Diagnostics

11 pages, 4258 KiB

Open AccessArticle

Pre- and Post-Operative Cone Beam Computed Tomography Assessment of the Temporomandibular Joint in Patients with Orthognathic Surgery

by Thomas J. Vogl, Wael Zyada, Rania Helal, Nagy N. Naguib, Neelam Lingwal and Nour-Eldin A. Nour-Eldin

Diagnostics 2024, 14(13), 1389; https://doi.org/10.3390/diagnostics14131389 (registering DOI) - 29 Jun 2024

Abstract

This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent [...] Read more.

This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent to 158 TMJs) (mean age = 26.62 ± 9.5 years) with a bilateral sagittal split osteotomy with or without Le Fort I surgeries (n = 29 Class II DFD, n = 50 Class III DFD) was performed. This included the compartmental measurement of TMJ spaces, in addition to the measurement of intercondylar distances and angles. Condylar position centricity was assessed using the Pullinger and Hollender formula. Clinical data were analysed for DFD class, the type of surgery and post-operative CBCT timing. Pre- and post-operative measurements were compared statistically using a paired t-test, Wilcoxon signed-rank test, and Stuart–Maxwell test. TMJ condyles tended to relocate post-operatively in a posterosuperior position with internal rotation in Class II DFD and a superior position with internal rotation in Class III DFD. However, the overall changes were within <0.5 mm translation and <4° rotation and the number of concentrically positioned condyles (according to the Pullinger and Hollender formula) did not change significantly. Orthognathic surgery is associated with minor post-operative translational and rotational condylar positional changes in Class II and III DFDs. Full article

(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)

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10 pages, 1346 KiB

Open AccessArticle

The Impact of Next-Generation Sequencing Added to Multiplex PCR on Antibiotic Stewardship in Critically Ill Patients with Suspected Pneumonia

by Kendall Kling, Chao Qi, Richard G. Wunderink and Chiagozie Pickens

Diagnostics 2024, 14(13), 1388; https://doi.org/10.3390/diagnostics14131388 (registering DOI) - 29 Jun 2024

Abstract

Introduction: In patients with suspected pneumonia who are tested with respiratory culture and multiplex PCR, the potential added benefit of next-generation sequencing technologies is unknown. Methods: This was a single-center, retrospective study in which residual bronchoalveolar lavage (BAL) specimens were retrieved from hospitalized [...] Read more.

Introduction: In patients with suspected pneumonia who are tested with respiratory culture and multiplex PCR, the potential added benefit of next-generation sequencing technologies is unknown. Methods: This was a single-center, retrospective study in which residual bronchoalveolar lavage (BAL) specimens were retrieved from hospitalized patients. We compared its research-use-only Respiratory Pathogen Illumina Panel (RPIP) results to culture and BioFire^® FilmArray Pneumonia Panel (BioFire^® PN) results from critically ill patients. Results: In total, 47 BAL specimens from 47 unique patients were included. All BAL samples were tested with culture and multiplex PCR. In total, 38 of the 47 BALs were consistent with a clinical picture of pneumonia per chart review. Additional testing of the 38 samples with the RPIP identified a new bacterium in 20 patients, a new virus in 4 patients, a new bacterium plus virus in 4 patients, and no additional organisms in 10 patients. In 17 (44.5%) of these patients, the RPIP results could have indicated an antibiotic addition. Compared with cultures, the RPIP had an overall sensitivity of 64% and specificity of 98%, with a 0% sensitivity for fungus and 14% sensitivity for mycobacteria. Compared with BioFire^® PN, the RPIP was 70% sensitive and 99% specific, with a 74% sensitivity for bacteria and 33% sensitivity for viruses. The RPIP was 29% more sensitive for HAP/VAP bacterial targets compared with CAP. Conclusions: Emerging NGS technologies such as the RPIP may have a role in identifying the etiology of pneumonia, even when patients have BAL culture and multiplex PCR results available. Similar to prior studies evaluating RPIP, our study showed this platform lacked sensitivity when compared with cultures, particularly for fungi and mycobacteria. However, the high specificity of the test can be leveraged when clinicians are seeking to rule out certain infections. Full article

(This article belongs to the Special Issue Applications of Next-Generation Sequencing Technologies for the Diagnosis and Management of Infectious Diseases)

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12 pages, 3125 KiB

Open AccessArticle

Dynamic Perviousness Has Predictive Value for Clot Fibrin Content in Acute Ischemic Stroke

by Vania Anagnostakou, Daniel Toth, Gergely Bertalan, Susanne Müller, Regina R. Reimann, Mark Epshtein, Jawid Madjidyar, Patrick Thurner, Tilman Schubert, Susanne Wegener and Zsolt Kulcsar

Diagnostics 2024, 14(13), 1387; https://doi.org/10.3390/diagnostics14131387 (registering DOI) - 29 Jun 2024

Abstract

Dynamic perviousness is a novel imaging biomarker, with clot density measurements at multiple timepoints to allow longer contrast to thrombus interaction. We investigated the correlations between dynamic perviousness and clot composition in the setting of acute ischemic stroke. Thirty-nine patients with large vessel [...] Read more.

Dynamic perviousness is a novel imaging biomarker, with clot density measurements at multiple timepoints to allow longer contrast to thrombus interaction. We investigated the correlations between dynamic perviousness and clot composition in the setting of acute ischemic stroke. Thirty-nine patients with large vessel occlusion (LVO) undergoing mechanical thrombectomy (MT) were analyzed. Patients received a three-phase CT imaging pre-thrombectomy and histopathological analysis of retrieved clots. Clot densities for every phase and change in densities between phases were calculated, leading to four patterns of dynamic perviousness: no contrast uptake, early contrast uptake with and without washout and late uptake. Clots were categorized into three groups based on dominant histologic composition: red blood cell (RBC)-rich, fibrin/platelet-rich and mixed. Clot composition was correlated with dynamic perviousness using the Kruskal–Wallis test and Pearson’s correlation analysis. The dynamic perviousness categories showed a significant difference between fibrin-rich clots when compared to RBC-rich plus mixed groups. The uptake without washout category had significantly fewer fibrin clots compared to the uptake with washout (p = 0.036), and nearly significantly fewer fibrin clots when compared to the no uptake category (p = 0.057). Contrast uptake with different patterns of contrast washout showed significant differences of the likelihood for fibrin-rich clots. Full article

(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)

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3 pages, 401 KiB

Open AccessInteresting Images

Cholecystocutaneous Fistula

by Francisco Tustumi, Giane Prata da Costa Filha and Guilherme Carvalhal Gnipper Cirillo

Diagnostics 2024, 14(13), 1386; https://doi.org/10.3390/diagnostics14131386 (registering DOI) - 29 Jun 2024

Abstract

This image article presents an 88-year-old indigenous woman with a history of several episodes of abdominal pain, for which she went to numerous different hospitals in the countryside, was always treated with analgesics, and then discharged. After a long time, the patient eventually [...] Read more.

This image article presents an 88-year-old indigenous woman with a history of several episodes of abdominal pain, for which she went to numerous different hospitals in the countryside, was always treated with analgesics, and then discharged. After a long time, the patient eventually was evaluated with magnetic resonance imaging. The test revealed a displaced gallbladder with thickened walls, multiple stones, and a fistulous tract extending to the skin. This case underscores the significant challenges faced by patients in regions with limited healthcare access, highlighting the impact of delayed diagnosis and inadequate management on patient outcomes. Full article

(This article belongs to the Special Issue Diagnosis of Hepatobiliary and Pancreatic Diseases)

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9 pages, 2080 KiB

Open AccessArticle

The Usefulness of 55° Wide-Field Spectral-Domain Optical Coherence Tomography in Monitoring the Features of Peripheral Subretinal Fluid Remnants after Rhegmatogenous Retinal Detachment Surgery

by Valentina Carta, Filippo Lixi, Pasquale Loiudice, Francesca Frongia, Filippo Tatti, Chiara Delpiano, Pierluca Cremonesi and Enrico Peiretti

Diagnostics 2024, 14(13), 1385; https://doi.org/10.3390/diagnostics14131385 (registering DOI) - 29 Jun 2024

Abstract

Background: This study aimed to assess the effectiveness of 55° wide-field (WF) spectral-domain (SD) optical coherence tomography (OCT) for detecting peripheral subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment (RRD). Methods: In this retrospective observational study, the retinal periphery was examined to [...] Read more.

Background: This study aimed to assess the effectiveness of 55° wide-field (WF) spectral-domain (SD) optical coherence tomography (OCT) for detecting peripheral subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment (RRD). Methods: In this retrospective observational study, the retinal periphery was examined to evaluate the possible presence of persistent SRF after surgery. OCT scans were acquired in infrared mode to use any peripheral vessel as a landmark for better repeatability in monitoring fluid remnants. Results: A total of 80 patients (10% with high myopia) were examined using 55° WF SD OCT after successful pars plana vitrectomy (83.8%) or scleral buckling (16.3%) for RRD. A total of 18 patients (22.5%), 16 of whom underwent pars plana vitrectomy and 2 who underwent scleral buckling, showed SRF at the OCT examination during the follow-up. Potential risk factors associated with SRF persistence were analyzed, revealing a significative association with young age (p = 0.009). After a follow-up period of 7.05 ± 2.44 months (ranging from 3 to 12 months), a complete resorption in all patients (100%) within 12 months was observed. Best-corrected visual acuity significantly improved in both groups over time. Conclusion: Using 55° WF SD-OCT successfully assessed the course of SRF reabsorption, offering a viable alternative for all those realities where technologies such as ultra-wide-field (UWF) OCT are not available. Full article

(This article belongs to the Special Issue Optical Coherence Tomography in Diagnosis of Ophthalmology Disease)

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31 pages, 557 KiB

Open AccessReview

Diagnostic Procedures for Inflammatory Bowel Disease: Laboratory, Endoscopy, Pathology, Imaging, and Beyond

by Seung Min Hong and Dong Hoon Baek

Diagnostics 2024, 14(13), 1384; https://doi.org/10.3390/diagnostics14131384 (registering DOI) - 28 Jun 2024

Abstract

Diagnosing inflammatory bowel disease (IBD) can often be challenging, and differentiating between Crohn’s disease and ulcerative colitis can be particularly difficult. Diagnostic procedures for IBD include laboratory tests, endoscopy, pathological tests, and imaging tests. Serological and stool tests can be easily performed in [...] Read more.

Diagnosing inflammatory bowel disease (IBD) can often be challenging, and differentiating between Crohn’s disease and ulcerative colitis can be particularly difficult. Diagnostic procedures for IBD include laboratory tests, endoscopy, pathological tests, and imaging tests. Serological and stool tests can be easily performed in an outpatient setting and provide critical diagnostic clues. Although endoscopy is an invasive procedure, it offers essential diagnostic information and allows for tissue biopsy and therapeutic procedures. Video capsule endoscopy and device-assisted enteroscopy are endoscopic procedures used to evaluate the small bowel. In addition to endoscopy, magnetic resonance imaging, computed tomography, and ultrasound (US) are valuable tools for small bowel assessment. Among these, US is noninvasive and easily utilized, making its use highly practical in daily clinical practice. Endoscopic biopsy aids in the diagnosis of IBD and is crucial for assessing the histological activity of the disease, facilitating a thorough evaluation of disease remission, and aiding in the development of treatment strategies. Recent advances in artificial intelligence hold promise for enhancing various aspects of IBD management, including diagnosis, monitoring, and precision medicine. This review compiles current procedures and promising future tools for the diagnosis of IBD, providing comprehensive insights. Full article

(This article belongs to the Special Issue Diagnostic Procedures for Inflammatory Bowel Disease: Laboratory, Endoscopy, Pathology, Imaging and Beyond)

14 pages, 1177 KiB

Open AccessArticle

Are There Differences in Skin Autofluorescence-Measured Advanced Glycation End-Product Levels between Chronic Kidney Disease and Kidney Transplant Recipients?

by Josipa Radić, Marijana Vučković, Hana Đogaš, Andrea Gelemanović, Andrej Belančić and Mislav Radić

Diagnostics 2024, 14(13), 1383; https://doi.org/10.3390/diagnostics14131383 (registering DOI) - 28 Jun 2024

Abstract

The aim of this cross-sectional study was to evaluate the differences in the levels of advanced glycation end products (AGE) between patients with chronic kidney disease (CKD) and kidney transplant recipients (KTRs) and to investigate the risk factors for the AGE levels in [...] Read more.

The aim of this cross-sectional study was to evaluate the differences in the levels of advanced glycation end products (AGE) between patients with chronic kidney disease (CKD) and kidney transplant recipients (KTRs) and to investigate the risk factors for the AGE levels in each group of these patients. There were 217 participants total, of which 99 (45.6%) were KTRs and 118 (54.4%) had CKD. Data on the levels of AGE, body mass composition, anthropometric parameters, central and peripheral blood pressure, and clinical and laboratory parameters were gathered for each study participant. The AGE values of the CKD and KTR groups did not differ from one another. In both groups, a lower estimated glomerular filtration rate, male sex, and older age were positive predictors for increased AGE values. Furthermore, higher levels of AGEs were linked to lower central systolic blood pressure (cSBP) in the CKD group, whilst, in the KTR group, higher levels of AGE were linked to a shorter time since kidney transplantation (KTx), more years of dialysis prior to KTx, lower levels of trunk visceral fat, the presence of arterial hypertension, and the absence of prescriptions for the antihypertensive medications urapidil and angiotensin II receptor blockers. Further studies are needed to better understand the above associations. Consequently, a personalised multidisciplinary approach to assess the cardiovascular as well as dietary and lifestyle risk factors to reduce the AGE levels in both KTRs and CKD patients may be implemented. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Kidney Disease)

6 pages, 8272 KiB

Open AccessInteresting Images

The Role of OCT in Follow-Up of Fungal Keratitis Caused by Beauveria bassiana in Contact Lens Wearer

by Cristina Martínez-Gil, María José Roig-Revert, Ester Fernández-López, Rosa María González-Pellicer, Juan José Camarena-Miñana and Cristina Peris-Martínez

Diagnostics 2024, 14(13), 1382; https://doi.org/10.3390/diagnostics14131382 (registering DOI) - 28 Jun 2024

Abstract

A 25-year-old Caucasic female was referred to our clinic after suffering from infectious keratitis in the right eye for a month. The patient was a contact lens user and had no history of ocular trauma. Furthermore, the patient did not report any [...] Read more.

A 25-year-old Caucasic female was referred to our clinic after suffering from infectious keratitis in the right eye for a month. The patient was a contact lens user and had no history of ocular trauma. Furthermore, the patient did not report any relevant antecedent. The main complaint was intense photophobia and pain. Infectious keratitis remains one of the main complications of contact lens wear and can become a therapeutic challenge in some patients. Although the most frequent causal agent is bacterial, other causes such as herpes virus, Acanthamoeba or fungi should be considered when antimicrobial therapy does not work as expected clinically. Fungal keratitis normally appears on previously damaged corneas, but it can also develop in contact lens wearers. Beauveria bassiana is an unusual pathogen which has been diagnosed more frequently lately per the clinical reports in the last 30 years, so it can be included in the diagnostic scheme when a fungal keratitis is suspected. In clinical management, AS-OCT may be a functional tool to assess the evolution and monitor the response to microbial agents and surgery. Although more studies are needed, some characteristic features have been described and can help to diagnose a fungal keratitis against other infections. AS-OCT can also play an important role in monitoring the corneal scarring after the keratitis episode, and it may be useful to plan post-infection therapy for visual rehabilitation. Full article

(This article belongs to the Special Issue Optical Coherence Tomography in Diagnosis of Ophthalmology Disease)

21 pages, 366 KiB

Open AccessArticle

Values and Diagnostic Accuracy of Electrodiagnostic Findings in Carpal Tunnel Syndrome Based on Age, Gender, and Diabetes

by Ahmad R. Abuzinadah

Diagnostics 2024, 14(13), 1381; https://doi.org/10.3390/diagnostics14131381 (registering DOI) - 28 Jun 2024

Abstract

Background: Appropriate cut-off values and diagnostic accuracy (DA) [sensitivity, specificity, predictive values, positive (PPV) and negative (NPV)] of electrodiagnostic findings for carpal tunnel syndrome (CTS) based on age, gender, and diabetes mellitus (DM) were not reported. Methods: In a retrospective study, we described [...] Read more.

Background: Appropriate cut-off values and diagnostic accuracy (DA) [sensitivity, specificity, predictive values, positive (PPV) and negative (NPV)] of electrodiagnostic findings for carpal tunnel syndrome (CTS) based on age, gender, and diabetes mellitus (DM) were not reported. Methods: In a retrospective study, we described the latency difference values and DA of comparative latency studies COLS [median to ulnar through palmar difference (palmdiff) and ring difference study (ringdiff), median to radial through thumb difference study (thumbdiff), and combined sensory index (CSI)] among non-CTS and CTS groups based on age, DM, and gender. Results: We included 632 patients (228 without CTS and 404 with CTS). For PPV > 90% and NPV > 50%, the best cut-offs among patients without DM, were 0.5ms, 0.8–1 ms, 1.4 ms, and 2 ms for palmdiff, thumbdiff, CSI (age < 60 years), and CSI (age > 60 years), respectively. The best cut-offs among patients with DM were 0.5 ms, 1.2 ms, 0.8 ms, 1.0–1.2 ms, 1.8 ms, 1–1.2 ms, 3.0 ms, and 3.5 ms for palmdiff (age < 50 years), palmdiff (age > 50 years), thumbdiff (age < 40 years), thumbdiff (age 40–59 years), thumbdiff (age > 60 years), CSI (age < 50 years), CSI (age 50–59 years), and CSI (age > 60 years), respectively. Conclusion: The cut-off values of COLS to confirm CTS and their DA were different according to age and DM. Full article

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

14 pages, 3951 KiB

Open AccessCase Report

Novel Ultrasound-Guided Hydrodissection with 5% Dextrose Techniques for the Treatment of Occipital Neuralgia Targeting the Greater Occipital Nerve

by King Hei Stanley Lam, Daniel Chiung-Jui Su, Yung-Tsan Wu, Aeneas Janze and Kenneth Dean Reeves

Diagnostics 2024, 14(13), 1380; https://doi.org/10.3390/diagnostics14131380 (registering DOI) - 28 Jun 2024

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Abstract

Background: Occipital neuralgia is a debilitating condition, and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissections with 5% dextrose [...] Read more.

Background: Occipital neuralgia is a debilitating condition, and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissections with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two cases are reported. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON passes through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial-caudal approaches provide additional options to address patient-specific anatomical considerations and preferences. Full article

(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology 2023)

13 pages, 440 KiB

Open AccessArticle

The Diagnostic Accuracy of Electrical Impedance Spectroscopy-Assisted Colposcopy, HPV mRNA Test, and P16/Ki67 Immunostaining as CIN2+ Predictors in Greek Population

by Nikolaos Tsampazis, Eleftherios Vavoulidis, Chrysoula Margioula-Siarkou, Marianthi Symeonidou, Stergios Intzes, Alexios Papanikolaou, Konstantinos Dinas and Angelos Daniilidis

Diagnostics 2024, 14(13), 1379; https://doi.org/10.3390/diagnostics14131379 (registering DOI) - 28 Jun 2024

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Abstract

Objective: To evaluate the diagnostic accuracy of Electrical Impedance Spectroscopy (EIS)-assisted colposcopy in detecting CIN2+ Greek women towards standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining. Methods: We conducted a cross-sectional observational study at the Cervical Pathology Clinic of the 2nd Obstetrics-Gynecology University [...] Read more.

Objective: To evaluate the diagnostic accuracy of Electrical Impedance Spectroscopy (EIS)-assisted colposcopy in detecting CIN2+ Greek women towards standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining. Methods: We conducted a cross-sectional observational study at the Cervical Pathology Clinic of the 2nd Obstetrics-Gynecology University Department of Hippokration Hospital Thessaloniki involving 316 patients from January 2022 to August 2023. All participants provided liquid-based cervical samples for cytology, HPV mRNA testing, and p16/Ki67 immunostaining. Main Outcome Measures: Subsequently, participants underwent both standalone colposcopy and EIS/ZedScan-assisted colposcopy, followed by cervical punch biopsies. Results: The incorporation of EIS significantly enhanced the sensitivity of colposcopy, increasing it from 54.17% to 100%, equivalent to that of HPV mRNA testing and p16/Ki67 immunostaining, while achieving a high specificity (95.45%). The specificities observed with EIS/ZedScan-assisted and standalone colposcopy were notably superior to those of HPV-related biomarkers (HPV mRNA test and p16/Ki67 immunostaining). When compared to standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining, EIS/ZedScan-assisted colposcopy demonstrated the most favorable combination of Positive and Negative Predictive Values, at 90.57% and 100%, respectively. The inclusion of EIS/ZedScan in colposcopy led to the detection of 44 additional cases of true CIN2+ (100% of the total CIN2+ confirmed histologically) that were missed by standalone colposcopy. This discovery suggests a 45.83% increase in the detection of CIN2+ cases. Conclusions: The integration of EIS with colposcopy has demonstrated effectiveness in detecting cervical lesions, resulting in a significant detection increase of CIN2+ cases while offering optimal levels of sensitivity, specificity, and predictive values for CIN2+ detection. Full article

(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)

24 pages, 1027 KiB

Open AccessArticle

An Advanced Lung Carcinoma Prediction and Risk Screening Model Using Transfer Learning

by Isha Bhatia, Aarti, Syed Immamul Ansarullah, Farhan Amin and Amerah Alabrah

Diagnostics 2024, 14(13), 1378; https://doi.org/10.3390/diagnostics14131378 (registering DOI) - 28 Jun 2024

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Abstract

Lung cancer, also known as lung carcinoma, has a high death rate, but an early diagnosis can substantially reduce this risk. In the current era, prediction models face challenges such as low accuracy, excessive noise, and low contrast. To resolve these problems, an [...] Read more.

Lung cancer, also known as lung carcinoma, has a high death rate, but an early diagnosis can substantially reduce this risk. In the current era, prediction models face challenges such as low accuracy, excessive noise, and low contrast. To resolve these problems, an advanced lung carcinoma prediction and risk screening model using transfer learning is proposed. Our proposed model initially preprocesses lung computed tomography images for noise removal, contrast stretching, convex hull lung region extraction, and edge enhancement. The next phase segments the preprocessed images using the modified Bates distribution coati optimization (B-RGS) algorithm to extract key features. The PResNet classifier then categorizes the cancer as normal or abnormal. For abnormal cases, further risk screening determines whether the risk is low or high. Experimental results depict that our proposed model performs at levels similar to other state-of-the-art models, achieving enhanced accuracy, precision, and recall rates of 98.21%, 98.71%, and 97.46%, respectively. These results validate the efficiency and effectiveness of our suggested methodology in early lung carcinoma prediction and risk assessment. Full article

(This article belongs to the Special Issue Artificial Intelligence in Cancers—2nd Edition)

15 pages, 2055 KiB

Open AccessArticle

Validation of a New Test for Measuring the Contrast Sensitivity Function (Optopad-CSF) at Near Vision

by Dolores de Fez, Celia García, Maria Josefa Luque-Cobija, Kevin J. Mena-Guevara, Paula Daudén and David P. Piñero

Diagnostics 2024, 14(13), 1377; https://doi.org/10.3390/diagnostics14131377 (registering DOI) - 28 Jun 2024

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Abstract

Our purpose is to develop and validate a new iPad-based contrast sensitivity (CS) test for measuring the contrast sensitivity function at near vision (Optopad-CSF). A total of 200 eyes of 100 healthy subjects (ages 17–63) were evaluated in a comparative study between the [...] Read more.

Our purpose is to develop and validate a new iPad-based contrast sensitivity (CS) test for measuring the contrast sensitivity function at near vision (Optopad-CSF). A total of 200 eyes of 100 healthy subjects (ages 17–63) were evaluated in a comparative study between the Optopad-CSF test (near vision) and the CSV-1000E test (distance vision). The agreement between tests was assessed with the index of contrast sensitivity (ICS) and the area under the curve (AUC). CS for all the spatial frequencies in both eyes showed a negative significant correlation with age, and corrected distance, and near visual acuities (r ≤ −0.512, p ≤ 0.013). A significantly lower CS was found with the Optopad-CSF test in the over-40-year-old subgroup for all the spatial frequencies evaluated compared to the below-40 subgroup (p ≤ 0.008). The mean AUC of the Optopad-CSF test (5.84) was twice that of the CSV-1000E test (2.76). The mean ICS of the Optopad-CSF (−0.019) and CSV-1000E (−0.075) tests showed similar values, both close to 0 (p = 0.3). There was a weak but significant correlation between the Optopad-CSF and CSV-1000E ICS tests (r = 0.246, p < 0.02). A range of normality for the values obtained with the Optopad-CSF test was calculated. The mean CS values in 16 bilateral cataract patients were out of the normal range for all the spatial frequencies evaluated (p < 0.001). Optopad-CSF is a valid portable system for measuring CS at near vision for five spatial frequencies, allowing the detection of age-related changes in CSF with age and CSF loss in cataracts, with no ceiling effect. Full article

(This article belongs to the Section Optical Diagnostics)

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11 pages, 969 KiB

Open AccessArticle

Convolutional Neural Network Model for Intestinal Metaplasia Recognition in Gastric Corpus Using Endoscopic Image Patches

by Irene Ligato, Giorgio De Magistris, Emanuele Dilaghi, Giulio Cozza, Andrea Ciardiello, Francesco Panzuto, Stefano Giagu, Bruno Annibale, Christian Napoli and Gianluca Esposito

Diagnostics 2024, 14(13), 1376; https://doi.org/10.3390/diagnostics14131376 (registering DOI) - 28 Jun 2024

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Abstract

Gastric cancer (GC) is a significant healthcare concern, and the identification of high-risk patients is crucial. Indeed, gastric precancerous conditions present significant diagnostic challenges, particularly early intestinal metaplasia (IM) detection. This study developed a deep learning system to assist in IM detection using [...] Read more.

Gastric cancer (GC) is a significant healthcare concern, and the identification of high-risk patients is crucial. Indeed, gastric precancerous conditions present significant diagnostic challenges, particularly early intestinal metaplasia (IM) detection. This study developed a deep learning system to assist in IM detection using image patches from gastric corpus examined using virtual chromoendoscopy in a Western country. Utilizing a retrospective dataset of endoscopic images from Sant’Andrea University Hospital of Rome, collected between January 2020 and December 2023, the system extracted 200 × 200 pixel patches, classifying them with a voting scheme. The specificity and sensitivity on the patch test set were 76% and 72%, respectively. The optimization of a learnable voting scheme on a validation set achieved a specificity of 70% and sensitivity of 100% for entire images. Despite data limitations and the absence of pre-trained models, the system shows promising results for preliminary screening in gastric precancerous condition diagnostics, providing an explainable and robust Artificial Intelligence approach. Full article

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

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18 pages, 9342 KiB

Open AccessArticle

Chemokine Receptor-4 Targeted PET/CT Imaging with ⁶⁸Ga-Pentixafor in Head and Neck Cancer—A Comparison with ¹⁸F-FDG and CXCR4 Immunohistochemistry

by Bawinile Hadebe, Lerwine Harry, Lerato Gabela, Siphelele Masikane, Maryam Patel, Sizwe Zwane, Venesen Pillay, Presha Bipath, Nonhlanhla Cebekhulu, Nozipho Nyakale, Prathima Ramdass, Mpumelelo Msimang, Colleen Aldous, Mike Sathekge and Mariza Vorster

Diagnostics 2024, 14(13), 1375; https://doi.org/10.3390/diagnostics14131375 - 28 Jun 2024

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Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is common, and its incidence is increasing, particularly in HIV-infected individuals who present with more aggressive disease. Despite aggressive treatment, the prognosis remains poor because of resistance to chemoradiation therapy. So far, studies report very [...] Read more.

Background: Head and neck squamous cell carcinoma (HNSCC) is common, and its incidence is increasing, particularly in HIV-infected individuals who present with more aggressive disease. Despite aggressive treatment, the prognosis remains poor because of resistance to chemoradiation therapy. So far, studies report very low [⁶⁸Ga]Ga-Pentixafor avidity in HNSCC. This study investigated the diagnostic performance of CXCR4-directed imaging of carcinoma of the oral cavity, oropharynx, and nasopharynx with positron emission tomography/computed tomography (PET/CT) using the radiolabelled chemokine ligand [⁶⁸Ga]Ga-Pentixafor and explored its ability to quantify CXCR4 expression in vivo. Materials and Methods: In this prospective cross-sectional study, twenty-three (23) patients aged 52.9 ± 10.4 (19.6), 17 males and 6 females with primarily diagnosed (n = 17) or pre-treated (n = 6) SCC of the oral cavity (OCSCC, n = 11), oropharynx (OPSCC, n = 9), nasopharynx (NPSCC, n = 2) and unknown primary (n = 1) underwent imaging with [⁶⁸Ga]Ga-Pentixafor-PET/CT. In 16/23 patients 2-[18F]fluoro-2-deoxy-D-glucose ([¹⁸F]F-FDG) served as a standard reference. All lesions were visually rated using a 5-point Likert scale. For both tracers, maximum standardized uptake values (SUVmax) and the total lesion uptake (TLU) were recorded and compared using the Wilcox-signed rank test. In addition, the tumor-to-background ratios were derived using the liver (TLR), spleen (TSR), and posterior cervical muscles (TMR) as background. The relationships between the SUVs of the two tracers were assessed using the Spearman correlation. CXCR4 immunohistochemistry (IHC) staining was correlated with ⁶⁸Ga-Pentixafor-PET/CT in 21/23 patients. Results: Ninety-one percent (21/23) of tumors were visually detected on [⁶⁸Ga]Ga-Pentixafor; however, [⁶⁸Ga]Ga-Pentixafor was less intense compared with [¹⁸F]F-FDG-PET. Quantitative analysis showed higher [¹⁸F]F-FDG SUVmax in comparison with [⁶⁸Ga]Ga-Pentixafor (16 ± 6.7 vs. 5.8 ± 2.6 g/mL, p = 0.011) and SUVmean (9.3 ± 4.1 vs. 3± 1.6 g/mL, p < 0.001) and TBR 4.9 ± 2.3 vs. 2.36 ± 1.4 p = 0.014. Nasopharyngeal cancer demonstrated more intense tracer accumulation than oropharyngeal and oral cavity malignancies. CXCR4 IHC staining was positive in 15/21 patients, and there was a statistically significant correlation between IHC staining and [⁶⁸Ga]Ga-Pentixafor SUVmean r = 0.5 p = 0.027, and performance status r = 0.83 p = 0.0104. Conclusions: In conclusion, although [⁶⁸Ga]Ga-Pentixafor cannot replace [¹⁸F]F-FDG as a diagnostic tool because of its lower avidity, the correlation between CXCR4 targeted ⁶⁸Ga-Pentixafor PET imaging and CXCR4 IHC staining indicates the potential of ⁶⁸Ga-Pentixafor as an effective tool for selecting patients who may benefit from therapies targeting CXCR4. In addition, [⁶⁸Ga]Ga-Pentixafor has no physiological brown fat uptake, which often obscures cervical lesions on [¹⁸F]F-FDG PET/CT imaging. Full article

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

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17 pages, 1379 KiB

Open AccessArticle

Diagnosing Progression in Glioblastoma—Tackling a Neuro-Oncology Problem Using Artificial-Intelligence-Derived Volumetric Change over Time on Magnetic Resonance Imaging to Examine Progression-Free Survival in Glioblastoma

by Mason J. Belue, Stephanie A. Harmon, Shreya Chappidi, Ying Zhuge, Erdal Tasci, Sarisha Jagasia, Thomas Joyce, Kevin Camphausen, Baris Turkbey and Andra V. Krauze

Diagnostics 2024, 14(13), 1374; https://doi.org/10.3390/diagnostics14131374 - 28 Jun 2024

Viewed by 143

Abstract

Glioblastoma (GBM) is the most aggressive and the most common primary brain tumor, defined by nearly uniform rapid progression despite the current standard of care involving maximal surgical resection followed by radiation therapy (RT) and temozolomide (TMZ) or concurrent chemoirradiation (CRT), with an [...] Read more.

Glioblastoma (GBM) is the most aggressive and the most common primary brain tumor, defined by nearly uniform rapid progression despite the current standard of care involving maximal surgical resection followed by radiation therapy (RT) and temozolomide (TMZ) or concurrent chemoirradiation (CRT), with an overall survival (OS) of less than 30% at 2 years. The diagnosis of tumor progression in the clinic is based on clinical assessment and the interpretation of MRI of the brain using Response Assessment in Neuro-Oncology (RANO) criteria, which suffers from several limitations including a paucity of precise measures of progression. Given that imaging is the primary modality that generates the most quantitative data capable of capturing change over time in the standard of care for GBM, this renders it pivotal in optimizing and advancing response criteria, particularly given the lack of biomarkers in this space. In this study, we employed artificial intelligence (AI)-derived MRI volumetric parameters using the segmentation mask output of the nnU-Net to arrive at four classes (background, edema, non-contrast enhancing tumor (NET), and contrast-enhancing tumor (CET)) to determine if dynamic changes in AI volumes detected throughout therapy can be linked to PFS and clinical features. We identified associations between MR imaging AI-generated volumes and PFS independently of tumor location, MGMT methylation status, and the extent of resection while validating that CET and edema are the most linked to PFS with patient subpopulations separated by district rates of change throughout the disease. The current study provides valuable insights for risk stratification, future RT treatment planning, and treatment monitoring in neuro-oncology. Full article

(This article belongs to the Special Issue Artificial Intelligence in Brain Cancer)

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16 pages, 1755 KiB

Open AccessArticle

Cross-Sectional Area and Echogenicity Reference Values for Sonography of Peripheral Nerves in the Lithuanian Population

by Evelina Grusauskiene, Agne Smigelskyte, Erisela Qerama and Daiva Rastenyte

Diagnostics 2024, 14(13), 1373; https://doi.org/10.3390/diagnostics14131373 - 28 Jun 2024

Viewed by 214

Abstract

Objectives: We aimed to provide data of nerve sizes and echogenicity reference values of the Lithuanian population. Methods: High-resolution ultrasound was bilaterally performed according to the Ultrasound Pattern Sum Score and Neuropathy ultrasound protocols for healthy Lithuanian adults. Cross-sectional area (CSA) measurement and [...] Read more.

Objectives: We aimed to provide data of nerve sizes and echogenicity reference values of the Lithuanian population. Methods: High-resolution ultrasound was bilaterally performed according to the Ultrasound Pattern Sum Score and Neuropathy ultrasound protocols for healthy Lithuanian adults. Cross-sectional area (CSA) measurement and echogenicity were used as the main parameters for investigation. Echogenicity was evaluated using ImageJ, and nerves were categorized in classes according to echogenicity. Results: Of 125 subjects enrolled, 63 were males (mean age 47.57 years, range 25–78 years) and 62 were females (mean age 50.50 years, range 25–80 years). Reference values of nerve sizes and values of echogenicity as a fraction of black in percentage of cervical roots, upper and middle trunks of the brachial plexus and the following nerves: vagal, median, ulnar, radial, superficial radial, tibial, fibular, and sural in standard regions were established. Mild to moderate correlations were found between nerves CSA, echogenicity values and anthropometric measurements with the differences according to sex. Inter-rater (ICC 0.93; 95% CI 0.92–0.94) and intra-rater (ICC 0.94; 95% CI 0.93–0.95) reliability was excellent. Conclusions: Reference values of nerve size and echogenicity of Lithuanians were presented for the first time as a novel such kind of publication from the Baltic countries. Full article

(This article belongs to the Topic Advances in Musculoskeletal Imaging and Their Applications, 2nd Edition)

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14 pages, 3276 KiB

Open AccessReview

Clinical Implications and Management of Spontaneous Portosystemic Shunts in Liver Cirrhosis

by Simona Juncu, Horia Minea, Irina Girleanu, Laura Huiban, Cristina Muzica, Stefan Chiriac, Sergiu Timofeiov, Florin Mihai, Camelia Cojocariu, Carol Stanciu, Anca Trifan and Ana-Maria Singeap

Diagnostics 2024, 14(13), 1372; https://doi.org/10.3390/diagnostics14131372 - 28 Jun 2024

Viewed by 191

Abstract

Portal hypertension from chronic liver disease leads to the formation of collateral blood vessels called spontaneous portosystemic shunts (SPSS). These shunts may form from existing vessels or through neo-angiogenesis. Their location affects clinical outcomes due to varying risks and complications. This review summarizes [...] Read more.

Portal hypertension from chronic liver disease leads to the formation of collateral blood vessels called spontaneous portosystemic shunts (SPSS). These shunts may form from existing vessels or through neo-angiogenesis. Their location affects clinical outcomes due to varying risks and complications. This review summarizes current knowledge on SPSS, covering their clinical impact and management strategies. Recent data suggest that SPSS increases the risk of variceal bleeding, regardless of shunt size. The size of the shunt is crucial in the rising incidence of hepatic encephalopathy (HE) linked to SPSS. It also increases the risk of portopulmonary hypertension and portal vein thrombosis. Detecting and assessing SPSS rely on computed tomography (CT) and magnetic resonance imaging. CT enables precise measurements and the prediction of cirrhosis progression. Management focuses on liver disease progression and SPSS-related complications, like HE, variceal bleeding, and portopulmonary hypertension. Interventional radiology techniques such as balloon-occluded, plug-assisted, and coil-assisted retrograde transvenous obliteration play a pivotal role. Surgical options are rare but are considered when other methods fail. Liver transplantation (LT) often resolves SPSS. Intraoperative SPSS ligation is still recommended in patients at high risk for developing HE or graft hypoperfusion. Full article

(This article belongs to the Special Issue Diagnosis and Management of Liver Cirrhosis and Portal Hypertension)

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12 pages, 655 KiB

Open AccessArticle

Puncture Accuracy of Robot-Assisted CT-Based Punctures in Interventional Radiology: An Ex Vivo Study

by Yannick Scharll, Nenad Radojicic, Gregor Laimer, Peter Schullian and Reto Bale

Diagnostics 2024, 14(13), 1371; https://doi.org/10.3390/diagnostics14131371 - 27 Jun 2024

Viewed by 137

Abstract

Objectives: The purpose of this study was to assess the performance of an optically tracked robot for computed-tomography (CT)-guided needle placements in a phantom study. Methods: In total, 240 needle punctures were carried out with the help of an optically tracked robotic device [...] Read more.

Objectives: The purpose of this study was to assess the performance of an optically tracked robot for computed-tomography (CT)-guided needle placements in a phantom study. Methods: In total, 240 needle punctures were carried out with the help of an optically tracked robotic device (Micromate) based on CT image datasets at three different slice thicknesses (1, 3, and 5 mm). Conically shaped targets inside a gelatin-filled plexiglass phantom were punctured. The target positioning error between the planned and actual needle trajectory was assessed by measuring the lateral positioning error (ND) between the target and the puncture needle and the Euclidean distance (ED) between the needle tip and target in control CTs. Results: The mean ND and ED for the thinnest CT slice thickness were 1.34 mm (SD ± 0.82) and 2.1 mm (SD ± 0.75), respectively. There was no significant impact of target depth on targeting accuracy for ND (p = 0.094) or ED (p = 0.187). The mean duration for the planning of one trajectory and for needle positioning were 42 s (SD ± 4) and 64 s (SD ± 7), respectively. Conclusions: In this ex vivo study, the robotic targeting device yielded satisfactory accuracy results at CT slice thicknesses of 1 and 3 mm. This technology may be particularly useful in interventions where the accurate placement of needle-like instruments is required. Full article

(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis)

13 pages, 1776 KiB

Open AccessArticle

Cryoballoon-Assisted Pulmonary Vein Isolation and Left Atrial Roof Ablation Using a Simplified Sedation Strategy without Esophageal Temperature Monitoring: No Notable Thermal Esophageal Lesions and Low Arrhythmia Recurrence Rates after 2 Years

by Damir Erkapic, Konstantinos Roussopoulos, Marko Aleksic, Korkut Sözener, Karel Kostev, Josef Rosenbauer, Samuel Sossalla, Dursun Gündüz, Joachim Labenz, Christian Tanislav and Kay Felix Weipert

Diagnostics 2024, 14(13), 1370; https://doi.org/10.3390/diagnostics14131370 - 27 Jun 2024

Viewed by 126

Abstract

Background: Atrial fibrillation (AF) ablation is increasingly effective for managing heart rhythm but poses risks like esophageal fistulas. Minimizing esophageal thermal lesions while simplifying procedures is crucial. Methods: This prospective study involved 100 consecutive AF patients undergoing cryoballoon ablation with simplified sedation, without [...] Read more.

Background: Atrial fibrillation (AF) ablation is increasingly effective for managing heart rhythm but poses risks like esophageal fistulas. Minimizing esophageal thermal lesions while simplifying procedures is crucial. Methods: This prospective study involved 100 consecutive AF patients undergoing cryoballoon ablation with simplified sedation, without esophageal temperature monitoring. Patients with paroxysmal AF (Group A) received pulmonary vein isolation only, while those with persistent AF (Group B) also had left atrial roof ablation. Gastroesophageal endoscopy was performed post-procedure to detect lesions, and cardiological follow-ups were conducted at 3, 12, and 24 months. Results: The cohort included 69% men, with a median age of 65.5 years. Post-ablation endoscopy was performed in 92 patients; esophageal lesions were found in 1.1% of Group A and none of Group B. GERD was diagnosed in 14% of patients, evenly distributed between groups and not linked to lesion occurrence. Gastric hypomotility was observed in 16% of patients, with no significant difference between groups. At 24 months, arrhythmia-free survival was 88% in Group A and 74% in Group B. Conclusion: Cryoballoon-assisted pulmonary vein isolation, with or without additional left atrial roof ablation and without esophageal temperature monitoring during a simplified sedation strategy, shows low risk of esophageal thermal injury and effective ablation outcomes. Full article

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

13 pages, 556 KiB

Open AccessSystematic Review

The Role of SPECT/CT and PET/CT Hybrid Imaging in the Management of Ectopic Thyroid Carcinoma—A Systematic Review

by Claudiu Peștean, Alexandru Pavel and Doina Piciu

Diagnostics 2024, 14(13), 1369; https://doi.org/10.3390/diagnostics14131369 - 27 Jun 2024

Viewed by 155

Abstract

Background and Objectives: Thyroid ectopy represents a rare disease with an incidence of 0.3–1/100,000. It occurs due to the defective embryological process of the thyroid gland development. The thyroid ectopic tissue may suffer malignant transformation. This review aims to shed light on the [...] Read more.

Background and Objectives: Thyroid ectopy represents a rare disease with an incidence of 0.3–1/100,000. It occurs due to the defective embryological process of the thyroid gland development. The thyroid ectopic tissue may suffer malignant transformation. This review aims to shed light on the roles that I-131 SPECT/CT (radioiodine 131 single-photon emission tomography fused with computed tomography) and F-18 PET/CT (fluorodeoxyglucose F18 positron emission tomography fused with computer tomography) may play in managing patients with ectopic thyroid carcinoma. Materials and Methods: A total number of 47 articles were identified on the PubMed and Google Scholar databases, and 3 other articles were selected from articles identified in the references cited in the retrieved articles. After refining the selection, the inclusion and exclusion criteria were applied, resulting in 10 articles that were included in the review. Results: The cases of ectopy included in this review were localised as follows: four cases in the thyroglossal duct, two cases in the mediastinum, one case in the oesophagus, one case in the thorax, one case with a pre-tracheal location, and one case with a latero-cervical location. In all the cases, F-18 FDG PET/CT was used as a diagnostic tool. In one case, F-18 FDG PET/CT was combined with I-131 SPECT/CT and MRI (magnetic resonance imaging). In one case, it was combined with 68 Ga-FAPI PET/CT (Ga-68 radiolabelled FAP inhibitor positron emission tomography fused with computer tomography). The maximum SUVs (standardised uptake values) ranged from 5.5 to 25 g/mL. Conclusions: F-18 PET/CT and I-131 SPECT/CT hybrid nuclear imaging is of great value in assessing ectopic thyroid carcinoma. F-18 FDG PET/CT plays an important role in the primary tumour evaluation and distant disease detection. Ga-68 FAPIs are a promising alternative. I-131 SPECT/CT adds important information related to the anatomical characterization of primary and distant iodine-avid lesions. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Thyroid Cancer)

10 pages, 1009 KiB

Open AccessBrief Report

Left Ventricular and Atrial Deformation in Patients with Acute Decompensated Heart Failure: A Pilot Study

by Jakub Jurica, Martin Jozef Péč, Marek Cingel, Tomáš Bolek, Marianna Barbierik Vachalcová, Simona Horná, Peter Galajda, Marián Mokáň and Matej Samoš

Diagnostics 2024, 14(13), 1368; https://doi.org/10.3390/diagnostics14131368 - 27 Jun 2024

Viewed by 172

Abstract

Aims: The aims of this study were to compare global longitudinal strain of the left ventricle (LV-GLS) and reservoir strain of the left atrium (R-LAS) values between patients with acute decompensation of chronic heart failure (HF) and a control group. Methods: Sixteen patients [...] Read more.

Aims: The aims of this study were to compare global longitudinal strain of the left ventricle (LV-GLS) and reservoir strain of the left atrium (R-LAS) values between patients with acute decompensation of chronic heart failure (HF) and a control group. Methods: Sixteen patients admitted to our ward for acute decompensation of HF were enrolled in this study. Transthoracic echocardiography (TTE) with two-dimensional speckle-tracking analysis (2D ST) was performed in each patient. The patients were divided into two subgroups according to the value of left ventricular ejection fraction (EF) using a cut-off value of ≤40% to distinguish heart failure with reduced ejection fraction (HFrEF) from heart failure with preserved ejection fraction (HFpEF). The control group consisted of 16 individuals without a history of cardiovascular disease, each of whom underwent 2D ST analysis as well. Results: We found that LV-GLS and R-LAS were significantly lower in both the HFrEF and HFpEF subgroups in comparison with the control group (LV-GLS: −13.4 ± 4.7% vs. −19.7 ± 2.5%, p ˂ 0.05; R-LAS: +12.2 ± 6.9% vs. +40.3 ± 7.4%, p ˂ 0.05). Furthermore, there was a significant difference in LV-GLS (−9.6 ± 3.2% vs. −15.2 ± 4.3%, p ˂ 0.05) but not in R-LAS (+13.7 ± 8.6% vs. +11.4 ± 6.2%) between the HFrEF and HFpEF subgroups. Conclusions: Our study demonstrated a significant difference in LV-GLS and R-LAS in all enrolled HF patients compared to the control group. There was also a significant difference in LV-GLS between the HFrEF and HFpEF subgroups. Full article

(This article belongs to the Special Issue Recent Advances in Echocardiography)

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9 pages, 245 KiB

Open AccessArticle

Clinical Pathological and Immunohistochemical Correlations in Gastric Cancer

by Mihaela Andronic, Dragoș-Viorel Scripcariu, Mădălina Maria Palaghia, Ana-Maria Trofin, Valentin Bejan and Viorel Scripcariu

Diagnostics 2024, 14(13), 1367; https://doi.org/10.3390/diagnostics14131367 - 27 Jun 2024

Viewed by 159

Abstract

Due to its high aggressiveness and polyclonal tumor state, stomach cancer is considered a severe health problem. In this study, we analyzed Her2 and Ki67 in correlation with patient data for the possibility of prognostic factors. The study included 48 cases of gastric [...] Read more.

Due to its high aggressiveness and polyclonal tumor state, stomach cancer is considered a severe health problem. In this study, we analyzed Her2 and Ki67 in correlation with patient data for the possibility of prognostic factors. The study included 48 cases of gastric tumors that had been surgically treated in a period of five years. The percentage was statistically significant for intestinal-type adenocarcinomas located in the medio-gastric region (p = 0.05); in the diffuse subtype, there were no Her2 positive samples, and in the mixed subtype only one out of three samples was Her2 positive. Our results confirm the existing data, and we can conclude that this link can be considered a prognostic factor in the progression and treatment effectiveness. Full article

(This article belongs to the Special Issue Advancements in Diagnosis and Prognosis of Gastrointestinal Diseases)

12 pages, 254 KiB

Open AccessArticle

Genetic Insights and Neonatal Outcomes in Preeclampsia and Eclampsia: A Detailed Analysis of the RS5707 Genotype

by Flavius George Socol, Elena Silvia Bernad, Marius Craina, Simona-Alina Abu-Awwad, Brenda-Cristiana Bernad, Ioana Denisa Socol, Simona Sorina Farcas, Ahmed Abu-Awwad and Nicoleta Ioana Andreescu

Diagnostics 2024, 14(13), 1366; https://doi.org/10.3390/diagnostics14131366 - 27 Jun 2024

Viewed by 233

Abstract

Background: Preeclampsia (PE) and eclampsia (E) are severe pregnancy complications with significant maternal and neonatal health impacts. This study explores the association of the rs5707 polymorphism in the renin-angiotensin system (RAS) with PE/E and related neonatal outcomes. Materials and Methods: We conducted a [...] Read more.

Background: Preeclampsia (PE) and eclampsia (E) are severe pregnancy complications with significant maternal and neonatal health impacts. This study explores the association of the rs5707 polymorphism in the renin-angiotensin system (RAS) with PE/E and related neonatal outcomes. Materials and Methods: We conducted a cross-sectional study involving 400 mother–newborn dyads at the “Pius Brinzeu” Emergency Clinical Hospital Timisoara. Participants were divided into a control group (254 normotensive women) and a PE/E group (146 women with PE/E). Genotyping for the rs5707 polymorphism was performed using real-time PCR, and statistical analyses assessed associations with maternal body mass index (BMI) and neonatal outcomes. Results: The AA genotype of rs5707 was significantly associated with a reduced risk of PE/E and more favorable neonatal outcomes, including higher Apgar scores, greater birth weights, and longer gestational ages. Conversely, the AC genotype correlated with increased maternal BMI and adverse neonatal outcomes. Odds ratios highlighted the protective effect of the AA genotype against PE/E and the increased risk associated with the AC genotype. Conclusions: This study revealed the critical role of the rs5707 polymorphism in PE/E development and neonatal health. Genetic screening for rs5707 could enhance early identification and personalized intervention strategies, improving outcomes for both mothers and neonates. Further research is needed to validate these findings across diverse populations and to uncover the underlying mechanisms. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Advances in Gynecology and Obstetrics)

20 pages, 3080 KiB

Open AccessArticle

A BERT-GNN Approach for Metastatic Breast Cancer Prediction Using Histopathology Reports

by Abdullah Basaad , Shadi Basurra , Edlira Vakaj , Ahmed Karam Eldaly and Mohammed M. Abdelsamea

Diagnostics 2024, 14(13), 1365; https://doi.org/10.3390/diagnostics14131365 - 27 Jun 2024

Viewed by 212

Abstract

Metastatic breast cancer (MBC) continues to be a leading cause of cancer-related deaths among women. This work introduces an innovative non-invasive breast cancer classification model designed to improve the identification of cancer metastases. While this study marks the initial exploration into predicting MBC, [...] Read more.

Metastatic breast cancer (MBC) continues to be a leading cause of cancer-related deaths among women. This work introduces an innovative non-invasive breast cancer classification model designed to improve the identification of cancer metastases. While this study marks the initial exploration into predicting MBC, additional investigations are essential to validate the occurrence of MBC. Our approach combines the strengths of large language models (LLMs), specifically the bidirectional encoder representations from transformers (BERT) model, with the powerful capabilities of graph neural networks (GNNs) to predict MBC patients based on their histopathology reports. This paper introduces a BERT-GNN approach for metastatic breast cancer prediction (BG-MBC) that integrates graph information derived from the BERT model. In this model, nodes are constructed from patient medical records, while BERT embeddings are employed to vectorise representations of the words in histopathology reports, thereby capturing semantic information crucial for classification by employing three distinct approaches (namely univariate selection, extra trees classifier for feature importance, and Shapley values to identify the features that have the most significant impact). Identifying the most crucial 30 features out of 676 generated as embeddings during model training, our model further enhances its predictive capabilities. The BG-MBC model achieves outstanding accuracy, with a detection rate of 0.98 and an area under curve (AUC) of 0.98, in identifying MBC patients. This remarkable performance is credited to the model’s utilisation of attention scores generated by the LLM from histopathology reports, effectively capturing pertinent features for classification. Full article

(This article belongs to the Special Issue Artificial Intelligence in Computational Pathology)

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15 pages, 2431 KiB

Open AccessArticle

Hybrid Explainable Artificial Intelligence Models for Targeted Metabolomics Analysis of Diabetic Retinopathy

by Fatma Hilal Yagin, Cemil Colak, Abdulmohsen Algarni, Yasin Gormez, Emek Guldogan and Luca Paolo Ardigò

Diagnostics 2024, 14(13), 1364; https://doi.org/10.3390/diagnostics14131364 - 27 Jun 2024

Viewed by 176

Abstract

Background: Diabetic retinopathy (DR) is a prevalent microvascular complication of diabetes mellitus, and early detection is crucial for effective management. Metabolomics profiling has emerged as a promising approach for identifying potential biomarkers associated with DR progression. This study aimed to develop a hybrid [...] Read more.

Background: Diabetic retinopathy (DR) is a prevalent microvascular complication of diabetes mellitus, and early detection is crucial for effective management. Metabolomics profiling has emerged as a promising approach for identifying potential biomarkers associated with DR progression. This study aimed to develop a hybrid explainable artificial intelligence (XAI) model for targeted metabolomics analysis of patients with DR, utilizing a focused approach to identify specific metabolites exhibiting varying concentrations among individuals without DR (NDR), those with non-proliferative DR (NPDR), and individuals with proliferative DR (PDR) who have type 2 diabetes mellitus (T2DM). Methods: A total of 317 T2DM patients, including 143 NDR, 123 NPDR, and 51 PDR cases, were included in the study. Serum samples underwent targeted metabolomics analysis using liquid chromatography and mass spectrometry. Several machine learning models, including Support Vector Machines (SVC), Random Forest (RF), Decision Tree (DT), Logistic Regression (LR), and Multilayer Perceptrons (MLP), were implemented as solo models and in a two-stage ensemble hybrid approach. The models were trained and validated using 10-fold cross-validation. SHapley Additive exPlanations (SHAP) were employed to interpret the contributions of each feature to the model predictions. Statistical analyses were conducted using the Shapiro–Wilk test for normality, the Kruskal–Wallis H test for group differences, and the Mann–Whitney U test with Bonferroni correction for post-hoc comparisons. Results: The hybrid SVC + MLP model achieved the highest performance, with an accuracy of 89.58%, a precision of 87.18%, an F1-score of 88.20%, and an F-beta score of 87.55%. SHAP analysis revealed that glucose, glycine, and age were consistently important features across all DR classes, while creatinine and various phosphatidylcholines exhibited higher importance in the PDR class, suggesting their potential as biomarkers for severe DR. Conclusion: The hybrid XAI models, particularly the SVC + MLP ensemble, demonstrated superior performance in predicting DR progression compared to solo models. The application of SHAP facilitates the interpretation of feature importance, providing valuable insights into the metabolic and physiological markers associated with different stages of DR. These findings highlight the potential of hybrid XAI models combined with explainable techniques for early detection, targeted interventions, and personalized treatment strategies in DR management. Full article

(This article belongs to the Special Issue Digital Technology and Artificial Intelligence in Ophthalmology)

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13 pages, 2868 KiB

Open AccessArticle

Diagnostic Benefits and Surgical Implications of Methods for Tumor Localization in Sigmoid and Rectum Tumors

by Mehmet Onur Gul, Mehmet Akcicek, Nidal Iflazoglu, Kadir Corbaci, Cuma Ali Emir, Mehmet Guzel and Cem Kaan Parsak

Diagnostics 2024, 14(13), 1363; https://doi.org/10.3390/diagnostics14131363 - 27 Jun 2024

Viewed by 162

Abstract

(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon [...] Read more.

(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon admission, we examined the patients’ first diagnostic colonoscopies and their preoperative repeat control colonoscopies and computed tomography (CT) report. (3) Results: In this study, 23 patients (57.5%) were male. The overall accuracy rates were 80.0% (32/40) in colonoscopy, 65.0% (26/40) in preoperative CT, and 87.5% (35/40) in retro CT, and the differences among the examination methods were statistically significant (p = 0.049). The sensitivity levels decreased to 50.0% for colonoscopy and preoperative CT and 75.0% for retro CT in rectosigmoid colon tumors. In rectal tumors, the sensitivity levels were 75.0% in colonoscopy, 60.0% in preoperative CT, and 80.0% in retro CT. In two patients, the tumor location was given incorrectly, and postoperative pathological evaluations indicated T3N0 tumors; the initially planned treatment was thus changed to include radiotherapy in addition to chemotherapy in the postoperative period because the tumor was located in the middle rectum. (4) Conclusions: Accuracy in tumor localization in sigmoid, rectosigmoid, and rectum tumors still needs to be improved, which could be accomplished with prospective studies. CT evaluations for cancer localization in this patient group should be re-evaluated by a radiologist. Full article

(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)

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23 pages, 5207 KiB

Open AccessReview

Central Vein Sign and Paramagnetic Rim Lesions: Susceptibility Changes in Brain Tissues and Their Implications for the Study of Multiple Sclerosis Pathology

by Carolina de Medeiros Rimkus, Fábio Seiji Otsuka, Douglas Mendes Nunes, Khallil Taverna Chaim and Maria Concepción Garcia Otaduy

Diagnostics 2024, 14(13), 1362; https://doi.org/10.3390/diagnostics14131362 - 27 Jun 2024

Viewed by 198

Abstract

Multiple sclerosis (MS) is the most common acquired inflammatory and demyelinating disease in adults. The conventional diagnostic of MS and the follow-up of inflammatory activity is based on the detection of hyperintense foci in T2 and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging [...] Read more.

Multiple sclerosis (MS) is the most common acquired inflammatory and demyelinating disease in adults. The conventional diagnostic of MS and the follow-up of inflammatory activity is based on the detection of hyperintense foci in T2 and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) and lesions with brain–blood barrier (BBB) disruption in the central nervous system (CNS) parenchyma. However, T2/FLAIR hyperintense lesions are not specific to MS and the MS pathology and inflammatory processes go far beyond focal lesions and can be independent of BBB disruption. MRI techniques based on the magnetic susceptibility properties of the tissue, such as T2*, susceptibility-weighted images (SWI), and quantitative susceptibility mapping (QSM) offer tools for advanced MS diagnostic, follow-up, and the assessment of more detailed features of MS dynamic pathology. Susceptibility-weighted techniques are sensitive to the paramagnetic components of biological tissues, such as deoxyhemoglobin. This capability enables the visualization of brain parenchymal veins. Consequently, it presents an opportunity to identify veins within the core of multiple sclerosis (MS) lesions, thereby affirming their venocentric characteristics. This advancement significantly enhances the accuracy of the differential diagnostic process. Another important paramagnetic component in biological tissues is iron. In MS, the dynamic trafficking of iron between different cells, such as oligodendrocytes, astrocytes, and microglia, enables the study of different stages of demyelination and remyelination. Furthermore, the accumulation of iron in activated microglia serves as an indicator of latent inflammatory activity in chronic MS lesions, termed paramagnetic rim lesions (PRLs). PRLs have been correlated with disease progression and degenerative processes, underscoring their significance in MS pathology. This review will elucidate the underlying physical principles of magnetic susceptibility and their implications for the formation and interpretation of T2*, SWI, and QSM sequences. Additionally, it will explore their applications in multiple sclerosis (MS), particularly in detecting the central vein sign (CVS) and PRLs, and assessing iron metabolism. Furthermore, the review will discuss their role in advancing early and precise MS diagnosis and prognostic evaluation, as well as their utility in studying chronic active inflammation and degenerative processes. Full article

(This article belongs to the Special Issue Advances in the Diagnosis of Nervous System Diseases—2nd Edition)

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11 pages, 573 KiB

Open AccessArticle

Diagnostic Yield and Outcomes of Small Bowel Capsule Endoscopy in Patients with Small Bowel Bleeding Receiving Antithrombotics

by Nikos Viazis, Dimitris Christodoulou, Vasilis Papastergiou, Konstantinos Mousourakis, Dimitra Kozompoli, Giannis Stasinos, Konstantina Dimopoulou, Periklis Apostolopoulos, Fotios Fousekis, Christos Liatsos, Nikolaos Kyriakos, Theodoros Argyropoulos and George Tribonias

Diagnostics 2024, 14(13), 1361; https://doi.org/10.3390/diagnostics14131361 - 27 Jun 2024

Viewed by 216

Abstract

We aimed to determine the diagnostic yield and outcome of patients receiving antithrombotic drug therapy subjected to small bowel capsule endoscopy (SBCE) for the investigation of small bowel bleeding (SBB). A multicenter retrospective analysis of collected data from all patients undergoing SBCE for [...] Read more.

We aimed to determine the diagnostic yield and outcome of patients receiving antithrombotic drug therapy subjected to small bowel capsule endoscopy (SBCE) for the investigation of small bowel bleeding (SBB). A multicenter retrospective analysis of collected data from all patients undergoing SBCE for the investigation of SBB from March 2003 to June 2023 was performed. The diagnostic yield of SBCE was defined as the detection of positive findings that could explain the cause of the patient’s bleeding. Rebleeding was defined as evidence of bleeding within 1 year after the index episode. During the study period, 8401 patients underwent SBCE for SBB investigation. Bleeding lesions were detected in 1103/2535 (43.5%) antithrombotic users, compared to 1113/5866 (18.9%) in nonusers (p < 0.00001). Following capsule endoscopy, a therapeutic intervention was possible in 390/2216 (17.5%) patients with a bleeding lesion. Rebleeding occurred in 927 (36.5%) of antithrombotic users (36.5%), compared to 795 (13.5%) of nonusers (13.5%, p < 0.00001). Both the diagnostic yield of SBCE and the rebleeding rates were higher in patients with SBB receiving antithrombotics. Therapeutic intervention was possible in a real-world setting only for a minority of patients with positive findings. Full article

(This article belongs to the Special Issue Imaging Research on Gastrointestinal Disorders)

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8 pages, 663 KiB

Open AccessCase Report

Femicide Circumstances and Harmfulness: Case Report and Focusing Review

by Chiara Stassi, Marco La Mantia, Giuseppe Francesco Lo Re, Valentina Martines, Stefania Zerbo, Giuseppe Davide Albano, Ginevra Malta and Antonina Argo

Diagnostics 2024, 14(13), 1360; https://doi.org/10.3390/diagnostics14131360 - 26 Jun 2024

Viewed by 155

Abstract

(1) Background: Femicide is an increasing phenomenon consisting of the murder of a woman for gender-related reasons. Despite the enactment of new laws aimed at controlling the phenomenon by toughening the penalties and introducing aggravating circumstances, there is an increasing trend that testifies [...] Read more.

(1) Background: Femicide is an increasing phenomenon consisting of the murder of a woman for gender-related reasons. Despite the enactment of new laws aimed at controlling the phenomenon by toughening the penalties and introducing aggravating circumstances, there is an increasing trend that testifies to the persistence of a flaw in the actual measures. (2) Case Presentation. We report the case of the murder of a 32-year-old woman—perpetrated by an ex-husband who refused to accept the end of the marriage—the analysis of which allowed us to frame the case as femicide. (3) Discussion. Despite global awareness of this phenomenon, the identification of risk factors to predict and prevent femicide is of utmost importance. This can be achieved by a multidisciplinary approach involving police officers, legal professionals, hospitals, governmental and nongovernmental organizations, and medico-legal departments aimed at promoting standardized methodologies. (4) Conclusions. We evaluate the contribution of forensic investigations to the identification of key elements that can help frame the murder of a woman as a femicide. Considering the devastating consequences for children who witness this kind of violence within the domestic setting, the planning of more impactful preventive actions is, thus, mandatory to minimize effects on public health. Full article

(This article belongs to the Special Issue Updates on Forensic Pathology)

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Diagnostics, Volume 14, Issue 13 (July-1 2024) – 76 articles

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