Journal Description
Diagnostics
Diagnostics
is an international, peer-reviewed, open access journal on medical diagnosis published semimonthly online by MDPI. The British Neuro-Oncology Society (BNOS), the International Society for Infectious Diseases in Obstetrics and Gynaecology (ISIDOG) and the Swiss Union of Laboratory Medicine (SULM) are affiliated with Diagnostics and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Inspec, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.7 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journal: LabMed.
Impact Factor:
3.6 (2022);
5-Year Impact Factor:
3.7 (2022)
Latest Articles
Frugal and Translatable [15O]O2 Production for Human Inhalation with Direct Delivery from the Cyclotron to a Hybrid PET/MR
Diagnostics 2024, 14(9), 902; https://doi.org/10.3390/diagnostics14090902 (registering DOI) - 25 Apr 2024
Abstract
Oxygen-15 (β+, t1/2 = 122 s) radiolabeled diatomic oxygen, in conjunction with positron emission tomography, is the gold standard to quantitatively measure the metabolic rate of oxygen consumption in the living human brain. We present herein a protocol for safe and effective
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Oxygen-15 (β+, t1/2 = 122 s) radiolabeled diatomic oxygen, in conjunction with positron emission tomography, is the gold standard to quantitatively measure the metabolic rate of oxygen consumption in the living human brain. We present herein a protocol for safe and effective delivery of [15O]O2 over 200 m to a human subject for inhalation. A frugal quality control testing procedure was devised and validated. This protocol can act as a blueprint for other sites seeking to implement similar imaging programs.
Full article
(This article belongs to the Section Medical Imaging and Theranostics)
Open AccessArticle
Analysis of Choriocapillaris Reperfusion Topography Following Faricimab Treatment for Neovascular Age-Related Macular Degeneration in Non-Treatment-Naïve patients
by
Max Brinkmann, Pasquale Viggiano, Giacomo Boscia, Mathis Danckwardt, Evelyn Susantija, Tom Müller, Niccolò Castellino, Jakob Schweighofer, Francesco Boscia, Mario Damiano Toro and Yosuf El-Shabrawi
Diagnostics 2024, 14(9), 901; https://doi.org/10.3390/diagnostics14090901 (registering DOI) - 25 Apr 2024
Abstract
To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in age-related macular degeneration (AMD) when transitioning from various anti-VEGF treatments to faricimab, using optical coherence tomography angiography (OCTA). 25 eyes of 22 individuals who underwent intravitreal faricimab injections for neovascular
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To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in age-related macular degeneration (AMD) when transitioning from various anti-VEGF treatments to faricimab, using optical coherence tomography angiography (OCTA). 25 eyes of 22 individuals who underwent intravitreal faricimab injections for neovascular AMD with type 1 MNV were included. OCTA images were obtained prior to (T0), after one (T1), and after three faricimab injections (T2); Noteworthy changes occurred in the first ring at T2 in comparison to T0. The percentage of CC flow deficit (FD%), FD average area (FDa), and FD number (FDn) in 5 rings (R1-R5) surrounding the dark halo around the MNV were calculated. A reduction in FD% at T2 compared to T0 (50.5 ± 10.2% at T0, 46.4 ± 10.6% at T2; p = 0.020) was seen, indicating CC reperfusion. Additionally, we observed a reduction in the average FDa (140.2 ± 172.1% at T0, 93.7 ± 101.8% at T2; p = 0.029). Our study highlights an FD% after three consecutive faricimab injections. The most pronounced effect was observed in the first ring, directly adjacent to the dark halo, suggesting a partial CC reperfusion surrounding the MNV, potentially indicating disease regression.
Full article
(This article belongs to the Special Issue Medical Optical Imaging: Current Diagnostics, Therapeutic and Surgical Applications in Ophthalmology—Third Edition)
Open AccessCorrection
Correction: Raymann, J.; Rajalakshmi, R. GAR-Net: Guided Attention Residual Network for Polyp Segmentation from Colonoscopy Video Frames. Diagnostics 2023, 13, 123
by
Joel Raymann and Ratnavel Rajalakshmi
Diagnostics 2024, 14(9), 900; https://doi.org/10.3390/diagnostics14090900 (registering DOI) - 25 Apr 2024
Abstract
There was an error in the original publication [...]
Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
Open AccessArticle
Reliability and Agreement Assessment of Sarcopenia Diagnosis through Comparison of Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry
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Jung Hun Lee, Hee Jin Kim, Sanghun Han, Seong Jun Park, Myongheon Sim and Kang Hyun Lee
Diagnostics 2024, 14(9), 899; https://doi.org/10.3390/diagnostics14090899 (registering DOI) - 25 Apr 2024
Abstract
A unified diagnostic criterion has yet to be established for sarcopenia. Therefore, we analyzed the reliability and validity of sarcopenia diagnosis using bioelectrical impedance analysis (BIA) compared with the gold standard, dual-energy X-ray absorptiometry (DEXA), and evaluated the predictive accuracy of BIA for
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A unified diagnostic criterion has yet to be established for sarcopenia. Therefore, we analyzed the reliability and validity of sarcopenia diagnosis using bioelectrical impedance analysis (BIA) compared with the gold standard, dual-energy X-ray absorptiometry (DEXA), and evaluated the predictive accuracy of BIA for diagnosis. The clinical trial, involving a total of 239 participants, was conducted between December 2018 and September 2019 on healthy volunteers without significant medical histories. The participants underwent health assessments, followed by sequential DEXA and BIA measurements. In both the low and normal appendicular skeletal muscle (ASM) groups, there were significant differences in the right arm, left arm, right leg, left leg, ASM, and ASM index (ASMI) between DEXA and BIA across all age groups (p < 0.05). BIA tended to overestimate compared to DEXA, but ASMI values for males and females were consistent with the criteria for sarcopenia. Bland–Altman analysis showed that each segment in both the low and normal ASM groups fell within the limits of agreement (LOA). The diagnosis of sarcopenia using BIA was significantly different from that using DEXA. However, it exhibited a significantly high correlation, fell within the LOA, and demonstrated high predictive accuracy. BIA can be considered an effective tool for diagnosing sarcopenia.
Full article
(This article belongs to the Special Issue Biomarkers and Clinical Imaging for Diagnosis, Prevention and Management of Muscle Decay)
Open AccessArticle
Environmental and Genetic Risk Factors in Developmental Dysplasia of the Hip for Early Detection of the Affected Population
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Judit A. Ramírez-Rosete, Alonso Hurtado-Vazquez, Antonio Miranda-Duarte, Sergio Peralta-Cruz, Ramiro Cuevas-Olivo, José Antonio Martínez-Junco, Rosalba Sevilla-Montoya, Berenice Rivera-Paredez, Rafael Velázquez-Cruz, Margarita Valdes-Flores, Claudia Rangel-Escareno, Gerardo J. Alanis-Funes, Laura Abad-Azpetia, Sacnicte G. Grimaldo-Galeana, Monica G. Santamaría-Olmedo and Alberto Hidalgo-Bravo
Diagnostics 2024, 14(9), 898; https://doi.org/10.3390/diagnostics14090898 (registering DOI) - 25 Apr 2024
Abstract
Diagnosis of developmental dysplasia of the hip (DDH) mostly relies on physical examination and ultrasound, and both methods are operator-dependent. Late detection can lead to complications in young adults. Current evidence supports the involvement of environmental and genetic factors, such as single nucleotide
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Diagnosis of developmental dysplasia of the hip (DDH) mostly relies on physical examination and ultrasound, and both methods are operator-dependent. Late detection can lead to complications in young adults. Current evidence supports the involvement of environmental and genetic factors, such as single nucleotide variants (SNVs). Incorporating genetic factors into diagnostic methods would be useful for implementing early detection and management of affected individuals. Our aim was to analyze environmental factors and SNVs in DDH patients. We included 287 DDH cases and 284 controls. Logistic regression demonstrated an association for sex (OR 9.85, 95% CI 5.55–17.46, p = 0.0001), family history (OR 2.4, 95% CI 1.2–4.5, p = 0.006), fetal presentation (OR 3.19, 95% CI 1.55–6.54, p = 0.002), and oligohydramnios (OR 2.74, 95%CI 1.12–6.70, p = 0.026). A model predicting the risk of DDH including these variables showed sensitivity, specificity, PPV, and NPV of 0.91, 0.53, 0.74, and 0.80 respectively. The SNV rs1800470 in TGFB1 showed an association when adjusted for covariables, OR 0.49 (95% CI 0.27–0.90), p = 0.02. When rs1800470 was included in the equation, sensitivity, specificity, PPV and NPV were 0.90, 0.61, 0.84, and 0.73, respectively. Incorporating no-operator dependent variables and SNVs in detection methods could be useful for establishing uniform clinical guidelines and optimizing health resources.
Full article
(This article belongs to the Special Issue Advanced Diagnosis and Management of Chronic Musculoskeletal Disorders)
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Open AccessArticle
Pulmonary Hypertension Detection Non-Invasively at Point-of-Care Using a Machine-Learned Algorithm
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Navid Nemati, Timothy Burton, Farhad Fathieh, Horace R. Gillins, Ian Shadforth, Shyam Ramchandani and Charles R. Bridges
Diagnostics 2024, 14(9), 897; https://doi.org/10.3390/diagnostics14090897 (registering DOI) - 25 Apr 2024
Abstract
Artificial intelligence, particularly machine learning, has gained prominence in medical research due to its potential to develop non-invasive diagnostics. Pulmonary hypertension presents a diagnostic challenge due to its heterogeneous nature and similarity in symptoms to other cardiovascular conditions. Here, we describe the development
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Artificial intelligence, particularly machine learning, has gained prominence in medical research due to its potential to develop non-invasive diagnostics. Pulmonary hypertension presents a diagnostic challenge due to its heterogeneous nature and similarity in symptoms to other cardiovascular conditions. Here, we describe the development of a supervised machine learning model using non-invasive signals (orthogonal voltage gradient and photoplethysmographic) and a hand-crafted library of 3298 features. The developed model achieved a sensitivity of 87% and a specificity of 83%, with an overall Area Under the Receiver Operator Characteristic Curve (AUC-ROC) of 0.93. Subgroup analysis showed consistent performance across genders, age groups and classes of PH. Feature importance analysis revealed changes in metrics that measure conduction, repolarization and respiration as significant contributors to the model. The model demonstrates promising performance in identifying pulmonary hypertension, offering potential for early detection and intervention when embedded in a point-of-care diagnostic system.
Full article
(This article belongs to the Special Issue Artificial Intelligence in Cardiology Diagnosis )
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Open AccessInteresting Images
Pseudokidney Sign in Gastric Cancer
by
Thomas Ferenc, Jelena Svetec Dvorski, Andro Matković, Maja Mijić, Eva Lovrić and Vinko Vidjak
Diagnostics 2024, 14(9), 896; https://doi.org/10.3390/diagnostics14090896 (registering DOI) - 25 Apr 2024
Abstract
Pseudokidney sign (PKS) is a characteristic sonographic finding of an abnormal mass with a reniform appearance, and a hyperechoic central region surrounded by a hypoechoic area. It has been seldom documented in gastric cancer. A 75-year-old male patient presented with a palpable abdominal
[...] Read more.
Pseudokidney sign (PKS) is a characteristic sonographic finding of an abnormal mass with a reniform appearance, and a hyperechoic central region surrounded by a hypoechoic area. It has been seldom documented in gastric cancer. A 75-year-old male patient presented with a palpable abdominal resistance in the left upper abdominal quadrant and ultrasound evaluation revealed a well-vascularized mass presenting with PKS. Regional lymphadenopathy was also found, and the working diagnosis of gastric cancer was established. The suspected diagnosis was later verified endoscopically and on pathohistological examinations as gastric adenocarcinoma. Computed tomography staging also revealed distant metastases to the lungs, liver, and adrenal glands and abdominal lymphadenopathy. The PKS often indicates gastrointestinal pathology, and it may be seen in benign and malignant conditions due to gastrointestinal wall thickening. Therefore, additional diagnostic examinations are advised for a more definite diagnosis.
Full article
(This article belongs to the Special Issue Advances in the Diagnostic Imaging of Gastrointestinal Diseases)
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Open AccessArticle
Revolutionizing Radiological Analysis: The Future of French Language Automatic Speech Recognition in Healthcare
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Mariem Jelassi, Oumaima Jemai and Jacques Demongeot
Diagnostics 2024, 14(9), 895; https://doi.org/10.3390/diagnostics14090895 (registering DOI) - 25 Apr 2024
Abstract
This study introduces a specialized Automatic Speech Recognition (ASR) system, leveraging the Whisper Large-v2 model, specifically adapted for radiological applications in the French language. The methodology focused on adapting the model to accurately transcribe medical terminology and diverse accents within the French language
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This study introduces a specialized Automatic Speech Recognition (ASR) system, leveraging the Whisper Large-v2 model, specifically adapted for radiological applications in the French language. The methodology focused on adapting the model to accurately transcribe medical terminology and diverse accents within the French language context, achieving a notable Word Error Rate (WER) of 17.121%. This research involved extensive data collection and preprocessing, utilizing a wide range of French medical audio content. The results demonstrate the system’s effectiveness in transcribing complex radiological data, underscoring its potential to enhance medical documentation efficiency in French-speaking clinical settings. The discussion extends to the broader implications of this technology in healthcare, including its potential integration with electronic health records (EHRs) and its utility in medical education. This study also explores future research directions, such as tailoring ASR systems to specific medical specialties and languages. Overall, this research contributes significantly to the field of medical ASR systems, presenting a robust tool for radiological transcription in the French language and paving the way for advanced technology-enhanced healthcare solutions.
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(This article belongs to the Topic AI in Medical Imaging and Image Processing)
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Open AccessArticle
Association of Serum Levels and Immunohistochemical Labelling of Des-Gamma-Carboxy-Prothrombin in Patients Undergoing Liver Transplantation for Hepatocellular Carcinoma
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Suzanne Chabert, Samuele Iesari, Geraldine Dahlqvist, Mina Komuta, Pamela Baldin, Evaldo Favi and Laurent Coubeau
Diagnostics 2024, 14(9), 894; https://doi.org/10.3390/diagnostics14090894 (registering DOI) - 25 Apr 2024
Abstract
Hepatocellular cancer (HCC) is one of the main reasons for liver transplantation (LT). Biomarkers, such as alpha-foetoprotein (AFP) and Des-gamma-carboxy-prothrombin (DCP), can be helpful in defining the recurrence risk post LT. This study aims to evaluate the association between the intensity of DCP
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Hepatocellular cancer (HCC) is one of the main reasons for liver transplantation (LT). Biomarkers, such as alpha-foetoprotein (AFP) and Des-gamma-carboxy-prothrombin (DCP), can be helpful in defining the recurrence risk post LT. This study aims to evaluate the association between the intensity of DCP immunohistochemical labelling and serum DCP levels in patients undergoing LT for HCC. We carried out a prospective monocentric study including patients who all underwent LT for cirrhosis between 2016 and 2018 and all fell under the Milan criteria. The accepted diagnostic criteria for HCC were contrast-enhanced imaging and histology. Thirty-nine patients were followed for a median of 21 months, with HCC lesions categorized into negative, focally positive, and diffusely positive groups based on DCP immunohistochemistry. The serum DCP levels were significantly higher in the positive groups (258 mAU/mL for the focally and 257 mAU/mL for the diffusely positive) than in the negative group (48 mAU/mL) (p = 0.005) at diagnosis and at the time of liver transplantation (220 mAU/mL for the diffuse positive group). Microvascular invasion (58.8% vs. 19.0% for the diffusely positive and negative groups, respectively, p < 0.001) and lesion size (20 mm in the diffusely labelled group versus 12 mm in the other groups, p = 0.002) were significantly correlated with DCP labelling. Late recurrence occurred only in the positive groups; in the negative group, it occurred within the first 3 months after transplantation. DCP labelling in liver lesions correlates with serum levels and a more aggressive tumour profile. Further investigation is needed to determine if highly DCP-labelled tumours allow for the better selection of high-risk patients before LT.
Full article
(This article belongs to the Special Issue Diagnostic and Prognostic Markers in Liver Diseases)
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Open AccessArticle
Clinical Implications of High-Sensitivity Troponin Elevation Levels in Non-ST-Segment Elevation Myocardial Infarction Patients: Beyond Diagnostics
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Constanza Bravo, Geovanna Vizcarra, Antonia Sánchez, Francisca Cárdenas, Juan Pablo Canales, Héctor Ugalde and Alfredo Parra-Lucares
Diagnostics 2024, 14(9), 893; https://doi.org/10.3390/diagnostics14090893 (registering DOI) - 25 Apr 2024
Abstract
Standard troponin has long been pivotal in diagnosing coronary syndrome, especially Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). The recent introduction of high-sensitivity troponin (hs-cTnI) has elevated it to the gold standard. Yet, its nuanced role in predicting angiographic lesions and clinical outcomes, notably in
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Standard troponin has long been pivotal in diagnosing coronary syndrome, especially Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). The recent introduction of high-sensitivity troponin (hs-cTnI) has elevated it to the gold standard. Yet, its nuanced role in predicting angiographic lesions and clinical outcomes, notably in specific populations like obesity, remains underexplored. Aim: To evaluate the association between hs-cTnI magnitude in NSTEMI patients and angiographic findings, progression to acute heart failure, and its performance in obesity. Methods: Retrospective study of 208 NSTEMI patients at a large university center (2020–2023). Hs-cTnI values were assessed for angiographic severity, acute heart failure, and characteristics in the obese population. Data collected and diagnostic performance were evaluated using manufacturer-specified cutoffs. Results: 97.12% of patients had a single culprit vessel. Hs-cTnI elevation correlated with angiographic stenosis severity. Performance for detecting severe coronary disease was low, with no improvement using a higher cutoff. No association was found between hs-cTnI and the culprit vessel location. Hs-cTnI did not predict acute heart failure progression. In the obese population, hs-cTnI levels were higher, but acute heart failure occurred less frequently than in non-obese counterparts. Conclusions: In NSTEMI, hs-cTnI elevation is associated with significant stenosis, but not with location or acute heart failure. Obesity correlates with higher hs-cTnI levels but a reduced risk of acute heart failure during NSTEMI.
Full article
(This article belongs to the Special Issue Diagnosis, Prognosis, and Management of Cardiovascular Disease)
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Open AccessArticle
Validation of a New Duplex Real-Time Polymerase Chain Reaction for Chlamydia trachomatis DNA Detection in Ocular Swab Samples
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Joana da Felicidade Ribeiro Favacho, Keren Kariene Leite, Thiago Jacomasso, Aline Burda Farias, Luciano Chaves Franco Filho, Samara Tatielle Monteiro Gomes, Herald Souza dos Reis, Gardene Dourado Mota, Pedro Henrique de Caires Schluga, Walleyd Sami Tassi, Rita de Cássia Pontello Rampazzo, Sheila Kay West, Charlotte Ann Gaydos, Antonio José Ledo Alves da Cunha and Alexandre Dias Tavares Costa
Diagnostics 2024, 14(9), 892; https://doi.org/10.3390/diagnostics14090892 (registering DOI) - 25 Apr 2024
Abstract
Trachoma is the world-leading infectious cause of preventable blindness and is caused by the bacteria Chlamydia trachomatis. In developing countries, diagnosis is usually based on clinical evaluation. Serological-based tests are cheaper than molecular-based ones, but the latter are more sensitive and specific.
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Trachoma is the world-leading infectious cause of preventable blindness and is caused by the bacteria Chlamydia trachomatis. In developing countries, diagnosis is usually based on clinical evaluation. Serological-based tests are cheaper than molecular-based ones, but the latter are more sensitive and specific. The present study developed a new duplex qPCR which concomitantly detects the C. trachomatis cryptic plasmid and the human 18S rRNA gene, with an LOD95% for C. trachomatis DNA of 13.04 genome equivalents per reaction. The new qPCR was tested using 50 samples from an endemic area and 12 from a non-endemic area that were previously characterized using direct immunofluorescence assay (DFA) and clinical evaluation. Among the 50 endemic samples, 3 were found to be positive by clinical evaluation (6%), 18 were found to be positive by DFA (36%), and 48 were found to be positive by qPCR (96%). Next, the new duplex qPCR was validated using 50 samples previously characterized by qPCR. Validation was carried out on a benchtop instrument (ABI7500) or on a portable point-of-care instrument (Q3-Plus), showing 95% specificity and 100% sensitivity. The ubiquitous presence of C. trachomatis DNA in samples from the endemic region confirms that constant monitoring is of paramount importance for the effective measurement of the elimination of trachoma. The newly developed duplex qPCR presented in this study, along with its validation in a portable qPCR system, constitutes important tools toward achieving this goal.
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(This article belongs to the Special Issue Microbiology Laboratory: Sample Collection and Diagnosis Advances)
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Open AccessArticle
Peroral Pancreatoscopy-Guided Lithotripsy Compared with Extracorporeal Shock Wave Lithotripsy in the Management of Pancreatic Duct Stones in Chronic Pancreatitis: A Multicenter Retrospective Cohort Study
by
Keisuke Iwata, Takuji Iwashita, Tsuyoshi Mukai, Yuhei Iwasa, Mitsuru Okuno, Kensaku Yoshida, Akinori Maruta, Shinya Uemura, Ichiro Yasuda and Masahito Shimizu
Diagnostics 2024, 14(9), 891; https://doi.org/10.3390/diagnostics14090891 (registering DOI) - 24 Apr 2024
Abstract
Background: Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for pancreatic stones in chronic pancreatitis. In contrast, peroral pancreatoscopy-guided lithotripsy (POPS-L) remains underexplored, with limited comparative studies to ESWL. This study compared the treatment outcomes of disposable POPS-L tools and ESWL for
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Background: Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for pancreatic stones in chronic pancreatitis. In contrast, peroral pancreatoscopy-guided lithotripsy (POPS-L) remains underexplored, with limited comparative studies to ESWL. This study compared the treatment outcomes of disposable POPS-L tools and ESWL for pancreatic stones. Methods: A retrospective analysis was conducted on 66 patients who had undergone pancreatic stone treatment at three institutions between 2006 and 2022. The treatment outcomes of POPS-L and ESWL were compared. Results: This study included 19 and 47 patients who had undergone POPS-L and ESWL, respectively. In a comparison between POPS-L and ESWL, the stone clearance rates were 78.9% vs. 70.2% (p = 0.55), while the procedure-related complication rates were 21% vs. 6.3% (p = 0.09). The median total session counts were 1 vs. 5 (p < 0.01). The cumulative stone recurrence rates were comparable in both groups. Multivariate analysis revealed no significant factors influencing the stone clearance rates, and the choice between POPS-L and ESWL did not affect the stone clearance rates. Conclusions: POPS-L and ESWL exhibited comparable treatment outcomes in terms of stone clearance, complications, and recurrence rates. Furthermore, POPS-L is advantageous due to the need for fewer sessions to achieve pancreatic stone clearance.
Full article
(This article belongs to the Section Medical Imaging and Theranostics)
Open AccessArticle
The Detection of Pulp Stones with Automatic Deep Learning in Panoramic Radiographies: An AI Pilot Study
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Ali Altındağ, Serkan Bahrilli, Özer Çelik, İbrahim Şevki Bayrakdar and Kaan Orhan
Diagnostics 2024, 14(9), 890; https://doi.org/10.3390/diagnostics14090890 (registering DOI) - 24 Apr 2024
Abstract
This study aims to evaluate the effectiveness of employing a deep learning approach for the automated detection of pulp stones in panoramic imaging. A comprehensive dataset comprising 2409 panoramic radiography images (7564 labels) underwent labeling using the CranioCatch labeling program, developed in Eskişehir,
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This study aims to evaluate the effectiveness of employing a deep learning approach for the automated detection of pulp stones in panoramic imaging. A comprehensive dataset comprising 2409 panoramic radiography images (7564 labels) underwent labeling using the CranioCatch labeling program, developed in Eskişehir, Turkey. The dataset was stratified into three distinct subsets: training (n = 1929, 80% of the total), validation (n = 240, 10% of the total), and test (n = 240, 10% of the total) sets. To optimize the visual clarity of labeled regions, a 3 × 3 clash operation was applied to the images. The YOLOv5 architecture was employed for artificial intelligence modeling, yielding F1, sensitivity, and precision metrics of 0.7892, 0.8026, and 0.7762, respectively, during the evaluation of the test dataset. Among deep learning-based artificial intelligence algorithms applied to panoramic radiographs, the use of numerical identification for the detection of pulp stones has achieved remarkable success. It is expected that the success rates of training models will increase by using datasets consisting of a larger number of images. The use of artificial intelligence-supported clinical decision support system software has the potential to increase the efficiency and effectiveness of dentists.
Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
Open AccessArticle
Optimizing Oxygen Delivery by Low-Flow Nasal Cannula to Small Infants: A Bench Study
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Aris Bertzouanis, Xenophon Sinopidis, Polyxeni Pelekouda, Ageliki Karatza, Gabriel Dimitriou and Sotirios Fouzas
Diagnostics 2024, 14(9), 889; https://doi.org/10.3390/diagnostics14090889 (registering DOI) - 24 Apr 2024
Abstract
Background: In infants treated with a low-flow nasal cannula (LFNC), the oxygen concentration delivered to the lungs (i.e., the effective FiO2) is difficult to estimate. The existing mathematical formulas rely on important assumptions regarding the values of respiratory parameters and, thus,
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Background: In infants treated with a low-flow nasal cannula (LFNC), the oxygen concentration delivered to the lungs (i.e., the effective FiO2) is difficult to estimate. The existing mathematical formulas rely on important assumptions regarding the values of respiratory parameters and, thus, may be inaccurate. We aimed to assess oxygen delivery by LFNC to small infants using realistic simulations on a mechanical breathing model. Methods: A mechanical breathing simulator (infant upper-airway replica, single-space breathing compartment, electric motor, microcontroller) was developed. Breathing simulations (n = 1200) were performed at various tidal volume (VT), inspiratory time (Ti), and respiratory rate (RR) combinations and different cannula flows. Results: Minute ventilation (MV) was the most significant predictor of effective FiO2. FiO2 was higher at lower VT and higher Ti values. Benaron and Benitz’s formula underestimated the effective FiO2 at lower MV values, while Finer’s formula significantly overestimated it. A set of predictive FiO2 charts was developed based on cannula flow, infant body weight, and RR. Conclusions: The effective FiO2 delivered by LFNC to small infants critically depends on VT, Ti, and RR. However, since VT and Ti values are not available in clinical practice, the existing mathematical formulas may be inaccurate. Our novel predictive FiO2 charts could assist in optimizing oxygen delivery by LFNC using easy-to-obtain parameters, such as infant body weight and RR.
Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
Open AccessBrief Report
Null Mismatch Repair Proteins Expression Reveals the Temporal Molecular Events in Lynch Syndrome-Related Cancers
by
Gianmaria Miolo, Wally Marus, Angela Buonadonna, Lucia Da Ros, Lara Della Puppa and Giuseppe Corona
Diagnostics 2024, 14(9), 888; https://doi.org/10.3390/diagnostics14090888 (registering DOI) - 24 Apr 2024
Abstract
The immunohistochemical assessment of mismatch repair (MMR) proteins represents a pivotal screening tool for identifying Lynch syndrome (LS)-related cancers, as the loss of their expression often indicates MMR dysfunction associated with genetic or epigenetic alterations. Frequently, LS-related colorectal cancers present germline pathogenic variants
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The immunohistochemical assessment of mismatch repair (MMR) proteins represents a pivotal screening tool for identifying Lynch syndrome (LS)-related cancers, as the loss of their expression often indicates MMR dysfunction associated with genetic or epigenetic alterations. Frequently, LS-related colorectal cancers present germline pathogenic variants in the MLH1 or MSH2 genes, which result in the simultaneous immunohistochemical loss of MLH1 and PMS2 or MSH2 and MSH6 proteins expression, respectively. Less commonly observed is the single involvement of the MSH6 or PMS2 proteins expression, indicative of the presence of germline pathogenic variants in the corresponding genes. Extremely rarely reported are the null immunohistochemistry phenotypes represented by the complete loss of expression of all MMR proteins. The molecular mechanisms contributing to the raising of this latter uncommon immunohistochemical phenotype are derived from the combination of pathogenic germline variants in MMR genes with the somatic hypermethylation of the MLH1 gene promoter. This study focuses on elucidating the molecular cascade leading to the development of the null immunohistochemical phenotype, providing valuable insights into understanding the sequential molecular events driving the LS-associated tumorigenesis, which may have pivotal implications in the clinical management of patients with LS-related cancers.
Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
Open AccessArticle
Correlations between Dental Age, Skeletal Age, and Mandibular Morphologic Index Changes in Turkish Children in Eastern Anatolia and Their Chronological Age during the Pubertal Growth Spurt Period: A Cross-Sectional Study
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Fatma Saraç, Büşra Baydemir Kılınç, Periş Çelikel, Murat Büyüksefil, Muhammet Burak Yazıcı and Sera Şimşek Derelioğlu
Diagnostics 2024, 14(9), 887; https://doi.org/10.3390/diagnostics14090887 - 24 Apr 2024
Abstract
In age determination, different methods aiming to obtain the closest result to chronological age have been investigated so far. The most commonly used one among these is the radiological method, which is usually used to evaluate the developmental stages of wrist bones or
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In age determination, different methods aiming to obtain the closest result to chronological age have been investigated so far. The most commonly used one among these is the radiological method, which is usually used to evaluate the developmental stages of wrist bones or teeth. In our study, we assessed bone age estimations using the Gilsanz–Ratib atlas (GRA), which has recently become commonly used for children aged 9 to 15 years; evaluated the dental age, determined with Cameriere’s European method; conducted morphometric measurements of the mandibular bone; and then examined their relationships with chronological age. The results of our study reveal that, in children during the puberty growth spurt, Cameriere’s EU formula might have higher accuracy in estimating chronological age in younger age groups, while the GRA might be more accurate for older ages. Additionally, we conclude that of the mandibular morphometric measurements, condylar height and tangential ramus height show strong positive correlations with age. As a result, we conclude that the morphometric measurements evaluated in the present study can be used as auxiliary methods in forensic anthropology and forensic dentistry.
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(This article belongs to the Special Issue Forensic Diagnosis)
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Open AccessArticle
Comparison of Ultrasound Attenuation Imaging Using a Linear versus a Conventional Convex Probe: A Volunteer Study
by
Olivia Hänni, Lisa Ruby, Catherine Paverd, Thomas Frauenfelder, Marga B. Rominger and Alexander Martin
Diagnostics 2024, 14(9), 886; https://doi.org/10.3390/diagnostics14090886 - 24 Apr 2024
Abstract
The study aimed to investigate the feasibility of attenuation imaging (ATI) measurements using a linear probe on healthy volunteers and compare measurements with the conventional convex probe. Attenuation imaging measurements of the liver tissue were taken using ultrasound with a convex and a
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The study aimed to investigate the feasibility of attenuation imaging (ATI) measurements using a linear probe on healthy volunteers and compare measurements with the conventional convex probe. Attenuation imaging measurements of the liver tissue were taken using ultrasound with a convex and a linear probe in 33 volunteers by two examining doctors, and the measurements were repeated 4–5 weeks later by one of them. The ATI values for the linear probe were in the range of the values for the convex probe for both examiners. Measurements did not change significantly for 32 out of 33 volunteers after 4–5 weeks when using the linear probe. The size of the region of interest (ROI) only impacted the ATI values for the convex probe; it did not affect the values taken with the linear probe. Healthy volunteers were measured, and their attenuation values were compared to those from a convex probe, commonly used in steatosis evaluation. When both probes were positioned in the same liver area, they showed good agreement in attenuation values, though depth significantly affected the measurements, with both probes providing different values at different depths. The study’s results aligned with previous research using the same system. Operator A and B’s results were compared, demonstrating similar ranges of values for both probes. The linear probe has been demonstrated to allow for superficial measurements and attain ATI values in line with that of the convex probe in the liver.
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(This article belongs to the Special Issue State of the Art of Abdominal Radiology)
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Open AccessArticle
Functional Exercise Capacity and Perceived Exertion in Patients with Empty Nose Syndrome
by
Wei-Te Hung, Ta-Jen Lee, Pei-Wen Wu, Chi-Che Huang, Po-Hung Chang and Chien-Chia Huang
Diagnostics 2024, 14(9), 885; https://doi.org/10.3390/diagnostics14090885 - 24 Apr 2024
Abstract
Empty nose syndrome (ENS) is a complex condition characterized by symptoms such as dyspnea, nasal discomfort, and emotional challenges. This study aimed to evaluate functional exercise capacity and perceived exertion in patients with ENS. Patients with ENS who presented with a range of
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Empty nose syndrome (ENS) is a complex condition characterized by symptoms such as dyspnea, nasal discomfort, and emotional challenges. This study aimed to evaluate functional exercise capacity and perceived exertion in patients with ENS. Patients with ENS who presented with a range of severe symptoms were prospectively enrolled. Pulmonary function was evaluated using spirometry, and functional exercise capacity was measured via the 6 min walk test (6-MWT). Perceived exertion was quantified using the Borg scale, and cardiopulmonary function was evaluated by monitoring peripheral oxygen saturation (SpO2). These parameters were assessed before and after nasal reconstruction surgery. A total of 44 patients with ENS were enrolled and classified into mild-to-moderate (n = 20) and severe (n = 24) symptom groups. Spirometry results showed no significant differences before and after surgery in the entire cohort. Perceived exertion showed significant postoperative improvement (p = 0.006). The severe ENS symptom group experienced significant improvement in SpO2 (p = 0.013) and perceived exertion (p = 0.002) at the end of the 6-MWT after surgery. Surgical intervention significantly enhanced functional exercise capacity (p = 0.038) in patients with mild-to-moderate ENS symptoms. Surgical reconstruction positively affected perceived exertion and SpO2 at the end of the 6-MWT in patients with ENS. The severity of ENS symptoms, as assessed by SNOT-25 scores, influenced these outcomes. These findings underscore the potential benefits of surgical intervention for enhancing exercise tolerance and respiratory efficiency.
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(This article belongs to the Section Pathology and Molecular Diagnostics)
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Videoautopsy—A Minimally Invasive Autopsy Method Using Endoscopic Techniques in Forensic Medicine: Clinical Features
by
Paweł Świderski, Szymon Rzepczyk, Beata Bożek and Czesław Żaba
Diagnostics 2024, 14(9), 884; https://doi.org/10.3390/diagnostics14090884 - 24 Apr 2024
Abstract
In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using
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In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using endoscopic methods. In the years 2020–2023, 15 videoautopsies were conducted at the Department of Forensic Medicine of the Poznan University of Medical Sciences in order to determine the usefulness of the method in forensic approaches. Each post-mortem examination included laparoscopy and thoracoscopy, followed by a classic autopsy to assess the effectiveness of the method. In total, the endoscopic examination allowed for determining the cause of death in 53.3% of cases, and when the cause of death was located in the abdominal cavity or chest, the percentage increased to 80%. Traumatic lesions had good recognition efficiency. In addition, it was also possible to collect material for histopathological and toxicological tests. Retroperitoneal organs were difficult to assess. The main limitation of the method is the inability to assess the inside of the skull and the structures of the central nervous system. Videoautopsy may become an important tool in post-mortem diagnostics and in forensic cases, especially when the alternative is to not perform an autopsy. Further research is necessary to standardise the examination protocol, optimise the instrumentation, and assess the potential synergistic effect with other methods of minimally and non-invasive post-mortem examination.
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(This article belongs to the Special Issue New Perspectives in Forensic Diagnosis)
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Open AccessArticle
Patlak Slope versus Standardized Uptake Value Image Quality in an Oncologic PET/CT Population: A Prospective Cross-Sectional Study
by
Semra Ince, Richard Laforest, Malak Itani, Vikas Prasad, Saeed Ashrafinia, Anne M. Smith, Richard L. Wahl and Tyler J. Fraum
Diagnostics 2024, 14(9), 883; https://doi.org/10.3390/diagnostics14090883 - 24 Apr 2024
Abstract
Patlak slope (PS) images have the potential to improve lesion conspicuity compared with standardized uptake value (SUV) images but may be more artifact-prone. This study compared PS versus SUV image quality and hepatic tumor-to-background ratios (TBRs) at matched time points. Early and late
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Patlak slope (PS) images have the potential to improve lesion conspicuity compared with standardized uptake value (SUV) images but may be more artifact-prone. This study compared PS versus SUV image quality and hepatic tumor-to-background ratios (TBRs) at matched time points. Early and late SUV and PS images were reconstructed from dynamic positron emission tomography (PET) data. Two independent, blinded readers scored image quality metrics (a four-point Likert scale) and counted tracer-avid lesions. Hepatic lesions and parenchyma were segmented and quantitatively analyzed. Differences were assessed via the Wilcoxon signed-rank test (alpha, 0.05). Forty-three subjects were included. For overall quality and lesion detection, early PS images were significantly inferior to other reconstructions. For overall quality, late PS images (reader 1 [R1]: 3.95, reader 2 [R2]: 3.95) were similar (p > 0.05) to early SUV images (R1: 3.88, R2: 3.84) but slightly superior (p ≤ 0.002) to late SUV images (R1: 2.97, R2: 3.44). For lesion detection, late PS images were slightly inferior to late SUV images (R1 only) but slightly superior to early SUV images (both readers). PS-based TBRs were significantly higher than SUV-based TBRs at the early time point, with opposite findings at the late time point. In conclusion, late PS images are similar to early/late SUV images in image quality and lesion detection; the superiority of SUV versus PS hepatic TBRs is time-dependent.
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(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)
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