Volumetric Assessment Research Articles

Surgical cytoreduction of deep-seated high-grade glioma through tubular retractor.

Maximal safe resection is the goal of surgical treatment for high-grade glioma (HGG). Deep-seated hemispheric gliomas present a surgical challenge due to safety concerns and previously were often considered inoperable. The authors hypothesized that use of tubular retractors would allow resection of deep-seated gliomas with an acceptable safety profile. The purpose of this study was to describe surgical outcomes and survival data after resection of deep-seated HGG with stereotactically placed tubular retractors, as well as to discuss the technical advances that enable such procedures. This is a retrospective review of 20 consecutive patients who underwent 22 resections of deep-seated hemispheric HGG with the Viewsite Brain Access System by a single surgeon. Patient demographics, survival, tumor characteristics, extent of resection (EOR), and neurological outcomes were recorded. Cannulation trajectories and planned resection volumes depended on the relative location of white matter tracts extracted from diffusion tractography. The surgical plans were designed on the Brainlab system and preoperatively visualized on the Surgical Theater virtual reality SNAP platform. Volumetric assessment of EOR was obtained on the Brainlab platform and confirmed by a board-certified neuroradiologist. Twenty adult patients (18 with IDH-wild-type glioblastomas and 2 with IDH-mutant grade IV astrocytomas) and 22 surgeries were included in the study. The cohort included both newly diagnosed (n = 17; 77%) and recurrent (n = 5; 23%) tumors. Most tumors (64%) abutted the ventricular system. The average preoperative and postoperative tumor volumes measured 33.1 ± 5.3 cm3 and 15.2 ± 5.1 cm3, respectively. The median EOR was 93%. Surgical complications included 2 patients (10%) who developed entrapment of the temporal horn, necessitating placement of a ventriculoperitoneal shunt; 1 patient (5%) who suffered a wound infection and pulmonary embolus; and 1 patient (5%) who developed pneumonia. In 2 cases (9%) patients developed new permanent visual field deficits, and in 5 cases (23%) patients experienced worsening of preoperative deficits. Preoperative neurological or cognitive deficits remained the same in 9 cases (41%) and improved in 7 (32%). The median overall survival was 14.4 months in all patients (n = 20) and in the newly diagnosed IDH-wild-type glioblastoma group (n = 16). Deep-seated HGGs, which are surgically challenging and frequently considered inoperable, are amenable to resection through tubular retractors, with an acceptable safety profile. Such cytoreductive surgery may allow these patients to experience an overall survival comparable to those with more superficial tumors.

Assessment of left atrial morphological and functional differences in professional male football players: a prospective, case-control study.

Intensive physical activity in athletes leads to considerable changes in the morphology and physiology of the left atrium through physiological, exercise-induced remodelling. This study aimed to assess the mechanical and electrophysiological changes in professional football players using electrocardiographic and echocardiographic assessment tools. This prospective, case-control study was performed between February and June 2022. The population consisted of elite male football players (n = 49, group F) as the study group, and healthy male non-athlete individuals of matching age (n = 50, group C) as the control group. All participants underwent electrocardiographic and echocardiographic (two-dimensional and tissue Doppler) examinations. Volumetric and functional assessment of the left atrium was identified as the study's primary outcome. There was no significant difference between the groups in terms of demographic and morphometric characteristics (p > 0.05). Maximum and minimum P waves and PR-interval duration were significantly higher in group F than in group C (p = 0.011, p = 0.005 and p < 0.001). Diameter, maximum and minimum volumes of the left atrium, and their corresponding indexes were significantly increased in group F (p < 0.0). Ejection fraction of the left atrium was significantly lower in group F than in group C (p = 0.001). Pulmonary acceleration time and tricuspid annular plane systolic excursion was significantly higher in the football players (p = 0.023 and p < 0.001). Increased diameter, maximum and minimum volumes of the left atrium, and their corresponding indexes could be demonstrated in the elite football players. The morphological and functional changes in the left atrium might be a physiological consequence of left atrial cardiac remodelling to intensive and chronic training.

Hippocampal volume in cases of relapsing remitting multiple sclerosis and its correlation with cognitive impairment

Background. Multiple sclerosis (MS) is a chronic inflammatory immune-mediated disease, distinguished by demyelination and oligodendropathy in the central nervous system. Cognitive impairment (CI) can impact patients at any stage of MS, including those with clinically isolated syndrome (CIS). Patients and methods. This is a prospective cross-sectional study which enrolled 60 patients with RRMS. They were subjected to cognitive scale assessment, routine brain MRI study and volumetric assessment of hippocampus. Results. This study found a significant positive correlation between duration of disease and Subjective memory complaints questionnaire (r=0.525, p=0.001). A significant negative correlation existed between disease duration and MMSE score (r=-0.404, p=0.001) and between disease duration and MoCA score (r=-0.310, p=0.016). No significant difference between both groups regarding the relative hippocampal volume. Mean relative right hippocampal volume is 0.0026 for cases versus 0.0027 among control group and mean relative left hippocampal volume is 0.0025 for cases versus 0.0026 among control group. Conclusion. Multiple sclerosis disease duration had an impact on cognitive state. However, hippocampal volume assessment did not predict the cognitive affection in patient with RRMS.

Evaluation of RANO Criteria for the Assessment of Tumor Progression for Lower-Grade Gliomas

Purpose: The Response Assessment in Neuro-Oncology (RANO) criteria for lower-grade gliomas (LGGs) define tumor progression as ≥25% change in the T2/FLAIR signal area based on an operator’s discretion of the perpendicular diameter of the largest tumor cross-section. Potential sources of error include acquisition inconsistency of 2D slices, operator selection variabilities in both representative tumor cross-section and measurement line locations, and the inability to quantify infiltrative tumor margins and satellite lesions. Our goal was to assess the accuracy and reproducibility of RANO in LG. Materials and Methods: A total of 651 FLAIR MRIs from 63 participants with LGGs were retrospectively analyzed by three blinded attending physicians and three blinded resident trainees using RANO criteria, 2D visual assessment, and computer-assisted 3D volumetric assessment. Results: RANO product measurements had poor-to-moderate inter-operator reproducibility (r2 = 0.28–0.82; coefficient of variance (CV) = 44–110%; mean percent difference (diff) = 0.4–46.8%) and moderate-to-excellent intra-operator reproducibility (r2 = 0.71–0.88; CV = 31–58%; diff = 0.3–23.9%). When compared to 2D visual ground truth, the accuracy of RANO compared to previous and baseline scans was 66.7% and 65.1%, with an area under the ROC curve (AUC) of 0.67 and 0.66, respectively. When comparing to volumetric ground truth, the accuracy of RANO compared to previous and baseline scans was 21.0% and 56.5%, with an AUC of 0.39 and 0.55, respectively. The median time delay at diagnosis was greater for false negative cases than for false positive cases for the RANO assessment compared to previous (2.05 &gt; 0.50 years, p = 0.003) and baseline scans (1.08 &gt; 0.50 years, p = 0.02). Conclusion: RANO-based assessment of LGGs has moderate reproducibility and poor accuracy when compared to either visual or volumetric ground truths.

Computer aided volumetric assessment of orbital structures in patients with Graves' orbitopathy: correlation with serum thyroid antiperoxidase antibodies and disease activity

IntroductionGraves' disease is an autoimmune disorder. Goiter and Graves' orbitopathy are frequently seen clinically. It would be helpful for the diagnosis, grading, prognosis, and treatment of this condition if it was possible to find serum biomarkers to establish a connection between the plasma levels of these compounds and orbital changes.MethodsA retrospective study was performed by revising the medical records of 44 patients with Graves' orbitopathy and 15 controls. The Osirix software (Pixmeo, Geneva, Switzerland) was used for manual orbital measurements. Plasma levels of Graves' orbitopathy substances were obtained in the analytical review of the patients.ResultsA greater muscle volume was observed in patients with Graves' orbitopathy in relation to the control group (p < 0.001). The clinical activity score (CAS) was associated to total muscle mass (p = 0.013) and retrorbital fat (p = 0.048). Our results indicated a direct relationship between serum concentrations of anti-thyroid peroxidase antibodies and inferior rectus thickening (p = 0.036); however, we did not observe a positive correlation between other muscle volumes and serum concentrations of various thyroid-related substances.ConclusionsThis study is the first that uses Osirix measurement software to manually assess orbital features in patients with Graves' orbitopathy. These measurements were compared to the outcomes of tests performed in a laboratory. Among several serum biomarkers, anti-thyroid peroxidase appears to be a reliable biomarker that correlates positively with inferior rectus muscle thickness in patients with thyroid eye disease. This may help to improve the management of this disease.

Harnessing the Hybridization of a Metal-Organic Framework and Superbase-Derived Ionic Liquid for High-Performance Direct Air Capture of CO2.

Direct air capture (DAC) of CO2 has emerged as the most promising "negative carbon emission" technologies. Despite being state-of-the-art, sorbents deploying alkali hydroxides/amine solutions or amine-modified materials still suffer from unsolved high energy consumption and stability issues. In this work, composite sorbents are crafted by hybridizing a robust metal-organic framework (Ni-MOF) with superbase-derived ionic liquid (SIL), possessing well maintained crystallinity and chemical structures. The low-pressure (0.4mbar) volumetric CO2 capture assessment and a fixed-bed breakthrough examination with 400ppm CO2 gas flow reveal high-performance DAC of CO2 (CO2 uptake capacity of up to 0.58mmol g-1 at 298 K) and exceptional cycling stability. Operando spectroscopy analysis reveals the rapid (400ppm) CO2 capture kinetics and energy-efficient/fast CO2 releasing behaviors. The theoretical calculation and small-angle X-ray scattering demonstrate that the confinement effect of the MOF cavity enhances the interaction strength of reactive sites in SIL with CO2 , indicating great efficacy of the hybridization. The achievements in this study showcase the exceptional capabilities of SIL-derived sorbents in carbon capture from ambient air in terms of rapid carbon capture kinetics, facile CO2 releasing, and good cycling performance.

What is the water footprint of EU food consumption? A comparison of water footprint assessment methods

Food consumption is responsible for most global water consumption and associated environmental consequences. Therefore, quantifying and monitoring the water footprint (WF) of food consumption patterns is relevant to support policymaking toward sustainable diets. Although multiple WF approaches are available, such as Water Footprint Assessment (WFA) and the model AWARE (Available Water Remaining) for supply chains analysis, the latest is considered the reference after following an international consultation process. This research aims to develop a comparative methodological approach between the volumetric blue water footprint assessment (WFA), a pressure method, and the scarcity-weighted WF AWARE model as an impact method to evaluate the WF of EU27 food consumption. Due to limited blue WFA data availability, two scopes were considered: an “aligned scope” (cradle to farm gate) comparing both methods and a “full supply chain scope” (cradle to grave) only possible with AWARE. In the aligned scope, almonds and cashew have the largest pressure and impact in both methods (per kg of product). EU food consumption has a WF pressure under an “aligned scope” of ≈54 m3/capita/year and an impact of ≈3525 m3 eq/capita/year. When considering the "full supply chain", WF impact due to EU food consumption increases by 30% (compared with the "aligned scope"), with wine and chocolate at the top of the ranking. Integration of WFA data within the LCA inventory could be explored when WFA data also covers indirect WF of background processes and other supply chain stages.

IMG-08. VOLUMETRIC MEASUREMENT OF TUMOR SIZE OUTPERFORMS STANDARD TWO-DIMENSIONAL METHOD IN EARLY PREDICTION OF TUMOR PROGRESSION IN PEDIATRIC GLIOMA

Abstract BACKGROUND Pediatric brain tumors (PBTs) are the leading cause of cancer-related death in children. Currently, based on the RAPNO guidelines, two-dimensional (2D) measurements are used to detect progression. However, due to the complex radiographic appearance of many PBTs, 2D measurements may not accurately reflect tumor growth. Here, we compared 3D, 2D, and qualitative radiologists’ interpretations in a group of PBTs to determine tumor progression. METHODS Six PBT patients (5 low-grade glioma, 1 ependymoma, age range at the time of baseline scan: 23-191 months) with an average of 5 imaging time points who had at least one episode of progression with subsequent surgery were included. Segmentation was performed on either T1 post-contrast or FLAIR, whichever that best identified the tumor. For 2D measurements, the two largest perpendicular diameters in a section that included the largest tumor component were measured. For the volumetric assessment, the tumors were manually segmented, and the volume was computed using the ITK-SNAP software. In multifocal tumors, only the tumor component that showed progression and underwent resection was included. A 25% and 41% increase in tumor size was considered as progression on 2D and 3D measurements, respectively. The time to progression (TTP) based on 2D vs 3D assessment as well as the official pediatric neuroradiologist interpretation based on the electronic health record report was compared. RESULTS In three of six patients, volumetric segmentation detected tumor progression at an earlier time point compared to 2D measurements and radiologists’ interpretation (median TTP: 134 compared to 503 for 2D and radiologist interpretation). For these three patients, the TTP based on 3D vs 2D assessment was: 252 vs 1299 days, 134 vs 503 days, and 80 vs 255 days. CONCLUSION Volumetric measurements can determine tumor progression earlier than the current standard method of 2D measurements and qualitative interpretation of radiologists in PBTs.

Role of Multimodality Imaging in Transcatheter Structural Interventions.

Cardiac imaging is the backbone for safe and optimal transcatheter structural interventions. Transthoracic echocardiogram is the initial modality to assess valvular disorders, while transesophageal echocardiogram is best to delineate the mechanism of valvular regurgitation, preprocedural assessment for transcatheter edge-to-edge repair, and for intraprocedural guidance. Cardiac computed tomography is the modality of choice for assessing calcifications, maneuvering multiplaner reconstruction of different cardiac structures, preprocedural planning for various transcatheter valve replacement, and assessing for hypoattenuated leaflet thickening and reduced leaflet motion. Cardiac magnetic resonance imaging is best known for most accurate volumetric assessment of valvular regurgitation and chamber size quantification. Cardiac positron emission tomography is the only modality that could assess active infection through using fluorine 18 fluorodeoxyglucose radiotracer.

VOLUMETRIC ANALYSIS OF RENAL MASSES AS PREDICTORS OF PARTIAL NEPHRECTOMY OUTCOMES.

Objective To examine the role of endophytic tumor volume assessment (endophycity) on perioperative partial nephrectomy outcomes. Patients and Methods Retrospective review of 212 consecutive laparoscopic and open partial nephrectomies from single institution using pre-operative imaging and one-year follow-up. Demographics, comorbidities, RENAL Nephrometry scores, and all peri- and post-operative outcomes were recorded. Volumetric analysis performed using imaging software, independently assessed by two, blinded radiologists. Univariate and multivariate statistical analysis were completed to assess predictive value of endophycity for all clinically meaningful outcomes. Results Among those undergoing minimally invasive surgery (MIS), lower tumor endophycity was associated with higher likelihood of trifecta outcome (negative surgical margin, <10% decline in eGFR, the absence of complications) irrespective of max tumor size. For MIS, estimated blood loss (EBL) increased with greater tumor endophycity regardless of tumor size. Among those who underwent open partial nephrectomy, lower tumor endophycity was associated with trifecta outcomes for tumors >4cm only. On multivariate analysis with log-scaled odds ratios (OR), tumor endophycity and total kidney volume had the strongest correlation with tumor-related complications (OR=3.23, 2.66). The analysis identified that tumor endophycity and tumor volume on imaging were inversely correlated with of trifecta outcomes (OR=0.53 for both covariates). Conclusions Volumetric assessment of tumor endophycity performed well in identifying partial nephrectomy outcomes. As automated imaging software improves, volumetric analysis may prove to be a useful adjunct in pre-operative planning and patient counseling.

Growing importance of brain morphometry analysis in the clinical routine: The hidden impact of MR sequence parameters

Volumetric assessment based on structural MRI is increasingly recognized as an auxiliary tool to visual reading, also in examinations acquired in the clinical routine. However, MRI acquisition parameters can significantly influence these measures, which must be considered when interpreting the results on an individual patient level.This Technical Note shall demonstrate the problem. Using data from a dedicated experiment, we show the influence of two crucial sequence parameters on the GM/WM contrast and their impact on the measured volumes. A simulated contrast derived from acquisition parameters TI/TR may serve as surrogate and is highly correlated (r=0.96) with the measured contrast.

Peritumoral edema measurements provide additional information to RANO-BM based assessment of lung cancer brain metastases after Gamma Knife therapy (P10-13.002)

<h3>Objective:</h3> In our study, we aimed to better understand the correlation between post-GK peritumoral edema and CE lesion. <h3>Background:</h3> Gamma Knife (GK) has become standard of care to treat brain metastases (BM), however there is little understanding of the posttreatment volumetric changes of peritumoral edema of BM due to paucity of tools for volumetric segmentation in neuroradiology clinical practice. Recently PACS-integrated tools have become available in select clinical practices, facilitating the comparison of volumetric treatment response curves of peritumoral edema to response curves of RANO-BM based measurements of the contrast-enhancing (CE) tumor core. <h3>Design/Methods:</h3> Patients with NSCLC BM ≥10 mm on post-contrast T1-weighted image and treated with GK had volumetric measurements for up to seven follow-ups using a PACS-integrated tool that segments the FLAIR hyperintense volume surrounding the CE lesion. The 2D and volumetric measurements were compared by creating response curves with incorporation of clinical information including steroid timing. <h3>Results:</h3> Fifty NSCLC BM were included with a median pretreatment metastasis volume of 8.5 cm³ (IQR 1–47 cm³, n=36). A significant decrease was measured at 0–90 days post-GK (median 1.2 cm³, IQR 0.5–6.1 cm³, n=31). The time of peak median peritumoral volume increase was at &gt;365 days (median 1.4 cm³, IQR 0.4–8.1 cm³, n=19). There was a positive correlation between longest diameter (LD) and peritumoral edema volume (r_s=.75, p&lt;.05). At 181–270 days post-GK 50% of BM showed incongruent response course for LD and peritumoral edema volume. The congruence/incongruence ratio of edema to enhancing portion of BM changed over follow-up time. <h3>Conclusions:</h3> Volumetric edema assessment of BM post-GK provides critical additional information as compared to RANO-BM based response curves. <b>Disclosure:</b> Miss Kaur has nothing to disclose. Mr. Cassinelli Petersen has nothing to disclose. Mr. Von Reppert has nothing to disclose. Mr. Jekel has nothing to disclose. Dr. Varghese has nothing to disclose. Dr. Dixe de Oliveira Santo has nothing to disclose. Dr. Omuro has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Omuro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ono Therapeutics. Dr. Omuro has received personal compensation in the range of $0-$499 for serving as a Consultant for Kiyatec. Dr. Omuro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pyramic. Dr. Omuro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Curevac. Dr. Omuro has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Opinion in Neurology. The institution of Dr. Omuro has received research support from NIH. The institution of Dr. Omuro has received research support from Agios. The institution of Dr. Omuro has received research support from Arcus Biosciences. The institution of Dr. Omuro has received research support from NIH. The institution of Dr. Omuro has received research support from NIH. The institution of Dr. Omuro has received research support from Denovo Biopharma. Dr. Chiang has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for monteris medical inc. Dr. Aboian has a non-compensated relationship as a Principal Investigator with Visage Imaging that is relevant to AAN interests or activities.

From Reverse Engineering Software to CAD-CAM Systems: How Digital Environment Has Influenced the Clinical Applications in Modern Dentistry and Orthodontics

Background: Reverse engineering (RE) or back engineering is a process that analyzes a physical object to obtain the primary data of the same project. RE technologies have different applications in industrial settings and productive chains; however, with the advent of digital technologies in dentistry and orthodontic fields, they are involved in the new diagnostic and clinical digital workflow. For example, 3D model scanning, 3D facial scanning, models superimposition, digital orthodontic setup, anatomical volumetric assessment, soft tissue analysis, orthodontic digital guided systems, and prototyped orthodontic appliances represent a few examples of the application of RE in orthodontics. Moreover, clinicians can manipulate the data derived from original digital file to enhance diagnosis and communication with other clinicians and dental technicians; however, RE and digital technologies systems are not exempt from shortcomings, including costs and knowledge curve. In this regard, the aim of the present manuscript was to describe the use of reverse engineering technologies in modern digital orthodontics and provide helpful information for those specialists who are at the beginning of the transition from analogic to digital orthodontic workflow.

3D Volume Assessment as an Objective Tool in Breast Asymmetry Management.

This study was conducted between November 2017 and September 2021 on 20 female patients seeking breast asymmetry correction at Kasr El-Ainy Hospital. All patients had volumetric breast assessment using a three-dimensional (3D) imaging system (3D LifeViz, Quantificare system), and MRI breast volumetry was done preoperatively in all patients. The patients were managed with different single-stage surgical procedures depending on the objective assessment of the volume differences between their breasts. Breast volume assessment using the 3D camera was done preoperatively and postoperatively. The preoperative mean volume difference was 159.45 cm3, and the postoperative mean difference was 16.75 cm3 with an overall reduction in mean volume difference of 89.5%. Comparing the 3D camera and MRI in assessing breast volume difference showed no statistical significance. The 3D technology is a useful objective tool to augment the surgeon's experience. It helped achieve an 84.57% reduction in volume difference in managing breast asymmetry with a single-stage procedure.

Sonic Well-Log Imputation Through Machine-Learning-Based Uncertainty Models

Sonic well logs provide critical information to calibrate seismic data and support geomechanical characterization. Advanced subsurface data analytics and machine learning enable new methods and workflows for property estimation, regression, and classification for geoscience and subsurface engineering applications. However, current applications for imputation of well-logging values rely only on model accuracy and low error predictions. T raditional model validation techniques are not enough to validate models and account for the substantial uncertainty in the subsurface. Well-logging imputation estimates and their associated uncertainty models are essential to the field development planning and decision-making workflows, such as reservoir modeling, volumetric resource assessment, predrill prediction with uncertainty, remaining resource mapping, and production allocation. When performing subsurface feature imputation with machine learning, we must expand our machine-learning model training and complexity tuning workflows to check the entire uncertainty model to ensure uncertainty distributions are precise and accurate. We propose a workflow that integrates the goodness metric to calculate accurate and precise uncertainty models of sonic well-log predictions based on ensembles of the machine-learning estimates. Our workflow combines model evaluation and visualization of the estimates and the uncertainty model with respect to measured depth. Our proposed method provides intuitive diagnostics and metrics to evaluate estimation accuracy and uncertainty model goodness.

12 - Developing a regional hub-and-spoke model for volumetric assessment of indeterminate pulmonary nodules supports efficient and effective management of pulmonary nodule pathways

12 - Developing a regional hub-and-spoke model for volumetric assessment of indeterminate pulmonary nodules supports efficient and effective management of pulmonary nodule pathways

Volumetric assessment of fat graft retention over implant by MRI

**Background**: Autologous fat grafting (AFG) is an increasingly popular adjunct to post-mastectomy breast reconstruction as it can produce a natural cosmetic outcome and alleviate undesirable radiotherapy-associated consequences, with low surgical risk. However, graft retention rates are variable and unpredictable. In order to improve and understand what influences graft retention rates, accurate and consistent methods for the measurement of graft retention must be developed.**Methods**: Twenty patients who were undergoing AFG following a previous mastectomy were prospectively enrolled. Of these, six women suitable for immediate breast reconstruction (IBR) with implant underwent MRI pre- and three months post-AFG. **Results**: All patients had a net gain in volume at three months post-procedure with a mean of 123.6 ± 56.07cm^3^; however, the percentage retention ranged from 30.0 to 104.7 per cent. **Conclusions**: This study has demonstrated the feasibility of measuring AFG retention over implant using MRI, as well as confirming variable tissue retention rates. This is an important step forward for studies on improving overall graft survival.

Distance mapping and volumetric assessment of the ankle and syndesmotic joints in progressive collapsing foot deformity

The early effects of progressive collapsing foot deformity (PCFD) on the ankle and syndesmotic joints have not been three-dimensionally quantified. This case-control study focused on using weight bearing CT (WBCT) distance (DM) and coverage maps (CM) and volumetric measurements as 3D radiological markers to objectively characterize early effects of PCFD on the ankle and syndesmotic joints. Seventeen consecutive patients with symptomatic stage I flexible PCFD and 20 matched controls that underwent foot/ankle WBCT were included. Three-dimensional DM and CM of the ankle and syndesmotic joints, as well volumetric assessment of the distal tibiofibular syndesmosis was performed as possible WBCT markers of early PCFD. Measurements were compared between PCFD and controls. Significant overall reductions in syndesmotic incisura distances were observed in PCFD patients when compared to controls, with no difference in the overall syndesmotic incisura volume at 1, 3, 5 and 10 cm proximally to the ankle joint. CMs showed significantly decreased articular coverage of the anterior regions of the tibiotalar joint as well as medial/lateral ankle joint gutters in PCFD patients. This study showed syndesmotic narrowing and decreased articular coverage of the anterior aspect of the ankle gutters and talar dome in stage I PCFD patients when compared to controls. These findings are consistent with early plantarflexion of the talus within the ankle Mortise, and absence of true syndesmotic overload in early PCFD, and support DM and CM as early 3D PCFD radiological markers.

Accuracy of preoperative liver volumetry in living donor liver transplantation—A systematic review and meta-analysis

BackgroundLiver volume measurement plays a critical role in the clinical success of living donor liver transplantation (LDLT). CT liver volumetry is used for volumetric assessment of the donor hepatectomy. However, the degree of accuracy of the preoperative predicted volumetric measurements remains unclear. PurposeThis systematic review will assess the accuracy of CT liver volumetry. Materials and MethodsA systematic literature search was conducted to evaluate the accuracy of the CT based liver volumetry. To assess the difference between the left and right liver lobe the ratio between preoperative estimated graft volume (EGV) and actual graft weight (AGW) was calculated. A meta-analysis was performed to compare the EGV to the AGW of the left and right lobe with automated and manual CT volume prediction. ResultsThirty-one studies met the inclusion criteria and 1336 patients were included in the meta-analysis. The EGV of the right liver is overestimated with a mean of 4.01% and 2.99% for automated and manual volumetry respectively. The left lobe is overestimated with 6.28% and 14.41% for automated and manual volumetry respectively. For a right lobe liver graft automated volume prediction showed a mean difference of 43.9 g (95% confidence interval (CI): 21.21–66.54, p<0.001) between EGV and AGW. For manual volume prediction this was 34.0 g (95% CI: 11.85–56.11, p = 0.003). For a left lobe with automated volume prediction the mean difference was 46.0 g (95% CI: 20.91–71.09, p<0.001) between EGV and AGW. For manual volume prediction this was 39.6 g (95% CI: 8.40–70.74, p = 0.01). ConclusionThe volumes of the right and left liver lobe seem to be overestimated with automated and manual CT volume prediction. Considering the larger estimation error in the prediction of the left liver lobe, special attention should be paid to the volume when performing a LDLT with a left liver lobe to prevent small for size syndrome.

Volumetric assessment of individual thalamic nuclei in patients with drug-naïve, first-episode major depressive disorder.

Despite the previous inconsistent findings of structural and functional abnormalities of the thalamus in patients with major depressive disorder (MDD), the disruption of the thalamic nuclei in the pathophysiology of this disorder has not yet been adequately studied. Therefore, we investigated the volumetric changes of thalamic subregions and their nuclei in drug-naïve, first-episode MDD patients. We also investigated the association between HAM-D scores, a clinical scale frequently used to evaluate the severity of depression and thalamic nuclei volumes in MDD patients. This study included 76 drug-naïve MDD patients and an equal number of healthy subjects. Magnetic resonance imaging (MRI) data were obtained using a 3T MR system and thalamic nuclei volumes were evaluated using FreeSurfer ver.7.11. The volumetric differences were compared by one-way analysis of covariance (ANCOVA) and to ensure that effects were not accounted for by other factors, age, sex, and ETICV variables were included as covariates. We observed significant volume reductions of the left whole thalamus (p < 0.003) and several thalamic nuclei mostly on the left side in the MDD group compared with healthy controls (HCs). Furthermore, we have revealed weak negative correlations between several thalamic nuclei volumes and HAM-D total and subscale scores. This is the first research study to investigate alterations of the various thalamic nuclei volumes in MDD patients compared with HCs. Moreover, we first analyzed the association between individual thalamic nuclei volumes and HAM-D subscale scores. Though our study may be restricted at certain levels, especially by the demographic difference between the two groups, they possibly contribute at a preliminary level to understanding the thalamic structural changes at its subregions in patients with drug-naïve, first-episode MDD.