Diagnostics

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)

► Show Figures

Figure 1

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)

► Show Figures

Figure 1

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)

► Show Figures

Figure 1

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

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

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

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

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)

► Show Figures

Figure 1

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

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)

► Show Figures

Figure 1

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

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)

► Show Figures

Figure 1

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

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)

► Show Figures

Figure 1

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

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)

► Show Figures

Figure 1

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

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)

► Show Figures

Figure 1

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

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

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

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)

Journal Description

Diagnostics

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI