Reliable Visual Assessment Research Articles

Comparison between a dual-time-window protocol and other simplified protocols for dynamic total-body 18F-FDG PET imaging

PurposeEfforts have been made both to avoid invasive blood sampling and to shorten the scan duration for dynamic positron emission tomography (PET) imaging. A total-body scanner, such as the uEXPLORER PET/CT, can relieve these challenges through the following features: First, the whole-body coverage allows for noninvasive input function from the aortic arteries; second, with a dramatic increase in sensitivity, image quality can still be maintained at a high level even with a shorter scan duration than usual. We implemented a dual-time-window (DTW) protocol for a dynamic total-body 18F-FDG PET scan to obtain multiple kinetic parameters. The DTW protocol was then compared to several other simplified quantification methods for total-body FDG imaging that were proposed for conventional setup.MethodsThe research included 28 patient scans performed on an uEXPLORER PET/CT. By discarding the corresponding data in the middle of the existing full 60-min dynamic scan, the DTW protocol was simulated. Nonlinear fitting was used to estimate the missing data in the interval. The full input function was obtained from 15 subjects using a hybrid approach with a population-based image-derived input function. Quantification was carried out in three areas: the cerebral cortex, muscle, and tumor lesion. Micro- and macro-kinetic parameters for different scan durations were estimated by assuming an irreversible two-tissue compartment model. The visual performance of parametric images and region of interest-based quantification in several parameters were evaluated. Furthermore, simplified quantification methods (DTW, Patlak, fractional uptake ratio [FUR], and standardized uptake value [SUV]) were compared for similarity to the reference net influx rate Ki.ResultsKi and K1 derived from the DTW protocol showed overall good consistency (P < 0.01) with the reference from the 60-min dynamic scan with 10-min early scan and 5-min late scan (Ki correlation: 0.971, 0.990, and 0.990; K1 correlation: 0.820, 0.940, and 0.975 in the cerebral cortex, muscle, and tumor lesion, respectively). Similar correlationss were found for other micro-parameters. The DTW protocol had the lowest bias relative to standard Ki than any of the quantification methods, followed by FUR and Patlak. SUV had the weakest correlation with Ki. The whole-body Ki and K1 images generated by the DTW protocol were consistent with the reference parametric images.ConclusionsUsing the DTW protocol, the dynamic total-body FDG scan time can be reduced to 15 min while obtaining accurate Ki and K1 quantification and acceptable visual performance in parametric images. However, the trade-off between quantification accuracy and protocol implementation feasibility must be considered in practice. We recommend that the DTW protocol be used when the clinical task requires reliable visual assessment or quantifying multiple micro-parameters; FUR with a hybrid input function may be a more feasible approach to quantifying regional metabolic rate with a known lesion position or organs of interest.

Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction.

ObjectivesTo compare the surgical outcomes of externally monitored and conventional buried flaps with the goal of determining the usefulness of external monitoring of buried flaps.MethodsIn this case-control study with propensity score matching, 30 patients were evenly divided into externally monitored buried flap and conventional buried flap groups. The total operative time for free flap reconstruction, the flap survival rate, the length of hospital stay, the initial time of a reliable visual assessment, complications, the final diet achieved, and the duration until diet initiation were compared between the groups.ResultsThe mean operative time for reconstruction was 115 minutes (interquartile range, 85–150 minutes) and 142 minutes (interquartile range, 95–180 minutes) in the externally monitored and conventional groups, respectively (P= 0.245). The median length of hospital stay was 24 days (interquartile range, 18–30 days) and 27 days (interquartile range, 20–41 days) in the externally monitored and conventional groups, respectively (P=0.298). The median duration until diet initiation was 15 days (interquartile range, 15–21 days) and 18 days (interquartile range, 15–34 days) in the externally monitored and conventional groups, respectively (P=0.466). The final diet, initial time of a reliable visual assessment, and complications were comparable between the groups, but the external skin paddle provided an excellent visual assessment immediately postoperatively in all cases.Conclusion The outcomes were comparable between the groups, indicating that externalization of the cutaneous component of a buried flap may be a straightforward and useful technique for monitoring a buried anterolateral thigh free flap in laryngopharyngeal reconstructions. The salvage and false-positive rates of compromised flaps should be compared in large subject groups in future studies to prove that the use of an external skin paddle improves flap monitoring.

ROLE OF HYSTEROSCOPIC GUIDED ENDOMETRIAL BIOPSY IN DIAGNOSIS OF ENDOMETRIAL PATHOLOGY IN PATIENTS WITH UNEXPLAINED RECURRENT IMPLANTATION FAILURE

Background: Hysteroscopy is one of the most important investigations in women with recurrent implantation failure (RIF). It allows reliable visual assessment of the cervical canal and uterine cavity and it is considered to be the gold standard to diagnose intrauterine pathology and has minimal intra-operative and post-operative morbidity. Objective: To evaluate the role of hysteroscopic guided endometrial biopsy in diagnosis of endometrial pathology in patients with unexplained recurrent implantation failure. Patients and methods: This prospective study was done on 100 patients attended SayedGalalHospital from March 2018 to September 2019, with history of recurrent implantation failure. All patients were evaluated by full history taking include (Personal, Menstrual, Obstetric, Past), Full clinical examination (General, Abdominal, Local), transvaginal ultrasound, hysteroscopy and biopsy. Samples were collected to be examined for histopathology to detect any disease and to be tabulated for computerized analysis. Results: Of the 100 patients of infertility with a history of recurrent implantation failure undergoing endometrial biopsy guided by hysteroscopy, 48 (48%) showed normal findings and 52 (52%) showed abnormal findings: 28 were with normal hysteroscope but endometrial biopsy showed signs of chronic endometritis (28%),12 showed both abnormal hysteroscope and positive signs of chronic endometritis (12%), 7 showed endometrial polyp (7%) ,4 showed fine intrauterine adhesions (4%), and 1 showed cervical stenosis (1%). Conclusion: Hysteroscopy is of a great value in the evaluation and diagnosis of the endometrial pathology in patients with unexplained recurrent implantation failure.

ROLE OF HYSTEROSCOPIC GUIDED ENDOMETRIAL BIOPSY IN DIAGNOSIS OF ENDOMETRIAL PATHOLOGY IN PATIENTS WITH UNEXPLAINED RECURRENT IMPLANTATION FAILURE

Background: Hysteroscopy is one of the most important investigations in women with recurrent implantation failure (RIF). It allows reliable visual assessment of the cervical canal and uterine cavity and it is considered to be the gold standard to diagnose intrauterine pathology and has minimal intra-operative and post-operative morbidity. Objective: To evaluate the role of hysteroscopic guided endometrial biopsy in diagnosis of endometrial pathology in patients with unexplained recurrent implantation failure. Patients and methods: This prospective study was done on 100 patients attended SayedGalalHospital from March 2018 to September 2019, with history of recurrent implantation failure. All patients were evaluated by full history taking include (Personal, Menstrual, Obstetric, Past), Full clinical examination (General, Abdominal, Local), transvaginal ultrasound, hysteroscopy and biopsy. Samples were collected to be examined for histopathology to detect any disease and to be tabulated for computerized analysis. Results: Of the 100 patients of infertility with a history of recurrent implantation failure undergoing endometrial biopsy guided by hysteroscopy, 48 (48%) showed normal findings and 52 (52%) showed abnormal findings: 28 were with normal hysteroscope but endometrial biopsy showed signs of chronic endometritis (28%),12 showed both abnormal hysteroscope and positive signs of chronic endometritis (12%), 7 showed endometrial polyp (7%) ,4 showed fine intrauterine adhesions (4%), and 1 showed cervical stenosis (1%). Conclusion: Hysteroscopy is of a great value in the evaluation and diagnosis of the endometrial pathology in patients with unexplained recurrent implantation failure.

Optical flow based waveform for the assessment of the vocal fold vibrations.

Assessing vocal fold (VF) vibrations is important for the diagnosis of several diseases, and is made possible through the analysis of videoendoscopy recordings. However, the visual analysis of these recordings is hard due to the high acquisition rate. For this reason, it is commonly used to extract the laryngeal activity information from the recordings and represent it in a way suitable to be visually analyzed. Waveforms, images and playbacks are examples of representations reported in the literature. The main limitation of some of them is the lack of precisely locating the pathology within the VFs. Whereas others require the segmentation of the glottis in all the images of the video which is a complex and hard task given the high amount of images in the video and the necessity for the user intervention. To overcome these problems, the present study proposes a new waveform that maps the local vibrations of the VFs without the need for segmenting all the images of the video. Instead, the segmentation is restricted to only one image per vibratory cycle. Then, a new optical flow based technique is proposed to deduce the cycle-to-cycle dynamics of the VFs. The ability of the proposed approach to provide a reliable visual assessment is experimentally evaluated using different types of phonation and different vocal pathologies.

An evaluation of genetic analyses, skull morphology and visual appearance for assessing dingo purity: implications for dingo conservation

The introgression of domestic dog genes into dingo populations threatens the genetic integrity of ‘pure’ dingoes. However, dingo conservation efforts are hampered by difficulties in distinguishing between dingoes and hybrids in the field. This study evaluates consistency in the status of hybridisation (i.e. dingo, hybrid or dog) assigned by genetic analyses, skull morphology and visual assessments. Of the 56 south-east Queensland animals sampled, 39 (69.6%) were assigned the same status by all three methods, 10 (17.9%) by genetic and skull methods, four (7.1%) by genetic and visual methods; and two (3.6%) by skull and visual methods. Pair-wise comparisons identified a significant relationship between genetic and skull methods, but not between either of these and visual methods. Results from surveying 13 experienced wild dog managers showed that hybrids were more easily identified by visual characters than were dingoes. A more reliable visual assessment can be developed through determining the relationship between (1) genetics and phenotype by sampling wild dog populations and (2) the expression of visual characteristics from different proportions and breeds of domestic dog genes by breeding trials. Culling obvious hybrids based on visual characteristics, such as sable and patchy coat colours, should slow the process of hybridisation.