Expiratory central airway collapse (ECAC) is caused by anterior displacement of the posterior membrane (EDAC) or weakening of the cartilaginous walls (TBM). Differentiating the 2 is challenging, resulting in misdiagnosis and missed opportunities for patients. We investigated how accurately providers identify each pathology on computed tomographic (CT) images. Images from 100 patients who underwent tracheobronchoplasty (TBP) were reviewed by 4 airway experts and categorized into TBM, EDAC, normal airway, or unknown by majority consensus. Selected images of patients with TBM (n=9) and EDAC (n=9) were distributed to respondents. Linear regression was used to investigate overall accuracy; inter-rater agreement was measured using Fleiss' kappa (κ). We recruited 35 surgeons and 35 pulmonologists. Most practiced at an academic center (68.5%) and cared for patients with ECAC (61.4%). Among surgeons, 14 (40.0%) performed ≥5 complex airway cases yearly, and 13 (37.1%) performed TBP. Only 1 (1.5%) assigned the correct diagnosis to all 18 patients, while 13 (18.6%) identified <50.0% of the correct diagnoses. Inter-rater agreement for respondents was low (κ=0.21; 95% CI: 0.17-0.30; P<0.01). Predictors of accuracy included ≥10 years in practice (β=0.49; 95% CI: 0.03-0.95; P=0.03) and practicing pulmonology (β=0.72; 95% CI: 0.15-1.29; P=0.02). Distinguishing EDAC and TBM is challenging, with poor agreement among clinicians. Therefore, clinicians should consider referring any patient with ECAC early for multidisciplinary evaluation.

Tomographic datasets have continued to grow in size and volume along with camera technology and synchrotron brilliance. These larger datasets require new methods of distributing the reconstruction process on high-performance computing systems. Here we present a program for reconstructing large datasets, allowing the usage of either CPU- or GPU-powered clusters, and show the successful reconstruction of a 24000 pixel-wide dataset. This program is currently in use at the DanMAX beamline at the MAX IV synchrotron and is used as the default reconstruction method for all tomographic experiments at the beamline. Scans reconstructed with the presented pipeline have been published in multiple journals.

The introduction of the drop-in gamma probe has advanced intraoperative molecular imaging during prostate cancer surgery. We have been able to convert the sensor's numeric readout to tomographic images, so-called robotic-SPECT (RoboSPECT) and investigate how this is impacted by radiopharmaceutical avidities and drop-in scan metrics. The gamma sensor readout was registered with its 3D position and orientation, allowing a custom reconstruction algorithm to generate RoboSPECT images. Evaluations occurred in 21 patients; 10 sentinel node procedures (SN; primary prostate cancer) and 11 PSMA-radioguided surgery (recurrent prostate cancer). RoboSPECT findings were related to respective pre- and intra-operative controls, including preoperative PSMA-PET/CT and/or SPECT/CT images and fluorescence detection (SN only). RoboSPECT proved to be safe and applicable in a range of conditions. In the SN-group, 26 SN-SPECT/CT lesions were successfully identified with SN-RoboSPECT (100%); 3 were tumor positive (sensitivity 100%). Only 73% of SNs were surgically visible with fluorescence imaging. For the PSMA guided group, the 14 lesions identified on PSMA-PET/CT were all visualized with PSMA-RoboSPECT (100%); 18 specimens were tumor positive (sensitivity 78% for both PSMA-PET/CT and PSMA-RoboSPECT). Preoperative PSMA-SPECT/CT only identified 4 PSMA-lesions (29%). No false positives were seen for roboSPECT and all final resection margins were clean. At 6-months 0% of the SN-patients and 20% of PSMA-patients showed biochemical recurrence. RoboSPECT provides 3D context that extends the utility of drop-in gamma tracing and assists the alignment between pre- and intra-operative target perception. Here SN-RoboSPECT clearly outperformed fluorescence SN imaging and PSMA-RoboSPECT outperformed preoperative PSMA-SPECT/CT imaging.

The high patient dose applied during acquisition of C-arm based CBCT scans limits the applicability of this imaging technique. Acquisition of only a region-of-interest can decrease the dose significantly. However, reconstruction from such truncated projection data can lead to severe artifacts in the tomographic image. For typical usages of C-arm based CBCT however, there often exists a prior CT or CBCT scan of the patient. The proposed method enables the incorporation of such priors into the reconstruction process by jointly registering and extrapolating the prior to the limited data acquisition scenario by maximizing consistency conditions across thusly extended projections. Results show improved image quality over simple heuristic extrapolation methods typically used in practice. The proposed method can be regarded as a novel hybrid registration and extrapolation algorithm similar to established DRR-based registration methods, but unlike these, working on mutually disjoint regions of the projection data.

This systematic review aimed to consolidate the clinical presentation, diagnostic and microbial findings, management approaches, and outcomes of maxillary sinus involvement caused by extruded endodontic filling materials. Searches were performed in PubMed, Web of Science, Embase, Scopus, ScienceDirect, and ProQuest up to August 2025. Observational studies reporting extrusion of filling material into the maxillary sinus, accompanied by clinical, imaging, and/or surgical descriptions, were included. Study quality was critically analyzed using the Joanna Briggs Institute tools. Of 4076 articles initially retrieved, 52 were selected for full-text reading, 39 met the inclusion criteria and were included, comprising 34 case reports and 5 case series. Maxillary first molars were the most frequently involved teeth (59%). Extrusion occurred predominantly during primary endodontic treatment. Filling material was identified in the left maxillary sinus in 21 cases (47%) and in the right maxillary sinus in 24 cases (53%). Clinical presentations ranged from incidental asymptomatic findings to severe manifestations such as acute sinusitis. In the included studies, diagnosis was established using radiographic and tomographic imaging as well as direct endoscopic evaluation. Surgical removal represented the most common definitive management approach. Clinical outcomes were predominantly favorable, with complete symptom resolution and functional recovery. Extrusion of endodontic filling materials into maxillary sinus most often involves maxillary first molars and is associated with clinically significant complications, particularly fungal sinusitis. The present findings emphasize the need for prevention, accurate diagnosis, and timely interdisciplinary care of this iatrogenic event.

ObjectiveMercedes Benz craniosynostosis is a multisutural pattern characterized by posterior vault constriction due to fusion of sagittal and bilateral lambdoid sutures. Middle-posterior cranial vault remodeling (MPCVR) and posterior cranial vault distraction osteogenesis (PCVDO) are commonly used to address posterior vault deficiency, but comparative data in this population remain limited. This study evaluates perioperative, volumetric, and craniometric outcomes following MPCVR and PCVDO in Mercedes Benz craniosynostosis.DesignA retrospective review of computed tomographic images before and 1 year after surgery.SettingTertiary pediatric institution.Patients, ParticipantsEighteen patients with Mercedes Benz craniosynostosis.InterventionsMPCVR or PCVDO.Main Outcome Measure(s)Demographics, operative characteristics, and craniometric measurements.ResultsEighteen patients were included; 50% underwent MPCVR, 27.8% PCVDO, and 22.2% strip craniectomy. PCVDO demonstrated a significantly shorter operative time than MPCVR (P = .008) and trended toward lower blood loss. MPCVR produced a 50.8% increase in total intracranial volume, with the greatest expansion in the posterior vault (60.6%). PCVDO resulted in a 28.6% total volume increase, with posterior expansion (21.5%). Craniometric outcomes showed MPCVR achieved larger gains in width (20.4%), middle height (19.3%), and posterior height (14.7%), whereas PCVDO produced greater increases in circumference (11.22%), cranial length (15.28%), and vertex angle (18.99%). Both procedures improved skull base angles, with larger reductions observed in the PCVDO group.ConclusionsMPCVR and PCVDO exhibit distinct expansion patterns in Mercedes Benz craniosynostosis. MPCVR offers broad volumetric remodeling, while PCVDO provides greater longitudinal expansion. These findings support individualized selection of posterior vault techniques for this rare craniosynostosis subtype.

Tibial plateau fractures are commonly missed on conventional radiographs (CR), particularly when subtle or nondisplaced. This study evaluates the diagnostic performance of Multitom Rax, a novel cone-beam computed tomography (CBCT)-based 3D augmented X-ray system that provides multiplanar tomographic reconstructions alongside CR, for the detection of tibial plateau (TP) fractures in the emergency setting. Over a four-month period, 23 emergency department patients with suspected knee fractures underwent 3D Augmented X-ray (Multitom RAX, Siemens Healthineers). Four blinded radiologists with varying experience levels sequentially interpreted conventional radiographs and 3D tomographic images. Reader confidence in presence or absence of fracture was rated on a five-point Likert scale. Reference standard was established by MRI, standard CT, surgery or consensus of three expert musculoskeletal radiologists. Diagnostic performance was evaluated via area under the receiver operating characteristic curve (AUC) and compared between modalities. Differences in AUC between modalities were assessed using confidence interval-based comparison at a 95% significance level (α = 0.05) with the null hypothesis of no difference in AUC. Five occult TP fractures were identified among 23 patients (21.7%, 95% CI: 7.5-43.7%). Only two were detected using CR by the most experienced reader, whereas all five were correctly identified on 3D reconstructions without false positives by more experienced radiologists. The per reader-averaged AUC across patients increased from 0.748 ± 0.087 with CR to 0.933 ± 0.043 with 3D. The difference in AUC (mean 0.185, 95% CI: [0.019, 0.369]) was significant at the 95% level (p = 0.023). 3D Augmented X-ray demonstrated superior sensitivity and diagnostic confidence in detecting subtle TP fractures compared to CR. These preliminary findings support the potential value of 3D CBCT-based imaging in the evaluation of acute knee trauma and warrant validation in larger studies.

To review and assess published imaging evidence for optic nerve stretch (ONS) in patients with dysthyroid optic neuropathy (DON), evaluating its prevalence, measurement methods, and potential association with disease pathophysiology. PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov were searched using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, for computerized tomographic or magnetic resonance imaging studies of ONS in thyroid eye disease. Data were extracted on imaging modality, ONS definition, and association with DON. Pooled proportions were calculated using random-effects models with logit transformation, and heterogeneity assessed with I2. Sixteen studies, comprising 1,277 orbits (508 DON and 769 non-DON), met the inclusion criteria. Five noncomparative studies, mostly earlier papers, report ONS in 43% (0%-100%) of 75 DON orbits. Eleven studies (1,202 orbits) compared orbits with and without DON: 6 studies examined optic nerve contour (317 DON and 435 non-DON) and reported ONS in 66% of DON and 37% of non-DON orbits. Only 2 studies reported ONS as being significantly associated with DON (74% and 64% of orbits), and both reported marked apical crowding (70% and 67%). The pooled ONS proportion was 56% (95% confidence interval: 37%-74%) in orbits with DON and 31% (95% confidence interval: 12%-59%) in non-DON orbits, with high heterogeneity (I2 > 80%). While optic-nerve stretch is frequently observed in DON, current evidence does not establish it as an independent cause. ONS may reflect geometric changes due to orbital soft-tissue expansion, and the principal mechanism for DON probably remains apical compression and microvascular ischemia of the optic nerve.

Accurate prognostic models are essential for optimizing treatment strategies in gallbladder adenocarcinoma (GBAC). We preliminarily constructed and validated a multimodal fusion model integrating clinical features, enhanced computed tomographic (CT) images, and digital histopathological images to predict postoperative survival. Data from 177 patients with GBAC who underwent surgery between January 2017 and May 2023 at two tertiary hospitals were retrospectively analyzed. A deep-learning radiomics model was developed using preoperative, portal-venous phase, contrast-enhanced CT images. A pathomics model was constructed from hematoxylin-and-eosin-stained whole-slide images using a multi-instance learning approach. The three single-modality models were integrated through late-fusion logistic regression to generate a multimodal nomogram. The deep-learning radiomics model achieved an area under the receiver operating characteristic curve (AUC-ROC) of 0.883. The pathomics and clinical models yielded AUC-ROCs of 0.780 and 0.693, respectively. The multimodal nomogram showed superior performance (AUC-ROC: 0.896; sensitivity: 0.903; specificity: 0.810; accuracy: 0.865; concordance index: 0.736). Calibration and decision curve analysis confirmed clinical utility. Kaplan-Meier analysis revealed notable survival differences between the high- and low-risk sub-cohorts. In this limited cohort, a multimodal model integrating CT-based radiomics, pathomics, and clinical features showed preliminary association with postoperative survival in GBAC, and has the potential to support individualized clinical risk stratification in the future.

To summarize recent advances in photoacoustic imaging (PAI) for the diagnosis of limb lymphedema. Relevant domestic and international studies on PAI were reviewed to systematically summarize its imaging principles, technological development, applications in the diagnosis of limb lymphedema, and recent advances in related technologies. PAI combines the high contrast of optical imaging with the favorable tissue penetration of ultrasound. It has evolved from high-resolution microscopic imaging to large-field tomographic imaging, portable imaging, and molecularly targeted imaging, thereby establishing a technical foundation for the clinical translation of lymphatic imaging. Current studies have shown that PAI can visualize lymphatic vessels, accompanying veins, and dermal backflow, while also providing functional information to a certain extent. It therefore shows promising potential in the early diagnosis, preoperative localization, intraoperative assessment, postoperative follow-up, and staging of limb lymphedema. Furthermore, advances in related integrative and innovative technologies have further expanded the value of PAI in the diagnosis of lymphedema. PAI provides a promising approach for precise diagnosis and perioperative management of limb lymphedema. However, large-scale prospective studies and standardized imaging protocols are required to validate its long-term clinical value.

The cerebellar tentorium, composed of 2 laminae of dura mater, is an essential structure that separates the posterior and middle cerebral fossae. As it has a dural sinus within its 2 laminae, it carries significant risk potential. Cranium shape may affect its morphological properties. The cephalic index (CI) can easily describe a ratio of the length and width of the cranium. People may have different CI values individually, or some populations have a typical cranium shape that gives a clue for the CI. The aim of the present study was to investigate the morphometric properties of the cerebellar tentorium related to CI groups. A total of 594 participants’ (304 women and 290 men) computed tomographic angiography image series were included in the presented study, retrospectively. We evaluated cerebellar tentorium’s morphometric properties, its length, and its angle according to the McRae line, and compared these measurements in relation to CI. All morphometric evaluations were completed using free licensed Horos Software v.3.3.6. According to our results, morphometric properties tended to be higher in men than in women. We also found morphometric differences in the cerebellar tentorium among the CI groups. However, our results demonstrated that age was not effective on the cerebellar tentorium’s morphometric organization. Cerebellar tentorium has a potential risk for injuries during posterior cranial fossa approaches. A number of studies aimed to evaluate patients’ position during surgical interventions. However, the morphometric properties of cerebellar tentorium were not considered during the evaluation of patients’ surgical position in previous studies. Though statistically significant, observed differences and correlations in tentorial morphometry were weak and likely of limited clinical utility. Findings contribute to anatomical reference data but may not be useful for inferring surgical guidance.

The middle conchal sinus (MCS) (ethmoidal sinus) remains one of the least understood equine paranasal compartments. Despite recognition of its involvement in sinonasal disease, disorders of the MCS often remain underdiagnosed in the absence of computed tomographic (CT) imaging due to limited anatomical understanding and challenges with radiographic visualisation. The objectives of the study were (1) to characterise the radiographic features and anatomical location of the MCS in horses and (2) to illustrate the practical relevance of the anatomical and radiographic findings in two clinical cases of MCS sinusitis. Descriptive anatomical and imaging study. Six equine cadaver heads representing different age groups underwent standard radiographic projections before and after sagittal sectioning and placement of wire markers outlining the MCS. Radiographs were evaluated to identify and describe anatomical landmarks. Two clinical cases of MCS sinusitis confirmed by CT were used for comparative assessment. The MCS was not readily identifiable on pre-dissection radiographs. Post-sectioning images revealed consistent latero-lateral radiographic landmarks, notably its ovoid shape superimposed on the ethmoturbinates and its location dorsal to the third maxillary molar (maxillary Triadan 11's). Oblique projections allowed differentiation on which side was affected. On dorsoventral projections, the MCS was consistently superimposed on the middle nasal meatus, the nasal septum and the rostral margin of the ethmoturbinates, allowing tentative localisation in all specimens. The clinical cases had pathological changes at the predicted MCS site, correlating with cadaveric observations. The main limitations of the study include the small number of specimens examined and that radiographic interpretation was performed by a non-blinded reviewer. This study provides a reproducible radiographic reference for localising the MCS using radiography. Improved awareness of its location and presentation on radiographs will aid clinicians in diagnosing sinus disease involving this compartment, especially when CT imaging is unavailable.

Proteomics represents a powerful but underutilized approach for characterizing eye aging. Here, leveraging data from three large-scale, cross-national cohorts of over 55,000 transethnic participants, we demonstrate the ability of high-throughput proteomics combined with deep learning (DL) phenotyping to track eye aging and disease in both discovery and external validation settings. Proteomic aging driven by machine learning modeling closely aligns with signals of eye aging and DL aging phenotypes. We identifiy and validate premature proteomic aging in individuals with major age-related eye diseases (AREDs), including cataract, diabetic retinopathy, age-related macular degeneration, and glaucoma, and propose evidence supporting proteomic aging acceleration as a robust biomarker for predicting these conditions beyond chronological age, with adaptability across sexes and ethnicities. We also develop a streamlined, cost-effective proteomic aging clock that preserves predictive performance while reducing assay complexity. By integrating advanced tomographic and angiographic imaging, we derive structural and functional biomarkers through DL-driven pipelines and link accelerated proteomic aging to both neuroretinal degeneration and microvascular rarefaction in the Guangzhou Diabetic Eye Study (GDES) and the High-definition Oculo-Phenomic Evaluation (HOPE) study, highlighting coupled neural-vascular decline in eye aging. Our findings position proteomic aging combined with AI as a scalable tool for tracking eye health and disease, and provides new insights into shared aging pathways underlying multiple ocular pathologies.

Accurate localization of biliary leaks with conventional imaging remains challenging. We report a critically ill patient with a suspected biliothoracic fistula following a perforated gastric ulcer repair. Dynamic hepatobiliary PET/CT using the tracer [68Ga]Ga-TEoS-DAZA enabled antegrade, high-temporal-resolution visualization of bile flow, directly demonstrating bile leakage into a drained abscess cavity with cranial extension into the thorax. Compared with scintigraphy and MRI, hepatobiliary PET offers superior dynamic tomographic imaging, robustness against motion artifacts, and precise leak localization, highlighting its potential value in complex biliary complications.

Noninvasive quantification of immune markers such as programmed death ligand-1 (PD-L1) remains a major challenge because conventional molecular imaging methods cannot readily distinguish target-bound from nonspecifically retained probes within the tumor microenvironment. Here, we establish a framework for noninvasive quantification of PD-L1 expression in deep-seated hepatocellular carcinoma (HCC) using asymptotic time-domain (ATD) fluorescence lifetime tomography.In vivotime-domain fluorescence imaging was performed in mice bearing orthotopic HCC tumors following administration of a PD-L1-targeted near-infrared fluorescent probe (αPDL1-800). Multi-exponential analysis of time-domain fluorescence data was used to derive four amplitude-based metrics of PD-L1 expression. Quantitativein vivomeasurements obtained from ATD tomography were validated againstex vivoPD-L1 expression measured by Western blotting. Among the evaluated metrics, a normalized parameter that accounts for inter-lifetime crosstalk demonstrated the strongest correlation withex vivoPD-L1 expression (r2 = 0.77). These findings establish a foundation for a noninvasive, nonionizing imaging approach to quantify and monitor receptor expression and support a future path for the longitudinal assessment of immune biomarkers in both preclinical studies and clinical settings.

In large field-of-view tomographic images, fine structures such as bone texture, porosity or root canals are poorly resolved. We developed a Generative-Adversarial-Network (GAN)-based super-resolution method for craniofacial cone-beam CT (CBCT) that recovers sharp edges while avoiding hallucinations. CBCT scans of 1 human skull, 4 cadaveric human heads, and 6 sheep heads were acquired at 270μm and 135μm voxel, and a GAN (Unet-Structure-Preserving Super-Resolution [UNetSPSR]) was designed to recover fine image details in the low-resolution images. Performance was benchmarked against state-of-the-art methods using peak-signal-to-noise-ratio (PSNR) and learned-perceptual-image-patch-similarity (LPIPS), and evaluated in segmentation of trabecular bone and root canals. Independent archival clinical CBCT scans from five patients and an external public dataset (n=50) were used for generalization testing. UNetSPSR achieved the highest PSNR (+0.66 on seen and +0.11 on unseen data relative to the runner-up) and the lowest LPIPS (-0.01), indicating superior recovery of fine image details. The comparable performance between seen and unseen internal test sets, demonstrates strong generalization within the target data distribution. On independent clinical and external datasets, the network enhanced fine structures without introducing visible artifacts, despite heterogeneous acquisition parameters, although the absence of high-resolution reference standards precluded definitive validation. UNetSPSR substantially reduced overestimation of trabecular morphology, decreasing trabecular thickness bias from 61% to 11%, and significantly improved microarchitectural measures on external data (p<0.05). Root canal segmentations more closely resembled high-resolution references, with improved quantitative metrics. UNetSPSR enables structure-preserving super-resolution of craniofacial CBCT, improving visualization of fine anatomical features. While results demonstrate internal generalization, further external validation is warranted.

Epicardial Adipose Tissue, Coronary Plaque Progression, and Major Adverse Cardiovascular Events: A Multicenter Study.

Scedosporium spp. rhinitis in 4 dogs from Northern California.

Investigating stress evolution in rock burst prone regions in an underground mine with seismic tomographic imaging

To determine the changes in amplitude of the flicker electroretinograms (ERGs) and central macular thickness (CMT) during the acute phase of acute anterior uveitis (AAU). Retrospective case series. Flicker ERGs (RETeval) and optical coherence tomographic (OCT) images were recorded from the affected and fellow eyes at multiple examination times. The outcomes are expressed as a ratio of the affected-to-fellow eyes (×100). The time courses were modeled by polynomial regression (degrees 1-4) with model selection based on R2, Akaike, or Bayesian information criteria (AIC, BIC), and the P values. The peak timing and uncertainty were estimated by patient-level cluster bootstrap resampling (B=2000). Eight eyes from eight patients (4 men, 4 women; mean age 48.8±15.8 years) underwent 3.3±1.0 paired ERG/OCT assessments. The ratio of the amplitudes of the two eyes had a significant nonlinear time course, and a 4th-degree model was best supported (R2=0.411, P=0.021). Bootstrap estimated an amplitude peak at 11.8 days (median 11.9; 95% CI 10.2-19.0) with a peak value of 134.6%. The ratios of the implicit times were not significantly associated with the disease duration. The CMT ratio had a significant nonlinear time course and a 2nd-degree model was best supported (R2=0.358, P=0.006). Bootstrap analyses estimated a CMT peak at 35.4 days (median 35.1; 95% CI 29.2-48.4) with a peak value of 108.6%. The flicker ERG amplitudes increase transiently around two weeks after the onset of AAU and subsequent macular thickening in the OCT images. These findings suggest that flicker ERGs may serve as an early functional retinal marker of subclinical posterior segment inflammation in eyes with AAU.