Lesion Clarity Research Articles

DESIGN AND ANALYSIS OF IODINE STAINING AND NBI IN THE DIAGNOSTIC MODEL AND DIAGNOSIS OF EARLY ESOPHAGEAL CANCER AND ITS PRECANCEROUS LESIONS

Objective: This study aimed to compare the differences between narrowband imaging (NBI) and Lugo’s iodine staining endoscopy (LCE) for detecting and elucidating the site, clarity, and diagnostic accuracy of early esophageal cancer and precancerous lesions. Methods: We included patients with a high risk of developing esophageal cancer who visited the Zhongjiang County People’s Hospital between October 2020 and October 2022. Endoscopic examination was performed on each study participant. White-light endoscopy was used to observe and locate the diseased mucosa, after which NBI mode and LCE staining were used to observe the boundary between the diseased and normal mucosa. Abnormal lesions were found, and biopsies were performed on the identifiable diseased parts for pathological examination. Inflammation, LGIN, HGIN, and early esophageal cancer were diagnosed, and the differences between them were compared in terms of the two enhanced-image endoscopy techniques. A semantic segmentation model based on deep learning was adopted to assist in the diagnosis of early esophageal cancer and accurately locate cancerous areas. In order to improve its accurate diagnostic rate, we also built a semantic segmentation network model to assist in the computer-aided diagnosis of early esophageal cancer. Results: A total of 69 cases of early esophageal cancer were included in this study. The patients were aged 40–75 years, with an average age of [Formula: see text] years. Most early esophageal cancer lesions were located in the middle of the esophagus in 45/69 (65.2%) cases. LCE obtained higher clarity of lesion boundaries than NBI (59.4% versus 45.0% and 27.7% versus 15.9%, respectively), and the proportion of unclear lesions was lower (8.6% versus 21.7% and 4.3% versus 17.4%, respectively; [Formula: see text]). For early esophageal cancer and precancerous lesions, the missed-diagnosis rate of white-light endoscopy was 20%, that of NBI was 3.15%, and that of LCE was 0%, with statistical significance ([Formula: see text]). The rate of missed diagnosis of LGIN (three cases) by NBI was 3.15%, which was not significantly different from that of LCE ([Formula: see text]). We found that the lesion area could be more accurately determined using deep learning models to segment NBI images. By constructing a deep learning model for the diagnosis and classification of esophageal cancer, its diagnostic rate rose to 99.5%. Conclusion: The age range of patients with early esophageal cancer in Zhongjiang County, Sichuan Province, was 40–75 years, and tumors mostly occurred in the middle of the esophagus. The boundary clarity of early esophageal carcinomas was higher on LCE than that on NBI. The diagnostic accuracies of NBI and LCE are much higher than those of conventional white-light endoscopy. Therefore, both LCE and NBI are helpful for detecting early esophageal cancer and precancerous lesions. Moreover, the diagnostic rate of clinical esophageal cancer can be effectively improved using a dedicated deep learning network model.

A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors

ObjectivesThis study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy.MethodsWe retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm2 and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1200 (rFOV-syDWIb=1200) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene’s test and Shapiro–Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann–Whitney U test.ResultsA higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWIb=1200/1500 compared to 13b-protocol rFOV-sDWIb=1200/1500 (p < 0.05). AUC of 5b-protocol syADCmean,b=1200/1500 and syADCminimum,b=1200/1500 was equal or higher than that of 13b-protocol sADCmean,b=1200/1500 and sADCminimum,b=1200/1500.ConclusionsrFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.

Traumatic Brain Magnetic Resonance Imaging Feature Extraction Based on Variable Model Algorithm in Stroke Examination.

The purpose of this study was to explore the diagnostic value of different sequence scanning of nonparametric variable model-based cranial magnetic resonance imaging (MRI) for ischemic stroke. A histogram analysis-based nonparametric variable model was proposed first, which was compared with the parametric deformation (PD) model and geometric deformation (GD) model. Then, 116 patients with acute ischemic stroke were selected as the research subjects. Routine MRI (T2WI, T1WI, FLAIR, DWI, SWI, and 3D TOF MRA) and MR SCALE-PWI were performed. The results showed that the nonparametric variable model algorithm was relatively complete in the actual segmentation results of MRI images, and the display clarity of lesions was better than PD and GD algorithms. The diagnostic sensitivity, specificity, and overall performance of the variable model algorithm were significantly higher than those of the other two algorithms (P < 0.05). According to ROC curve analysis, the AUC areas of DWI, SWI, 3D TOF MRA, and MR SCALE-PWI for the diagnosis of ischemic penumbra were 0.793, 0.825, 0.871, and 0.933, respectively. In summary, the segmentation results of MRI images by the nonparametric variable model based on histogram analysis were relatively complete, and the clarity of lesions was better than that of the traditional model. MRI images can effectively identify the occurrence of ischemic stroke. Moreover, MR SCALE-PWI had a good early identification effect on ischemic penumbra, which can reduce unnecessary treatment for patients.

Incremental Value of Post Diuretic 68Ga-PSMA-11 PET-CT in Characterization of Indeterminate lLesions in Prostate Cancer.

Objective:The aim of current study is to evaluate the role of diuretic assisted 68Ga-PSMA PET-CT, on image quality and clinical interpretation of indeterminate/equivocal lesions in pre-Lasix imaging of Prostate cancer. Materials and Methods:Forty-five patients underwent baseline 68Ga-PSMA-11 scan 45-60 minutes post tracer injection followed by post Lasix study after ±15 minutes. The contrast to noise ratios (CNR), noise and SUVmax were determined for the focal uptakes in both pre and post Lasix images. All continuous variables were expressed as mean ± SD. Images were assessed by two experienced physicians in order to evaluate lesion detectability and delineations that have an impact on clinical interpretation. Results:Of total 45 patients, 12/45 (27%) showed unremarkable scan along with 33/45 (73%) showing metastases. Sixteen out of 45 (36%) of the metastatic scans showed indeterminate/equivocal lesions. In these cases, post Lasix study showed false negative findings in 7/45 (16%), better delineation of lesions 10/45 (22%), better confidence towards reporting lesions as abnormal in 5/45 (11%) with an overall 11/45 (24%) of the cases who showed increase in the number of the lesions after the Lasix study. The overall CNR was evaluated using Wilcoxon Rank test (p-value = 0.02) which suggested significant improved ratios in the post-Lasix imaging by 49.6%±24.5. There was a substantial agreement (k =0.76) between the physicians when comparing the lesion clarity and delineation in post Lasix images. The average score for physician one and two being 2.4 ±0.71 and 2.53±0.52 respectively.Conclusion: Post diuretic 68Ga-PSMA imaging at ± 15 minutes clears the unwanted activity in the urinary tract which in turn improves the contrast to noise ratios. Thus leading to decline in false positive findings, improved diagnostic certainty of physician and better detection of indeterminate lesions in 68Ga-PSMA imaging.

ANALISIS INFORMASI CITRA ANATOMI MSCT THORAX DENGAN KASUS EFUSI PLEURA KANKER PARU PADA WINDOW MEDIASTINUM POST KONTRAS MENGGUNAKAN VARIASI NILAI WINDOW WIDTH

Background: Malignancy of lung cancer is the biggest cause of pleural effusion. To diagnose lung cancer pleural effusion, a thorax MSCT can be examined. The MSCT parameter that affects image contrast is window width. The purpose of this study was to determine the differences in the anatomical information of thorax MSCT images in the post contrast mediastinal window to the use of window width range 350-600 HU values in cases of lung cancer pleural effusion, and to determine the appropriate window width value to obtain optimal anatomic image information on Thorax MSCT in cases of lung cancer pleural effusion.Methods: This type of research is quasi experimental. The research was conducted at the Radiology Installation of the Dr. Moewardi Hospital. The data were 60 images of the post contrast mediastinal window thorax MSCT axial slice from 10 patients with 6 window width variations (350 HU, 400 HU, 450 HU, 500 HU, 550 HU, 600 HU). An image assessment was conducted by 3 respondents regarding the resulting of 5 anatomical information. Data analysis used Friedman statistical test.Results: The results showed that there was a difference in the anatomical information of the thorax MSCT in the post contrast mediastinal window to the window width variation in cases of lung cancer pleural effusion with a significance level of p value 0,000 (ρ 0.05). Differences in anatomical image information occur in the anatomy of the aorta, limits of pleural effusion with lesions and clarity of lesions, where as there is no difference in anatomy of the right and left primary bronchus. The optimal use of the window width value for thorax MSCT in the post contrast mediastinal window cases of lung cancer pleural effusion is WW 350 HU with a rank value of 4.61.Conclusions: This study shows that the use of 350 HU window width produces better anatomical image information than the use of other window widths in the case of pleural effusion of lung cancer.

Quantitative analysis of radiation dosage and image quality between digital breast tomosynthesis (DBT) with two-dimensional synthetic mammography and full-field digital mammography (FFDM)

PurposeCurrently in diagnostic setting for breast cancer, FFDM and DBT are performed conjunctively. However, performing two imaging modalities may increase radiation exposure by double. Two-dimensional reconstructed images created from DBT with 2DSM, has a potential to replace conventional FFDM in concerning both radiation dosage and image quality. With increasing concerns for individual radiation exposure, studies analyzing radiation dosage in breast imaging modalities are needed. This study compared radiation dosage and image quality between DBT + 2DSM versus FFDM. Methods and materials374 patients (mean age 52 years) who underwent both DBT and FFDM were retrospectively reviewed. Radiation dosage data were obtained by radiation dosage scoring and monitoring program Radimetrics (Bayer HealthCare, Whippany, NJ). Entrance dose and mean glandular doses in each breast were obtained for both modalities. To compare image quality of DBT + 2DSM and FFDM, a 5-point scoring system for lesion clarity was assessed. The parameters of radiation dosage (entrance dose, mean glandular dose) and image quality (lesion clarity scoring) were compared. ResultsFor entrance dose, DBT had lower mean dosage (14.8 mGy) compared with FFDM (21.8 mGy, p-value < 0.0001). Mean glandular doses for both breasts were lower in DBT (Left 1.74, Right 2.1) compared with FFDM (Left 2.85, Right 2.74, p-value < 0.0001). Lesion clarity score was higher in DBT with 2DSM (mean score 4.03) compared with FFDM (3.82, p-value < 0.0001). ConclusionDBT showed lower radiation entrance dose and mean glandular doses to both breasts compared with FFDM. DBT + 2DSM had better image quality than FFDM, suggesting that DBT with 2DSM has potential as an alternative to FFDM.

Optimized protocol for (18)F-choline PET/CT in patients with biochemically relapsed prostate cancer: experiences on 250 consecutive cases.

We review acquisition F-choline PET/CT methodology, evaluate a new F-choline acquisition protocol for prostate cancer (PC), and propose a standardized acquisition protocol on F-choline in PC patients. Two hundred fifty consecutive PC patients (mean age 72 years, mean PSA 7.9 ng/mL) were prospectively evaluated with F-choline PET/CT. An early scan of the pelvis (1 bed position of 4 minutes) was followed by a whole-body scan at 1 hour. Early and 1 delayed hour images of the pelvis were compared. Twenty-one percent of patients (n = 57) with positive F-choline demonstrated abnormal local uptake; 18% of patients (n = 45) showed distant localization only; 23% of patients (n = 53) had both local and distant localization; 38% of patients (n = 38) did not show any pathological uptake. All early images showed absence of radioactive urine in ureters, bladder, or urethra with satisfactory visualization of the prostatic region. Considering the group of patients with local uptake only, the prostatic region uptake, confirmed by late images, was better visualized in the early phase in 32/57 cases (SUVmax 12.4 ± 3.2 vs. 7.3 ± 5.2, P <0.01). Instead distant lesions were visualized on both early and late images with similar uptakes values (SUVmax 9.8 ± 4.1 vs. 10.3 ± 4.5, P = N.S.). Early F-choline images improve pelvic prostate cancer lesion clarity. All pathologic pelvic deposits (prostate, lymph nodes, bone) were visualized both in the early and late images.