Hypointense pericholedochal ring sign, observed in T2W sequences, was detected in 74.2% (n = 32) of the PDA group and 11.1% (n = 3) of the non-PDA group, and the findings were statistically significant (p <0.001). Hypointense pericholedochal ring sign in axial T2W sequences in periampullary tumours is a complementary MRI finding in the distinction between the PDA and the non-PDA groups. Magnetic resonance imaging, Pancreatic ductal adenocarcinoma, Periampullary tumours, Pericholedochal ring sign.

Clinical Utility of Radiographic Signs in Neuroradiology

Several characteristic radiographic signs associated with various diseases are useful in neuroradiological practice; however, their clinical usefulness varies widely. This article presents some common signs and the associated pathological features, particularly those observed on computed tomography and magnetic resonance imaging or pathognomonic signs that are useful for accurate diagnosis, even in patients with rare diseases.

Dual-Mode Embedded Impulse-Radio Ultra-Wideband Radar System for Biomedical Applications.

This paper presents a real-time and non-contact dual-mode embedded impulse-radio (IR) ultra-wideband (UWB) radar system designed for microwave imaging and vital sign applications. The system is fully customized and composed of three main components, an RF front-end transmission block, an analog signal processing (ASP) block, and a digital processing block, which are integrated in an embedded system. The ASP block enables dual-path receiving for image construction and vital sign detection, while the digital part deals with the inverse scattering and direct current (DC) offset issues. The self-calibration technique is also incorporated into the algorithm to adjust the DC level of each antenna for DC offset compensation. The experimental results demonstrate that the IR-UWB radar, based on the proposed algorithm, successfully detected the 2D image profile of the object as confirmed by numerical derivation. In addition, the radar can wirelessly monitor vital sign behavior such as respiration and heartbeat information.