Modern Imaging Techniques Research Articles

Preoperative Imaging-Guided Surgical Planning in Complex Pelvic Fractures - Innovations in Traumatology and Radiology for Enhanced Clinical Outcomes: A Systematic Review

This systematic review will explore role of preoperative imaging-guided surgical planning for the management of complex pelvic fractures. Pelvic fractures occurs in high-energy trauma and cause challenges for intricate anatomy and have a high association with vascular, visceral injuries. Traditional imaging methods frequently fail to capture injury complexity while increasing surgical risks. Recent advancements of imaging technology CT, MRI, 3D reconstructions along with and AI-based predictive models offer enhanced precision in diagnosing and planning surgical interventions with detailed insights into fracture patterns, bone density, and soft tissue damage which enable accurate surgical planning to reduce intraoperative complications and shorten recovery times. We aim to systematically investigate effectiveness of modern imaging techniques with potencies in clinical outcomes, with an emphasis on improved surgical accuracy and patient safety. Analyzing range of studies, we have established evidence-based recommendations for integrating advanced imaging technologies into routine trauma care showing critical role these innovations play in improving both short-term recovery and long-term clinical outcomes for patients having complex pelvic fractures.

Molecular and Cellular Neurobiology of Spreading Depolarization/Depression and Migraine: A Narrative Review.

Migraine is a prevalent neurological disorder, particularly among individuals aged 20-50 years, with significant social and economic impacts. Despite its high prevalence, the pathogenesis of migraine remains unclear. In this review, we provide a comprehensive overview of cortical spreading depolarization/depression (CSD) and its close association with migraine aura, focusing on its role in understanding migraine pathogenesis and therapeutic interventions. We discuss historical studies that have demonstrated the role of CSD in the visual phenomenon of migraine aura, along with modern imaging techniques confirming its propagation across the occipital cortex. Animal studies are examined to indicate that CSD is not exclusive to migraines; it also occurs in other neurological conditions. At the cellular level, we review how CSD is characterized by ionic changes and excitotoxicity, leading to neuronal and glial responses. We explore how CSD activates the trigeminal nervous system and upregulates the expression of calcitonin gene-related peptides (CGRP), thereby contributing to migraine pain. Factors such as genetics, obesity, and environmental conditions that influence the CSD threshold are discussed, suggesting potential therapeutic targets. Current treatments for migraine, including prophylactic agents and CGRP-targeting drugs, are evaluated in the context of their expected effects on suppressing CSD activity. Additionally, we highlight emerging therapies such as intranasal insulin-like growth factor 1 and vagus nerve stimulation, which have shown promise in reducing CSD susceptibility and frequency. By elucidating the molecular and cellular mechanisms of CSD, this review aims to enhance the understanding of migraine pathogenesis and support the development of targeted therapeutic strategies.

Magnetic Resonance Imaging of the Heart is a Robust Method for Diagnosing Myocardial Lesions with Low Availability in Emergency Cardiology Departments

This article discusses the problem of underuse, low availability of modern imaging techniques such as magnetic resonance imaging of the heart (MRI). This technique is characterized by high accuracy and uniqueness in the diagnosis of myocardial lesions of various genesis. The widespread introduction of this technique in emergency cardiology departments can improve the accuracy of diagnosis and the effectiveness of patient therapy. Despite the high costs of implementation and current use, modern diagnostic methods can save healthcare resources by reducing hospital stays and improving treatment outcomes.

Personalised High Tibial Osteotomy Surgery Is Accurate: An Assessment Using 3D Distance Mapping

Early-stage knee osteoarthritis is often suitable for treatment with high tibial osteotomy (HTO). This is an effective joint-preserving treatment, resulting in good postoperative outcomes. To overcome the limitations of traditional HTO, the surgical technique and correction accuracy can be enhanced by personalised procedures using three-dimensional digital planning and metal additive manufacturing, The purpose of this clinical trial study was to evaluate the three-dimensional accuracy of a new personalised HTO procedure, using modern imaging techniques, 3D modelling, and distance map analysis (DMA). Twenty-five patients were treated with the personalised HTO procedure. Before surgery and after 6 months, they underwent clinical evaluation scoring, radiographic imaging, and computed-tomography scanning to generate morphological models. Specifically, preoperative tibia models were used to plan the tibia correction and the design and position of the fixation plate. Preoperative, planned, and postoperative models were imported in computer-aided and designing software (Geomagic ControlTM 2014, 3D Systems, Rock Hill, SC, USA) for DMA implementation to assess geometrical differences between model surfaces. A very good reproduction of the planned tibia morphology was achieved postoperatively (average differences between −0.9 mm and 1.4 mm). DMA values associated with fixation-plate deformation were less than 1 mm, similar to those for plate-to-tibia surface-contour matching. Overall, personalised digitally planned HTO utilising three-dimensional printed surgical guides and plates enables accurate planned correction and plate placement.

Takayasu Arteritis in a Young Female Patient: A Case Report

Takayasu arteritis (TA) is a rare chronic inflammatory vasculitis that primarily affects large vessels like the aorta, mainly in women under 40, particularly of Asian descent. Its exact cause is unknown but is linked to cell-mediated inflammation, leading to complications such as occlusion and aneurysms. Symptoms vary widely, complicating diagnosis. Modern imaging techniques like computed tomography angiography (CTA) are crucial for early detection, which can significantly reduce complications. This case report highlights a 28-year-old woman with extensive aorto-arteritis, underscoring the importance of timely imaging and intervention in managing TA.

Comparative Analysis of Traditional and Modern Imaging Techniques in Neurological Disorders

Comparative Analysis of Traditional and Modern Imaging Techniques in Neurological Disorders

Possibility to measure the volume of coronary sinus in contrast-enhanced computed tomography.

Modern imaging techniques such as computed tomography (CT) can help in the assessment of coronary sinus volume in a vitro manner, but there is no comprehensive research on this topic so far. Hence, we decided to develop a methodology for measuring the volume of the coronary sinus in multi-detector CT and to try to apply it in practice. Forty-nine patients (22 men) were included in this research, with a mean age of 70.08 ± 13.6 years. Scanning with retrospective ECG-gating was performed using a Toshiba Aquilion 64 (slice: 0.5 mm; helical pitch: 12.8; rotation time: 0.4 s). 80 ± 20 cm3 of non-ionic contrast was administered to each patient. The volume of coronary sinus and other data measurements were performed using Vitrea 2 workstations. The organ volume measurement function was used to measure volume objects in CT scans. To standardise the measurements, they were all performed to the place where the vein of Marshall reaches the coronary sinus. In cases of loss of vein of Marshall, the first lateral vein was used as the junction between the coronary sinus and the great cardiac vein. The coronary sinus volume varied from 0.96 cm3 to 8.52 cm3. The average volume was 3.71 ± 1.64 cm3. There was a significant correlation between end diastolic volume and coronary sinus volume (r = 0.33, p = 0.02). In most cases the quality of visualisation was good - the average was calculated as 4.16 ± 0.87. The Thebesian valve was present in 22 cases (44.9%); however, no statistical relationship between the presence of the Thebesian valve and coronary sinus was observed. It is possible to visualise and calculate the volume of the coronary sinus in cardiac CT.

Radiology of malignant cervical adenopathy

Imaging of neck and skull base has significantly improved the diagnosis and management of neck conditions. Prior to the use of CT, MRI and PET imaging, the value of plain radiographs of the neck was limited. Today, modern imaging techniques are an essential adjunct to the physical examination of the neck, can confidently limit the differential, and in many clinical scenarios yield a specific diagnosis. In addition, the value of imaging cannot be understated in surgical planning and surveillance. This article will review the techniques used in neck lymph node imaging and cover several of the most common conditions that result in malignant lymphadenopathy in the neck.

EEG Techniques with Brain Activity Localization, Specifically LORETA, and Its Applicability in Monitoring Schizophrenia.

Background/Objectives: Electroencephalography (EEG) is considered a standard but powerful tool for the diagnosis of neurological and psychiatric diseases. With modern imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and magnetoencephalography (MEG), source localization can be improved, especially with low-resolution brain electromagnetic tomography (LORETA). The aim of this review is to explore the variety of modern techniques with emphasis on the efficacy of LORETA in detecting brain activity patterns in schizophrenia. The study's novelty lies in the comprehensive survey of EEG methods and detailed exploration of LORETA in schizophrenia research. This evaluation aligns with clinical objectives and has been performed for the first time. Methods: The study is split into two sections. Part I examines different EEG methodologies and adjuncts to detail brain activity in deep layers in articles published between 2018 and 2023 in PubMed. Part II focuses on the role of LORETA in investigating structural and functional changes in schizophrenia in studies published between 1999 and 2024 in PubMed. Results: Combining imaging techniques and EEG provides opportunities for mapping brain activity. Using LORETA, studies of schizophrenia have identified hemispheric asymmetry, especially increased activity in the left hemisphere. Cognitive deficits were associated with decreased activity in the dorsolateral prefrontal cortex and other areas. Comparison of the first episode of schizophrenia and a chronic one may help to classify structural change as a cause or as a consequence of the disorder. Antipsychotic drugs such as olanzapine or clozapine showed a change in P300 source density and increased activity in the delta and theta bands. Conclusions: Given the relatively low spatial resolution of LORETA, the method offers benefits such as accessibility, high temporal resolution, and the ability to map depth layers, emphasizing the potential of LORETA in monitoring the progression and treatment response in schizophrenia.

Case report of spontaneous coronary artery dissection in a 50‑year‑old man

BackgroundSpontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality.Case presentationWe describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA.ConclusionsTo stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.

Is it possible to regress atherosclerotic lesions with long-term treatment with lipoprotein apheresis?

The article presents the up-to-date information on the effect of lipoprotein apheresis (LA) on atherosclerotic lesions. Some studies using modern diagnostic imaging techniques (such as intravascular ultrasound or magnetic resonance imaging) have clearly demonstrated plaque regression. Coronary angiography has also seen reversal or at least slow plaque progression. Plaque regression likely leads to a decrease in the incidence of atherosclerotic cardiovascular events (CVEs). However, this has not yet been fully proven. Recent data indicate that reduction in low-density lipoprotein cholesterol and lipoprotein(a) levels is not a major factor in reducing the incidence of atherosclerotic CVEs in patients undergoing extracorporeal treatment. The most significant risk factors in this case are older age and a greater CVE rate observed before the start of LA, as well as smoking. New studies using modern diagnostic imaging methods in patients receiving LA are necessary.

A comprehensive morphometric analysis of superior and inferior mesenteric arteries using cadaveric dissection and MDCT angiography

BackgroundSuperior mesenteric artery (SMA) and inferior mesenteric artery (IMA) are vital vascular structures supplying the majority of the intestinal tract. Despite their clinical significance, comprehensive morphometric studies combining traditional cadaveric dissection with modern imaging techniques are scarce in literature. This study aimed to provide a detailed morphometric analysis of the SMA and IMA using both cadaveric dissection and multi-detector computed tomography (MDCT) angiography. MethodsThe study utilized a dual approach, combining cadaveric dissection (30 formalin-fixed cadavers) and MDCT angiography (images from 50 patients). Measurements including stem lengths, diameters at origin, and distances from the aortic bifurcation were taken, along with assessment of vertebral levels of origin and branching patterns. Data from both components were analyzed using descriptive statistics. ResultsKey findings for SMA include: Mean stem length: 3.19 ± 0.72 cm (cadaveric) vs. 2.53 ± 0.53 cm (MDCT); Mean diameter at origin: 0.93 ± 0.22 cm (cadaveric) vs. 0.57 ± 0.10 cm (MDCT); Most common vertebral level of origin: Upper border of L1 (78 % of cases); Branching pattern variations observed in 23.3 % of cadaveric specimens, which included the origin of the inferior pancreaticoduodenal artery from the first jejunal artery, a common trunk for right colic and ileocolic arteries, and absence of middle colic artery. For IMA: Mean stem length: 3.61 ± 1.29 cm (cadaveric) vs. 3.41 ± 0.69 cm (MDCT); Mean diameter at origin: 0.50 ± 0.11 cm (cadaveric) vs. 0.26 ± 0.05 cm (MDCT); Most common vertebral level of origin: Upper border of L3 (40 % of cases). No variations observed in branching pattern. ConclusionsThe detailed measurements, frequency of variations, and comparison between traditional and modern assessment techniques offer a nuanced understanding of mesenteric vascular anatomy. This study bridges the gap between classical anatomical knowledge and contemporary imaging capabilities, potentially improving surgical planning, interventional procedures, and radiological interpretation.

Optical molecular imaging in cancer research: current impact and future prospect

Abstract Cancer has long been a major threat to human health. Recent advancements in molecular imaging have revolutionized cancer research by enabling early and precise disease localization, essential for effective management. In particular, optical molecular imaging is an invaluable cancer detection tool in preoperative planning, intraoperative guidance, and postoperative monitoring owing to its noninvasive nature, rapid turnover, safety, and ease of use. The tumor microenvironment and cells within it express distinct biomarkers. Optical imaging technology leverages these markers to differentiate tumor tissues from surrounding tissues and capture real-time images with high resolution. Nevertheless, a robust understanding of these cancer-related molecules and their dynamic changes is crucial for effectively managing cancer. Recent advancements in optical molecular imaging technologies offer novel approaches for cancer investigation in research and practice. This review investigates the modern optical molecular imaging techniques employed in both preclinical and clinical research, including bioluminescence, fluorescence, chemiluminescence, photoacoustic imaging, and Raman spectroscopy. We explore the current paradigm of optical molecular imaging modalities, their current status in preclinical cancer research and clinical applications, and future perspectives in the fields of cancer research and treatment.

A single Angiofil-latex injection for both radiological and anatomical assessment of arterial territories in the limbs

IntroductionPostmortem evaluation of the human vascular system has a long history, with advancements ranging from dissections to modern imaging techniques like computed tomography (CT scan). This study designs a novel combination of Angiofil, a liquid radiopaque polymer, and latex, a flexible cast material, for cadaveric vascular analysis. Material & methodsThe aim was to synergize the advantages of both components, providing accurate radiological images and optimal dissection conditions. Three arterial territories (lateral circumflex femoral artery, profunda brachii artery, and radial artery) were injected and assessed through CT scans and dissections. ResultsThe Angiofil-latex mixture allowed successful visualization of the vascular networks, offering a simple, reproducible, and non-toxic approach. Quantitative assessments of the three territories, including diameters and lengths, showed comparable results between CT scan and dissection. DiscussionThe technique precision and versatility make it an accessible and valuable tool for anatomical studies, potentially extending its application to MRI analyses. Overall, the Angiofil-latex combination presents a cost-effective solution for researchers, offering enhanced visibility and detailed anatomical insights for various applications, including anatomical variation studies.

A Visual Interface for Exploring Hypotheses About Neural Circuits.

One of the fundamental problems in neurobiological research is to understand how neural circuits generate behaviors in response to sensory stimuli. Elucidating such neural circuits requires anatomical and functional information about the neurons that are active during the processing of the sensory information and generation of the respective response, as well as an identification of the connections between these neurons. With modern imaging techniques, both morphological properties of individual neurons as well as functional information related to sensory processing, information integration and behavior can be obtained. Given the resulting information, neurobiologists are faced with the task of identifying the anatomical structures down to individual neurons that are linked to the studied behavior and the processing of the respective sensory stimuli. Here, we present a novel interactive tool that assists neurobiologists in the aforementioned tasks by allowing them to extract hypothetical neural circuits constrained by anatomical and functional data. Our approach is based on two types of structural data: brain regions that are anatomically or functionally defined, and morphologies of individual neurons. Both types of structural data are interlinked and augmented with additional information. The presented tool allows the expert user to identify neurons using Boolean queries. The interactive formulation of these queries is supported by linked views, using, among other things, two novel 2D abstractions of neural circuits. The approach was validated in two case studies investigating the neural basis of vision-based behavioral responses in zebrafish larvae. Despite this particular application, we believe that the presented tool will be of general interest for exploring hypotheses about neural circuits in other species, genera and taxa.

Systematic Review on Pathology and Drug Efficacy Clinical Trials (1973-2023) for Cognitive Impairment and Alzheimer’s Dementia

Rationale: The systematic review evaluates the results of last fifty years (1973-2023) of clinical trials on pathology and treatment for cognitive impairment including Alzheimer’s dementia (AD dementia). Objectives: Alzheimer’s dementia is a growing public health concern worldwide. The systematic review analyzes the disease confirming pathological findings presented by modern imaging techniques MRI/ PET. In addition, we analyze the success of fifty years of therapeutic advancements of the neurological disabilities and count on the safe drugs to treat clinical conditions of AD dementia. Findings: We followed the PRISMA guidelines to determine the inclusion and exclusion criteria for the selection of clinical records collected from the NCBI databases. We analyzed the drug efficacy results on the three aspects of the AD brain: (a) morphological deformation of the choroid plexus and hippocampus; (b) senile plaques with amyloid beta42 (Abeta42) including hyperintensities of neurons; and (c) inhibitory action of acetylcholinesterase enzyme. The pathological findings include detection of Abeta42 plaques in cerebral cortex and retention ability of trial drugs in cerebrospinal fluid versus blood plasma of AD patients in the context of disease progression and treatment efficacy. The clinical trial records demonstrated evidence of genetic susceptibility factor(s) clustered in European populations. The susceptibility is also found due to mutations in the presenilin-1 gene and expression of the ApoEε-allele among the population. The clinical records demonstrate moderate efficacy of cholinesterase inhibitors Donepezil and Rivastigmine in improving cognition. The antibodies aducanumab, donanemab, and lecanemab show low to moderate success in removing plaques and reducing plasma Abeta burden. Conclusion: The cholinesterase inhibitors demonstrate moderate success in improving cognition. However, the overall efficacy of antibody treatment was poor. The findings suggest a need for new generation drugs which can clear plaques and improve cognition for AD.

Enhancing ectasia screening using advanced AS-OCT: a case series of challenging refractive candidates.

Ectasia screening in candidates for laser refractive surgery is mandatory during preoperative evaluation. Despite the availability of modern imaging techniques, refractive surgeons often face borderline decisions when patients present with suspicious tomographic findings. This case series presents refractive candidates with suspicious tomographic findings and demonstrates how to interpret them using Scheimpflug imaging and additional anterior segment optical coherence tomography (AS-OCT). Department of Ophthalmology, University Hospital, LMU Munich. This case series examines six potential candidates for refractive surgery with a mean age of 29.2 ± 3.9 years, whose corneal assessments using Scheimpflug imaging raised suspicion for ectasia. Each candidate was additionally examined with AS-OCT and reevaluated. The mean manifest subjective spherical equivalent was -3.67 ± 1.8 diopters. The total corneal thickness measured 537 µm ± 30 µm at its thinnest point. None of the candidates had any reported underlying corneal or ophthalmic diseases, and slit lamp examinations revealed no abnormal morphological findings. Both Scheimpflug imaging and AS-OCT are appropriate tools for screening refractive candidates for ectasia. While topographic and elevation analyses yielded comparable results regarding corneal structure, the epithelial mapping provided by AS-OCT played a critical role in decision-making for cases with borderline tomographic findings. Establishing a global consensus on the use of epithelial mapping in ectasia screening is necessary.

Exclusion of non-Involved uterus from the target volume (EXIT-trial): An individualized treatment for locally advanced cervical cancer using modern radiotherapy and imaging techniques followed by completion surgery

Background and purposeChemoradiotherapy followed by brachytherapy is the standard of care for locally advanced cervical cancer (LACC). In this study, we postulate that omitting an iconographical unaffected uterus (+12 mm distance from the tumour) from the treatment volume is safe and that no tumour will be found in the non-targeted uterus (NTU) leading to reduction of high-dose volumes of surrounding organs at risk (OARs) Material and MethodsIn this single-arm phase 2 study, two sets of target volumes were delineated: one standard-volume (whole uterus) and an EXIT-volume (exclusion of non-tumour-bearing parts of the uterus with a minimum 12 mm margin from the tumour). All patients underwent chemoradiotherapy targeting the EXIT-volume, followed by completion hysterectomy. In 15 patients, a plan comparison between two treatment plans (PTV vs PTV_EXIT) was performed. The primary endpoint was the pathological absence of tumour involvement in the non-targeted uterus (NTU). Secondary endpoints included dosimetric impact of target volume reduction on OARs, acute and chronic toxicity, overall survival (OS), locoregional recurrence-free survival (LRFS), and progression-free survival (PFS). ResultsIn all 21 (FIGO stage I: 2; II: 14;III: 3; IV: 2) patients the NTU was pathologically negative. Ssignificant reductions in Dmean in bladder, sigmoid and rectum; V15Gy in sigmoid and rectum, V30Gy in bladder, sigmoid and rectum; V40Gy and V45Gy in bladder, bowel bag, sigmoid and rectum; V50Gy in rectum were achieved. Median follow-up was 54 months (range 7–79 months). Acute toxicity was mainly grade 2 and 5 % grade 3 urinary. The 3y- OS, PFS and LRFS were respectively 76,2%, 64,9% and 81 %. ConclusionMRI-based exclusion of the non-tumour-bearing parts of the uterus at a minimum distance of 12 mm from the tumour out of the target volume in LACC can be done without risk of residual disease in the NTU, leading to a significant reduction of the volume of surrounding OARS treated to high doses.

Spinal Cord Injury Management Based on Microglia-Targeting Therapies.

Spinal cord injury is a complicated medical condition both from the clinician's point of view in terms of management and from the patient's perspective in terms of unsatisfactory recovery. Depending on the severity, this disorder can be devastating despite the rapid and appropriate use of modern imaging techniques and convenient surgical spinal cord decompression and stabilization. In this context, there is a mandatory need for novel adjunctive therapeutic approaches to classical treatments to improve rehabilitation chances and clinical outcomes. This review offers a new and original perspective on therapies targeting the microglia, one of the most relevant immune cells implicated in spinal cord disorders. The first part of the manuscript reviews the anatomical and pathophysiological importance of the blood-spinal cord barrier components, including the role of microglia in post-acute neuroinflammation. Subsequently, the authors present the emerging therapies based on microglia modulation, such as cytokines modulators, stem cell, microRNA, and nanoparticle-based treatments that could positively impact spinal cord injury management. Finally, future perspectives and challenges are also highlighted based on the ongoing clinical trials related to medications targeting microglia.

The Ethmomaxillary Sinus-A False Duplicate Maxillary Sinus.

Functional endoscopic sinus surgery consistently benefits from good anatomical knowledge and modern imaging techniques. Ethmoid air cells migrate in specific topographical sites near the ethmoid. Posterior ethmoid air cells that descend into the maxillary sinus (MS) are ethmomaxillary sinuses (EMSs) that into the superior nasal meatus. Few previous studies found EMSs in 0.68% to 16.48% of cases. An EMS differs from a Haller's infraorbital cell nearing the ethmoidal infundibulum. A posterior ethmoid air cell intercalated between the ethmoid, MS and sphenoidal sinus is a Sieur's cell, but it could also be regarded as an EMS. An EMS should be discriminated from a maxillary recess of the sphenoidal sinus. An EMS could determine Onodi's maxillary bulla into the MS. The false duplicate MS described by Zuckerkandl consists of a MS draining into the middle nasal meatus adjoined by an EMS draining into the superior nasal meatus. These are separated by the ethmomaxillary septum. The latter may be confused with an intrasinus septum of the MS if the drainage pathways are not adequately documented. Therefore, a case-by-case anatomic identification of the pneumatic spaces nearing the MS should be performed before surgical endoscopic approaches of the nose and sinuses.