Multiplanar Imaging Research Articles

Exploration and expectation of magnetic resonance imaging in the evaluation of prostate cancer

With the progress of imaging technology, magnetic resonance imaging (MRI) has become the preferred imaging method for prostate cancer due to its excellent soft tissue resolution and the capability of multiparametric and multi-planar imaging. This paper briefly describes the current application and research progress of MRI in the preoperative qualitative diagnosis, staging assessment and postoperative recurrence monitoring of prostate cancer. The purpose is to deepen the understanding of clinicians and radiologists on the value of MRI in prostate cancer, and to promote the exploration of MRI in the management of prostate cancer.

Limited Axial Interpretation of Coronary CT Angiography in the Emergency Department Setting

PurposeIncorporating coronary CT angiographic (CCTA) imaging into emergency department (ED) workflows has been limited by the need for 24/7 real-time postprocessing. The aim of this study was to determine whether interpretation of transaxial CCTA images alone (limited axial interpretation [LI]) is noninferior to interpretation of combined transaxial and multiplanar reformation images (full interpretation [FI]) in assessing patients with acute chest pain in the ED. MethodsCCTA examinations from 74 patients were evaluated by two radiologists, one without dedicated CCTA training and one with basic CCTA experience. Each examination was evaluated three times in separate sessions, once by LI and twice by FI, in random order. Nineteen coronary artery segments were rated as having significant stenoses (≥50%) or not. Interreader agreement was assessed using Cohen’s κ statistic. The primary analysis was whether the accuracy of LI for detecting significant stenosis was noninferior to that of FI at the patient level (margin = −10%). Secondary analyses included similar analyses of sensitivity and specificity, at both the patient and vessel levels. ResultsInterreader agreement for significant stenosis was good for both LI and FI (κ = 0.72 vs 0.70, P = .74). Average accuracy for significant stenosis at the patient level was 90.5% for LI and 91.9% for FI, with a difference of −1.4%. The accuracy of LI was noninferior to FI, because the confidence interval did not include the noninferiority margin. Noninferiority was also found for patient-level sensitivity and for accuracy, sensitivity, and specificity at the vessel level. ConclusionsLI of the coronary arteries using transaxial CCTA images may be sufficient for the detection of significant coronary artery disease in the ED setting.

Imaging Recommendations for Diagnosis, Staging, and Management of Bone Tumors

AbstractPrimary bone sarcomas account for less than 1% of diagnosed cancers each year. In this era of multiplanar and functional imaging, the approach to the radiographic diagnosis of bone cancers goes much beyond traditional radiography. Radiographs are still the most pertinent part of the initial diagnosis of bone tumors. Multimodal imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help with issues such as complex anatomy, marrow assessment, soft assessment, and better local staging. The emerging imaging modality such as positron emission tomography (PET)-CT/PET-MRI has further transformed the imaging of bone malignancies. Radiologist plays an important role in the workup, staging, and management of bone tumors. The purpose of this article is to review imaging recommendations for better diagnosis, staging, and management of bone tumors.

MRI EVALUATION OF WRIST JOINT PATHOLOGIES IN PATIENTS PRESENTING WITH CHRONIC PAINFUL WRIST.

Background: MRI is an efcient approach for assisting in the diagnosis of chronic wrist pain. Due to its high resolution, multiplanar imaging capabilities & no use of ionizing radiation, MRI is useful for evaluating different ligaments, tendons, carpal tunnel, articular cartilage, and bone marrow in wrist joint. MRI is useful in the identication, characterization, and staging of osseous damage and illness. This is Material & methods: cross sectional descriptive study performed in tertiary care hospital during year 2021-22. In this study, 50 patients presenting with chronic wrist pain without trauma underwent MRI wrist. Wrist joint & its pathologies in these patients were evaluated on 3T MRI scanner. In this study Results: 20% cases were diagnosed with tendinitis followed by 18% cases were diagnosed with Tenosynovitis, 16% cases with Ganglion cyst, 10% cases with carpal tunnel syndrome, 8% cases with degenerative TFCC tear, 6% cases with RA, 4% each cases with GCT, Gout, Osteoid osteoma and TB arthritis respectively and 2% each cases were diagnosed with infective arthritis, Kienbock's disease and simple osseous cyst respectively. Conclusion: 1) MRI wrist joint with 3D imaging is a radiation free imaging technique which is very useful in diagnosing different pathologies of wrist joint. 2) MRI is important modality to diagnose precisely the various non traumatic pathologies of wrist joint causing chronic pain. 3) It is a radiation free technique which is very helpful for the conclusive diagnosis & further treatment of the patient.

Animating Eco-aesthetics: Multiplanar Images, Interspecies Government, and Eco-conscious Gaming in The Legend of Hei (2019) and Its TV Series (2011–Present)

Abstract This study on the animation feature The Legend of Hei (2019) and its TV animation series (2011 to the present) endeavors to explore nascent models of eco-aesthetics in Chinese animation through an intersectional framework bridging studies of eco-politics, eco-cinema, and contemporary animation and media studies. Through close analysis of multiplanar imaging and limited animation in the animation feature, I discuss how varied animation techniques in the film contribute to aesthetic effects of appearance and disappearance, diversified characterization, and representations of contesting models of ecological subjectivities, bio-politics, and environmental governance. Contrary to a radical ecologist’s approach that resorts to forceful undertakings to “rescue nature,” the animation projects an alternative ethico-political method that promotes co-existence, inter-species governance, tolerance, and the art of “letting be.” The latter half of the essay situates the TV animation series The Battle of Luo Xiaohei in the milieu of eco-cinema and media ecology. I argue that the TV animation’s transmedial presentation of ACG gaming, platformativity, and parasocial participation of gamers, human characters and elfin alike, offer new insights on videogaming as social and cultural responses to environmental crises, also drawing attention to the ethico-political potential of parasocial gameplay in promoting democratic ideals of ecosystem governance.

Role of radiology in post COVID-19 rhinocerebral fungal infections

The purpose of this study was to describe common radiographic patterns that may be useful in predicting the diagnosis of rhinocerebral mucormycosis. Methods: We retrospectively evaluated the imaging and clinical data of four males and one female, 3 to 72 years old, with rhinocerebral mucormycosis. Results: All the patients presented with sinusitis and ophthalmological symptoms. Most of the patients (80%) had isointense lesions relative to brain in T1-weighted images. The signal intensity in T2-weighted images was more variable, with only one (20%) patient showing hyperintensity. A pattern of anatomic involvement affecting the nasal cavity, maxillary sinus, orbit, and ethmoid cells was consistently observed in all five patients (100%). Our series demonstrated a mortality rate of 60%. Conclusion: Progressive and rapid involvement of the cavernous sinus, vascular structures and intracranial contents is the usual evolution of rhinocerebral mucormycosis. In the context of immunosupression, a pattern of nasal cavity, maxillary sinus, ethmoid cells, and orbit inflammatory lesions should prompt the diagnosis of mucormycosis. Multiplanar magnetic resonance imaging shows anatomic involvement, helping in surgery planning. However, the prognosis is grave despite radical surgery and antifungals.

COMPARATIVE ANALYSIS OF HIGH RESOLUTION ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN SHOULDER PATHOLOGIES

Introduction: A wide plethora of Shoulder Pathologies are frequently encountered in patients presenting with shoulder pain. They are routinely evaluated using High Resolution Ultrasonography, Magnetic Resonance Imaging and Arthrography. Despite good diagnostic accuracy in using each of these modalities, certain limitations persist. To recognize com Aims and Objectives: mon pathologies of the Shoulder on Ultrasonography and Magnetic Resonance Imaging. Correlate Ultrasonography and Magnetic Resonance Imaging ndings and establish the superiority and determine diagnostic modality of choice for various pathologies Results: Overall detection rates (sensitivity) of any kind of rotator cuff tears using ultrasound were 78.38 %. This sensitivity difference was statistically very signicant. US has a very high specicity rate of 90.91 %. Ultrasound suffers severe handicaps when it comes to study the labroligamentous complex injuries in patients with instability, Whereas MRI proved to be far superior in labroligamentous complex injuries. High Resolution Ultrasonography and Magneti Conclusion c Resonance Imaging are excellent modalities with high efciency in the detection of various shoulder pathologies, provided user is adequately experienced / trained and familiar with complex shoulder anatomy. MRI is a versatile investigation tool for studying all shoulder pathologies affording great soft tissue contrast and multiplanar imaging and ultrasound has signicant clinical applications outside rotator cuff evaluation

Musculoskeletal Computed Tomography: How to Add Value When Reporting Adult Upper Limb Trauma.

There is increasing reliance on computed tomography to evaluate fractures and dislocations following routine evaluation with plain radiography, critical in preoperative planning; computed tomography can provide multiplanar reformats and 3-dimensional volume-rendered imaging, providing a better global assessment for the orthopedic surgeon. The radiologist plays a critical role in appropriately reformatting the raw axial images to illustrate best the findings that will help determine further management. In addition, the radiologist must succinctly report the pertinent findings that will have the most significant bearing on treatment, assisting the surgeon in deciding between nonoperative and operative management. The radiologist should also carefully review imaging to look for ancillary findings in the setting of trauma beyond the bones and joints, including the lungs and rib cage when visualized.In this review article, we will systematically describe key features for fractures of the scapula, proximal humerus, distal humerus, radial head and neck, olecranon, coronoid process through a case-based approach, and distal radius. Although there are numerous detailed classification systems for each of these fractures, we aim to focus on the core descriptors that underpin these classification systems. The goal is to provide the radiologist with a checklist of critical structures they must assess and findings that they should mention in their report, emphasizing those descriptors that influence patient management.

FactFinders for patient safety: Motor stimulation testing in lumbar radiofrequency neurotomy and radiofrequency neurotomy in patients with posterior hardware

This series of FactFinders presents a brief summary of the evidence and outlines recommendations regarding the use of motor stimulation testing in lumbar radiofrequency neurotomy and performance of radiofrequency neurotomy in patients with posterior spinal hardware.The evidence in support of the following facts is presented: (1) Motor stimulation does not inherently protect against unwanted damage to the spinal nerve, exiting spinal nerve root or its ventral ramus due to a lack of sensitivity of this test for identification of electrode contact or close proximity to sensorimotor nerves. Even when motor stimulation is performed, verification of correct electrode placement with multiplanar imaging including a minimum of true anterior-posterior and lateral fluoroscopic views is a recommended safeguard. (2) The existence of posterior spinal hardware is not an absolute contraindication to radiofrequency neurotomy, but direct contact with hardware should be avoided.

Computed tomography in skull base fractures in infants and young children

Aim of the study is to show the possibilities of multiplanar reformation and 3D reconstructions of computed tomography in the diagnosis of skull base fractures in young children.
 Materials and methods. In one thousand three hundred thirty four children under 3 years of age with traumatic brain injury (TBI) CT was performed on a 128-slice Philips Ingenuity CT scanner; in 707 (53%) in the first 6 hours, in 254 (19%) — after 6 hours, but during the first 24 hours, in 205 (15%) children within 3 days and in 168 (13%) children later on 3 days after injury. Scanning of the area of interest (head + cervical spine) was made with the maximum possible reduction in parameters to minimize the radiation dose. Contrast was not used in children from 0 to 3 years of age with TBI. Post-processing included isotropic multi-planar reformatted (MPR) and 3D images.
 Results. Of the 1334 children examined, 730 were boys and 604 were girls. In 448 (33.58%) children, fractures of the skull bones were diagnosed, in 366 (81.7%) of them, fractures were combined with intracranial injuries. Fractures of the skull base were in 83 (18.52%) of 448 children. In 65% (n = 54) of cases, basal fractures were combined with fractures of the temporal bones, 31.5% 
 (n = 17) of these children had liquorrhea. Fractures of the anterior fossa (12% of the total number of fractures of the base of the skull) of the base of the skull or fronto-basal fractures were accompanied by additional fractures of the orbits and/or other bones of the facial skull in 56.6% of cases. Fractures of the middle cranial fossa were diagnosed in 54 (65%) children. Fractures of the posterior cranial fossa were found in 19 (23%) of 83 children. In addition to fractures of the bones of the base of the skull, 32 (38.6%) children were diagnosed with fractures of the bones of the vault and intracranial injuries.
 Conclusion. The use of multiplanar reformation and 3D reconstruction increased the sensitivity and specificity of diagnosing skull base fractures in children compared to conventional axial CT. The essential advantages of using 3D reconstruction are the availability of the technique, the absence of additional scanning time and radiation exposure.

Ultrasound Control of Cervical Regeneration after Large Loop Excision of the Transformation Zone: Results of an Innovative Measurement Technique

The objective of this research is to evaluate cervical regeneration after large loop excision of the transformation zone (LLETZ) through the identification of a new sonographic reference point at the level of the uterine margins. In the period March 2021-January 2022, a total of 42 patients affected by CIN 2-3 were treated with LLETZ at the University Hospital of Bari (Italy). Before performing LLETZ, cervical length and volume were measured with trans-vaginal 3D ultrasound. From the multiplanar images, the cervical volume was obtained using the Virtual Organ Computer-aided AnaLysis (VOCAL™) program with manual contour mode. The line that connects the points where the common trunk of the uterine arteries reaches the uterus splitting into the ascending major branch and the cervical branch was considered as the upper limit of the cervical canal. From the acquired 3D volume, the length and the volume of the cervix were measured between this line and the external uterine os. Immediately after LLETZ, the removed cone was measured using Vernier's caliper, and before fixation in formalin, the volume of the excised tissue was evaluated by the fluid displacement technique based on the Archimedes principle. The proportion of excised cervical volume was 25.50 ± 17.43%. The volume and the height of the excised cone were 1.61 ± 0.82 mL and 9.65 ± 2.49 mm corresponding to 14.74 ± 11.91% and 36.26 ± 15.49% of baseline values, respectively. The volume and length of the residual cervix were also assessed using 3D ultrasound up to the sixth month after excision. At 6 weeks, about 50% of cases reported an unchanged or lower cervical volume compared to the baseline pre-LLETZ values. The average percentage of volume regeneration in examined patients was equal to 9.77 ± 55.33%. In the same period, the cervical length regeneration rate was 69.41 ± 14.8%. Three months after LLETZ, a volume regeneration rate of 41.36 ± 28.31% was found. For the length, an average regeneration rate of 82.48 ± 15.25% was calculated. Finally, at 6 months, the percentage of regeneration of the excised volume was 90.99 ± 34.91%. The regrowth percentage of the cervical length was 91.07 ± 8.03%. The cervix measurement technique that we have proposed has the advantage of identifying an unequivocal reference point in 3D cervical measurement. Ultrasound 3D evaluation could be useful in the clinical practice to evaluate the cervical tissue deficit and express the "potential of cervical regeneration" as well as provide the surgeon useful information about the cervical length.

Auto-Detection of Motion Artifacts on CT Pulmonary Angiograms with a Physician-Trained AI Algorithm.

Purpose: Motion-impaired CT images can result in limited or suboptimal diagnostic interpretation (with missed or miscalled lesions) and patient recall. We trained and tested an artificial intelligence (AI) model for identifying substantial motion artifacts on CT pulmonary angiography (CTPA) that have a negative impact on diagnostic interpretation. Methods: With IRB approval and HIPAA compliance, we queried our multicenter radiology report database (mPower, Nuance) for CTPA reports between July 2015 and March 2022 for the following terms: "motion artifacts", "respiratory motion", "technically inadequate", and "suboptimal" or "limited exam". All CTPA reports were from two quaternary (Site A, n = 335; B, n = 259) and a community (C, n = 199) healthcare sites. A thoracic radiologist reviewed CT images of all positive hits for motion artifacts (present or absent) and their severity (no diagnostic effect or major diagnostic impairment). Coronal multiplanar images from 793 CTPA exams were de-identified and exported offline into an AI model building prototype (Cognex Vision Pro, Cognex Corporation) to train an AI model to perform two-class classification ("motion" or "no motion") with data from the three sites (70% training dataset, n = 554; 30% validation dataset, n = 239). Separately, data from Site A and Site C were used for training and validating; testing was performed on the Site B CTPA exams. A five-fold repeated cross-validation was performed to evaluate the model performance with accuracy and receiver operating characteristics analysis (ROC). Results: Among the CTPA images from 793 patients (mean age 63 ± 17 years; 391 males, 402 females), 372 had no motion artifacts, and 421 had substantial motion artifacts. The statistics for the average performance of the AI model after five-fold repeated cross-validation for the two-class classification included 94% sensitivity, 91% specificity, 93% accuracy, and 0.93 area under the ROC curve (AUC: 95% CI 0.89-0.97). Conclusion: The AI model used in this study can successfully identify CTPA exams with diagnostic interpretation limiting motion artifacts in multicenter training and test datasets. Clinical relevance: The AI model used in the study can help alert technologists about the presence of substantial motion artifacts on CTPA, where a repeat image acquisition can help salvage diagnostic information.

Reducing crosstalk of a multi-plane holographic display by the time-multiplexing stochastic gradient descent.

Multi-plane reconstruction is essential for realizing a holographic three-dimensional (3D) display. One fundamental issue in conventional multi-plane Gerchberg-Saxton (GS) algorithm is the inter-plane crosstalk, mainly caused by the neglect of other planes' interference in the process of amplitude replacement at each object plane. In this paper, we proposed the time-multiplexing stochastic gradient descent (TM-SGD) optimization algorithm to reduce the multi-plane reconstruction crosstalk. First, the global optimization feature of stochastic gradient descent (SGD) was utilized to reduce the inter-plane crosstalk. However, the crosstalk optimization effect would degrade as the number of object planes increases, due to the imbalance between input and output information. Thus, we further introduced the time-multiplexing strategy into both the iteration and reconstruction process of multi-plane SGD to increase input information. In TM-SGD, multiple sub-holograms are obtained through multi-loop iteration and then sequentially refreshed on spatial light modulator (SLM). The optimization condition between the holograms and the object planes converts from one-to-many to many-to-many, improving the optimization of inter-plane crosstalk. During the persistence of vision, multiple sub-hologram jointly reconstruct the crosstalk-free multi-plane images. Through simulation and experiment, we confirmed that TM-SGD could effectively reduce the inter-plane crosstalk and improve image quality.The proposed TM-SGD-based holographic display has wide applications in tomographic 3D visualization for biology, medical science, and engineering design, which need to reconstruct multiple independent tomographic images without inter-plane crosstalk.

The multiplanar imaging microscope with a laser induced thermal lens: A practical case study

The article presents the operation of the first in the world fully functional multi-planar, ready-to-use bright-field microscope equipped with a laser induced thermal lens. Also, for the first time the imaging capabilities of a thermal lens formed in a polymer sample are presented. The microscope objective and the thermal lens are used in a multifocal configuration which allows recording in the same plane the images of objects belonging to different object planes, separated by a distance that exceeds significantly the objective depth-of-field. The thermal lens kinetics response to laser on/off switching as well as the effect of the geometry of illumination light on the microscope multiplanar imaging capability are shown. Multiplanar exemplary images are presented as well.

Prenatal diagnosis and characterization of extra-axial, supratentorial pial arteriovenous malformation using high-resolution transvaginal neurosonography.

Prenatal diagnosis and characterization of extra-axial, supratentorial pial arteriovenous malformation using high-resolution transvaginal neurosonography.

Effect of dual trigger with chorionic gonadotropin hormone and follicle-stimulating hormone on endometrial thickness in infertile women who had superovulation with an aromatase inhibitor

Beginning in October 2020 and ending in April 2021, researchers from Al-Nahrain University's High Institute for Infertility Diagnosis and Assisted Reproductive Technologies compared the success rates of two different methods of diagnosing and treating infertility. The major purpose of the research was to assess the impact of a combined trigger (follicle-stimulating hormone [FSH] and human chorionic gonadotropin [hCG]) on endometrial receptivity (endometrial thickness, endometrial pattern, sub-endometrial blood flow). A total of 100 females took part in the study. All patients gave their informed written consent, and the study was approved by the Al-Nahrain University Ethics Committee. Procedure Time To confirm ovulation, measure and analyze the endometrial pattern, and examine the sub-endometrial blood flow, a vaginal ultrasound was done 36 to 48 hours following trigger ovulation. All four hormones (FSH, LH, Progesterone, and E2) were tested in the blood at the same time to determine whether a couple was fertile, a complete medical history, and physical examination whereas performed on each member of the pair. An ultrasound vaginal probe was used to do the transvaginal examination. Patients were placed in the dorsal lithotomy position with an empty bladder for early follicular US (CD 2-3) to assess the number of antral follicles, measure endometrial thickness, and rule out ovarian cysts or other pathology. A second ultrasound was performed during the middle of the cycle (CD9-14) to determine whether a mature follicle had been found. A multiplanar image of the uterus was acquired after an ultrasound scan was swept across the mid-sagittal plane. Endometrial thickness in the median longitudinal plane of the uterus was calculated as the largest distance from one basal endometrial interface via the endometrial canal to the opposite endometrial-myometrial interface of the anterior-posterior uterine wall. A statistically significant difference was found between Group A's average E2 concentration of 69.62 pg/mL and Groups B and C's concentrations of 53.32 and 36.65 pg/mL. (P 0.001). In group C, there was a statistically significant difference in E2 levels on the day of the trigger and the day of the IUI (P = 0.036). On the day of IUI compared to the day of trigger, no statistically significant differences were seen between the study groups for any of the other hormonal indicators (P > 0.05). There were no significant differences (P > 0.05) in any of the baseline clinical measures between the research groups. All clinical indicators were comparable across groups (P > 0.05). There were no statistically significant differences (P > 0.05) between the research groups on any other clinical indicators. When comparing groups, A, B, and C on the decline in RI between the trigger and IUI days, group A significantly outperformed the others (P = 0.003). There was no statistically significant difference (P > 0.05) in any of the other clinical parameters between the IUI and trigger groups on the day of IUI.

Investigation of the Relationship between Right Coronary Artery-Aorta Angle and Coronary Artery Disease and Associated Risk Factors.

At the level of the left coronary artery tree, there is evidence showing an association between bifurcation angle and coronary artery disease (CAD), and this motivated us to explore similar associations at the level of the right coronary artery (RCA). The purpose of this study was to determine whether there is a relationship between RCA-aorta angle and CAD and age, sex, body mass index, smoking status, hypertension, and high blood cholesterol. The coronary computed tomography angiography datasets and CAD risk factor checklists of 250 patients were retrospectively reviewed, with RCA-aorta angles measured via multiplanar reformation images. Independent t-tests were used to compare mean RCA-aorta angle measurements between groups, correlations between continuous variables were assessed using Pearson and Spearman correlations, and a general linear model was used to adjust for potentially confounding variables. Coronary angle measurements were conducted by two independent assessors with very strong intraclass correlation (r=0.999, p<0.001). A significantly smaller mean RCA-aorta angle was observed in the CAD group (79.07 ± 24.88°) compared to the normal group (92.08 ± 19.51°, p=0.001), in smokers (76.63 ± 22.94°) compared to non-smokers (85.25 ± 23.84°, p=0.016), and a narrow RCA-aorta angle was negatively correlated with BMI (r=-0.174, p=0.010). This study suggests a relationship between narrow RCA-aorta angles and CAD, smoking, and increasing BMI.

Osteochondritis dissecans of the temporomandibular joint: a scoping review.

To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ). An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'Temporomandibular Joint Disorders', 'Osteochondritis Dissecans', 'Joint Loose Bodies' and 'Temporomandibular Joint'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. Ten articles were included in the analysis - six case reports, one case series, one retrospective study, one comparative study and one correlational study - with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons. OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.

Adult Acquired Flatfoot Deformity: A Narrative Review about Imaging Findings.

Adult acquired flatfoot deformity (AAFD) is a disorder caused by repetitive overloading, which leads to progressive posterior tibialis tendon (PTT) insufficiency. It mainly affects middle-aged women and occurs with foot pain, malalignment, and loss of function. After clinical examination, imaging plays a key role in the diagnosis and management of this pathology. Imaging allows confirmation of the diagnosis, monitoring of the disorder, outcome assessment and complication identification. Weight-bearing radiography of the foot and ankle are gold standard for the diagnosis of AAFD. Magnetic Resonance Imaging (MRI) is not routinely needed for the diagnosis; however, it can be used to evaluate the spring ligament and the degree of PTT damage which can help to guide surgical plans and management in patients with severe deformity. Ultrasonography (US) can be considered another helpful tool to evaluate the condition of the PTT and other soft-tissue structures. Computed Tomography (CT) provides enhanced, detailed visualization of the hindfoot, and it is useful both in the evaluation of bone abnormalities and in the accurate evaluation of measurements useful for diagnosis and post-surgical follow-up. Other state-of-the-art imaging examinations, like multiplanar weight-bearing imaging, are emerging as techniques for diagnosis and preoperative planning but are not yet standardized and their scope of application is not yet well defined. The aim of this review, performed through Pubmed and Web of Science databases, was to analyze the literature relating to the role of imaging in the diagnosis and treatment of AAFD.

3D Echocardiogram Reconstruction Employing a Flip Directional Texture Pyramid

Three dimensional (3D) echocardiogram enables cardiologists to visualize suspicious cardiac structures in detail. In recent years, this three-dimensional echocardiogram carries important clinical value in virtual surgical simulation. However, this 3D echocardiogram involves a trade-off difficulty between accuracy and efficient computation in clinical diagnosis. This paper presents a novel Flip Directional 3D Volume Reconstruction (FD-3DVR) method for the reconstruction of echocardiogram images. The proposed method consists of two main steps: multiplanar volumetric imaging and 3D volume reconstruction. In the creation of multiplanar volumetric imaging, two-dimensional (2D) image pixels are mapped into voxels of the volumetric grid. As the obtained slices are discontinuous, there are some missing voxels in the volume data. To restore the structural and textural information of 3D ultrasound volume, the proposed method creates a volume pyramid in parallel with the flip directional texture pyramid. Initially, the nearest neighbors of missing voxels in the multiplanar volumetric imaging are identified by 3D ANN (Approximate Nearest Neighbor) patch matching method. Furthermore, a flip directional texture pyramid is proposed and aggregated with distance in patch matching to find out the most similar neighbors. In the reconstruction step, structural and textural information obtained from different flip angle directions can reconstruct 3D volume well with the desired accuracy. Compared with existing 3D reconstruction methods, the proposed Flip Directional 3D Volume Reconstruction (FD-3DVR) method provides superior performance for the mean peak signal-to-noise ratio (40.538 for the proposed method I and 39.626 for the proposed method II). Experimental results performed on the cardiac datasets demonstrate the efficiency of the proposed method for the reconstruction of echocardiogram images.