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Diagnostics
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Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases
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Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 10997

Special Issue Editor

Prof. Dr. Jean-Paul P.M. De Vries

E-Mail Website
Guest Editor
Chair Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Interests: vascular surgery; aneurysm; carotid; peripheral arterial disease; peri-operative [tele]monitoring; critical limb ischemia; vascular graft infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

During the last decade, an increasing number of patients are suffering with complex diseases. There is an unmet need for innovative imaging modalities and treatment strategies to overcome these complex pathologies. The implementation of new imaging tools is essential during the entire patient journey, including diagnostic, therapeutic, and follow-up modalities. It will help to improve clinical outcomes, but it must also facilitate physicians to work in an healthy environment with minimal negative effects. The use of state-of-the-art imaging serves as a basis for patient-tailored and disease-specific treatments. In this Special Issue, authors are cordially invited to submit manuscripts covering the entire spectrum, which includes fundamental research to clinically applied studies focusing on inventive imaging techniques to improve outcomes in often multimorbid patients with correspondingly complex diseases.

Prof. Dr. Jean-Paul P.M. De Vries
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (6 papers)

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Editorial

Jump to: Research, Review

3 pages, 170 KiB  
Editorial
Innovative Imaging Techniques: Nice to Have or Essential to Treat Complex Diseases?
by Jean-Paul P. M. de Vries
Diagnostics 2023, 13(19), 3127; https://doi.org/10.3390/diagnostics13193127 - 5 Oct 2023
Viewed by 678
Abstract
Nowadays, a substantial number of our patients have multimorbidity, and need treatment for complex diseases [...] Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)

Research

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10 pages, 1233 KiB  
Article
Validation of a Length-Adjusted Abdominal Arterial Calcium Score Method for Contrast-Enhanced CT Scans
by Raul Devia-Rodriguez, Maikel Derksen, Kristian de Groot, Issi R. Vedder, Clark J. Zeebregts, Reinoud P. H. Bokkers, Robert A. Pol, Jean-Paul P. M. de Vries and Richte C. L. Schuurmann
Diagnostics 2023, 13(11), 1934; https://doi.org/10.3390/diagnostics13111934 - 1 Jun 2023
Cited by 1 | Viewed by 1512
Abstract
Background: The Agatston score on noncontrast computed tomography (CT) scans is the gold standard for calcium load determination. However, contrast-enhanced CT is commonly used for patients with atherosclerotic cardiovascular diseases (ASCVDs), such as peripheral arterial occlusive disease (PAOD) and abdominal aortic aneurysm (AAA). [...] Read more.
Background: The Agatston score on noncontrast computed tomography (CT) scans is the gold standard for calcium load determination. However, contrast-enhanced CT is commonly used for patients with atherosclerotic cardiovascular diseases (ASCVDs), such as peripheral arterial occlusive disease (PAOD) and abdominal aortic aneurysm (AAA). Currently, there is no validated method to determine calcium load in the aorta and peripheral arteries with a contrast-enhanced CT. This study validated a length-adjusted calcium score (LACS) method for contrast-enhanced CT scans. Method: The LACS (calcium volume in mm3/arterial length in cm) in the abdominal aorta was calculated using four-phase liver CT scans of 30 patients treated between 2017 and 2021 at the University Medical Center Groningen (UMCG) with no aortic disease. Noncontrast CT scans were segmented with a 130 Hounsfield units (HU) threshold, and a patient-specific threshold was used for contrast-enhanced CTs. The LACS was calculated and compared from both segmentations. Secondly, the interobserver variability and the influence of slice thickness (0.75 mm vs. 2.0 mm) was determined. Results: There was a high correlation between the LACS from contrast-enhanced CT scans and the LACS of noncontrast CTs (R2 = 0.98). A correction factor of 1.9 was established to convert the LACS derived from contrast-enhanced CT to noncontrast CT scans. LACS interobserver agreement on contrast-enhanced CT was excellent (1.0, 95% confidence interval = 1.0–1.0). The 0.75 mm CT threshold was 541 (459–625) HU compared with 500 (419–568) HU on 2 mm CTs (p = 0.15). LACS calculated with both thresholds was not significantly different (p = 0.63). Conclusion: The LACS seems to be a robust method for scoring calcium load on contrast-enhanced CT scans in arterial segments with various lengths. Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)
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10 pages, 11992 KiB  
Article
Ultrasound for the Detection of Inflammatory Abdominal Aortic Aneurysms: A Case and Validation Series
by Berend G. C. Slijkhuis, David J. Liesker, Sherilyn A. C. Konter, Annet Possel-Nicolai, Reinoud P. H. Bokkers, Niek H. J. Prakken, Elisabeth Brouwer, Riemer H. J. A. Slart, Arie M. van Roon, Ben R. Saleem and Douwe J. Mulder
Diagnostics 2023, 13(10), 1669; https://doi.org/10.3390/diagnostics13101669 - 9 May 2023
Cited by 1 | Viewed by 1907
Abstract
Inflammatory abdominal aortic aneurysms (iAAA) are a form of noninfectious aortitis in patients with abdominal aortic aneurysms (AAA). Ultrasound could help to detect iAAA early. This retrospective observational study assessed the potential of using ultrasound to detect iAAA in a case series of [...] Read more.
Inflammatory abdominal aortic aneurysms (iAAA) are a form of noninfectious aortitis in patients with abdominal aortic aneurysms (AAA). Ultrasound could help to detect iAAA early. This retrospective observational study assessed the potential of using ultrasound to detect iAAA in a case series of iAAA patients, and the diagnostic value of ultrasound to detect iAAA in consecutive patients in a follow-up for AAA, referred to as a feasibility study. In both studies, diagnosis of iAAA was based on a cuff surrounding the aneurysm using CT (golden standard). The case series included 13 patients (age 64 (61; 72) years; 100% male). The feasibility study included 157 patients (age 75 (67; 80) years; 84% male). In the case series, all iAAA patients showed a cuff surrounding the aortic wall on ultrasound. In the feasibility study with AAA patients, ultrasound yielded no cuff in 147 (93.6%; CT negative in all cases), a typic cuff in 8 (5.1%; CT positive in all cases), and an inconclusive cuff in 2 (1.3%; CT negative in both cases) patients. Sensitivity and specificity were 100% and 98.7%, respectively. This study indicates that iAAA can be identified with ultrasound, and safely ruled out. In positive ultrasound cases, additional CT imaging might still be warranted. Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)
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21 pages, 3912 KiB  
Article
Detection of Tumour-Targeted IRDye800CW Tracer with Commercially Available Laparoscopic Surgical Systems
by Daan J. Sikkenk, Andrea J. Sterkenburg, Iris Schmidt, Dimitris Gorpas, Wouter B. Nagengast and Esther C. J. Consten
Diagnostics 2023, 13(9), 1591; https://doi.org/10.3390/diagnostics13091591 - 29 Apr 2023
Cited by 2 | Viewed by 1827
Abstract
(1) Introduction: Near-infrared fluorescence (NIRF) combined with tumour-targeted tracers, such as bevacizumab-800CW, could aid surgical decision-making. This study explored the use of IRDye800CW, conjugated to bevacizumab, with four commercially available NIRF laparoscopes optimised for indocyanine green (ICG). (2) Methods: A (lymph node) phantom [...] Read more.
(1) Introduction: Near-infrared fluorescence (NIRF) combined with tumour-targeted tracers, such as bevacizumab-800CW, could aid surgical decision-making. This study explored the use of IRDye800CW, conjugated to bevacizumab, with four commercially available NIRF laparoscopes optimised for indocyanine green (ICG). (2) Methods: A (lymph node) phantom was made from a calibration device for NIRF and tissue-mimicking material. Serial dilutions of bevacizumab-800CW were made and ICG functioned as a reference. System settings, working distance, and thickness of tissue-mimicking material were varied to assess visibility of the fluorescence signal and tissue penetration. Tests were performed with four laparoscopes: VISERA ELITE II, Olympus; IMAGE1 S™ 4U Rubina, KARL STORZ; ENDOCAM Logic 4K platform, Richard Wolf; da Vinci Xi, Intuitive Surgical. (3) Results: The lowest visible bevacizumab-800CW concentration ranged between 13–850 nM (8–512 times diluted stock solution) for all laparoscopes, but the tracer was not visible through 0.8 cm of tissue in all systems. In contrast, ICG was still visible at a concentration of 0.4 nM (16,384 times diluted) and through 1.6–2.4 cm of tissue. Visibility and tissue penetration generally improved with a reduced working distance and manually adjusted system settings. (4) Conclusion: Depending on the application, bevacizumab-800CW might be sufficiently visible with current laparoscopes, but optimisation would widen applicability of tumour-targeted IRDye800CW tracers. Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)
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13 pages, 2046 KiB  
Article
Differences in Cardiac-Pulsatility-Induced Displacement and Geometry Changes between the Cook ZBIS and Gore IBE: Postoperative Comparison Using ECG-Gated CTA Scans
by Jaimy A. Simmering, Majorie van Helvert, Joost A. van Herwaarden, Cornelis H. Slump, Robert H. Geelkerken and Michel M. P. J. Reijnen
Diagnostics 2023, 13(3), 496; https://doi.org/10.3390/diagnostics13030496 - 29 Jan 2023
Cited by 3 | Viewed by 1716
Abstract
To what extent the stentgraft design of iliac branch devices (IBDs) relates to dynamic deformation is currently unknown. Therefore, this study aimed to quantify and compare displacement and geometry changes during the cardiac cycle of two common IBDs. This paper presents a two-center [...] Read more.
To what extent the stentgraft design of iliac branch devices (IBDs) relates to dynamic deformation is currently unknown. Therefore, this study aimed to quantify and compare displacement and geometry changes during the cardiac cycle of two common IBDs. This paper presents a two-center trial with patients treated with a Zenith bifurcated iliac side (ZBIS) or Gore iliac branch endoprosthesis (IBE). All patients underwent a retrospective electrocardiogram (ECG)-gated computed tomographic angiography (CTA) during follow-up. Cardiac-pulsatility-induced displacement was quantified for the following locations: (neo) bifurcation of the aorta, IBD flow divider, distal markers of the internal iliac artery (IIA) component and first IIA bifurcation. Geometrical parameters (length, tortuosity index, curvature and torsion) were quantified over centerlines. Displacement was more pronounced for the IBE than the ZBIS, e.g., craniocaudal displacement of 0.91 mm (0.91–1.13 mm) vs. 0.57 mm (0.40–0.75 mm, p = 0.004), respectively. The IBDs demonstrated similar geometrical parameters in the neo-common iliac artery and distal IIA, except for the larger dynamic curvature and torsion of the distal IIA in IBEs. The IBEs showed more dynamic length and curvature change compared to the ZBIS in the stented IIA. The IIA trajectory showed more pronounced deformation during the cardiac cycle after placement of an IBE than a ZBIS, suggesting the IBE is more conformable than the ZBIS. Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)
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Review

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14 pages, 1964 KiB  
Review
General Overview and Diagnostic (Imaging) Techniques for Neurogenic Thoracic Outlet Syndrome
by Stijn B. J. Teijink, Niels Pesser, Jens Goeteyn, Renée J. Barnhoorn, Marc R. H. M. van Sambeek, Bart F. L. van Nuenen, Hugh A. Gelabert and Joep A. W. Teijink
Diagnostics 2023, 13(9), 1625; https://doi.org/10.3390/diagnostics13091625 - 4 May 2023
Cited by 5 | Viewed by 2514
Abstract
Thoracic outlet syndrome is an uncommon and controversial syndrome. Three different diagnoses can be made based on the compressed structure, arterial TOS, venous TOS, and neurogenic TOS, though combinations do exist as well. Diagnosing NTOS is difficult since no specific objective diagnostic modalities [...] Read more.
Thoracic outlet syndrome is an uncommon and controversial syndrome. Three different diagnoses can be made based on the compressed structure, arterial TOS, venous TOS, and neurogenic TOS, though combinations do exist as well. Diagnosing NTOS is difficult since no specific objective diagnostic modalities exist. This has resulted in a lot of controversy in recent decades. NTOS remains a clinical diagnosis and is mostly diagnosed based on the exclusion of an extensive list of differential diagnoses. To guide the diagnosis and treatment of TOS, a group of experts published the reporting standards for TOS in 2016. However, a consensus was not reached regarding a blueprint for a daily care pathway in this document. Therefore, we constructed a care pathway based on the reporting standards for both the diagnosis and treatment of NTOS patients. This care pathway includes a multidisciplinary approach in which different diagnostic tests and additional imaging techniques are combined to diagnose NTOS or guide patients in their treatment for differential diagnoses. The aim of the present work is to discuss and explain the diagnostic part of this care pathway. Full article
(This article belongs to the Special Issue Innovative Diagnostic Imaging Techniques to Improve Outcomes in Complex Diseases)
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