Role Of Diagnostic Imaging Research Articles

Efficacy of ultrasound as a primary mode of investigation in the diagnosis of non-traumatic acute abdomen in pediatrics patients

Background: The role of diagnostic imaging is to determine whether the condition is medically or surgically treatable and, if possible, to diagnose the exact nature of the disease. Chest radiography is also commonly used to demonstrate extra-abdominal causes of acute abdominal pain, such as pneumonia. Ultrasonography is the initial choice of investigation that is likely useful to conclude for the following reasons, namely, it is relatively inexpensive, lack of radiation exposure, less time-consuming, easy, painless, and rarely requiring sedation. Usually, no preparation is required except in a few cases. It is also the preferred imaging tool for evaluating the surgical and non-surgical causes of acute abdomen in children. Ultrasound is also the preferred screening method for children suspected of having intra-abdominal mass. Aim and Objective: The present study is undertaken: (1) To identify specific causes of non-traumatic acute abdominal (NTA) pain in children; (2) to adopt the diagnostic efficacy of sonography as an initial tool for assessing those patients with probable clinical diagnosis; and (3) to triage patients for conservative or immediate surgery with available clinical diagnostic methods. Materials and Methods: A retrospective study of 100 pediatric patients aged between 1 and 14 years of both sexes with a history of non-traumatic acute abdomen attending outpatient services, in-patient, and emergency department at the Chamarajanagar Institute of Medical Sciences (CIMS) was conducted between March 2016 and March 2018 (for 2 years) for sonography. Results: Among 100 individuals, we had males followed by females (53%; 47%). The most common clinical symptoms of children with NTA were pain. Other symptoms included vomiting (66.7%; 15%), fever (68.5%; 31.6%), diarrhea (40%; 60%), cough (50%; 50%), and constipation (1%; 1%). The maximum number of cases in the group was >5 years–14 years. The most common sonography findings in this study were non-specific mesenteric lymphadenitis 49.4%, appendicitis (18.7%), intussusception, and cystitis (6.7%). followed by renal hydronephrosis (5.3%). Conclusion: Sonography, along with the associated clinical features, is a valuable adjuvant for a probable diagnosis. Other investigations such as laboratory findings, contrast-enhanced CT scan as indicated by the patient’s condition and requirement can be supported. This is particularly important in C-grade locations where other higher modes of investigation may not be available.

Role of diagnostic imaging in diagnosis of camel lameness: Current status and future prospectives

Role of diagnostic imaging in diagnosis of camel lameness: Current status and future prospectives

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population.

The purpose of this review is to analyze and consolidate recently published literature to provide updated guidelines on the diagnosis and management of nontuberculous mycobacterial lymphadenitis (NTM LAD) in the pediatric population and to suggest areas of further research. Diagnosis of NTM LAD relies on a detailed clinical history, physical examination, laboratory tests, and imaging techniques. Treatment strategies vary widely, with a shift towards complete surgical excision being observed due to its higher cure rate, improved aesthetic outcomes, and lower recurrence rates. However, patient-specific factors must be considered. The role of genetic factors, such as Mendelian susceptibility to mycobacterial disease (MSMD), is being increasingly recognized and could lead to targeted therapies. Despite strides in the understanding and management of NTM LAD, substantial gaps remain in key areas such as the role of diagnostic imaging, optimal treatment parameters, postoperative care, and surveillance strategies. In this article, we explain our approach to NTM using the most relevant evidence-based medicine while offering directions for future work.

Assessment of Amniotic Fluid Volume in Pregnancy

Amniotic fluid (AF) is an integral part of the fetal environment and is essential for fetal growth and development. Pathways of AF recirculation include the fetal lungs, swallowing, absorption through the fetal gastrointestinal tract, excretion through fetal urine production, and movement. In addition to being a marker for fetal health, adequate AF is necessary for fetal lung development, growth, and movement. The role of diagnostic imaging is to provide a detailed fetal survey, placental evaluation, and clinical correlation with maternal conditions to help identify causes of AF abnormalities and thereby enable specific therapy. Oligohydramnios prompts evaluation for fetal growth restriction as well as genitourinary issues, including renal agenesis, multicystic dysplastic kidneys, ureteropelvic junction obstruction, and bladder outlet obstruction. Premature preterm rupture of membranes should also be clinically excluded as a cause of oligohydramnios. Clinical trials evaluating amnioinfusion are underway as a potential intervention for renal causes of oligohydramnios. Most cases of polyhydramnios are idiopathic, with maternal diabetes being a common cause. Polyhydramnios prompts evaluation for fetal gastrointestinal obstruction and oropharyngeal or thoracic masses, as well as neurologic or musculoskeletal anomalies. Amnioreduction is performed only for maternal indications such as symptomatic polyhydramnios causing maternal respiratory distress. Polyhydramnios with fetal growth restriction is paradoxical and can occur with maternal diabetes and hypertension. When these maternal conditions are absent, this raises concern for aneuploidy. The authors describe the pathways of AF production and circulation, US and MRI assessment of AF, disease-specific disruption of AF pathways, and an algorithmic approach to AF abnormalities. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.

Panoramic Radiography Features of Medication-Related Osteonecrosis of the Jaws (MRONJ)

The diagnosis of medication-related osteonecrosis of the jaws (MRONJ) relies on the application of the clinical criteria stated in the American Association of Oral and Maxillofacial Surgeons position paper. The role of diagnostic imaging in integrating MRONJ clinical assessment is still debated, as pathognomonic imaging features have not been yet recognized. The present study retrospectively evaluated the radiographic signs of MRONJ on panoramic radiography with the aim of describing the characteristics of the lesions at different stages of the disease. The presence of alterations of the lamina dura (thickening or loss), the persistence of the alveolar socket following tooth extraction, and bone alterations (including sequestrum, sclerosis, osteolysis, mandibular canal enhancement, pathologic fracture, sinus involvement, and periosteal reaction) were investigated. The occurrence of each radiographic sign was stratified depending on oral status, antiresorptive pharmacological treatment administered, and general health variables. A weak relationship between radiographic signs and disease stage was observed. Mandibular canal enhancement was associated with the advanced disease stage (p-value < 0.001). The distribution of the different radiographic features was not influenced by the underlying disease (osteoporosis or oncologic disease) treated with antiresorptive drugs. Bone sequestrum was more frequently encountered in the mandible. Panoramic radiography appears to be a valid support in the assessment of MRONJ lesions. The clinician should be aware of the signs associated with MRONJ occurrence in order to improve the diagnostic performance and provide adequate treatment.

Prediction of Surgical Outcome in Advanced Ovarian Cancer by Imaging and Laparoscopy: A Narrative Review.

Maximal-effort upfront or interval debulking surgery is the recommended approach for advanced-stage ovarian cancer. The role of diagnostic imaging is to provide a systematic and structured report on tumour dissemination with emphasis on key sites for resectability. Imaging methods, such as pelvic and abdominal ultrasound, contrast-enhanced computed tomography, whole-body diffusion-weighted magnetic resonance imaging and positron emission tomography, yield high diagnostic performance for diagnosing bulky disease, but they are less accurate for depicting small-volume carcinomatosis, which may lead to unnecessary explorative laparotomies. Diagnostic laparoscopy, on the other hand, may directly visualize intraperitoneal involvement but has limitations in detecting tumours beyond the gastrosplenic ligament, in the lesser sac, mesenteric root or in the retroperitoneum. Laparoscopy has its place in combination with imaging in cases where ima-ging results regarding resectability are unclear. Different imaging models predicting tumour resectability have been developed as an adjunctional objective tool. Incorporating results from tumour quantitative analyses (e.g., radiomics), preoperative biopsies and biomarkers into predictive models may allow for more precise selection of patients eligible for extensive surgery. This review will discuss the ability of imaging and laparoscopy to predict non-resectable disease in patients with advanced ovarian cancer.

Current concepts in the diagnosis and treatment of adhesive capsulitis: role of diagnostic imaging and ultrasound-guided interventional procedures.

Adhesive capsulitis is a common cause of painful shoulder, characterized by pain and restricted range of motion of the glenohumeral joint. With a well-known clinical presentation, and an increasing understanding of its clinical and radiologic features, early diagnosis of adhesive capsulitis is becoming a reality. Although often treated conservatively, for refractory cases arthroscopic release and open capsulotomy have been the only therapeutic option for a long time. Therefore, in the last years, a particular effort was put into the development of novel minimal-invasive techniques capable of pain relief and functional range improvement of the glenohumeral joint. The purpose of this literature review is to report the main updates on diagnosis and treatment for adhesive capsulitis with a focus on imaging diagnosis techniques and novel minimally invasive ultrasound-guided treatments. Results showed that ultrasound-guided procedures come with a high success rate in terms of pain reduction and improved range of motion, thus making the ultrasound a unique tool capable of giving the operator real-time diagnostic information confirming the clinical suspicion, and subsequently performing an interventional procedure.

Potential risks and treatment options for colonic diverticular disease Novelties based on international guidelines

The prevalence of colonic diverticulosis is growing worldwide due to dietary and lifestyle changes. Colonic diverticulosis does not cause any complaints in a significant proportion of individuals; therefore, it is usually diagnosed by accident and does not require any treatment. Diverticular disease, which constitutes about 25% of the cases, is associated with presenting symptoms, and has various forms based on the course and severity of the disease. From the early 2000s, the better understanding of the pathophysiologic pathways which play a role in the development of the diverticular disease (genetic background, low-grade chronic inflammation and intestinal dysbiosis) promoted prevention, diagnostics and finding treatment options. The main conclusions: It is a challenge to distinguish uncomplicated but symptomatic diverticular disease from irritable bowel syndrome. The prevalence of acute diverticulitis is lower than it was previously assumed. The role of diagnostic imaging, mainly abdominal computer tomography, has become more important to aid the rapid and correct diagnosis of acute diverticulitis and to determine its severity. Although a high-fiber diet may be recommended for general health purposes, there is little evidence that it benefits recovery during acute diverticulitis episodes or prevents recurrent episodes. Traditional antibiotic therapy as the mainstay of treatment of acute uncomplicated diverticulitis such as routine hospital admission has been challenged recently. In an acute episode of diverticulitis, performing colonoscopy should be avoided as it is associated with an increased risk of colonic perforation. If there was no screening colonoscopy within 3 years, it is strongly recommended at least 6 weeks after the acute episode to exclude colorectal carcinoma. Routine colonoscopy may be omitted in certain cases. Complicated acute diverticulitis should not necessarily be treated by emergency surgery. In thecase of hemodynamically stable and immunocompetent patients, resection with primary anastomosis may be preferred over a Hartmann's procedure for the treatment of perforated diverticulitis and diffuse peritonitis. With this review, the authors intend to facilitate providing up-to-date and customized treatment of diverticular disease in the daily practice.

Mechanical and Imaging Properties of a Clinical-Grade Kidney Phantom Based on Polydimethylsiloxane and Elastomer.

Medical imaging phantoms are considered critical in mimicking the properties of human tissue for calibration, training, surgical planning, and simulation purposes. Hence, the stability and accuracy of the imaging phantom play a significant role in diagnostic imaging. This study aimed to evaluate the influence of hydrogen silicone (HS) and water (H2O) on the compression strength, radiation attenuation properties, and computed tomography (CT) number of the blended Polydimethylsiloxane (PDMS) samples, and to verify the best material to simulate kidney tissue. Four samples with different compositions were studied, including samples S1, S2, S3, and S4, which consisted of PDMS 100%, HS/PDMS 20:80, H2O/PDMS 20:80, and HS/H2O/PDMS 20:40:40, respectively. The stability of the samples was assessed using compression testing, and the attenuation properties of sample S2 were evaluated. The effective atomic number of S2 showed a similar pattern to the human kidney tissue at 1.50 × 10−1 to 1 MeV. With the use of a 120 kVp X-ray beam, the CT number quantified for S2, as well measured 40 HU, and had the highest contrast-to-noise ratio (CNR) value. Therefore, the S2 sample formulation exhibited the potential to mimic the human kidney, as it has a similar dynamic and is higher in terms of stability as a medical phantom.

Content and consistency of clinical guidelines for diagnostic imaging of non-traumatic lower back, knee and shoulder pain: A scoping review

Purpose: For many patients with musculoskeletal (MSK) pain such as low back (LBP), knee and shoulder pain, there is clinical uncertainty about the role of diagnostic imaging. Given the aging population and the prevalence of structural changes in those with and without pain, the relevance of scan findings is often questionable. Despite this, the use of diagnostic imaging is increasing, and patients often perceive imaging results to be authoritative.

Can New ENZIAN Score 2020 Represent a Staging System Improving MRI Structured Report?

Structured reporting systems for endometriotic disease are gaining a central role in diagnostic imaging: our aim is to evaluate applicability and the feasibility of the recent ENZIAN score (2020) assessed by MRI. A total of 60 patients with suspected tubo–ovarian/deep endometriosis were retrospectively included in our study according to the following criteria: availability of MR examination; histopathological results from laparoscopic or surgical treatment; patients were not assuming estro-progestin or progestin therapy. Three different readers (radiologists with 2-, 5-, and 20-years of experience in pelvic imaging) have separately assigned a score according to the ENZIAN score (revised 2020) for all lesions detected by magnetic resonance imaging (MRI). Our study showed a high interobserver agreement and feasibility of the recent ENZIAN score applied to MRI; on the other hand, our experience highlighted some limitations mainly due to MRI’s inability to assess tubal patency and mobility, as required by the recent score (2020). In view of the limitations which arose from our study, we propose a modified MRI-ENZIAN score that provides a complete structured reporting system, more suitable for MRI. The high interobserver agreement of the recent ENZIAN score applied to MRI confirms its validity as a complete staging system for endometriosis, offering a shared language between radiologists and surgeons.

Role of Diagnostic Imaging in Chronic Recurrent Multifocal Osteomyelitis (CRMO) in Children: An Observational Study.

The aim of this single-center observational study was to analyze the applicability of various imaging studies to the diagnosis and further evaluation of patients with chronic recurrent multifocal osteomyelitis (CRMO). The analysis included the data of 10 patients with CRMO treated between 2016 and 2021. The mean ages of the patients at the first manifestation of CRMO and ultimate diagnosis were 10 years and 7 months and 11 years and 10 months, respectively. Conventional radiography demonstrated focal loss of bone density in only 30% of the patients. Computed tomography showed disseminated foci with non-homogeneous osteolytic/osteosclerotic structure, with a massive loss of cortical layer and strong periosteal reaction. On magnetic resonance imaging (MRI), most patients presented with multifocal hypodense areas on T1-weighted images, with the enhancement of signal on T-weighted and STIR sequences. The duration of follow-up varied between 3 months and 3 years. In 40% of the patients, both clinical symptoms and the abnormalities seen on MRI resolved completely, whereas another 50% showed partial regression of clinical and radiological manifestations. MRI findings, co-existing with characteristic clinical manifestations, play a pivotal role in establishing the ultimate diagnosis of CRMO. MRI can also be used to monitor the outcomes of treatment in CRMO patients.

Low-Field Magnetic Resonance Imaging: A New Generation of Breakthrough Technology in Clinical Imaging.

Magnetic resonance imaging (MRI) plays a pivotal role in diagnostic imaging. In today's clinical environment, scanners with field strengths of 1.5 to 3 T are most commonly used. However, recent technological advancements might help to augment the clinical usage and availability of MRI via the introduction of high-performance low-field MRI systems (ranging from ~0.1-0.55 T in current systems). The combination of low field strength and high-performance hardware is characterized by increased flexibility, excellent quality of results, and reduced cost. This review discusses the multifaceted potential advantages of a new generation of high-performance low-field MRI systems and presents the potential impact of such systems in terms of socioeconomic benefits as well as positive effects on patient care.

Role of diagnostic imaging in diagnosis by Covid-19

The diagnosis from Covid-19 provides the set of several examinations such as: clinical examinations, laboratoryexaminations, radiographic examinations. Using radiological imaging, RX and chest CT, it is possible to evaluatethe impairment of lung function and thanks to this aspect it is possible to define the severity and clinical conditionsof the patient. In this way, it allows timely therapeutic intervention especially if the patient shows a mild condition insuch a way as to avoid the onset of further complications. Chest X-rays allow both an initial assessment of patientsand the possibility to perform a differential diagnosis towards other possible causes of lung parenchyma involvement.The CT scan, which highlights the peculiar characteristics of COVID pneumonia, is performed both as diagnosticconfirmation and in the patient’s follow-up.

Role of diagnostic imaging in diagnosis by Covid-19

The diagnosis from Covid-19 provides the set of several examinations such as: clinical examinations, laboratory examinations, radiographic examinations. Using radiological imaging, RX and chest CT, it is possible to evaluate the impairment of lung function and thanks to this aspect it is possible to define the severity and clinical conditions of the patient. In this way, it allows timely therapeutic intervention especially if the patient shows a mild condition in such a way as to avoid the onset of further complications. Chest X-rays allow both an initial assessment of patients and the possibility to perform a differential diagnosis towards other possible causes of lung parenchyma involvement. The CT scan, which highlights the peculiar characteristics of COVID pneumonia, is performed both as diagnostic confirmation and in the patient’s follow-up.

Changing the Goal Posts: Prostate-specific Membrane Antigen Targeted Theranostics in Prostate Cancer.

Prostate-specific membrane antigen (PSMA) theranostics is changing the face of prostate cancer diagnosis and therapy. PSMA, a transmembrane protein over-expressed in many prostate cancers, is a promising target for theranostics. Theranostics is the concept of small molecule proteins that are labelled to different radionuclides and can be used for either diagnosis or therapy, dependent on whether they are labelled with an imaging or therapy radionuclide. By directly targeting the cancer cells with imaging and then for therapy, this approach embodies the philosophy of precision medicine - right drug, right time, right dose. The question is how to best utilise these new imaging and therapy agents in clinical practice. This review will evaluate the importance of PSMA in prostate cancer, its role in diagnostic imaging, and its potential as a therapy of advanced prostate cancer. Electronic databases including MEDLINE, Scopus, professional websites were searched. PSMA-directed theranostics has an expanding role in prostate cancer because of its utility as a sensitive diagnostic tool that can be coupled with efficacious and low-toxicity therapeutic options. Ongoing research is required to determine how to use this effective tool for best patient care. PSMA theranostics is rapidly being incorporated into the routine care of men with prostate cancer. Understanding its strengths, its limitations, and where it may be valuable in clinical care is important in undertaking best patient practice.

Current status and prospects of reactor produced medical radioisotopes in China

Medical radioisotopes as the cornerstone of modern nuclear medicine play an irreplaceable role in diagnostic imaging and therapy of various diseases, like malignant tumors, cardiovascular and brain disorders, according to achieve molecular level imaging tracking and precise targeted clearance of small lesions. The most commonly used reactor produced medical radioisotopes include molybdenum-99/technetium-99m (99Mo/99mTc) generator, iodine-131/125 (125/131I), strontium-89 (89Sr), and lutetium-177 (177Lu) and so on. Amongst them, 99mTc is by far the most widely used and best known diagnostic isotope. 131I and 177Lu are already being applied routinely in nuclear medicine nowadays and will increase further as new precise targeted therapies developed, especially 177Lu combined with various targeted molecules to achieve a variety of systemic metastasis of malignant tumors is recognized as a revolutionary prospect in the medical community. In the future, many more patients will suffer from different kinds of diseases, which are need medical radioisotopes to diagnostic imaging and therapy. Therefore, safeguarding a reliable supply to make medical radioisotopes available for all patients who require radiotherapy or imaging is highly important. In this review, a brief account of various aspects of the recent research progress of reactor produced medical radioisotopes in China is introduced. For each medical radioisotope under consideration, like 99Mo, 131I, 125I, 177Lu, 89Sr and 90Y and so on, the status of technology for clinical scale production as well as clinical application is discussed. There are many challenges that face reactor produced radioisotopes production and application for medical diagnostics and therapy in China. The serious relying on importation of reactor produced medical radioisotopes from overseas is pointed out. 99Mo,125I, 89Sr and 90Y are imported completely and the vast majority of 131I and 177Lu are also imported. The import dependent of medical radioisotopes has become a bottleneck for the advances in nuclear medicine and has seriously restrained the healthy development of national public health in China. Some real experience in the development of the production of medical radioisotopes in China indicates that progress in this field is possible if the following conditions are fulfilled. Firstly, establish long-term national plan and improve support management for the independent supply of medical radioisotopes. Secondly, increase the production capacity and alleviate supply-demand contradiction by optimizing the production organization process in the existing reactor resource. Thirdly, increase the annual appropriated budget for research and development to realize the independent production of medical radioisotopes and radiopharmaceuticals. Finally, establish a technology innovation platform of production, teaching and research integration for medical radioisotopes and radiopharmaceuticals. We also discuss the potential and future uses of reactor produced medical radioisotopes. In the future, the production and application of medical radioisotopes will be one of the hot spots in the field of nuclear technology application. From the standpoint of radioisotope therapy, particular hopes for the future are related to “targeted” therapy, in which a radioisotope is delivered directly into the affected cell by biological “transporters” to kill malignant tumors with radiation. “Personalized” medicine (radiotheranostics) refers to the use of medical radioisotopes-labeled agents to perform simultaneous imaging and therapy of a target lesion is the key development direction of new radiopharmaceuticals. These new directions require development of a broad dedicated production of radioisotopes specially intended for these purposes. In addition, 223Ra, 225Ac and other α-nuclide labeled radiopharmaceuticals will also be focused on.

Incidentally discovered COVID-19 pneumonia: the role of diagnostic imaging

Incidentally discovered COVID-19 pneumonia: the role of diagnostic imaging

The role of diagnostic imaging in the primary testicular cancer: initial staging, response assessment and surveillance.

Testicular cancers are a group of uncommon malignancies that account for less than 1% of new cancer cases per year in the United States and globally. The disease typically affects men between the ages of 20-44, and the overwhelming majority of tumors are germ cell in origin. Most cases of testicular cancer are organ confined at diagnosis and have a good overall prognosis. Testicular cancers are staged by the tumor, node, metastasis, serum markers (TNMS) classification set forth by the American Joint Commission on Cancer staging. Diagnostic imaging plays a crucial role in initial staging, specifically in assessing the primary tumor prior to orchiectomy and evaluating for regional and/or distant metastasis. Multimodality imaging is used for initial staging, with ultrasound and computed tomography (CT) most commonly utilized. Diagnostic imaging is also important in evaluating response in patients who initially present with metastatic disease as well as in patients who are undergoing surveillance. Typically, CT is used for response assessment and surveillance, with magnetic resonance imaging (MRI) and positron emission tomography (PET) serving as adjunct modalities. This article reviews the role of various diagnostic imaging modalities and how they are employed in the diagnosis, staging, response assessment and surveillance of primary testicular cancer.

Ultrasound image segmentation with multilevel threshold based on differential search algorithm

Ultrasound (US) image segmentation plays a very important role in diagnostic imaging. In order to extract special tissues from images, this study proposes a new method for segmentation of US images. The proposed method uses multilevel threshold segmentation which is based on Otsu and differential search algorithm. Testing in simulation US images shows that the proposed algorithm has a better result of segmentation than the three existing methods, including region growing, the active contour model and k-means technique. The proposed method gets the highest F m values and the smallest area errors in experiments. Vivo US images are also tested by the proposed method and it achieves a good segmentation result.