Vertical Diameter Research Articles

Characterization of the external limbus on corneoscleral topography with ultrawide-field optical coherence tomography

PurposeTo present a new method for 3-dimensional external limbal demarcation on corneoscleral topography derived from optical coherence tomography (OCT). Limbal shape is investigated and compared to other landmarks. MethodsImages from the anterior segment were obtained with a ultrawide-field (20 mm) OCT. An automated algorithm was developed to demarcate the topographic limbus based on the transition from corneal to scleral curvature. The internal limbus was manually identified as the scleral spur on the OCT images. The external topographic limbus was fit with a circle on a plane. Ellipticity and ovality were defined by the lateral limbal deviation from the best-fit circle. Toricity was defined by the axial deviation from the best-fit plane. Repeatability was assessed by the within-subject standard deviation from two repeated measurements. For comparison, the white-to-white (WTW) diameter was obtained from Pentacam HR. Results18 eyes from 11 subjects were analyzed. The topographic limbal diameter was 12.16 ± 0.68 mm (mean ± standard deviation) horizontally and 11.18 ± 0.65 mm vertically. The repeatability for the topographic limbal diameter was 0.054 mm. The internal and WTW horizontal limbal diameters were significantly smaller (linear mixed-effects model (GLMM), p <.017). The vertical internal limbal diameter was significantly larger (GLMM p <.05). The topographic limbus had significant ellipticity (0.25 ± 0.13 mm, wider horizontally, repeatability of 0.07 mm) and toricity (0.15 ± 0.08 mm, flatter horizontally, repeatability of 0.10 mm). Low coefficients of determination were found for the topographical limbus with the internal limbus (R2=0.021 and R2=0.039, for horizontal and vertical diameters respectively) and with the WTW (R2=0.146 for the horizontal diameter). ConclusionThe proposed method to demarcate the 3D external topographical limbus is repeatable. The topographic limbal shape and size cannot be accurately derived from WTW nor internal limbus measures. This new technology may improve the process of scleral lens fitting.

Anatomic Features of the Interthalamic Adhesion in the Pediatric Population

The main goal of this retrospective study was to examine the morphology of the interthalamic adhesion (ITA) in normal children aged between 1 and 18 years. The study universe consisted of magnetic resonance images of 180 healthy pediatric subjects (age, 9.50 ± 5.20 years, sex, 90 girls and 90 boys). The cross-sectional area (CSA), vertical diameter (VD), and horizontal diameter (HD) of the ITA were measured and in addition, its location was noted. HD, VD, and CSA of the ITA were measured as 8.47 ± 1.64 mm, 7.59 ± 1.57 mm, and 52.06 ± 18.51 mm2, respectively. HD did not change from infancy until postpubescence, but then significantly decreased (P < 0.001). VD increased up to early childhood but then did not alter until the end of prepubescence. After that period, it decreased in postpubescence (P < 0.001). CSA tended to decrease in an irregular pattern according to pediatric age periods (P < 0.001). The ITA was located at the anterosuperior quadrant in 138 individuals (76.70%), at the anteroinferior quadrant in 7 individuals (3.90%), and the center of the lateral wall of the third ventricle in 35 individuals (19.40%). Linear functions were calculated as y= 9.490-0.107× age (years) for HD, y= 8.453-0.091× age (years) for VD, and y= 63.559-1.211× age (years) for CSA. ITA size irregularly decreases with advancing age from 1 to 18 years. Our calculated linear functions, showing the growth dynamics of the ITA by pediatric ages, may be helpful in estimating its dimension.

Radiographic determination of the tracheal indices at caudal cervical, thoracic-inlet, and intra-thoracic trachea in non-bulldog brachycephalic breeds without evidence of cardiorespiratory disease

BackgroundCongenital tracheal hypoplasia is a component of airway syndrome affecting a wide variety of brachycephalic dog breeds. Several radiographic procedures were utilized to assess vertical tracheal diameter (VTD) in dogs. The objective of this study was to calculate the tracheal indices at the caudal cervical, thoracic-inlet, and intra-thoracic tracheal regions on the right lateral thoracic radiograph to further establish a screening protocol for diagnosis of tracheal hypoplasia in non-bulldog brachycephalic breeds. Dogs without clinical or radiographic evidence of tracheal, respiratory, or cardiovascular abnormalities were investigated. The absolute and average VTDs were normalized by manubrium length (ML), thoracic-inlet distance (Ti-D), and proximal 3rd rib width (PR3-W). Manubrium-tracheal index (M-TI), thoracic inlet-tracheal index (Ti-TI), and proximal R3-tracheal score (PR3-TS) were calculated. Correlations between averaged VTD and each of the normalizing parameters (ML, Ti-D, and PR3-W), and between M-TI and each of the previously established procedures (Ti-TI and PR3-TS) were determined.ResultsEighty healthy subjects met the inclusion criteria for the study. There were significant differences (P ≤ 0.0001) among the means of absolute and normalized VTDs at the 3 tracheal levels. The smallest VTD was identified at the thoracic inlet. The average tracheal diameter showed a better correlation with ML (rs=0.81, P < 0.0001) compared to Ti-D and PR3-W. There was a strong correlation (rs=0.83, P < 0.0001) between the averaged M-TI and Ti-TI.ConclusionRadiographic M-TI could be an alternative to traditional procedures to assess the tracheal lumen in non-bulldog brachycephalic dogs. M-TI < 0.39, < 0.30, or < 0.34 at caudal cervical, thoracic inlet, or intrathoracic trachea, respectively, may indicate tracheal hypoplasia in non-bulldog brachycephalic breeds. Screening of tracheal diameter using M-TI should be recommended. However, further investigation of non-bulldog brachycephalic breeds with cardiac and/or respiratory disease is indicated.

Morphometric Analysis and Incidence of Accessory Foramen Transversarium in a Population in Eastern Turkey

The aim of this study is to reveal the incidence and morphometric features of the accessory foramen transversarium in the population in eastern Turkey. In the study, a total of 125 cervical vertebrae of unknown gender and age, located in the Anatomy Department of Ataturk, Erzincan Binali Yıldırım and Kafkas University Medical Faculties, were used and accessory foramen transversarium was detected in 22 (17.6 %) of these cervical vertebrae. In this study, the area, vertical and horizontal diameters of the accessory foramen transversarium were measured for the first time. It was determined that the accessory foramen transversarium with the largest area was in C3-C6 (6.8 mm2) and the smallest area was in C7 (1.06 mm2). It was determined that the largest vertical diameter was C7 (2.38 mm), the smallest one was C3-C6 (0.91 mm), the largest horizontal diameter (3.66 mm), and the smallest (1.6 mm) were C3-C6. In addition, accessory foramen transversariums were typified. One foramen arcuate was also detected during the examinations. As a result, osteometric measurements of the accessory foramen transversarium were revealed. We think that these data will be an important reference in head and neck surgery, in the clinical approach of a. vertebralis, and in the evaluations of radiologists in the neck region.

Diagnostic value of patellofemoral parameters in small breed dogs with medial patellar luxation: a tangential X-ray study

Knowing the diagnostic value of radiological patellofemoral parameters is important for evaluating the status of small-breed dogs with medial patellar luxation (MPL). This retrospective survey was conducted in four small dog breeds (Mini Pinscher, Pomeranian, Chihuahua, and Yorkshire terrier) on 46 healthy stifle joints and 72 joints with grade II and III MPL. The following morphometric parameters were measured on tangential radiographs: trochlear sulcus angle, lateral and medial trochlear inclination angles, trochlear depth, horizontal and vertical patellar diameters, length of the lateral and medial patellar facets, lateral and medial facet angles, Wiberg angle, congruence angle, and axial linear patellar displacement. Receiver operating characteristic (ROC) analysis was performed to evaluate the cut-off values, sensitivity, and specificity of the parameters associated with MPL. The trochlear sulcus angle and trochlear depth were capable of consistently identifying the MPL-affected joints (AUCs &gt; 0.9). The parameters describing the position of the patella within the trochlear groove (congruence angle and axial linear patellar displacement) were found to be the most accurate, with an AUC of over 0.990 and a sensitivity/specificity of over 94%. The patellar morphology parameters had no diagnostic value in distinguishing between healthy and MPL stifles.

Interthalamic Adhesion: Can it be used to Diagnose Idiopathic Intracranial Hypertension?

This retrospective study aimed at determining the dimension of the interthalamic adhesion (ITA) in patients with the idiopathic intracranial hypertension (IIH) for assisting in preoperative radiologic diagnosis. The study universe consisted of magnetic resonance images of 20 patients with IIH (age: 22.70 ± 4.04 years, sex: 14 females and 6 males) and 20 normal subjects (age 22.30± 2.94 years, sex: 14 females and 6 males). To determine the morphology of ITA, its height (vertical diameter) and width (horizontal diameter) were measured on the coronal and axial planes, respectively. The height and width of ITA in IIH were measured as 2.58 ± 0.71 mm (range: 1.40-4.20 mm) and 2.73 ± 0.77 mm (range: 1.70-4.40 mm), respectively. Its height and width in controls were measured as 4.99 ± 1.04 mm (range: 2.70-6.30 mm) and 4.92 ± 1.11 mm (range: 2.60-6.50 mm), respectively. ITA height and width in IIH was significantly smaller compared with controls (P < 0.001). For an arbitrary cutoff of 3.85 mm, the sensitivity of the height of ITA was 85% with 95% specificity. For an arbitrary cutoff of 4.45 mm, the sensitivity of the width of ITA was 75% with 100% specificity. The height and width of ITA are approximately 50% smaller in IIH than controls; therefore alterations in the dimension of ITA may be a valuable radiologic sign for the diagnosis of IIH.

Effect of Genotype and Sex on Chemical Composition, Physicochemical Properties, Texture and Microstructure of Spent Broiler Breeder Meat

The aim of this research is to compare the carcass composition and meat quality characteristics of spent Cobb 500 and Ross 308 broiler breeders. A total of 28 carcasses were evaluated—7 female and 7 male carcasses from each genotype. Dissection was performed, and the percentages of neck, wings, skin with subcutaneous fat, abdominal fat, residual components, breast and leg muscles were calculated relative to the eviscerated carcass weight. The breast and leg muscles were evaluated for their chemical composition, color attributes (Lab), acidity (pH24), and electrical conductivity (EC24). Analysis of the structure and texture of the pectoralis major muscle was performed. The genotype of the birds had an impact on the eviscerated carcass weight, percentage of skin with subcutaneous fat, leg muscles, wings, and neck. Broiler breeder genotypes differed in terms of the chemical composition of the breast and leg muscles, except for the water content in the breast muscle and the collagen content in both the breast and leg muscles. The breast muscles of Cobb 500 exhibited lower cooking loss, pH24, redness, and yellowness, while the leg muscles of Ross 308 had lower EC24 but higher cooking loss and lightness values. The pectoralis major muscle of Cobb 500 was firmer and more tender, with a smaller cross-sectional area of the muscle fiber and a smaller vertical (V) diameter of the muscle fiber. Males were characterized by a greater carcass weight and a higher percentage of leg muscles, neck, and carcass remains. On the other hand, females had a higher percentage of breast muscles, skin with subcutaneous fat, and abdominal fat. The sex of the birds affected the chemical composition of the breast and leg muscles, with the exception of the water content in the breast muscles and collagen content in the breast and leg muscles. The breast muscles of females were characterized by higher values of yellowness, although they also exhibited lower pH and cooking loss. In terms of texture analysis of the pectoralis major muscle, the meat of females was characterized by higher tenderness and firmness. However, the analysis of the structure showed that males had a thicker perimysium and endomysium. Regardless of broiler origin and sex, significant differences were found between the breast and leg muscles in terms of the assessed physicochemical features (pH24, EC24, cooking loss), color attributes (Lab) and chemical composition (protein, intramuscular fat, and collagen contents). Genotype and sex interactions were significant for the chemical composition of the breast muscles (protein, fat, collagen) and leg muscles (fat), as well as for the yellow color saturation of the breast muscles and springiness of the pectoralis major muscle. The study produced results that showed the meat and carcasses of spent hens and roosters to be suitable for processing due to their favorable chemical composition, high nutritional value and good technological properties, as assessed based on the results of meat texture and structure.

Effect of the macular shape on hole findings in idiopathic macular hole differs depending on the stage of the macular hole

This study aimed to investigate the relationship between macular shape and idiopathic macular hole (MH) findings using an objective method. We present retrospective observational case series on patients with MH. The shape of the macular area was quantified using quadratic equations, and the ocular shape (OS) index was calculated. The correlation between the OS index and macular hole findings for each stage was evaluated. Pearson's correlation coefficient showed a significant correlation between the OS index and horizontal hole diameter (p = 0.044), bottom diameter (p = 0.006), and vertical bottom diameter (p = 0.024) in stage 2. For stage 4, there was a negative and significant correlation between the OS index and age (p = 0.037), and horizontal (p = 0.021) and vertical (p = 0.027) bottom diameter. Multiple regression analysis showed that the horizontal (p = 0.0070) and vertical (p = 0.031) bottom diameter and OS index were independently and positively correlated in stage 2. In stage 4, the OS index was independently and negatively correlated with the horizontal (p = 0.037) and vertical (p = 0.048) bottom diameter. The ocular shape of the macula affects MH findings, and its impact depends on its stage.

A prospective observational study on evaluating the efficacy of bedside optic nerve sheath diameter in assessing clinical progression of patients admitted in neurosurgical ICU with comparisons to CT scans and GCS score

Background: Ultrasound of the optic nerve sheath diameter (ONSD) is a non-invasive, repeatable tool that can be used to measure intracranial pressure in a dynamic way with high diagnostic accuracy. The goal of this study was to find out if a bedside ultrasonographic measurement of optic nerve sheath diameter (ONSD) can accurately predict the computed tomography (CT) findings of high intracranial pressure (ICP) and changes to the Glasgow Coma Scale (GCS) in adult head injury patients in the Neurosurgery ICU. Methods: For 54 patients in the neurosurgical intensive care unit, we conducted a retrospective analysis of the results of cranial ultrasounds. Those under the age of 18 and those with apparent visual injuries were ineligible. Both horizontal and vertical optic nerve sheath diameters were measured 3 mm beneath the globe in each eye using a 7.5-10MHz ultrasonographic probe. A binocular change in optic nerve sheath diameter of more than 2.00 mm was deemed abnormal in two consecutive readings in the same patient. Patients in the neurosurgical ICU were given a GCS score, which was used to classify their level of brain damage as mild, moderate, or severe. The accuracy of the optic nerve sheath diameter was evaluated using cranial CT findings of shift, oedema, or effacement that suggested an increased intracranial pressure. Results: The research has 54 participants. According to the results, 68.5% of those who took the study were men, while 31.5% of those who did so were women. Nearly 16.7 per cent of respondents were between the ages of 18 and 40, while 40.7% of respondents were between the ages of 40 and 60, and 42.6% of respondents were above 60. The significant change in ONSD- fall in GCS and CT-progression scan-findings correlation was very strong. When compared to CT scan progression, the ONSD bedside sonographic test had an 86.7% sensitivity and an 89.7% specificity for detecting elevated ICP. The Positive Predictive Value of the reduction in GCS with advancement in CT scan was 80% and the Negative Predictive Value was 89.7%, respectively. Conclusions: The sensitivity, specificity, and positive predictive value of bedside ONSD ultrasonography in predicting high intracranial pressure are significant to those of progression in CT scan and drop in GCS. An ONSD bedside measurement may be used to determine elevated ICP since it is non-invasive and repeatable.

Three-Dimensional (3D) Analysis of Orbital Morphometry in Healthy Anatolian Adults: Sex, Side Discrepancies, and Clinical Relevance.

Background and objective The complex structural integrity of the orbit is crucial for visual functions. Three-dimensional (3D) reconstructions from radiological images have revolutionized anatomical understanding, eliminating the limitations of two-dimensional (2D) imaging and offering intricate spatial details for complex structures. The aim of this study was to analyze the detailed morphometry of the orbit in healthy Anatolian adults, considering sex, side discrepancies, and clinical relevance using 3D models reconstructed from multidetector computed tomography (MDCT) images. Materials and methods Fifty-six (44.44%) males and 70 (55.56%) females (total: 126, mean age: 48.62) MDCT images were randomly selected and 3D skull models were reconstructed using 3D Slicer software. Measurements were conducted in millimeters (mm) for transverse and vertical diameters, circumference of the orbital opening, orbital wall lengths, as well as intraorbital and extraorbital distances. Results The method of measurements showed high reproducibility of results. The mean values for transverse and vertical diameters, circumference of the orbital opening, medial and lateral wall lengths, roof and floor lengths, and intraorbital and extraorbital distances were 40.23±2.12 mm (p<0.001), 34.94±2.16 mm (p=0.365), 44.74 ±3.02 mm (p<0.001), 46.30±2.69 mm (p<0.001), 51.26±2.91 mm (p<0.001), 49.01±3.22 mm (p<0.001), 126.10±5.71 mm (p<0.001), 19.63±2.35 mm (p=0.026), and 94.09±4.84 mm (p<0.001), respectively. Conclusion The study's high measurement reproducibility contributes significantly to the existing literature and clinical practice. These findings offer specific insights into Anatolian orbital morphometry, aiding in surgical planning, implant placement, and diagnostic assessments. The precise measurement values serve as a reliable reference for clinicians, facilitating the identification of normal and abnormal orbital anatomy and enhancing patient care. We believe this study provides valuable data for craniofacial and ophthalmological research, benefiting both clinical practice and future research endeavors in these fields.

Mechanisms of action of an intravesical balloon as a therapy for stress urinary incontinence

Aims:Previous studies have indicated that the intravesical placement of an air-filled balloon alleviates much of the symptoms caused by stress urinary incontinence (SUI) in women. However, the exact working mechanisms behind this therapy are not yet fully understood. The current study aims to elucidate the potential physiological mechanisms underlying this minimally invasive intervention. Methods:We have evaluated video urodynamic data in women undergoing this therapy (n = 5), during which participants were asked to cough with increasing intensity. For each participant, we have videos before insertion of the balloon and one week following insertion. We identified a frame in a resting situation in which the maximum horizontal and vertical bladder dimensions were measured. We expressed the maximum vertical diameter as a ratio of the maximum horizontal diameter. We then used custom-written scripts to identify the bladder and balloon in each frame of the video urodynamic investigation and subtracted information regarding the location of the bladder neck and diameters of the balloon. We then used this information to plot the displacement of the bladder neck and size of the balloon during coughing. Results:The diameters of the balloon were significantly decreased during coughing (p ≤ 0.05). We found a significant increase of the maximum vertical diameter expressed as a ratio of the maximum horizontal diameter before and after insertion of the intravesical balloon (p ≤ 0.05). The maximum displacement of the caudal bladder limit increased significantly after placement of the intravesical balloon was (p ≤ 0.05). Conclusions:Our results imply that the balloon compresses in response to increases in abdominal pressure, and the bladder obtains a significantly more vertically oriented shape after placement of the balloon. Moreover, it appears that placement of the balloon significantly increases the mobility of the bladder neck. The balloon is indicated to absorb some of the increases in intravesical pressure during episodes of high abdominal pressure. We propose that the balloon inwardly pushes the bladder wall upwards, causing the organ to acquire a more vertically oriented shape. Additionally, we postulate that this change in bladder shape will increase the mobility of the bladder neck, thereby increasing the kinking capability of the urethra.

Morphometric Analysis of the Mental Foramen and Mandibular Canal Using Orthopantomogram and Cone-Beam Computed Tomography: A Comparative Radiographic Study

Abstract Purpose: A pre-operative radiographic evaluation of the morphometry of the mental foramen (MF) and its true relationship to the alveolar crest (AC) and the mandibular canal (MC) and its true relationship to the roots of the mandibular third molar (M3) would help in negating possible sensory impairment during surgical procedures. Materials and Methods: A retrospective study of 50 cone-beam computed tomography (CBCT) and orthopantomogram (OPG) images of the same patients were selected. The diameters of MF, MC, distance between AC-MF and distance between apices of 3rd molar-MC were measured. Results: On OPG and CBCT, the mean values of the vertical diameter of MF were found as 3.044 mm and 2.948 mm, whereas the mean horizontal diameters obtained were 3.033 mm and 3.023 mm, respectively. The mean values of the diameter of MC were measured at 2.750 mm and 2.894 mm, respectively. The mean values of distance from M3 apex to MC and distance from AC to MF were obtained as 1.371 mm and 1.748 mm and 14.715 mm and 13.656 mm, respectively. Conclusion: The difference in the mean values of the diameter of the MF was statistically insignificant. The rest of the parameters gave us values which were statistically significant (P &lt; 0.05). Therefore, in an era of steadfast increased use of dental implants and frequent need for planning disimpactions, the use of CBCT can truly help us dislodge the limitations of two-dimensional imaging and thereby help us carry out such surgical procedures more efficiently and with no or minimal complications.

Effect of pipe installation and external load on buried steel pipe responses: Experimental and numerical investigations

During pipe installation, compacting soil at pipe sides causes an initial pipe deformation which is known as the “peaking” effect. However, in conventional pipe design codes, only pipe deformation caused by vertical overburden is considered while the “peaking” effect is ignored. In this study, a full-scale test was conducted on a Grade X52 steel pipe with a diameter of 600 mm to investigate the impacts of both soil compaction and vertical overburden on pipe deformation. Soil compaction and external load were found to elongate and shorten the vertical pipe diameter, respectively. The “peaking” effect was observed during the installation procedure accompanied by the highest pipe stress measured at the pipe crown. Then, a two-dimensional finite element model was created and validated based on the calculated pipe stresses from the experimental study. A parametric study was performed thereafter to numerically study the impacts of soil water content, pipe wall thickness, compaction pressure, and lift thickness on pipe responses due to soil compaction and external load. An increase in the “peaking” effect is observed with increasing soil water content and compaction pressure, while an increase in pipe wall thickness or lift thickness would cause a decrease in the “peaking” effect.

Sternal foramina: An imaging study.

To investigate the computed tomography (CT) image characteristics, adjacent tissues, and related measurement indices of the sternal foramina and provide an anatomical basis for the safety of minimally invasive sternum surgery. The data from 2500 thoracic multi-slice computed tomography (MSCT) cases from January 2020 to June 2021 were analyzed retrospectively. The number and location of the sternal foramina and adjacent tissues (mediastinal adipose tissue, lung, pericardium) were observed. The size of the sternal foramina, CT value of the tissue inside the foramina, subcutaneous adipose tissue thickness, distance from skin to lung, distance from skin to the pericardium, and manubrio-foraminal distance were measured. Sex differences were compared for each indicator performed. The incidence of sternal foramina was 4.44% (111/2500), with 83 males and 28 females. All sternal foramina were located at the mesosternum's fourth to sixth costal cartilage level. The transverse diameter of the sternal foramina was (0.60 ± 0.29) cm, and the vertical diameter was (0.68 ± 0.39) cm, which was greater in males than females (p > 0.01). The CT value of the tissue in the sternal foramina was (-77.05 ± 32.26) Hu, and there was no statistical difference between male and female patients (t = -1.780, p = 0.078). The adjacent tissues of the sternal foramina were only adjacent to adipose tissue in 41 cases (36.94%), pericardium in 18 patients (16.22%), lung tissue in 37 cases (33.33%), and both kinds of tissue in 15 cases (13.51%). The sternal foramina were not adjacent to the left lung in the female patients. In the sternal foramina region, the thickness of subcutaneous adipose tissue was (1.13 ± 0.51) cm, the distance from skin to lung was (1.86 ± 0.57) cm, the distance from skin to pericardium was (3.07 ± 0.72) cm, the manubrio-foraminal distance was (12.68 ± 1.31) cm, which was significantly greater in males than in females (p < 0.05). The sternal foramina are closely related to the heart and lungs. The size and location of sternal foramina, the thickness of subcutaneous adipose tissue, and the distance from skin to heart and lung are all crucial factors in evaluating the safety of sternal puncture biopsy.

Comparing optic nerve head parameters in two Spanish dog breeds using digital planimetry

The optic discs of dogs exhibit considerable size, shape, and colour variations, depending on the degree of myelination. This variability makes the interpretation of lesions difficult, owing to the lack of reference patterns. This study aimed to compare optic nerve head (ONH) parameters determined by digital planimetry (DP) in two pure-bred dogs, Spanish Greyhound (SG) and Spanish Water Dog (SWD). The vertical and horizontal diameters, area, circularity, and the proportion of the ONH at the tapetal or non-tapetal zone (top height and bottom height) were calculated using image treatment software and compared between breeds.Significant between-breed differences were detected for all parameters, with SWD exhibiting greater height, width, area, top height, and lower circularity of the ONH than SG. Linear regression revealed that age significantly influenced mean disc height (R2 = 0.310; p = 0.0001), mean disc width (R2 = 0.280; p = 0.0001), mean disc area (R2 = 0.281; p = 0.0001), and circularity (R2 = 0.243; p = 0.0001). The multiple regression model significantly predicted mean disc height, width, and area [(S) (R2 = 0.715; p = 0.001), (R2 = 0.742; p = 0.001), and (S) (R2 = 0.736; p = 0.001), respectively], based on age and breed. Excellent concordance was observed between the measurements of experienced and novice researchers, and there were no differences between the parameters measured by the researcher and those obtained by the software. Planimetric ONH measurements can be easily performed by novice operators using a portable fundus camera and digital computer software. These results may be of considerable clinical value, but further studies are required because of the great variability of the ONH in dogs.

Investigation of OCTA Biomarkers in Fabry Disease: A Long Term Follow-Up of Macular Vessel Area Density and Foveal Avascular Zone Metrics.

Retinal microvasculature is known to be altered in patients with Fabry disease (FD). We aimed to investigate the long-term changes in macular microvasculature and explore a reliable retinal biomarker for treatment monitoring in FD. Prospective study of 26 eyes with FD followed up to 48months (mean 24, range 8-48). OCT angiography (OCTA) images (2.9 × 2.9mm) were obtained using Heidelberg Spectralis II at baseline and follow-up. Macular vessel area density (VAD, %) was measured in three layers: superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) in three peri-macular circular sectors (c1, c2, c3). Additionally, foveal avascular zone (FAZ) area (mm2) and horizontal and vertical diameters (µm) were assessed. VAD decreased over time in SVP, ICP (in sectors c2 and c3) and DCP (all sectors) (p < 0.04). VAD reduction was predominantly seen in treated FD patients. FAZ and horizontal diameters increased at follow-up in FD patients compared to baseline (p ≤ 0.025). Correlation analysis showed a moderate to strong negative correlation between VAD of SVP and DCP in the innermost circle and FAZ in treated patients (r = - 0.6; p < 0.0001). This is the first long-term follow-up OCTA study in FD to our knowledge. A decrease in VAD, pronounced in the peripheral circle and deeper layers, as well as an enlargement of the FAZ could be observed over time. These changes reflect the vascular remodelling during the course of the disease. Interestingly, the reduction of VAD was more pronounced in treated patients. This could be a result of enzyme replacement therapy and could be potentially used as a reliable biomarker for monitoring the treatment of the disease. A baseline examination of VAD and FAZ before treatment initiation is meaningful. Larger studies are needed to establish the use of VAD and FAZ as biomarkers for treatment monitoring.

Predicting BRAFV600E mutations in papillary thyroid carcinoma using six machine learning algorithms based on ultrasound elastography

The most common BRAF mutation is thymine (T) to adenine (A) missense mutation in nucleotide 1796 (T1796A, V600E). The BRAFV600E gene encodes a protein-dependent kinase (PDK), which is a key component of the mitogen-activated protein kinase pathway and essential for controlling cell proliferation, differentiation, and death. The BRAFV600E mutation causes PDK to be activated improperly and continuously, resulting in abnormal proliferation and differentiation in PTC. Based on elastography ultrasound (US) radiomic features, this study seeks to create and validate six distinct machine learning algorithms to predict BRAFV6OOE mutation in PTC patients prior to surgery. This study employed routine US strain elastography image data from 138 PTC patients. The patients were separated into two groups: those who did not have the BRAFV600E mutation (n = 75) and those who did have the mutation (n = 63). The patients were randomly assigned to one of two data sets: training (70%), or validation (30%). From strain elastography US images, a total of 479 radiomic features were retrieved. Pearson's Correlation Coefficient (PCC) and Recursive Feature Elimination (RFE) with stratified tenfold cross-validation were used to decrease the features. Based on selected radiomic features, six machine learning algorithms including support vector machine with the linear kernel (SVM_L), support vector machine with radial basis function kernel (SVM_RBF), logistic regression (LR), Naïve Bayes (NB), K-nearest neighbors (KNN), and linear discriminant analysis (LDA) were compared to predict the possibility of BRAFV600E. The accuracy (ACC), the area under the curve (AUC), sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV), decision curve analysis (DCA), and calibration curves of the machine learning algorithms were used to evaluate their performance. ① The machine learning algorithms' diagnostic performance depended on 27 radiomic features. ② AUCs for NB, KNN, LDA, LR, SVM_L, and SVM_RBF were 0.80 (95% confidence interval [CI]: 0.65–0.91), 0.87 (95% CI 0.73–0.95), 0.91(95% CI 0.79–0.98), 0.92 (95% CI 0.80–0.98), 0.93 (95% CI 0.80–0.98), and 0.98 (95% CI 0.88–1.00), respectively. ③ There was a significant difference in echogenicity,vertical and horizontal diameter ratios, and elasticity between PTC patients with BRAFV600E and PTC patients without BRAFV600E. Machine learning algorithms based on US elastography radiomic features are capable of predicting the likelihood of BRAFV600E in PTC patients, which can assist physicians in identifying the risk of BRAFV600E in PTC patients. Among the six machine learning algorithms, the support vector machine with radial basis function (SVM_RBF) achieved the best ACC (0.93), AUC (0.98), SEN (0.95), SPEC (0.90), PPV (0.91), and NPV (0.95).

Interreader Agreement and Longitudinal Progression of Incomplete/Complete Retinal Pigment Epithelium and Outer Retinal Atrophy in Age-Related Macular Degeneration

To analyze the ability to evaluate changes over time of individual lesions of incomplete or complete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA and cRORA, respectively) in patients with intermediate age-related macular degeneration (iAMD). OCT images from patients enrolled in Proxima B clinical trial (NCT02399072) were utilized. Patients enrolled in the Proxima B clinical trial, from the cohort with geographic atrophy (GA) in 1 eye and iAMD in the other eye at baseline, were included. Junior and senior readers analyzed OCT images for the qualitative presence of 9 distinct early atrophic features (presence of zone of choroidal hypertransmission, attenuation and/or disruption of RPE, disruption of ellipsoid zone [EZ] and external limiting membrane [ELM], outer nuclear layer [ONL] thinning, outer plexiform layer [OPL]/inner nuclear layer [INL] subsidence, and hyporeflective wedge-shaped band). If deemed "present," 7 features were quantified with a predefined tolerance level of 50 μm (diameter for the zone of choroidal hypertransmission, zone of attenuation and/or disruption of the RPE, outer retinal thickness left/right vertical diameter, outer retinal thickness thinnest vertical diameter, annotation of EZ, and ELM disruption). Interreader agreements for qualitative assessments (κ-type statistics) and quantitative measurements (Bland-Altman statistics) were assessed. Progression of the lesion features over time was described. Moderate agreement was found for presence of choroidal hypertransmission (κ= 0.54), followed by ELM disruption (κ= 0.58), OPL/INL subsidence (κ= 0.46), and a hyporeflective wedge-shaped band (κ= 0.47). Quantification measurements showed that choroidal hypertransmission had the highest agreement, whereas RPE attenuation/disruption had the lowest agreement. Longitudinal adjudicated changes for quantitative measurements of lesion progression showed that choroidal hypertransmission and ELM disruption showed significant progression, whereas EZ disruption and RPE attenuation/disruption did not. The ability to evaluate changes over time for specific features of iRORA and cRORA was explored. The most robust biomarker was found to be choroidal hypertransmission, followed by ELM disruption and the qualitative markers of OPL/INL subsidence, as well as a wedge-shaped band. Disease progression over time could be assessed by some, but not all, spectral-domain OCT features that were explored. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Diagnostic Value of Dynamic 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (18F-FDG PET-CT) in Cervical Lymph Node Metastasis of Nasopharyngeal Cancer.

Dynamic 18F-FDG PET-CT scanning can accurately quantify 18F-FDG uptake and has been successfully applied in diagnosing and evaluating therapeutic effects in various malignant tumors. There is no conclusion as to whether it can accurately distinguish benign and malignant lymph nodes in nasopharyngeal cancer. The main purpose of this study is to reveal the diagnostic value of dynamic PET-CT in cervical lymph node metastasis of nasopharyngeal cancer through analysis. We first searched for cervical lymph nodes interested in static PET-CT, measured their SUV-Max values, and found the corresponding lymph nodes in magnetic resonance images before and after treatment. The valid or invalid groups were included according to the changes in lymph node size before and after treatment. If the change in the product of the maximum diameter and maximum vertical transverse diameter of the lymph node before and after treatment was greater than or equal to 50%, they would be included in the valid group. If the change was less than 50%, they would be included in the invalid group. Their Ki values were measured on dynamic PET-CT and compared under different conditions. Then, we conducted a correlation analysis between various factors and Ki values. Finally, diagnostic tests were conducted to compare the sensitivity and specificity of Ki and SUV-Max. We included 67 cervical lymph nodes from different regions of 51 nasopharyngeal cancer patients and divided them into valid and invalid groups based on changes before treatment. The valid group included 50 lymph nodes, while the invalid group included 17. There wer significant differences (p < 0.001) between the valid and the invalid groups in SUV-Max, Ki-Mean, and Ki-Max values. When the SUV-Max was ≤4.5, there was no significant difference in the Ki-Mean and Ki-Max between the two groups (p > 0.05). When the SUV-Max was ≤4.5 and pre-treatment lymph nodes were <1.0 cm, the valid group had significantly higher Ki-Mean (0.00910) and Ki-Maximum (0.01004) values than the invalid group (Ki-Mean = 0.00716, Ki-Max = 0.00767) (p < 0.05). When the SUV-Max was ≤4.5, the pre-treatment lymph nodes < 1.0 cm, and the EBV DNA replication normal, Ki-Mean (0.01060) and Ki-Max (0.01149) in the valid group were still significantly higher than the invalid group (Ki-Mean = 0.00670, Ki-Max = 0.00719) (p < 0.05). The correlation analysis between different factors (SUV-Max, T-stage, normal EB virus DNA replication, age, and pre-treatment lymph node < 1.0 cm) and the Ki value showed that SUV-Max and a pre-treatment lymph node < 1.0 cm were related to Ki-Mean and Ki-Max. Diagnostic testing was conducted; the AUC value of the SUV-Max value was 0.8259 (95% confidence interval: 0.7296-0.9222), the AUC value of the Ki-Mean was 0.8759 (95% confidence interval: 0.7950-0.9567), and the AUC value of the Ki-Max was 0.8859 (95% confidence interval: 0.8089-0.9629). After comparison, it was found that there was no significant difference in AUC values between Ki-Mean and SUV-Max (p = 0.220 > 0.05), and there was also no significant difference in AUC values between Ki max and SUV-Max (p = 0.159 > 0.05). By calculating the Youden index, we identified the optimal cut-off value. It was found that the sensitivity of SUV-Max was 100% and the specificity was 66%, the sensitivity of Ki-Mean was 100% and the specificity was 70%, and the sensitivity of Ki-Max was 100% and the specificity was 72%. After Chi-Square analysis, it was found that there was no significant difference in specificity between Ki-Mean and SUV-Max (p = 0.712), and there was also no significant difference in specificity between Ki-Max and SUV-Max (p = 0.755). Dynamic PET-CT has shown a significant diagnostic value in diagnosing cervical lymph node metastasis of nasopharyngeal cancer, especially for the small SUV value, and lymph nodes do not meet the metastasis criteria before treatment, and EBV DNA replication is normal. Although the diagnostic accuracy, sensitivity, and specificity of dynamic PET-CT were not significantly different from traditional static PET-CT, the dynamic PET-CT had a more accurate tendency.

Optical Coherence Tomography-Derived Measurements of the Optic Nerve Head Structure of Aboriginal and Torres Strait Islander Children.

This study demonstrated significant differences in optic nerve head characteristics in Aboriginal and Torres Strait Islander children compared with non-Indigenous children, which has implications for glaucoma risk and diagnosis in Aboriginal and Torres Strait Islander populations. The purpose of this study was to examine the optic nerve head (ONH) characteristics of visually normal Aboriginal and Torres Strait Islander children and non-Indigenous Australian children. Spectral domain optical coherence tomography imaging was performed on the right eye of 95 Aboriginal and Torres Strait Islander children and 149 non-Indigenous Australian children (5-18 years). Horizontal and vertical line scans, centered on the ONH, were analyzed to determine the dimensions of the ONH (Bruch membrane opening diameter), optic cup diameter, Bruch membrane opening minimum rim width, and the peripapillary retinal nerve fiber layer thickness. The vertical but not horizontal Bruch membrane opening diameter of Aboriginal and Torres Strait Islander children was significantly larger than non-Indigenous children (mean difference: 0.09mm, P = 0.001). The horizontal (mean difference: 0.12mm, P = 0.003) and vertical cup diameter (mean difference: 0.16mm, P < 0.001) were also significantly larger in Aboriginal and Torres Strait Islander children, as were the horizontal and vertical cup-to-disc ratios (both P < 0.01). Aboriginal and Torres Strait Islander children also had a significantly thinner Bruch membrane opening minimum rim width in the superior, nasal, and temporal meridians (all P < 0.001). Peripapillary retinal nerve fiber layer thickness did not differ between groups. Differences exist in the ONH structure between Aboriginal and Torres Strait Islander children and non-Indigenous children, which may have implications for the detection and monitoring of ocular disease in this population and highlights the need to extend this research to the adult population.