Diagnostics

15 pages, 8147 KiB

Open AccessArticle

Enhancing Veress Needle Entry with Proximal Vibroacoustic Sensing for Automatic Identification of Peritoneum Puncture

by Moritz Spiller, Nazila Esmaeili, Thomas Sühn, Axel Boese, Salmai Turial, Andrew A. Gumbs, Roland Croner, Michael Friebe and Alfredo Illanes

Diagnostics 2024, 14(15), 1698; https://doi.org/10.3390/diagnostics14151698 - 5 Aug 2024

Viewed by 926

Abstract

Laparoscopic access, a critical yet challenging step in surgical procedures, often leads to complications. Existing systems, such as improved Veress needles and optical trocars, offer limited safety benefits but come with elevated costs. In this study, a prototype of a novel technology for [...] Read more.

Laparoscopic access, a critical yet challenging step in surgical procedures, often leads to complications. Existing systems, such as improved Veress needles and optical trocars, offer limited safety benefits but come with elevated costs. In this study, a prototype of a novel technology for guiding needle interventions based on vibroacoustic signals is evaluated in porcine cadavers. The prototype consistently detected successful abdominal cavity entry in 100% of cases during 193 insertions across eight porcine cadavers. The high signal quality allowed for the precise identification of all Veress needle insertion phases, including peritoneum puncture. The findings suggest that this vibroacoustic-based guidance technology could enhance surgeons’ situational awareness and provide valuable support during laparoscopic access. Unlike existing solutions, this technology does not require sensing elements in the instrument’s tip and remains compatible with medical instruments from various manufacturers. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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18 pages, 2530 KiB

Open AccessReview

Anatomical Factors of the Anterior and Posterior Maxilla Affecting Immediate Implant Placement Based on Cone Beam Computed Tomography Analysis: A Narrative Review

by Milica Vasiljevic, Dragica Selakovic, Gvozden Rosic, Momir Stevanovic, Jovana Milanovic, Aleksandra Arnaut and Pavle Milanovic

Diagnostics 2024, 14(15), 1697; https://doi.org/10.3390/diagnostics14151697 - 5 Aug 2024

Cited by 1 | Viewed by 959

Abstract

Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material [...] Read more.

Background: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. Material and Methods:To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. Findings: Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. Conclusion: The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement. Full article

(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)

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17 pages, 4157 KiB

Open AccessArticle

A Cross-Sectional Validation of Horos and CoreSlicer Software Programs for Body Composition Analysis in Abdominal Computed Tomography Scans in Colorectal Cancer Patients

by Andrés Jiménez-Sánchez, María Elisa Soriano-Redondo, José Luis Pereira-Cunill, Antonio Jesús Martínez-Ortega, José Ramón Rodríguez-Mowbray, Irene María Ramallo-Solís and Pedro Pablo García-Luna

Diagnostics 2024, 14(15), 1696; https://doi.org/10.3390/diagnostics14151696 - 5 Aug 2024

Viewed by 1204

Abstract

Background: Body composition assessment using computed tomography (CT) scans may be hampered by software costs. To facilitate its implementation in resource-limited settings, two open-source segmentation programs (Horos and CoreSlicer) were transversally validated in colorectal cancer patients. Methods: Contrast-enhanced abdominal CT scans were analyzed [...] Read more.

Background: Body composition assessment using computed tomography (CT) scans may be hampered by software costs. To facilitate its implementation in resource-limited settings, two open-source segmentation programs (Horos and CoreSlicer) were transversally validated in colorectal cancer patients. Methods: Contrast-enhanced abdominal CT scans were analyzed following the Alberta protocol. The Cross-Sectional Area (CSA) and intensities of skeletal muscle tissue (MT), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT) were measured. The Skeletal Muscle Index (SMI) was calculated. Cutoff points were applied to the SMI, MT intensity, and VAT CSA to define muscle atrophy, myosteatosis, and abdominal obesity. The inter-software agreement was evaluated using different statistical tools. Results: A total of 68 participants were measured. The MT CSA and SMI displayed no differences. The MT CSA agreement was excellent, and both programs provided equal muscle atrophy prevalences. CoreSlicer underestimated the MT intensity, with a non-significant myosteatosis prevalence increase (+5.88% and +8.82%) using two different operative definitions. CoreSlicer overestimated the CSA and intensity in both VAT and SAT, with a non-significant increase (+2.94%) in the abdominal obesity prevalence. Conclusions: Both software programs were feasible tools in the study group. The MT CSA showed great inter-software agreement and no muscle atrophy misdiagnosis. Segmentation differences in the MT intensity and VAT CSA caused limited diagnostic misclassification in the study sample. Full article

(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)

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15 pages, 8506 KiB

Open AccessArticle

Comparative Efficacy and Safety of Self-Expandable vs. Balloon-Expandable Stent Grafts in Visceral Artery Aneurysm Management

by Reza Talaie, Pooya Torkian, Anthony Spano, Alireza Mahjoubnia, Siobhan M. Flanagan, Michael Rosenberg, Jian Lin, Jafar Golzarian and Preshant Shrestha

Diagnostics 2024, 14(15), 1695; https://doi.org/10.3390/diagnostics14151695 - 5 Aug 2024

Viewed by 878

Abstract

Purpose: This study assesses the efficacy and safety of self-expandable (SE) versus balloon-expandable (BE) stent grafts for managing visceral artery aneurysms (VAAs), focusing on procedural success and complication rates. Materials and Methods: We conducted a retrospective analysis of VAA patients treated at our [...] Read more.

Purpose: This study assesses the efficacy and safety of self-expandable (SE) versus balloon-expandable (BE) stent grafts for managing visceral artery aneurysms (VAAs), focusing on procedural success and complication rates. Materials and Methods: We conducted a retrospective analysis of VAA patients treated at our institution from April 2006 to September 2021. The study reviewed patient demographics, aneurysm characteristics, treatment details, and outcomes, including endoleaks. Results: Among the 23 patients analyzed, splenic artery aneurysms represented 44% of cases. Fifteen patients were treated with balloon-expandable stent grafts (BE SGs), and eight patients were treated with self-expandable stent grafts (SE SGs). For saccular aneurysms, the average neck size was 10.10 ± 8.70 mm in the BE group versus 18.50 ± 3.40 mm in the SE group (p = 0.23), with an average sac size of 20.10 ± 18.9 mm in the BE group versus 15.60 ± 12.7 mm in the SE group (p = 0.16). The average sac-to-neck ratio was 1.69 ± 2.23 in the BE group versus 1.38 ± 0.33 in the SE group (p = 0.63). The BE group exhibited a significantly higher endoleak rate (60%) compared to the SE group (12.5%; p = 0.03). Conclusions: While further investigation is needed to fully assess the outcomes of stent graft treatment for VAAs, initial data show a significantly higher endoleak rate with BE SGs compared to SE SGs. The SE SGs may offer better outcomes due to their superior ability to conform to tortuous and mobile visceral arteries. Full article

(This article belongs to the Special Issue Diagnosis and Management of Cardiovascular Disorders)

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16 pages, 2520 KiB

Open AccessSystematic Review

Assessing, Advising, and Advancing the Filling Practices of the Radiology Request Form in Africa: A Systematic Review

by Mohamed Hajalamin, Almontasir Awadalla and Mahmoud Mukhtar

Diagnostics 2024, 14(15), 1694; https://doi.org/10.3390/diagnostics14151694 - 5 Aug 2024

Viewed by 1860

Abstract

Despite the increased use of diagnostic imaging in Africa, the completion of the Radiology Request Form (RRF) remains suboptimal, often relying on paper-based communication. To examine the practices surrounding RRF completion in the African continent, on 25 March 2024, we conducted a systematic [...] Read more.

Despite the increased use of diagnostic imaging in Africa, the completion of the Radiology Request Form (RRF) remains suboptimal, often relying on paper-based communication. To examine the practices surrounding RRF completion in the African continent, on 25 March 2024, we conducted a systematic review of peer-reviewed articles describing the practice in African settings. Non-African studies, studies involving non-human subjects, and articles examining the practice of the RRF for interventional usage were excluded. Our search involves PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science, Google Scholar, and African Journals Online. The included studies were 3004, of which 30 met the inclusion criteria. These studies span eight countries and highlighted several shortcomings, including the usage of informal forms, unconventional abbreviations, illegibility, inaccuracy, and the lack of important fields from institutional forms, commonly the last menstrual period and the referrer’s contact details. We also found widespread non-compliance in all RRF fields; half of the studies did not have an adequately filled form. Incomplete RRFs lead to delayed imaging, increased workloads for radiographers and radiologists, and potential misdiagnoses due to insufficient information. It will also impede the application of radiation protection principles. To address these challenges, empowering radiographers and radiologists and encouraging best practices is essential. Regular audits and educational initiatives aimed at clinicians are recommended. While transitioning to a paperless communication system might help, implementing nationwide quality improvement projects to standardise radiology request forms is currently more feasible. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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12 pages, 1490 KiB

Open AccessArticle

Compressed SENSitivity Encoding (SENSE): Qualitative and Quantitative Analysis

by Eliseo Picchi, Silvia Minosse, Noemi Pucci, Francesca Di Pietro, Maria Lina Serio, Valentina Ferrazzoli, Valerio Da Ros, Raffaella Giocondo, Francesco Garaci and Francesca Di Giuliano

Diagnostics 2024, 14(15), 1693; https://doi.org/10.3390/diagnostics14151693 - 5 Aug 2024

Viewed by 1018

Abstract

Background. This study aimed to qualitatively and quantitatively evaluate T1-TSE, T2-TSE and 3D FLAIR sequences obtained with and without Compressed-SENSE technique by assessing the contrast (C), the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR). Methods. A total of 142 MRI images were [...] Read more.

Background. This study aimed to qualitatively and quantitatively evaluate T1-TSE, T2-TSE and 3D FLAIR sequences obtained with and without Compressed-SENSE technique by assessing the contrast (C), the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR). Methods. A total of 142 MRI images were acquired: 69 with Compressed-SENSE and 73 without Compressed-SENSE. All the MRI images were contoured, spatially aligned and co-registered using 3D Slicer Software. Two radiologists manually drew 12 regions of interests on three different structures of CNS: white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF). Results. C values were significantly higher in Compressed-SENSE T1-TSE compared to No Compressed-SENSE T1-TSE for three different structures of the CNS. C values were also significantly lower for Compressed-SENSE 3D FLAIR and Compressed-SENSE T2-TSE compared to the corresponding No Compressed-SENSE scans. While CNR values did not significantly differ in GM-WM between Compressed-SENSE and No Compressed-SENSE for the 3D FLAIR and T1-TSE sequences, the differences in GM-CSF and WM-CSF were always statistically significant. Conclusion. Compressed-SENSE for 3D T2 FLAIR, T1w and T2w sequences enables faster MRI acquisition, reducing scan time and maintaining equivalent image quality. Compressed-SENSE is very useful in specific medical conditions where lower SAR levels are required without sacrificing the acquisition of helpful diagnostic sequences. Full article

(This article belongs to the Special Issue Clinical Advances and Applications in Neuroradiology)

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10 pages, 2163 KiB

Open AccessArticle

An Immunohistochemical Study of MAGE Proteins in Hepatocellular Carcinoma

by Stylianos Tologkos, Vasiliki Papadatou, Achilleas G. Mitrakas, Olga Pagonopoulou, Grigorios Tripsianis, Triantafyllos Alexiadis, Christina-Angelika Alexiadi, Antonios-Periklis Panagiotopoulos, Christina Nikolaidou and Maria Lambropoulou

Diagnostics 2024, 14(15), 1692; https://doi.org/10.3390/diagnostics14151692 - 5 Aug 2024

Viewed by 1040

Abstract

Hepatocellular carcinoma (HCC) is one the most common primary malignancies with high mortality and morbidity. The melanoma-associated antigen (MAGE) gene family includes several genes that are highly expressed in numerous human cancers, making many of them part of the cancer-testis antigen (CTA) family. [...] Read more.

Hepatocellular carcinoma (HCC) is one the most common primary malignancies with high mortality and morbidity. The melanoma-associated antigen (MAGE) gene family includes several genes that are highly expressed in numerous human cancers, making many of them part of the cancer-testis antigen (CTA) family. MAGE-C1 is expressed in various malignancies but is absent in normal cells, except for the male germ line. Its presence is associated with a worse prognosis, increased tumor aggressiveness, and lymph node invasion. Similarly, MAGE-C2 is linked to the development of various malignant tumors. Despite these associations, the roles and mechanisms of MAGE-C1/MAGE-C2 in HCC remain unclear. This study aimed to evaluate the expression of MAGE-C1 and MAGE-C2 in HCC and correlate it with clinicohistological characteristics. Our findings indicated that MAGE-C1 expression is associated with a higher number of nodules, elevated AFP levels, HBV or HCV positivity, older age, male sex, and lymph node invasion. MAGE-C2 expression was correlated with these characteristics and the presence of cirrhosis. These results align with the limited literature, which suggests a correlation between MAGE expression and older age and HBV infection. Consequently, our study suggests that MAGE-C1 and MAGE-C2 are promising novel biomarkers for prognosis and potential therapeutic targets in HCC. Full article

(This article belongs to the Special Issue Pathology of Hepatobiliary Diseases)

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26 pages, 3348 KiB

Open AccessArticle

Hybrid Feature Mammogram Analysis: Detecting and Localizing Microcalcifications Combining Gabor, Prewitt, GLCM Features, and Top Hat Filtering Enhanced with CNN Architecture

by Miguel Alejandro Hernández-Vázquez, Yazmín Mariela Hernández-Rodríguez, Fausto David Cortes-Rojas, Rafael Bayareh-Mancilla and Oscar Eduardo Cigarroa-Mayorga

Diagnostics 2024, 14(15), 1691; https://doi.org/10.3390/diagnostics14151691 - 5 Aug 2024

Cited by 1 | Viewed by 1258

Abstract

Breast cancer is a prevalent malignancy characterized by the uncontrolled growth of glandular epithelial cells, which can metastasize through the blood and lymphatic systems. Microcalcifications, small calcium deposits within breast tissue, are critical markers for early detection of breast cancer, especially in non-palpable [...] Read more.

Breast cancer is a prevalent malignancy characterized by the uncontrolled growth of glandular epithelial cells, which can metastasize through the blood and lymphatic systems. Microcalcifications, small calcium deposits within breast tissue, are critical markers for early detection of breast cancer, especially in non-palpable carcinomas. These microcalcifications, appearing as small white spots on mammograms, are challenging to identify due to potential confusion with other tissues. This study hypothesizes that a hybrid feature extraction approach combined with Convolutional Neural Networks (CNNs) can significantly enhance the detection and localization of microcalcifications in mammograms. The proposed algorithm employs Gabor, Prewitt, and Gray Level Co-occurrence Matrix (GLCM) kernels for feature extraction. These features are input to a CNN architecture designed with maxpooling layers, Rectified Linear Unit (ReLU) activation functions, and a sigmoid response for binary classification. Additionally, the Top Hat filter is used for precise localization of microcalcifications. The preprocessing stage includes enhancing contrast using the Volume of Interest Look-Up Table (VOI LUT) technique and segmenting regions of interest. The CNN architecture comprises three convolutional layers, three ReLU layers, and three maxpooling layers. The training was conducted using a balanced dataset of digital mammograms, with the Adam optimizer and binary cross-entropy loss function. Our method achieved an accuracy of 89.56%, a sensitivity of 82.14%, and a specificity of 91.47%, outperforming related works, which typically report accuracies around 85–87% and sensitivities between 76 and 81%. These results underscore the potential of combining traditional feature extraction techniques with deep learning models to improve the detection and localization of microcalcifications. This system may serve as an auxiliary tool for radiologists, enhancing early detection capabilities and potentially reducing diagnostic errors in mass screening programs. Full article

(This article belongs to the Special Issue Quantitative and Intelligent Analysis of Medical Imaging, 2nd Edition)

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6 pages, 747 KiB

Open AccessCase Report

Parathyroid Adenoma Detected in ⁶⁸Ga-PSMA PET/CT but Not in the Dedicated Imaging Modalities

by Maja Cieślewicz, Natalia Andryszak, Kacper Pełka, Ewelina Szczepanek-Parulska, Marek Ruchała, Jolanta Kunikowska and Rafał Czepczyński

Diagnostics 2024, 14(15), 1690; https://doi.org/10.3390/diagnostics14151690 - 5 Aug 2024

Viewed by 969

Abstract

Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and ^99mTc-MIBI scintigraphy [...] Read more.

Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and ^99mTc-MIBI scintigraphy (SPECT) along with ¹⁸F-fluorocholine PET/CT are commonly employed, there are cases with false-negative imaging results. Case presentation: This case report presents a patient with primary hyperparathyroidism and a parathyroid adenoma detected solely through ⁶⁸Ga-PSMA-11 PET/CT, typically used for prostate cancer diagnosis. The lesion observed in the PET/CT was confirmed as a parathyroid adenoma through laboratory evaluation, while other imaging techniques failed to detect it. Conclusions: This finding suggests that the PSMA ligands’ particular affinity for neovascularisation in focal changes may facilitate the visualisation of parathyroid adenomas. The utilisation of ⁶⁸Ga-PSMA-11 PET/CT in primary hyperparathyroidism could potentially improve the preoperative localization of parathyroid adenomas when conventional imaging methods are inconclusive. Full article

(This article belongs to the Special Issue Research Update on Nuclear Medicine)

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13 pages, 3224 KiB

Open AccessArticle

Prediction of Bone Marrow Metastases Using Computed Tomography (CT) Radiomics in Patients with Gastric Cancer: Uncovering Invisible Metastases

by Jiwoo Park, Minkyu Jung, Sang Kyum Kim and Young Han Lee

Diagnostics 2024, 14(15), 1689; https://doi.org/10.3390/diagnostics14151689 - 5 Aug 2024

Viewed by 1084

Abstract

We investigated whether radiomics of computed tomography (CT) image data enables the differentiation of bone metastases not visible on CT from unaffected bone, using pathologically confirmed bone metastasis as the reference standard, in patients with gastric cancer. In this retrospective study, 96 patients [...] Read more.

We investigated whether radiomics of computed tomography (CT) image data enables the differentiation of bone metastases not visible on CT from unaffected bone, using pathologically confirmed bone metastasis as the reference standard, in patients with gastric cancer. In this retrospective study, 96 patients (mean age, 58.4 ± 13.3 years; range, 28–85 years) with pathologically confirmed bone metastasis in iliac bones were included. The dataset was categorized into three feature sets: (1) mean and standard deviation values of attenuation in the region of interest (ROI), (2) radiomic features extracted from the same ROI, and (3) combined features of (1) and (2). Five machine learning models were developed and evaluated using these feature sets, and their predictive performance was assessed. The predictive performance of the best-performing model in the test set (based on the area under the curve [AUC] value) was validated in the external validation group. A Random Forest classifier applied to the combined radiomics and attenuation dataset achieved the highest performance in predicting bone marrow metastasis in patients with gastric cancer (AUC, 0.96), outperforming models using only radiomics or attenuation datasets. Even in the pathology-positive CT-negative group, the model demonstrated the best performance (AUC, 0.93). The model’s performance was validated both internally and with an external validation cohort, consistently demonstrating excellent predictive accuracy. Radiomic features derived from CT images can serve as effective imaging biomarkers for predicting bone marrow metastasis in patients with gastric cancer. These findings indicate promising potential for their clinical utility in diagnosing and predicting bone marrow metastasis through routine evaluation of abdominopelvic CT images during follow-up. Full article

(This article belongs to the Special Issue Application of Artificial Intelligence in Gastrointestinal Disease)

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12 pages, 8410 KiB

Open AccessArticle

Enhancing Retina Images by Lowpass Filtering Using Binomial Filter

by Mofleh Hannuf AlRowaily, Hamzah Arof, Imanurfatiehah Ibrahim, Haniza Yazid and Wan Amirul Mahyiddin

Diagnostics 2024, 14(15), 1688; https://doi.org/10.3390/diagnostics14151688 - 5 Aug 2024

Viewed by 835

Abstract

This study presents a method to enhance the contrast and luminosity of fundus images with boundary reflection. In this work, 100 retina images taken from online databases are utilized to test the performance of the proposed method. First, the red, green and blue [...] Read more.

This study presents a method to enhance the contrast and luminosity of fundus images with boundary reflection. In this work, 100 retina images taken from online databases are utilized to test the performance of the proposed method. First, the red, green and blue channels are read and stored in separate arrays. Then, the area of the eye also called the region of interest (ROI) is located by thresholding. Next, the ratios of R to G and B to G at every pixel in the ROI are calculated and stored along with copies of the R, G and B channels. Then, the RGB channels are subjected to average filtering using a 3 × 3 mask to smoothen the RGB values of pixels, especially along the border of the ROI. In the background brightness estimation stage, the ROI of the three channels is filtered by binomial filters (BFs). This step creates a background brightness (BB) surface of the eye region by levelling the foreground objects like blood vessels, fundi, optic discs and blood spots, thus allowing the estimation of the background illumination. In the next stage, using the BB, the luminosity of the ROI is equalized so that all pixels will have the same background brightness. This is followed by a contrast adjustment of the ROI using CLAHE. Afterward, details of the adjusted green channel are enhanced using information from the adjusted red and blue channels. In the color correction stage, the intensities of pixels in the red and blue channels are adjusted according to their original ratios to the green channel before the three channels are reunited. The resulting color image resembles the original one in color distribution and tone but shows marked improvement in luminosity and contrast. The effectiveness of the approach is tested on the test images and enhancement is noticeable visually and quantitatively in greyscale and color. On average, this method manages to increase the contrast and luminosity of the images. The proposed method was implemented using MATLAB R2021b on an AMD 5900HS processor and the average execution time was less than 10 s. The performance of the filter is compared to those of two other filters and it shows better results. This technique can be a useful tool for ophthalmologists who perform diagnoses on the eyes of diabetic patients. Full article

(This article belongs to the Special Issue Advances in Medical Image Processing, Segmentation and Classification)

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18 pages, 10331 KiB

Open AccessArticle

Evaluation of the Alveolar Crest and Cemento-Enamel Junction in Periodontitis Using Object Detection on Periapical Radiographs

by Tai-Jung Lin, Yi-Cheng Mao, Yuan-Jin Lin, Chin-Hao Liang, Yi-Qing He, Yun-Chen Hsu, Shih-Lun Chen, Tsung-Yi Chen, Chiung-An Chen, Kuo-Chen Li and Patricia Angela R. Abu

Diagnostics 2024, 14(15), 1687; https://doi.org/10.3390/diagnostics14151687 - 4 Aug 2024

Viewed by 1239

Abstract

The severity of periodontitis can be analyzed by calculating the loss of alveolar crest (ALC) level and the level of bone loss between the tooth’s bone and the cemento-enamel junction (CEJ). However, dentists need to manually mark symptoms on periapical radiographs (PAs) to [...] Read more.

The severity of periodontitis can be analyzed by calculating the loss of alveolar crest (ALC) level and the level of bone loss between the tooth’s bone and the cemento-enamel junction (CEJ). However, dentists need to manually mark symptoms on periapical radiographs (PAs) to assess bone loss, a process that is both time-consuming and prone to errors. This study proposes the following new method that contributes to the evaluation of disease and reduces errors. Firstly, innovative periodontitis image enhancement methods are employed to improve PA image quality. Subsequently, single teeth can be accurately extracted from PA images by object detection with a maximum accuracy of 97.01%. An instance segmentation developed in this study accurately extracts regions of interest, enabling the generation of masks for tooth bone and tooth crown with accuracies of 93.48% and 96.95%. Finally, a novel detection algorithm is proposed to automatically mark the CEJ and ALC of symptomatic teeth, facilitating faster accurate assessment of bone loss severity by dentists. The PA image database used in this study, with the IRB number 02002030B0 provided by Chang Gung Medical Center, Taiwan, significantly reduces the time required for dental diagnosis and enhances healthcare quality through the techniques developed in this research. Full article

(This article belongs to the Special Issue Artificial Intelligence in the Diagnostics of Dental Disease)

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11 pages, 846 KiB

Open AccessArticle

A 10-Year Retrospective Cohort Study of Endometrial Cancer Outcomes and Associations with Lymphovascular Invasion: A Single-Center Study from Germany

by Alexandra Nienhaus, Rahavie Rajakulendran and Elena Bernad

Diagnostics 2024, 14(15), 1686; https://doi.org/10.3390/diagnostics14151686 - 4 Aug 2024

Viewed by 954

Abstract

This 10-year retrospective cohort study at a single-center clinic in Germany aimed to analyze the outcomes of endometrial cancer patients and explore the impact of lymphovascular invasion (LV) on patient outcomes and disease-free survival (DFS). Identifying correlations among demographic data, tumor characteristics, treatment [...] Read more.

This 10-year retrospective cohort study at a single-center clinic in Germany aimed to analyze the outcomes of endometrial cancer patients and explore the impact of lymphovascular invasion (LV) on patient outcomes and disease-free survival (DFS). Identifying correlations among demographic data, tumor characteristics, treatment modalities, and survival outcomes could enhance patient management and improve survival rates. The study encompassed patients diagnosed and treated for endometrial cancer from January 2010 to December 2020. Clinical and pathological data were extracted from medical records for 311 patients, focusing on variables such as age, histological type, tumor grade, type of surgical treatment, and adjuvant therapies. Survival analysis was conducted using the Kaplan–Meier method and multivariate Cox proportional hazard models to identify factors independently associated with survival. The study demonstrated that lymphovascular invasion significantly impacted survival outcomes on Kaplan–Meier analysis (log-rank p-value = 0.0058). Patients with LV showed a marked decrease in DFS compared to those without LV invasion, with a median DFS of 3.2 years and a hazard ratio of 2.18 (95% CI: 1.56–3.04, p < 0.001). Furthermore, high-grade tumors and p53 positivity were strongly associated with reduced DFS, with hazard ratios of 1.93 (p = 0.001) and 2.11 (p < 0.001), respectively. Patients with distant metastasis exhibited the most significant decline in survival, with a hazard ratio of 5.56 (95% CI: 2.45–10.18, p < 0.001). Despite comprehensive surgical and adjuvant therapies, these high-risk factors dictated poorer outcomes. The presence of lymphovascular invasion, high-grade tumors, and genetic markers like MSI and p53 are pivotal in predicting the course of endometrial cancer. This study underscores the necessity for aggressive management strategies in patients exhibiting these high-risk features to potentially improve prognosis and survival outcomes. The findings advocate for enhanced therapeutic strategies tailored to the biological behavior of the tumor, thereby aiming to elevate the overall survival rates for women diagnosed with endometrial cancer. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Gynecological Oncology)

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12 pages, 559 KiB

Open AccessArticle

Prognostic Utility of dNLR, ALRI, APRI, and SII in COVID-19 Patients with Diabetes: A Cross-Sectional Study

by Alexandra Ioana Danila, Flavius Cioca, Sai Teja Gadde, Sai Praveen Daruvuri, Romulus Timar and Elena Hogea

Diagnostics 2024, 14(15), 1685; https://doi.org/10.3390/diagnostics14151685 - 4 Aug 2024

Viewed by 1058

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has necessitated the identification of biomarkers that can predict disease severity, particularly in vulnerable populations such as individuals with diabetes. This study aims to evaluate the predictive value of inflammatory and liver function markers, specifically derived Neutrophil [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic has necessitated the identification of biomarkers that can predict disease severity, particularly in vulnerable populations such as individuals with diabetes. This study aims to evaluate the predictive value of inflammatory and liver function markers, specifically derived Neutrophil to Lymphocyte Ratio (dNLR), aspartate aminotransferase (AST)-to-lymphocyte ratio (ALRI), AST to Platelet Ratio Index (APRI), and Systemic Inflammation Index (SII), in COVID-19 patients with and without diabetes. This cross-sectional study included 336 participants, comprising 168 patients with diabetes matched with 168 without, based on gender, body mass index (BMI), and COVID-19 severity at hospitalization. The study was conducted at Victor Babes Hospital for Infectious Diseases and Pulmonology from January 2021 to December 2023. All participants had a confirmed SARS-CoV-2 infection and met the inclusion criteria of being 18 years or older with type 1 or type 2 diabetes as per American Diabetes Association guidelines. At 3 days post symptom onset, significant differences in inflammatory and liver function markers were observed between the two groups. The dNLR, ALRI, APRI, and SII were notably higher in diabetic patients. At a dNLR cutoff of 2.685, the sensitivity and specificity were 70.312% and 65.978%, respectively, with an AUC of 0.624 (p < 0.001). The ALRI showed a cutoff of 0.812, with a sensitivity of 76.429% and specificity of 69.541% (AUC 0.752, p < 0.001). These markers demonstrated statistically significant hazard ratios at both 3 and 7 days, indicating their predictive relevance for severe COVID-19 outcomes. For instance, at 7 days, SII demonstrated a hazard ratio of 2.62 (CI: 1.29–5.04, p < 0.001), highlighting its strong prognostic capability. The study successfully identified significant differences in inflammatory and liver function markers between COVID-19 patients with and without diabetes, with these markers showing good predictive value for disease severity. The results underscore the potential of these biomarkers, particularly ALRI and SII, as valuable tools in managing COVID-19, aiding in the timely identification of patients at increased risk of severe outcomes. Full article

(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)

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17 pages, 1320 KiB

Open AccessArticle

The Importance of Topographical Recognition of Pulmonary Arteries in Diagnostics and Treatment of CTEPH, Based on an Analysis of a Dissected Case Model—A Pilot Study

by Matiss Zicans, Dzintra Kazoka, Mara Pilmane and Andris Skride

Diagnostics 2024, 14(15), 1684; https://doi.org/10.3390/diagnostics14151684 - 3 Aug 2024

Viewed by 959

Abstract

Background: Knowledge of the anatomy of pulmonary arteries is essential in many invasive procedures concerning pulmonary circulation. In the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH), two-dimensional (2D) pulmonary angiography is used. Recognizing the topographic course of the pulmonary arteries and [...] Read more.

Background: Knowledge of the anatomy of pulmonary arteries is essential in many invasive procedures concerning pulmonary circulation. In the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH), two-dimensional (2D) pulmonary angiography is used. Recognizing the topographic course of the pulmonary arteries and understanding the status in three dimensions (3D) is paramount. This study aimed to evaluate and describe the branching variant of pulmonary arteries in a single case, as well as morphological parameters of the segmental arteries, like length, diameter and branching angles. Methods: One pair of embalmed human cadaver lungs was dissected by a scalpel and surgical forceps and was measured up to the subsegmental arteries. Results: The diameters (ranging from 3.04 to 9.29 mm) and lengths (ranging from 9.09 to 53.91 mm) of the pulmonary segmental arteries varied. The proximal branching angles were wide and close to perpendicular, while distally, the angles between the segmental and subsegmental arteries were narrower (30–45°). Upon evaluating the branching, rare variations were identified and delineated, notably in the lower lobes of both lungs. Conclusions: Utilizing knowledge and data in clinical settings is instrumental for effectively diagnosing and treating CTEPH. Further research is required to explore the complications in invasive procedures related to various anatomical variations. Full article

(This article belongs to the Special Issue Advances in Human Anatomy)

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12 pages, 1981 KiB

Open AccessArticle

Three-Dimensional Analysis of the Maxillary Sinuses in Ancient Crania Dated to the V–VI Centuries BCE from Opi (Italy): Volumetric Measurements in Ancient Skulls from the Necropolis of Opi, Abruzzi, Italy

by Felice Festa, Ruggero D’Anastasio, Stefano Benazzi and Monica Macrì

Diagnostics 2024, 14(15), 1683; https://doi.org/10.3390/diagnostics14151683 - 3 Aug 2024

Viewed by 777

Abstract

Cone beam computed tomography (CBCT) can provide precise information about complex anatomical structures as it is characterised by rapid volumetric image acquisition with high resolution. The aim of this study was to provide measurements for 20 ancient skulls of the Samnite people found [...] Read more.

Cone beam computed tomography (CBCT) can provide precise information about complex anatomical structures as it is characterised by rapid volumetric image acquisition with high resolution. The aim of this study was to provide measurements for 20 ancient skulls of the Samnite people found in the necropolis of Opi, a small and isolated mountain village in Abruzzo, a region in central Italy. All the images (left and right) of the 20 ancient skulls from Opi were acquired. All the data are the property of the Department of Innovative Technologies in Medicine and Dentistry of G. D’Annunzio University, Chieti, and different parameters (area and volume) were measured and evaluated. The mean and standard deviation of the facial measurements were also calculated. All the data were subjected to statistical analysis. CBCT scan data of 20 fossil skulls did not show significant values regarding the MS area and the volume between the right and left sides. In the ancient skulls, no difference was found between the right and left sides. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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11 pages, 4245 KiB

Open AccessArticle

Role of Cine-Magnetic Resonance Imaging in the Assessment of Mediastinal Masses with Uncertain/Equivocal Findings from Pre-Operative Computed Tomography Scanning

by Umberto Cariboni, Lorenzo Monti, Emanuele Voulaz, Efrem Civilini, Enrico Citterio, Costanza Lisi and Giuseppe Marulli

Diagnostics 2024, 14(15), 1682; https://doi.org/10.3390/diagnostics14151682 - 2 Aug 2024

Viewed by 764

Abstract

Background: Malignant neoplasms originating from or involving the mediastinum represent a diagnostic and therapeutic challenge when they are in contact with nearby cardiovascular structures. We aimed to test the diagnostic accuracy of cine-magnetic resonance imaging (cine-MRI) in detecting the infiltration of cardiovascular structures [...] Read more.

Background: Malignant neoplasms originating from or involving the mediastinum represent a diagnostic and therapeutic challenge when they are in contact with nearby cardiovascular structures. We aimed to test the diagnostic accuracy of cine-magnetic resonance imaging (cine-MRI) in detecting the infiltration of cardiovascular structures in cases with uncertain or equivocal findings from contrast-enhanced Computed Tomography (CT) scanning. Methods: Fifty patients affected by tumors with a suspected invasion of mediastinal cardiovascular structures at the pre-operative chest CT scan stage underwent cine-MRI before surgery at our Institution. Intraoperative findings and the histological post-surgical report were used as a reference standard to define infiltration. Inter- and intra-observer agreement for CT scans and cine-MRI were also computed over a homogenous sample of 14 patients. Results: Cine-MRI had a higher negative predictive value (93% vs. 54%, p < 0.001) than CT scans, higher sensitivity (91% vs. 16%, p < 0.001), as well as greater accuracy (66% vs. 50%, p < 0.001) in detecting cardiovascular invasion. Cine-MRI also showed better inter- and intra-observer agreement for infiltration detection. Conclusions: Cine-MRI outperforms conventional contrast-enhanced chest CT scans in the preoperative assessment of cardiovascular infiltration by mediastinal or pulmonary tumors, making it a useful imaging modality in the preoperative staging and evaluation of patients with equivocal findings at the chest CT scan stage. Full article

(This article belongs to the Special Issue Medical Radiology in Italy: Current Progress)

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9 pages, 1716 KiB

Open AccessArticle

Quantitative Edge Analysis Can Differentiate Pancreatic Carcinoma from Normal Pancreatic Parenchyma

by Maria Chiara Ambrosetti, Alberto Ambrosetti, Matilde Bariani, Giuseppe Malleo, Giancarlo Mansueto and Giulia A. Zamboni

Diagnostics 2024, 14(15), 1681; https://doi.org/10.3390/diagnostics14151681 - 2 Aug 2024

Viewed by 744

Abstract

This study aimed to introduce specific image feature analysis, focusing on pancreatic margins, and to provide a quantitative measure of edge irregularity, evidencing correlations with the presence/absence of pancreatic adenocarcinoma. We selected 50 patients (36 men, 14 women; mean age 63.7 years) who [...] Read more.

This study aimed to introduce specific image feature analysis, focusing on pancreatic margins, and to provide a quantitative measure of edge irregularity, evidencing correlations with the presence/absence of pancreatic adenocarcinoma. We selected 50 patients (36 men, 14 women; mean age 63.7 years) who underwent Multi-detector computed tomography (MDCT) for the staging of pancreatic adenocarcinoma of the tail of the pancreas. Computer-assisted quantitative edge analysis was performed on the border fragments in MDCT images of neoplastic and healthy glandular parenchyma, from which we obtained the root mean square deviation SD of the actual border from the average boundary line. The SD values relative to healthy and neoplastic borders were compared using a paired t-test. A significant SD difference was observed between healthy and neoplastic borders. A threshold SD value was also found, enabling the differentiation of adenocarcinoma with 96% specificity and sensitivity. We introduced a quantitative measure of boundary irregularity, which correlates with the presence/absence of pancreatic adenocarcinoma. Quantitative edge analysis can be promptly performed on select border fragments in MDCT images, providing a useful supporting tool for diagnostics and a possible starting point for machine learning recognition based on lower-dimensional feature space. Full article

(This article belongs to the Special Issue Abdominal Imaging: Recent Advances and Future Trends)

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12 pages, 1101 KiB

Open AccessArticle

Diagnostic Yield of Trio Whole-Genome Sequencing in Children with Undiagnosed Developmental Delay or Congenital Anomaly: A Prospective Cohort Study

by Jaewon Kim, Jaewoong Lee, Myungshin Kim and Dae-Hyun Jang

Diagnostics 2024, 14(15), 1680; https://doi.org/10.3390/diagnostics14151680 - 2 Aug 2024

Viewed by 838

Abstract

Developmental delays (DD) and congenital anomalies (CA) are prevalent yet often remain undiagnosed despite comprehensive genetic testing. This study aims to investigate the diagnostic yield of trio whole-genome sequencing (WGS) in children presenting with DD or CA who remained undiagnosed after previous genetic [...] Read more.

Developmental delays (DD) and congenital anomalies (CA) are prevalent yet often remain undiagnosed despite comprehensive genetic testing. This study aims to investigate the diagnostic yield of trio whole-genome sequencing (WGS) in children presenting with DD or CA who remained undiagnosed after previous genetic testing. A prospective cohort study was conducted on children with undiagnosed DD or CA at a single tertiary hospital. All participants suspected of genetic conditions had undergone chromosome analysis, chromosome microarray analysis (CMA), and clinical exome sequencing (CES); however, a subset remained undiagnosed. The WGS test was administered to both the affected children and their parents. A total of 52 children were included, and 10 (19.2%) had undergone a genetic diagnosis through WGS. Eight of these cases were associated with autosomal dominant and de novo variants. WGS led to successful diagnosis due to several factors, including small structural variants, genes not covered in the CES panel, the discovery of newly implicated genes, issues related to coverage depth, low variant allele frequency, challenges in variant interpretation, and differences in the interpretation of variants of unknown significance among clinicians. This study highlights the clinical value of trio WGS testing in undiagnosed children with DD or CA. Notably, an additional 19.2% of affected children were diagnosed through this method. Full article

(This article belongs to the Special Issue Clinical Prognostic and Predictive Biomarkers, 2nd Edition)

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7 pages, 2737 KiB

Open AccessInteresting Images

A Case of Dedifferentiated Liposarcoma That Contributes to Accompanying Vessels of Various Size

by Yosuke Yamada, Kai Mizoguchi, Eisuke Shiba, Honami Mishima, Shinya Otsuki, Masahito Hoki, Masahiro Hirata, Akio Sakamoto, Shuichi Matsuda, Alexander Marx, Masanori Hisaoka and Hironori Haga

Diagnostics 2024, 14(15), 1679; https://doi.org/10.3390/diagnostics14151679 - 2 Aug 2024

Viewed by 879

Abstract

Dedifferentiated liposarcoma (DDLPS) is a non-lipogenic sarcoma, generally arising from well-differentiated liposarcoma (WDLPS), although it can develop de novo. DDLPS tumors rarely trans-differentiate into non-adipose mesenchymal tissues; however, the latter lack notable variety and mostly show striated muscle or osteogenic/chondrogenic differentiation. Here, we [...] Read more.

Dedifferentiated liposarcoma (DDLPS) is a non-lipogenic sarcoma, generally arising from well-differentiated liposarcoma (WDLPS), although it can develop de novo. DDLPS tumors rarely trans-differentiate into non-adipose mesenchymal tissues; however, the latter lack notable variety and mostly show striated muscle or osteogenic/chondrogenic differentiation. Here, we report a case of DDLPS that contained numerous atypical vessels. A man in his sixties presented with a large tumor in his right thigh, and the tumor was surgically resected. Microscopically, most of the tumor was WDLPS, but a minor portion showed DDLPS, consisting of high-grade spindle cells. Remarkably, the DDLPS contained vessels of various sizes with atypical cytoarchitecture, including vessels with seemingly muscular layers. Immunohistochemically, the atypical cells within the vascular wall expressed aSMA, consistent with smooth muscle cells or pericytes, whereas surrounding high-grade spindle cells only focally expressed it, and these aSMA-positive cells within the vessels exhibited MDM2 amplification by immuno-fluorescence in situ hybridization. Our results demonstrate that DDLPS can trans-differentiate into smooth muscle cells of various-sized accompanying vessels, which may support their survival and proliferation. Full article

(This article belongs to the Special Issue Clinical Prognostic and Predictive Biomarkers, 2nd Edition)

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11 pages, 1009 KiB

Open AccessArticle

Sinus Irrigation with N-Acetylcysteine after Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Preliminary Report of a Single-Blind Randomized Controlled Trial

by Jee Hye Wee, Joo Hyun Park, Min Woo Park, Young Seok Choi and Hahn Jin Jung

Diagnostics 2024, 14(15), 1678; https://doi.org/10.3390/diagnostics14151678 - 2 Aug 2024

Viewed by 1194

Abstract

Nasal irrigation is crucial following endoscopic sinus surgery (ESS), especially for managing chronic rhinosinusitis (CRS). This study assessed the effectiveness of N-acetylcysteine (NAC) irrigation during the post-ESS period of patients with CRS without nasal polyposis. In this prospective, single-blind randomized controlled trial, 49 [...] Read more.

Nasal irrigation is crucial following endoscopic sinus surgery (ESS), especially for managing chronic rhinosinusitis (CRS). This study assessed the effectiveness of N-acetylcysteine (NAC) irrigation during the post-ESS period of patients with CRS without nasal polyposis. In this prospective, single-blind randomized controlled trial, 49 patients (NAC, n = 24; saline, n = 25) undergoing ESS were assigned to receive either NAC or saline irrigations twice daily for a month. The preoperative and postoperative assessments conducted included Lund–Macka (LM) and Lund–Kennedy (LK) endoscopic scores, the Nasal Obstruction Symptom Evaluation (NOSE) scale, and the Sino-Nasal Outcome Test-20 (SNOT-20). At 2 weeks, 1 month, and 3 months after the operation, endoscopic findings and symptoms were evaluated. Both groups showed no differences in age, sex, LM and LK scores, NOSE scale, and SNOT-20 preoperatively. In terms of the endoscopic findings regarding the sinonasal mucosa after ESS, the NAC group had slightly lower scores 2 weeks, 1 month, and 3 months after the operation, but this difference was not statistically significant. The NAC group showed significant improvement in VAS scores, namely, postnasal drip (1.0, p = 0.041), smell dysfunction (0.8, p = 0.003), and crust (1.5, p = 0.034), compared to the control group’s scores of 2.6, 4.7, and 3.6, respectively, 2 weeks after the operation, although no significant differences were observed in VAS scores for any symptoms 1 and 3 months after the operation. NAC was well tolerated, and no adverse events were reported. NAC irrigation showed benefits over saline irrigation in terms of improving postnasal drip, smell dysfunction, and crust after ESS for CRS without nasal polyposis in the immediate postoperative period. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)

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14 pages, 2341 KiB

Open AccessArticle

Evaluation of Machine Learning Classification Models for False-Positive Reduction in Prostate Cancer Detection Using MRI Data

by Malte Rippa, Ruben Schulze, Georgia Kenyon, Marian Himstedt, Maciej Kwiatkowski, Rainer Grobholz, Stephen Wyler, Alexander Cornelius, Sebastian Schindera and Felice Burn

Diagnostics 2024, 14(15), 1677; https://doi.org/10.3390/diagnostics14151677 - 2 Aug 2024

Viewed by 1224

Abstract

In this work, several machine learning (ML) algorithms, both classical ML and modern deep learning, were investigated for their ability to improve the performance of a pipeline for the segmentation and classification of prostate lesions using MRI data. The algorithms were used to [...] Read more.

In this work, several machine learning (ML) algorithms, both classical ML and modern deep learning, were investigated for their ability to improve the performance of a pipeline for the segmentation and classification of prostate lesions using MRI data. The algorithms were used to perform a binary classification of benign and malignant tissue visible in MRI sequences. The model choices include support vector machines (SVMs), random decision forests (RDFs), and multi-layer perceptrons (MLPs), along with radiomic features that are reduced by applying PCA or mRMR feature selection. Modern CNN-based architectures, such as ConvNeXt, ConvNet, and ResNet, were also evaluated in various setups, including transfer learning. To optimize the performance, different approaches were compared and applied to whole images, as well as gland, peripheral zone (PZ), and lesion segmentations. The contribution of this study is an investigation of several ML approaches regarding their performance in prostate cancer (PCa) diagnosis algorithms. This work delivers insights into the applicability of different approaches for this context based on an exhaustive examination. The outcome is a recommendation or preference for which machine learning model or family of models is best suited to optimize an existing pipeline when the model is applied as an upstream filter. Full article

(This article belongs to the Topic AI in Medical Imaging and Image Processing)

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10 pages, 2354 KiB

Open AccessArticle

Differentiating Well-Differentiated from Poorly-Differentiated HCC: The Potential and the Limitation of Gd-EOB-DTPA in the Presence of Liver Cirrhosis

by Andrea Goetz, Niklas Verloh, Kirsten Utpatel, Claudia Fellner, Janine Rennert, Ingo Einspieler, Michael Doppler, Lukas Luerken, Leona S. Alizadeh, Wibke Uller, Christian Stroszczynski and Michael Haimerl

Diagnostics 2024, 14(15), 1676; https://doi.org/10.3390/diagnostics14151676 - 2 Aug 2024

Viewed by 823

Abstract

This study uses magnetic resonance imaging (MRI) to investigate the potential of the hepatospecific contrast agent gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) in distinguishing G1- from G2/G3-differentiated hepatocellular carcinoma (HCC). Our approach involved analyzing the dynamic behavior of the contrast agent in different phases of [...] Read more.

This study uses magnetic resonance imaging (MRI) to investigate the potential of the hepatospecific contrast agent gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) in distinguishing G1- from G2/G3-differentiated hepatocellular carcinoma (HCC). Our approach involved analyzing the dynamic behavior of the contrast agent in different phases of imaging by signal intensity (SI) and lesion contrast (C), to surrounding liver parenchyma, and comparing it across distinct groups of patients differentiated based on the histopathological grading of their HCC lesions and the presence of liver cirrhosis. Our results highlighted a significant contrast between well- and poorly-differentiated lesions regarding the lesion contrast in the arterial and late arterial phases. Furthermore, the hepatobiliary phase showed limited diagnostic value in cirrhotic liver parenchyma due to altered pharmacokinetics. Ultimately, our findings underscore the potential of Gd-EOB-DTPA-enhanced MRI as a tool for improving preoperative diagnosis and treatment selection for HCC while emphasizing the need for continued research to overcome the diagnostic complexities posed by the disease. Full article

(This article belongs to the Special Issue Diagnostic and Interventional Radiology of Liver Diseases)

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17 pages, 3036 KiB

Open AccessArticle

Association of Sleep Patterns and Respiratory Disturbance Index with Physiological Parameters in Pediatric Patients with Self-Perceived Short Stature

by Jing-Yang Huang, Pei-Lun Liao, Hua-Pin Chang and Pen-Hua Su

Diagnostics 2024, 14(15), 1675; https://doi.org/10.3390/diagnostics14151675 - 2 Aug 2024

Viewed by 995

Abstract

Objective: To investigate the relationships of sleep patterns and respiratory disturbance index (RDI) with key physiological parameters (height, body mass index (BMI), bone age (BA), and IGF-1 levels) in children aged 6 to 16 years with self-perceived short stature. Methods: For this cross-sectional [...] Read more.

Objective: To investigate the relationships of sleep patterns and respiratory disturbance index (RDI) with key physiological parameters (height, body mass index (BMI), bone age (BA), and IGF-1 levels) in children aged 6 to 16 years with self-perceived short stature. Methods: For this cross-sectional study, conducted from October 2019 to November 2021, 238 children aged 6 to 16 years with self-perceived short stature were enrolled. The primary outcomes of sleep patterns and the RDI were non-invasively collected at home using the LARGAN Health AI-Tech Sleep Apnea and Sleep Quality Examination System, which operates based on polygraphy. Additionally, various physiological parameters, including height, BMI, bone age, and IGF-1 levels, were measured to assess their associations with sleep patterns and RDI. Results: Significant age-related reductions were observed in both the total and deep sleep durations. Children aged 6–9 years averaged 8.5 ± 1.0 h of total sleep, which decreased to 8.1 ± 1.1 h in ages 10–11 and further to 7.5 ± 0.9 h in ages 12–16 (p < 0.0001). Deep sleep followed a similar pattern, decreasing from 4.4 ± 1.1 h in the youngest group to 3.3 ± 1.0 h in the oldest (p < 0.0001). Notably, girls experienced significantly longer deep sleep than boys, averaging 4.0 ± 1.2 h compared to 3.6 ± 1.2 h (p = 0.0153). In a multivariable regression analysis, age (beta = 4.89, p < 0.0001) and RDI (beta = −0.54, p = 0.0022) were significantly associated with body height. Age and deep sleep duration (beta = −0.02, p = 0.0371) were significantly associated with BMI. Conclusions: The results demonstrate significant age-related decreases in the total and deep sleep duration among children with self-perceived short stature, along with a notable association between RDI and body height and an association between deep sleep duration and BMI. These findings suggest that sleep disturbances in pediatric endocrine patients are intricately linked with physiological growth parameters. The identified correlations underline the importance of monitoring sleep patterns in this demographic to better understand the impact of endocrine disorders on developmental health. Further research is needed to explore interventions that could alleviate these sleep disturbances, thereby potentially improving outcomes for the affected children. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

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13 pages, 1385 KiB

Open AccessArticle

The Effect of Therapeutic Hypothermia on Ischemic Brain Injury in a Rat Model of Cardiac Arrest: An Assessment Using ¹⁸F-FDG PET

by Daehee Kim, Woon Jeong Lee, Seon Hee Woo, Hye Won Lee, Bom Sahn Kim and Hai-Jeon Yoon

Diagnostics 2024, 14(15), 1674; https://doi.org/10.3390/diagnostics14151674 - 2 Aug 2024

Viewed by 2704

Abstract

Purpose: Therapeutic hypothermia (TH) is widely acknowledged as one of the interventions for preventing hypoxic ischemic brain injury in comatose patients following cardiac arrest (CA). Despite its recognized efficacy, recent debates have questioned its effectiveness. This preclinical study evaluated the impact of TH [...] Read more.

Purpose: Therapeutic hypothermia (TH) is widely acknowledged as one of the interventions for preventing hypoxic ischemic brain injury in comatose patients following cardiac arrest (CA). Despite its recognized efficacy, recent debates have questioned its effectiveness. This preclinical study evaluated the impact of TH on brain glucose metabolism, utilizing fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) in a rat model of CA. Methods: Asphyxia CA was induced in Sprague-Dawley rats using vecuronium. Brain PET images using ¹⁸F-FDG were obtained from 21 CA rats, who were randomized to receive either TH or no intervention. Of these, 9 rats in the TH group received hypothermia under general anesthesia and mechanical ventilation for eight hours, while the remaining 12 rats in the non-TH group were observed without intervention. We conducted regional and voxel-based analyses of standardized uptake values relative to the pons (SUVR_pons) to compare the two groups. Results: Survival rates were identical in both the TH and non-TH groups (67%). There was no discernible difference in the SUVR_pons across the brain cortical regions between the groups. However, in a subgroup analysis of the rats that did not survive (n = 7), those in the TH group (n = 3) displayed significantly higher SUVR_pons values across most cortical regions compared to those in the non-TH group (n = 4), with statistical significance after false-discovery rate correction (p < 0.05). Conclusions: The enhancement in SUVR_pons due to TH intervention was only observed in the cortical regions of rats with severe encephalopathy that subsequently died. These findings suggest that the beneficial effects of TH on brain glucose metabolism in this asphyxia CA model may be confined to cases of severe ischemic encephalopathy. Full article

(This article belongs to the Special Issue Diagnosis and Management in Emergency Medicine)

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16 pages, 2770 KiB

Open AccessArticle

Nasal Microbiome in Granulomatosis with Polyangiitis Compared to Chronic Rhinosinusitis

by Eliza Brożek-Mądry, Zofia Burska, Katarzyna Życińska and Janusz Sierdziński

Diagnostics 2024, 14(15), 1673; https://doi.org/10.3390/diagnostics14151673 - 2 Aug 2024

Viewed by 910

Abstract

Rhinosinusitis in granulomatosis with polyangiitis (GPA) is categorised as a secondary, diffuse and inflammatory chronic rhinosinusitis (CRS). It is one of the conditions that impacts the nasal microbiota. This study aimed to compare the nasal microbiomes of patients with GPA, CRS and NSP. [...] Read more.

Rhinosinusitis in granulomatosis with polyangiitis (GPA) is categorised as a secondary, diffuse and inflammatory chronic rhinosinusitis (CRS). It is one of the conditions that impacts the nasal microbiota. This study aimed to compare the nasal microbiomes of patients with GPA, CRS and NSP. A total of 31 patients were included in the study (18 GPA, 6 CRS and 7 nasal septum perforation (NSP)). In all patients, SNOT 22, a nasal endoscopy (Lund–Kennedy scale) and a brush swab were performed. The metagenomic analysis was carried out based on the hypervariable V3-V4 region of the 16S rRNA gene. At the genus level, statistically significant differences were observed in two comparisons: the GPA/NSP and the GPA/CRS groups. In the GPA/NSP group, the differences were related to four genera (Actinomyces, Streptococcus, Methylobacterium-Methylorubrum, Paracoccus), while in the GPA/CRS group, they were related to six (Kocuria, Rothia, Cutibacterium, Streptococcus, Methylobacterium-Methylorubrum, Tepidimonas). Patients with GPA had lower diversity compared to CRS and NSP patients. There were no statistically significant differences found for the Staphylococcus family and Staphylococcus aureus between the three groups. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)

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18 pages, 3428 KiB

Open AccessArticle

Assessing the Efficacy of the Spectrum-Aided Vision Enhancer (SAVE) to Detect Acral Lentiginous Melanoma, Melanoma In Situ, Nodular Melanoma, and Superficial Spreading Melanoma

by Teng-Li Lin, Chun-Te Lu, Riya Karmakar, Kalpana Nampalley, Arvind Mukundan, Yu-Ping Hsiao, Shang-Chin Hsieh and Hsiang-Chen Wang

Diagnostics 2024, 14(15), 1672; https://doi.org/10.3390/diagnostics14151672 - 1 Aug 2024

Cited by 2 | Viewed by 1234

Abstract

Skin cancer is the predominant form of cancer worldwide, including 75% of all cancer cases. This study aims to evaluate the effectiveness of the spectrum-aided visual enhancer (SAVE) in detecting skin cancer. This paper presents the development of a novel algorithm for snapshot [...] Read more.

Skin cancer is the predominant form of cancer worldwide, including 75% of all cancer cases. This study aims to evaluate the effectiveness of the spectrum-aided visual enhancer (SAVE) in detecting skin cancer. This paper presents the development of a novel algorithm for snapshot hyperspectral conversion, capable of converting RGB images into hyperspectral images (HSI). The integration of band selection with HSI has facilitated the identification of a set of narrow band images (NBI) from the RGB images. This study utilizes various iterations of the You Only Look Once (YOLO) machine learning (ML) framework to assess the precision, recall, and mean average precision in the detection of skin cancer. YOLO is commonly preferred in medical diagnostics due to its real-time processing speed and accuracy, which are essential for delivering effective and efficient patient care. The precision, recall, and mean average precision (mAP) of the SAVE images show a notable enhancement in comparison to the RGB images. This work has the potential to greatly enhance the efficiency of skin cancer detection, as well as improve early detection rates and diagnostic accuracy. Consequently, it may lead to a reduction in both morbidity and mortality rates. Full article

(This article belongs to the Special Issue Optical Imaging: Trends, Impact, and Application in Medical and Biomedical Diagnostics)

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25 pages, 1295 KiB

Open AccessReview

Computed Tomography Angiography Identified High-Risk Coronary Plaques: From Diagnosis to Prognosis and Future Management

by Kyriakos Dimitriadis, Nikolaos Pyrpyris, Panagiotis Theofilis, Emmanouil Mantzouranis, Eirini Beneki, Panagiotis Kostakis, George Koutsopoulos, Konstantinos Aznaouridis, Konstantina Aggeli and Konstantinos Tsioufis

Diagnostics 2024, 14(15), 1671; https://doi.org/10.3390/diagnostics14151671 - 1 Aug 2024

Viewed by 1133

Abstract

CT angiography has become, in recent years, a main evaluating modality for patients with coronary artery disease (CAD). Recent advancements in the field have allowed us to identity not only the presence of obstructive disease but also the characteristics of identified lesions. High-risk [...] Read more.

CT angiography has become, in recent years, a main evaluating modality for patients with coronary artery disease (CAD). Recent advancements in the field have allowed us to identity not only the presence of obstructive disease but also the characteristics of identified lesions. High-risk coronary atherosclerotic plaques are identified in CT angiographies via a number of specific characteristics and may provide prognostic and therapeutic implications, aiming to prevent future ischemic events via optimizing medical treatment or providing coronary interventions. In light of new evidence evaluating the safety and efficacy of intervening in high-risk plaques, even in non-flow-limiting disease, we aim to provide a comprehensive review of the diagnostic algorithms and implications of plaque vulnerability in CT angiography, identify any differences with invasive imaging, analyze prognostic factors and potential future therapeutic options in such patients, as well as discuss new frontiers, including intervening in non-flow-limiting stenoses and the role of CT angiography in patient stratification. Full article

(This article belongs to the Special Issue New Trends and Advances in Cardiac Imaging)

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13 pages, 1037 KiB

Open AccessSystematic Review

Audiovestibular Dysfunction in Systemic Lupus Erythematosus Patients: A Systematic Review

by Jiann-Jy Chen, Chih-Wei Hsu, Yen-Wen Chen, Tien-Yu Chen, Bing-Syuan Zeng and Ping-Tao Tseng

Diagnostics 2024, 14(15), 1670; https://doi.org/10.3390/diagnostics14151670 - 1 Aug 2024

Viewed by 1152

Abstract

Audiovestibular dysfunction in patients with systemic lupus erythematosus has been underestimated for decades. Systemic lupus erythematosus can affect both the auditory and vestibular systems simultaneously. Several potential pathophysiological mechanisms behind systemic lupus erythematosus-related audiovestibular dysfunction have been proposed, including antibody-mediated immune responses, cell-mediated [...] Read more.

Audiovestibular dysfunction in patients with systemic lupus erythematosus has been underestimated for decades. Systemic lupus erythematosus can affect both the auditory and vestibular systems simultaneously. Several potential pathophysiological mechanisms behind systemic lupus erythematosus-related audiovestibular dysfunction have been proposed, including antibody-mediated immune responses, cell-mediated cytotoxicity, immune complex deposition in microvessels, central involvement in the audiovestibular pathway, and ototoxicity from medications used in systemic lupus erythematosus treatment. Currently available tests to evaluate audiovestibular function in systemic lupus erythematosus patients are neither specific nor sensitive. Nevertheless, there is no consensus regarding the efficacy of treatments for audiovestibular dysfunction in such patients. In this systematic review, we electronically searched the PubMed, Embase, ClinicalKey, Web of Science, and ScienceDirect platforms to find eligible articles. The first inspection date was on 29 December 2023 and the final update search date was on 11 June 2024. Further, we rated the quality of the included articles with Newcastle–Ottawa Scale. Based upon the aforementioned systematic review process, we have summarized the currently available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction related to systemic lupus erythematosus. Furthermore, we have proposed a specific steroid treatment protocol to manage audiovestibular dysfunction related to systemic lupus erythematosus. Audiovestibular dysfunction related to systemic lupus erythematosus may be responsive to adequate treatments, potentially allowing for reversibility if the disease is recognized and managed in a timely manner. Therefore, to provide clinically relevant evidence to clinicians, we have organized this literature review article to summarize the available evidence on the characteristics, pathophysiology, examination, and treatment of audiovestibular dysfunction in patients with systemic lupus erythematosus. Finally, based on our modified steroid treatment protocol, we would like to provide a new treatment strategy to clinicians to manage systemic lupus erythematosus-related audiovestibular dysfunction. Full article

(This article belongs to the Section Clinical Laboratory Medicine)

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Open AccessReview

Artificial Intelligence (AI) Applications for Point of Care Ultrasound (POCUS) in Low-Resource Settings: A Scoping Review

by Seungjun Kim, Chanel Fischetti, Megan Guy, Edmund Hsu, John Fox and Sean D. Young

Diagnostics 2024, 14(15), 1669; https://doi.org/10.3390/diagnostics14151669 - 1 Aug 2024

Cited by 1 | Viewed by 1808

Abstract

Advancements in artificial intelligence (AI) for point-of-care ultrasound (POCUS) have ushered in new possibilities for medical diagnostics in low-resource settings. This review explores the current landscape of AI applications in POCUS across these environments, analyzing studies sourced from three databases—SCOPUS, PUBMED, and Google [...] Read more.

Advancements in artificial intelligence (AI) for point-of-care ultrasound (POCUS) have ushered in new possibilities for medical diagnostics in low-resource settings. This review explores the current landscape of AI applications in POCUS across these environments, analyzing studies sourced from three databases—SCOPUS, PUBMED, and Google Scholars. Initially, 1196 records were identified, of which 1167 articles were excluded after a two-stage screening, leaving 29 unique studies for review. The majority of studies focused on deep learning algorithms to facilitate POCUS operations and interpretation in resource-constrained settings. Various types of low-resource settings were targeted, with a significant emphasis on low- and middle-income countries (LMICs), rural/remote areas, and emergency contexts. Notable limitations identified include challenges in generalizability, dataset availability, regional disparities in research, patient compliance, and ethical considerations. Additionally, the lack of standardization in POCUS devices, protocols, and algorithms emerged as a significant barrier to AI implementation. The diversity of POCUS AI applications in different domains (e.g., lung, hip, heart, etc.) illustrates the challenges of having to tailor to the specific needs of each application. By separating out the analysis by application area, researchers will better understand the distinct impacts and limitations of AI, aligning research and development efforts with the unique characteristics of each clinical condition. Despite these challenges, POCUS AI systems show promise in bridging gaps in healthcare delivery by aiding clinicians in low-resource settings. Future research endeavors should prioritize addressing the gaps identified in this review to enhance the feasibility and effectiveness of POCUS AI applications to improve healthcare outcomes in resource-constrained environments. Full article

(This article belongs to the Special Issue Ultrasound: An Important Tool in Critical Care)

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Diagnostics, Volume 14, Issue 15 (August-1 2024) – 120 articles

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