Radiology Research Articles

Prevalence of Alveolar Bone Dehiscence and Fenestration in Adults with buccally positioned canines-A CBCT Study

Detecting alveolar bone fenestrations and dehiscences before orthodontic treatment is imperative due to their potential implications. These defects can contribute to gingival recession and diminish the support structure of canine teeth. Failure to recognize buccal alveolar bone issues increases the risk of treatment relapse.The aim of this study was to determine the prevalence of alveolar bony dehiscence and fenestration in adults with buccally positioned canines. Thirty individuals aged between 18 and 35 undergoing orthodontic treatment in the Department of Orthodontics in the institution were chosen randomly for this study. Their CBCT records were obtained from the Department of Oral Medicine and Radiology, S******* Dental College and Hospital. Statistical analysis was conducted using IBM SPSS Version 23. The chi-square test was employed to explore the relationship between fenestrations, dehiscences, and gender. It was observed that 40% of females had dehiscence, while 36% of males exhibited this condition. Fenestrations were present in 35% of males and 40% of females. In the context of this study's limitations, a statistically significant relationship was found regarding dehiscence width among females (p=0.019, p<0.05), highlighting a heightened vulnerability compared to males. Conversely, the association of fenestration prevalence between males and females did not reach statistical significance (p=0.178, p>0.05). These findings suggest that females may have a greater propensity for bony alveolar dehiscence and fenestration relative to males.

Kruskal Szekeres generative adversarial network augmented deep autoencoder for colorectal cancer detection.

Cancer involves abnormal cell growth, with types like intestinal and oesophageal cancer often diagnosed in advanced stages, making them hard to cure. Symptoms are like burning sensations in the stomach and swallowing difficulties are specified as colorectal cancer. Deep learning significantly impacts the medical image processing and diagnosis, offering potential improvements in accuracy and efficiency. The Kruskal Szekeres Generative Adversarial Network Augmented Deep Autoencoder (KSGANA-DA) is introduced for early colorectal cancer detection and it comprises two stages; Initial stage, data augmentation uses Affine Transform via Random Horizontal Rotation and Geometric Transform via Kruskal-Szekeres that coordinates to improve the training dataset diversity, boosting detection performance. The second stage, a Deep Autoencoder Anatomical Landmark-based Image Segmentation preserves edge pixel spatial locations, improving precision and recall for early boundary detection. Experiments validate KSGANA-DA performance and different existing methods are implemented into Python. The results of KSGANA-DA are to provide higher precision by 41%, recall by 7%, and lesser training time by 46% than compared to conventional methods.

REVISÃO DE LITERATURA: MANEJO DO PACIENTE COM COLANGITE ESCLEROSANTE PRIMÁRIA

The primary sclerosing cholangitis (PSC) is a progressive, idiopathic, immune mediated disease, characterized by intra or extrahepatic cholestasis, Inflammation and fibrosis of the bile ducts, which may progress to liver cirrhosis or cholangiocarcinoma (CCA) in the vast majority of patients. Objective: Analyze what the current literature discusses about the management of PSC. Method: A systematic review was carried out using the PubMed and SciELO database, applying the descriptors "Primary Sclerosing Cholangitis" AND "Cholangite" AND "Clinical management" AND Cholangiocarcmoma. Discussion: It is more common in men, with an average diagnosis at 35 years old. The PSC has a wide range of symptoms and stages of the disease. In the beginning, symptoms are rare and patients may be asymptomatic. The most commonly found symptoms are pruritus, fatigue, right upper quadrant abdominal pain, jaundice, fever, and weight loss. In about 75% of patients with PSC, liver function tests are chronically abnormal and fluctuating with a most commonly found pattern of cholestatic condition with elevation of alkaline phosphatase (AF) and yglutamyl transferase (GGT). Although endoscopic retrograde cholangiopancreatography (ERCP) is conventionally considered the gold standard test for the diagnosis of PSC, the main modality of choice currently for Imaging diagnosis in patients with suspected PSC is magnetic resonance cholangiopancreatography (CPRM). Due to the absence of effective medical therapy for PSC, liver transplantation (LT) remains the only curative option. There is little evidence for the use of medications as a way to inhibit the progression of the disease. Still several new drugs are under investigation, representing the potential to improve survival and clinical outcomes in PSC. Final considerations: We conclude that it is extremely important to approach the management of PSC. The diagnosis is a great challenge since its clinical, laboratory and imaging aspects overlap, as it was portrayed during this exposure. Nevertheless, due to the various differential diagnoses ofjaundice with cholestatic pattern, the etiological search is crucial and the absence of effective medical therapy, with several new drugs under analysis, should guide further studies to improve the survival and clinical outcomes of these patients. Another point to be considered is that there is a scarcity of data in the literature that address the PSC in the Brazilian population.

CNN-Based Cancer Image Diagnosis: Current Progress and Future Directions

Abstract. With the development of deep learning technology, CNN (Convolutional Neural Network) models have shown great value in medical image analysis, especially in diagnosing early lung cancer, breast cancer, and brain tumors. In this study, we recall and organize the application and progress of CNN models in the field of cancer and tumor diagnosis in the past five years to provide a theoretical basis and reference for related researchers. This article introduces the principles of different CNN cancer diagnostic models and compares and analyzes their results, and ultimately finds that these models have significant advantages in improving the accuracy and efficiency of cancer diagnosis, but at the same time, there are also problems such as too much reliance on large datasets, high model complexity, and poor generalization ability. In the future, we can consider optimizing the performance of CNN network models, enhancing the generalization ability of the models, and developing data enhancement techniques on this basis, so that CNN models can be better applied in the field of cancer diagnosis.

EGS SO21 - The undifferentiated general surgical take over 10 years: Emergency imaging

Abstract Background The undifferentiated emergency general surgical take in July 2013 and July 2023, at a District General Hospital, was reviewed with the aim of understanding increasing pressures on the surgical and radiology departments, and subsequently identifying areas in which we could adapt to facilitate these demands. Method Patients were identified retrospectively if they had been cared for by the emergency general surgical team in July 2013 or July 2023. Further information was collected from electronic notes, with a focus on admission and initial imaging modalities. Patients were excluded if information was not available electronically. Results Of the 395 patients in July 2013, and 594 in July 2023, 55% and 61% respectively had imaging studies within 7 days of admission. 11% (n=44/395) of patients in 2013 had abdominal X-ray without further imaging, compared to 6% (n=33/594) in 2023. Computed Tomography (CT) use increased by 35%, whilst ultrasound scanning (USS) increased only by 11%. Time from admission to scans of all types has reduced from 0.79 days (+/-0.16, p=0.02) in 2013 to 0.60 (+/-0.1, p=0.02) days in 2023. Conclusion Overall volume of imaging has increased slightly, although the proportion of patients being scanned is largely unchanged, with subtle variation in preferred imaging modalities. CT is marginally more common, whilst USS remains mostly unchanged. The use of abdominal x-ray without subsequent imaging has decreased, demonstrating its reducing use in clinical judgement and reliance on alternative imaging techniques. Time from admission to scan of all kinds has reduced, despite increasing demands on radiology departments.

EGS SO05 - Improving the Flow of Patients Attending Surgical Assessment Unit: Introduction of Ambulatory USS Slots - Closed Loop Audit

Abstract Background Modern emergency surgical service recognises that a significant proportion of patients presenting with acute abdomen can be diagnosed and treated in the ambulatory fashion. However, this approach requires multidisciplinary cooperation between the general surgery team and radiology department. We aimed to assess and improve the flow of patients presenting to Surgical Assessment Unit (SAU) with complaints of right iliac fossa (RIF) and right upper quadrant (RUQ) pain. Method We performed a retrospective analysis of all ambulatory patients returning to SAU of a District General Hospital with RUQ and RIF pain in January 2023. We measured the waiting time between the arrival to SAU and the time of USS. We presented the results in a local meeting and negotiated the introduction of two daily USS slots for SAU patients. We re-assessed the impact of the USS slots on waiting times in July 2023. Results In January 2023, 13 patients returned to SAU for USS. The minimum waiting time for this cohort was 59 minutes and the maximum waiting time was 3 hours and 39 minutes. The median was 2 hours and 15 minutes. In July 2023, 18 patients returned to SAU for USS. The minimum waiting time for this cohort was 4 minutes and the maximum waiting time was 2 hours and 20 minutes. The median was 1 hour and 5 minutes. There was an average reduction of 1 hour and 10 minutes in waiting time for USS. Conclusion The introduction of two USS slots per day for patients returning to SAU with RUQ and RIF pain resulted in a 48% reduction in waiting times. This improved the flow of patients, sped up the diagnosis and timely access to treatment, as well as significantly improved patients experience and satisfaction. We would recommend close co-operation between general surgery and radiology to allow timely access to imaging for patients presenting with acute abdomen to SAU.

Improved Diagnostic Performance Using Dual-Energy CT-Derived Slope Parameter Images in Crohn's Disease.

The objective of the study is to explore the image quality and diagnosis performance of the dual-energy CT-derived slope parameter images (SPI) generated by the algorithm based on the slope function in the diagnosis of Crohn's disease (CD). Seventy-six CD patients and 53 disease-free control group subjects who underwent dual-energy CT enterography were retrospectively collected. Portal venous phase 120kVp-like and virtual monoenergetic images at 40-100keV (VMI40-100) were reconstructed. SPIs corresponding to the spectral curve between 40 and 100keV (SPI40-100) were generated using Python. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of normal and abnormal intestinal walls were calculated. Image quality, noise, and contrast were independently scored by two radiologists using a 5-point scale. Four radiologists conducted CD diagnosis with three reading models (120kVp-like, 120kVp-like with optimal VMI, and 120kVp-like with SPI40-100). The diagnostic performances of the three reading models for diagnosing CD were evaluated using receiver operating characteristic (ROC) curves. The CNR in SPI40-100 was higher than in the other images (P < 0.05). The subjective evaluation showed that there was no statistical difference between the contrast of SPI40-100 and VMI40 (P > 0.05), but that of the two images was higher than the other images (P < 0.05). The scoring on the overall image quality of VMI50 was superior to that of other images (P < 0.05). The combined model of 120kVp-like with SPI40-100 had the strongest confidence (cases with high confidence: 36, 58, 49, 47 for radiologists 1, 2, 3, 4) and the highest efficiency in diagnosing CD (areas under the ROC curve: 0.973, 0.977, 0.982, 0.991 for radiologists 1, 2, 3, 4). SPI40-100 generated by the algorithm based on the slope function exhibited good image quality. The combined model of 120kVp-like with SPI40-100 could improve radiologists' diagnostic efficiency and confidence in diagnosing CD.

RADIOLOGICAL ASSESSMENT OF SPONDYLOLISTHESIS OF LUMBOSACRAL SPINE

Introduction: One major injury or frequent minor injuries cause the vertebral body, pedicle and superior articular surfaces to slide forward. This disorder is known as spondylolisthesis and is usually accompanied by symptoms, often proportional to the degree of forward movement. Patients may complain of pain in the lower back that spreads to the thighs, and limited range of motion is possible Objectives: The aim of this study is to determine the frequency of spondylolisthesis by age and gender in the patients studied at SKB Mostar. Research methodology: The method of content analysis was used to retrospectively examine X-ray, CT and MRI examinations of patients with the clinical features of lumbar pain syndrome in the period from 1 January 2019 to 1 January 2020 in patients who underwent radiological examination of the LS spine at the Clinical Institute of Radiology of the University Clinical Hospital Mostar. Data were collected from IMPAX at the SKB Mostar Department of Radiology. The input parameters that were observed were: pain syndrome, diagnosis. The output parameters were the radiological findings from the X-ray, CT, and MRI scans. Results: During the study period, 297 spinal scans were performed, and spondylolisthesis was found in 32 patients, or 11%. The youngest respondent was 8 years old, and the oldest was 85 years old. The average age of the respondents was 64.37 years. The largest number of respondents was in the age group of over 75 years old. Of the tests performed, the most common were CT scans, followed by MRI, and the rarest were X-ray scans. The highest prevalence of spondylolisthesis was found in vertebrae L4-L5 and L5-S1 at 41%. Spondylolisthesis was found bilaterally in 9% of cases at the L3-L4 and L5 vertebrae. Conclusion: Most often, spondylolisthesis is found in L4-L5 and L5-S1 vertebrae. There was no difference according to gender, and most often subjects older than 75 years had spondylolisthesis.

Knowledge and Attitudes toward Dental X-Rays among Patients at Muhimbili School of Dentistry in Tanzania

Background Dental X-rays are vital diagnostic tools in dentistry, providing critical information for treatment planning. However, patient awareness and understanding of the risks and benefits associated with dental radiography can significantly influence their attitudes toward these procedures. Method This cross-sectional study was conducted in 2008 at the Radiology Department of Muhimbili Dental School. A total of seventy patients attending the dental clinic who underwent periapical and orthopantomogram (OPG) radiography were surveyed. Data were collected using structured questionnaires designed to assess knowledge and attitudes regarding dental X-rays. Results The results revealed that 70% of participants understood the radiation risks associated with X-rays, while 75% were aware of the indications for their use. However, only 60% were familiar with the benefits of OPG. In terms of attitudes, 80% of patients agreed that X-rays are essential for diagnosis, and 85% believed their dentist should explain the necessity of X-rays. Conclusion The findings indicate that while patients at Muhimbili Dental School exhibit a moderate level of knowledge and positive attitudes toward dental X-rays, there is a need for enhanced patient education regarding the risks and benefits. Implementing educational initiatives could improve understanding and alleviate concerns related to dental radiography.

OGC SO36 - Complications of palliative oesophageal cancer stent insertion: Audit for a five year period

Abstract Background Oesophageal stents are commonly used for the palliative treatment of inoperable oesophageal malignancy[1]. Stenting of the oesophagus may provide safe and quickly effective management for late-stage disease symptoms. However, there are common complications associated with the oesophageal stents. This audit looks at the types of early and delayed complications from oesophageal stenting, specifically for malignancy. We aim to stratify the types of complication, association between complications and the type of stent used, and the frequency of repeat stenting or repositioning. This will provide patients with better expectations of the complications and compare our practice against published international standards Method All fluoroscopy guided stent insertions between 1/1/2019 and 31/12/2023 for oesophageal malignancy were requested from the hospital radiology department. 101 patients were included for analysis. Their basic demographics were obtained, as well as a disease profile including tumour histology, staging and whether they underwent radiotherapy or chemotherapy. Complications of the stent insertion were then logged. The number of times stents were replaced or repositioned were noted. The type of stent, size parameters, features such as covering, antimigration device and anti-reflux valve were also assessed. In addition, any hospital admissions related to stent complications were also recorded. Results Of 101 patients, the median age was 75, with a higher proportion of male patients ( 71%). After stent fitting there was a median survival length of 94 days. 45% of patients had complications related to the stent. Stent migration was the most frequent complication, 14% of patients experienced stent migration into the stomach, which required repositioning or restenting. Both middle and lower oesophagus stents had equal complication rate. 25% of patients were reported to have overgrowth of tumour affecting the stent, and there was no significant difference in those fitted with a covered stent, meant to reduce overgrowth complications. Conclusion The complications directly resulting from oesophageal stents may adversely affect the palliation of oesophageal cancer patients. In this cohort, the most commonly occurring complications were migration of the stent, immediate symptoms after insertion, and overgrowth of the tumour. Although overgrowth of tumour is part of the disease progression, in many cases it made retrieval of the existing stent or reinsertion more difficult. Our results found no significant difference for complication rates between the different stents, nor the inclusion of antimigration devices. There were no deaths directly due to the stent and no oesophageal perforations reported.

Abstract 4121816: Viral Venture: A Case of Myocarditis and IgA Vasculitis from Adenovirus Infection

Case Description: A 19-year-old man presented to the emergency department for 3 days of shortness of breath, progressive bilateral lower extremity rash, generalized fatigue, and diffuse joint following an earlier visit to urgent care for pharyngitis symptoms. Physical exam was notable for tachycardia, pain with active wrist and ankle range of motion, pharyngeal erythema, cervical adenopathy, and confluent erythematous palpable purpura and petechiae noted on bilateral lower extremities with scattered lesions on his thighs, arms, and back. Laboratory workup notable for markedly elevated high-sensitivity troponin to 3398 ng/L, and elevated CRP. Further workup was notable for normal urinalysis, negative streptococcus antigen, negative ANCA antibodies, ANA, Hepatitis B and C, and cryoglobulins. Imaging and cardiac workup were notable for normal left ventricular function and cardiac MRI notable for late gadolinium enhancement in the anteroapical mid-myocardial region suggestive of myocarditis. Skin biopsy ultimately revealed immunodeposition of IgA on superficial capillaries compatible with a diagnosis of IgA vasculitis. The patient was started on steroids for IgA vasculitis with rapid improvement in his symptoms and he was discharged home in good condition. Discussion: Recognizing the severe complications of viral infection can lead to prompt treatment and prevention of progression to severe end organ damage. Our case highlights rarely reported cardiac involvement of IgA vasculitis secondary to adenovirus infection based on laboratory and imaging diagnosis with cardiac MRI. To date, only 16 cases of cardiac involvement in IgA vasculitis have been reported. This case adds to the limited body of published cases describing this presentation of IgA vasculitis and is also consistent with the results of prior cases suggesting that an immunosuppressive regimen including glucocorticoids may help to prevent disease progression and induce remission in cases with cardiac involvement without the need for endomyocardial biopsy.

SURG-23. ESTABLISHMENT OF AN APPROPRIATE GLIOMA SURGERY SYSTEM CONSIDERING MOLECULAR AND FUNCTIONAL BOUNDARIES

Abstract Gliomas are invasive tumors and cannot be cured by surgery. But surgical removal has also been proven to affect treatment outcomes. Recent advances in molecular diagnostics have identified IDH mutations, especially in lower grade gliomas, allowing the identification of so-called molecular boundaries. It is conceivable that expanded resection to the molecular border may improve treatment outcome. On the other hand, extended resection may be incompatible with functional preservation. In such cases, it is also important to consider that the impact of surgery on treatment outcome has also been proven to vary by glioma genotype. While total resection has a significant prognostic impact on survival in astrocytomas with IDH mutations, the impact on survival in oligodendrogliomas that are sensitive to chemoradiotherapy and, conversely, in high-grade tumors without IDH mutations is lower than in the former. Therefore, it is important to determine the extent of removal after considering the tumor type. In general, various surgical support devices such as surgical navigation systems, fluorescent diagnosis using 5ALA, intraoperative electrophysiological monitoring, awake functional brain mapping, and intraoperative MRI are applied during glioma surgery. In addition to these, we have developed a surgical system that also focuses on tumor subtypes by introducing preoperative tumor type prediction using AI imaging and intraoperative rapid genetic diagnosis. We have further developed intraoperative rapid genetic diagnosis to identify genetic mutations around the tumor, enabling the detection of molecular boundaries. It is now possible to remove as much as possible, considering the molecular boundary, while paying sufficient attention to preservation of brain functions. Gliomas are intractable diseases, but their treatment outcomes have steadily improved over time. We are now in an era of a tailor-made surgery based on a variety of data. Implementing “appropriate surgical procedures” we aim at further improvement of treatment outcomes.

Transrectal ultrasound-guided intraprostatic injection therapy for treatment of chronic prostatitis in a Ugandan population

Abstract Background Globally, the clinical understanding of prostatitis has been obscured mainly due non-specificity of clinical features, no uniform diagnostic criteria and its protracted treatment course. Conventional treatment of chronic prostatitis by oral or parenteral routes of drug administration remains a challenge basically because of the poor ability of drugs to penetrate prostate epithelium; the alternative of direct prostate injection has not been thoroughly studied in an African population. The aim of this retrospective study was to determine the effect of transrectal ultrasound (TRUS)-guided intraprostatic injection of a cocktail of antibiotics, antifungal and long-acting steroids on alleviating symptoms attributed to chronic prostatitis in Ugandan patients. Methods We conducted a retrospective review of records among patients who were referred with symptoms attributed to chronic prostatitis at the Radiology Department of Ernest Cook Ultrasound Research and Education Institute (ECUREI). Patients were treated using TRUS-guided intraprostatic injection of a cocktail of antibiotics, antifungal agents and long-acting steroids. Results At baseline, we found that out of the 131 patients, 90 had pain or burning during urination in the last week to seeking care and 89 had symptoms, which had kept them away from doing the kinds of things they would usually do. Additionally, 85 of the total number of patients felt terrible about their symptoms. Post intervention, after 1 year following completion of intraprostatic injection therapy (IPIT), we found that most patients had mild residual symptoms which were largely; mild pain and burning at urination. None of the patients had symptoms, which kept them away from doing the kind of things they would usually do. Furthermore, 62 patients felt delighted about their quality of life, whereas prior to treatment, none was delighted. Eighty-five patients had felt terrible about their quality of life prior to the IPIT, but post therapy, no patient felt terrible. Conclusion Transrectal ultrasound-guided intraprostatic injection therapy of a drug cocktail composed of antibiotics, antifungal agents, long-acting steroids and lidocaine for treatment of patients presenting with symptoms attributed to chronic prostatitis and refractory to conventional oral therapy has shown a good response in this study.

DISP-10. RACIAL AND SOCIOECONOMIC DIFFERENCES IN CLINICAL AND ACCESS TO CARE OUTCOMES IN NEUROSURGICAL-ONCOLOGY PATIENTS

Abstract BACKGROUND Large database studies have identified racial and socioeconomic differences in neurosurgical-oncologic outcomes. For clearer insights and understanding, more detailed and prospective evaluation is needed. METHODS We retrospectively analyzed a database of 1475 patients undergoing surgery for CNS tumors over 5 years. Multivariate analysis, specific to various pathologies, was conducted to identify demographic and socioeconomic factors (including age, sex, racial identity, primary language, insurance status, and income estimate) associated with access to care and clinical outcomes. Additionally, prospective patient-centered interviews were conducted on neuro- oncology patients to qualitatively explore reasons for disparities in healthcare. RESULTS Significant associations were found between racial identities (White n=911; Hispanic n=285; Asian n=206; Black n=74) and sex (ANOVA p 0.0043), age (p&amp;lt;0.0001), income estimate (p&amp;lt;0.0001), primary language (p&amp;lt;0.0001), and insurance status (p&amp;lt;0.0001). Among different pathologies, presentation to the ED, rather than outpatient setting, was consistently associated with a non- English primary language (p=0.0312) and Medi-Cal insurance (p=0.0029). Time from imaging diagnosis to neurosurgical consultation was associated with non- English primary language (p=0.0262) and Medi-Cal (p=0.0030). Delay between recommendation for surgery and date of surgery was significant in Black patients (p=0.0112). A non- English primary language was negatively associated with having a gross total resection (p=0.0087). Notably, adjuvant treatments were less likely for those with non-English primary language (p=0.0203), Black race (p=0.0049), and Medi-Cal coverage (p=0.0014). Cox regression analysis identified only age (p&amp;lt;0.0001) as a predictor of poorer overall survival in oncologic cases. Prospective interviews identified cultural, economic (work- related), and healthcare navigation issues as reasons for differences in access to care. CONCLUSIONS Across the spectrum of neurosurgical oncology diagnoses, racial and socioeconomic factors independently associate with access to care but not clinical outcome variables. Further investigation is needed, particularly in patients with non- English primary languages and cultural attitudes towards chemotherapy and radiation therapy.

Evaluation of the Safety Rate in the Diagnostic Radiology Departments in Alkhoms City, Libya

Diagnostic radiation such as X-rays and CT scans play a central role in the diagnosis of diseases. Excessive radiation exposure poses a high risk for healthcare providers as well as patients, which may cause serious diseases such as cancer. Providing protection requirements in the radiation departments and continuous inspection to prevent radiation leakage is the right way to provide human protection. The current study aimed to evaluate the safety rate in the diagnostic radiology departments in Alkhoms City. The questionnaire designed for the study in Arabic language, presented to experts for verification and review, then distributed to eleven medical centres in the Alkhoms region containing many relevant questions regarding the radiology department such as the name and address of a medical centre, in-formation about users and safety. Lead plates are present in 91% of health centres 36% of health centres installed lead plates for 1-5 years, 27% for 6-10 years, and 36% for 21 years or more. Lead plates are inspected once in 27%, three times in 9%, and four times or more in 9% of medical centres, on the other hand, 56% of medical centres didn’t inspect lead plates since installed. The lead plates last examined in 27% of medical centres a year ago, in 9% examined less than five years ago, and in 9% examined less than twenty years ago. On the other hand, 56% of medical centres have not performed any check-ups since installation. Protection glass and lead plates are present in 82% of medical centres, a radiation protection gown is present in 36%, and a dosimeter is present in 9% of medical centres only. Only 18% of health centres have organised a training programme for their radiology department staff. The safety rate in radiology departments in Alkhoms City- Libya is low because most medical centres lack protective equipment, and if they do, there is no regular inspection or testing of this equipment.

Estimating Morphological Nose Features for Craniofacial Reconstruction: A Retrospective Study

Abstract Background: Craniofacial reconstruction is one of the techniques used in forensic sciences to rebuild the probable antemortem face of unknown human skulls. Considering the soft-tissue thickness, the skull is covered with clay or similar material. After covering, facial features such as lips, ears, eyes, and nose should be added. The nose has considerable diversity. This variety makes it have substantial importance for facial recognition. Aims and Objectives: The current study aimed to determine the morphology of the nose of the Anatolian population and develop regression formulas to estimate the nose shape using the measurements of the skull. Materials and Methods: The current study was conducted on three-dimensional computed tomography cranial images. The images belonging to 50 adult patients (25 males, 25 females) were taken from the Radiology Department of Bursa Uludag University Medical Faculty Hospital. Eighteen parameters on bony structure and twenty-four parameters on soft tissue were measured using ImageJ software. SPSS 22.0 was performed for statistical analyses. Results: The regression formulas were developed to estimate the nose morphology belonging to the skull using the correlated parameters between the bony structure of the skull and soft tissue. Conclusion: Accurate nasal shape prediction means increasing the identification of the unknown skull. We believe that the regression formulas, developed with this idea could be helpful in craniofacial reconstruction.

The effectiveness of deep learning model in differentiating benign and malignant pulmonary nodules on spiral CT.

Pulmonary nodule, one of the most common clinical phenomena, is an irregular circular lesion with a diameter of ⩽ 3 cm in the lungs, which can be classified as benign or malignant. Differentiating benign and malignant pulmonary nodules has an essential effect on clinical medical diagnosis. To explore the clinical value and diagnostic effects of the lung nodule classification and segmentation algorithm based on deep learning in differentiating benign and malignant pulmonary nodules. A deep learning model with a fine-grained classification manner for the discrimination of pulmonary models in Dr.Wise Lung Analyzer. This study retrospectively enrolled 120 patients with pulmonary nodules detected by chest spiral CT from March 2021 to September 2022 in the radiology department of Ninghai First Hospital. The DL-based method and physicians' accuracy, sensitivity, and specificity results were compared using the pathological results as the gold standard. The ROC curve of the deep learning model was plotted, and the AUCs were calculated. On 120 CT images, pathologically diagnosed 81 malignant nodules and 122 benign modules. The AUCs of radiologists' diagnostic approach and DL-base method for differentiating patients were 0.62 and 0.81; radiologists' diagnostic approach and DL-base method achieved AUCs of 0.75 and 0.90 for benign and malignant pulmonary nodules differentiate. The accuracy, sensitivity, and specificity with the deep learning model were 73.33%, 78.75%, and 62.50%, respectively, while the accuracy, sensitivity, and specificity with the physician's diagnosis were 63.33%, 66.25%, and 57.500. There was no significant difference between the diagnosis results of the proposed DL-based method and the radiologists' diagnostic approach in differentiating benign and malignant lung nodules on spiral CT (P< 0.05).

Magnetic resonance imaging diagnosis of ankle joint athletic injury based on machine learning algorithms

The diagnosis of ankle joint athletic injuries using traditional magnetic resonance imaging (MRI) relies on the subjective judgment and experience of doctors, and small structural changes in athletic injuries are difficult to accurately detect and diagnose. By using machine learning (ML) algorithms and image processing techniques to obtain objective and consistent diagnostic results, the accuracy of diagnosing ankle joint athletic injuries can be improved. This article collected a large number of MRI images of ankle joint athletic injuries, and preprocessed the collected images to extract morphological and texture features, and perform feature fusion. The Residual Network (ResNet) was improved, and the Leaky linear rectification function (ReLU, Corrected linear unit) activation function was introduced. The transfer learning was utilized to increase the convergence speed of the model, and the global maximum pooling layer and softmax classifier were used to construct the fully connected layer. After sufficient training on the training set, the findings on the test set indicated that the average accuracy of the improved ResNet model for ankle joint injury classification was 98.3%. The use of an improved ResNet model can effectively improve the diagnostic effectiveness of ankle joint athletic injuries, providing a new method for medical diagnosis of MRI.

Clinical Results of Percutaneous Transhepatic Biliary Drainage With Different Hepatic Access and Methods in the Treatment of Obstructive Jaundice.

Percutaneous transhepatic biliary drainage (PTBD) is a common procedure for biliary obstruction jaundice caused by biliary tract obstruction. PTBD can be performed using external or external-internal methods, by the right or left lobe approach. However, differences in both the method used and the hepatic approach may affect success rates and complications. Therefore, this study aimed to examine the outcomes and complications of PTBD and compare them according to different methods and hepatic approaches. Patients who underwent PTBD procedures in our interventional radiology department due to benign or malignant pathologies between March 2021 and March 2024 were included in the study. The diagnoses of the patients, and total and direct bilirubin values before and after the procedure were recorded. The clinical results and the complications of PTBD were compared statistically according to the hepatic approach and method. Univariate logistic regression analysis was performed to determine significant factors associated with PTBD success and complications. Sixty patients were included in our study (32 men, 28 women; mean age: 67.14±13.61y). The most common indication was malignant bile duct obstruction (90%). The obstruction was mostly at the level of the common bile duct (46.7%). The success rate of PTBD was the highest with the left-side external biliary drainage approach (left-side external biliary drainage, 81.2%; right-side internal-external biliary drainage, 77.8%; right-side external biliary drainage, 69.2%; P=0.596). The complication rate was higher for right-side access (right side 15.9%, left side 12.5%, P=0.744). Univariate logistic regression analysis revealed that PTBD success in females was 5 times higher than in males [Exp(B): 5.000, β: 1.609, P<0.05]. Univariate logistic regression analysis revealed that methods used, entry lobes, and entry levels did not significantly affect PTBD success and complication incidence (P>0.05). All approaches and methods used during PTBD were associated with low complications and high success rates. Nevertheless, external biliary drainage with right hepatic access has the lowest clinical success rate and a higher complication rate than the left-lobe approach. We observed that left-sided external biliary drainage was the most successful method and had fewer complications.

ESTIMATION OF DOSE ESTIMATION USING THE SPECIFIC DOSE SIZE METHOD OF RADIOGRAPH IMAGE REPEAT ANALYSIS AS A FORM OF RADIATION SAFETY IN THE RADIOLOGY INSTALLATION OF KLATEN ISLAMIC HOSPITAL

Repeat analyses are radiographs that are not clinically acceptable and are requested to be retaken. The primary purpose of the repeat analyses program is to take corrective action, record the repeated radiographic images, and determine the cause of the repetition so that it can be minimized or even eliminated. Klaten Islamic Hospital needs to keep its radiology services optimal and safe for patients as a referral hospital. One indicator of the quality of service is the low repetition rate of radiographic images. This study aims to determine the percentage of factors causing the repetition of radiographic images and suggested solutions to minimize repeat radiographic images in the Radiology Department. Survey research with a quantitative approach to repeating radiographic images at the Radiology Department. The study was conducted in February-May 2024 using observation, survey, and documentation. The percentage of repetition of radiographic images at the Radiology Installation of Klaten Islamic Hospital in the first month was 2.72%, in the second month was 3.04%, in the third month was 4.05%, and in the fourth month was 3.43%. Factors causing the repetition of radiographic images include miscollimation (clipped), artifacts, exposure factors, tools, and patient movement. Suggested solutions to minimize the factors causing the repetition of radiographic images in the Radiology Installation of Klaten Islamic Hospital are good communication between radiographers and patients, double checking before exposure, clear instructions to patients, ensuring there are no objects that can become artifacts, using appropriate exposure parameters, calibrating and testing suitability regularly, reporting if there is equipment damage, and using immobilization techniques. Keywords: Repeat Analyses, Digital Radiography, radiation safety for patient.