Neoseiulus mites as biological control agents against Megalurothrips usitatus (Thysanoptera: Thripidae) and Frankliniella intonsa (Thysanoptera: Thripidae) on cowpea crop: laboratory to field.

Megalurothrips usitatus (Bagnall) (Thysanoptera: Thripidae) and Frankliniella intonsa (Trybom) (Thysanoptera: Thripidae) have been detrimental to cowpea production in many countries. Laboratory experiments were conducted to determine the prey stage preference and functional response of 2 predatory mites species, Neoseiulus barkeri (Hughes) (Acari: Phytoseiidae), and Neoseiulus californicus (McGregor) (Acari: Phytoseiidae), towards 2 thrips species (TS), M. usitatus, and F. intonsa, at varying densities and life stages on cowpea. Results shown that Neoseiulus species had a preference for different life stages of prey. Neoseiulus barkeri consumed more M. usitatus nymphs, while N. californicus consumed more F. intonsa (second-instar nymphs). The functional response of the 2 Neoseiulus spp. to nymphs of 2 TS was Type II on cowpea. The higher attack rate coefficient (a') and shorter handling time (Th) values were found on N. barkeri against M. usitatus, and a similar trend was found for those in N. californicus against F. intonsa. Field-caged trials were conducted to evaluate the effectiveness of Neoseiulus spp. in controlling 2 TS. The results have shown that Neoseiulus spp. was effective in controlling the 2 TS, with varying control efficacies at high or low release rates. The study provided valuable information on using Neoseiulus spp. as biological control agents against M. usitatus and F. intonsa in cowpea crops.

Parthenogenesis affects interspecific competition between Megalurothrips usitatus and Frankliniella intonsa (Thysanoptera: Thripidae) in changing environment: evidence from life table study.

The thrips Megalurothrips usitatus Bagnall and Frankliniella intonsa Trybom (Thysanoptera: Thripidae) are important pests in cowpea-growing areas of south China. Parthenogenesis is an important reproductive form of thysanopterans, and plays an important role in maintaining population growth. To understand the developmental and reproductive characteristics of these 2 thrips species during parthenogenesis, we compared the age-stage life tables of M. usitatus and F. intonsa on cowpea pods under natural regimes during the summer and winter. The results showed that the total preadult period and total preoviposition period of M. usitatus were significantly longer than those of F. intonsa in both seasons. Moreover, longevity of adult M. usitatus (29.53 days) was shorter compared with adult F. intonsa (34.00 days) in summer, whereas higher fecundity (220.8 eggs/female) and more oviposition days (37.83 days) were observed in M. usitatus compared with F. intonsa in winter (fecundity = 179.83 eggs/female, oviposition days = 33.03 days). The net and gross reproductive rates of M. usitatus were significantly greater than those of F. intonsa during winter. In addition, the intrinsic and finite rates of increase of M. usitatus were significantly lower than those of F. intonsa, and the mean generation time of M. usitatus was significantly longer than that of F. intonsa both in summer and winter. These results indicated that parthenogenesis has species specificity among thrips, which in turn affects population development, especially under changing environments.

Assessing the effectiveness of imidacloprid and thiamethoxam via root irrigation against Megalurothrips usitatus (Thysanoptera: Thripidae) and its residual effects on cowpea.

Systemic neonicotinoid insecticides (NEOs) applied by seed-treatment or root application have emerged as a prevalent strategy for early-season insect pest management. This research investigated the effectiveness of imidacloprid and thiamethoxam, administered through root irrigation, in managing thrips in cowpea [Vigna unguiculata (Linn.) Walp.], and the residual properties of both insecticides in cowpea and soil. The results show that thrips density depends on the application rate of insecticides. At the maximum application rate (1,500 µg/ml, active ingredient), imidacloprid and thiamethoxam controlled thrips densities below the economic injury level (EIL, the EIL of thrips on cowpea was 7/flower) for 20 days and 25 days with the density of 6.90 and 6.93/flower at the end of the periods, respectively. Imidacloprid and thiamethoxam residues decreased gradually over time and decreased sharply after 15 days after treatment (DAT), the 2 insecticides were not detected (<0.001 mg/kg) at 45 DAT. According to our findings, the application of imidacloprid and thiamethoxam via root irrigation proved residual control lasting up to 20-25 days for controlling thrips damage at experimental rates, with a strong association to their residual presence in cowpea (0.6223 < R2 < 0.9545). Considering the persistence of the imidacloprid and thiamethoxam, the maximum tested application rate (1,500 µg/ml) was recommended. As the residues of imidacloprid and thiamethoxam were undetectable in cowpea pods at all tested rates, it may be suggested that the use of each insecticide is safe for consumers and effective against thrips, and could be considered for integrated thrips management in the cowpea ecosystem.

Establishment of Beauveria bassiana as a fungal endophyte in potato plants and its virulence against potato tuber moth, Phthorimaea operculella (Lepidoptera: Gelechiidae).

The potato tuber moth, Phthorimaea operculella, is the most damaging potato pest in the world and is difficult to control as the larvae are internal feeders in the foliage and tubers. Entomopathogenic fungi that colonize plants as endophytes have lethal and sublethal pathological effects on insect pests. We show that Beauveria bassiana colonizes the aerial parts of potato plants endophytically after inoculation through soil drenching. Endophytic B. bassiana persisted in potato foliage for more than 50 days postinoculation. Bioassays indicated that foliage of B. bassiana-inoculated potato plants were pathogenic against larvae of P. operculella. Sublethal experiments indicated that B. bassiana negatively affected the growth, development, and reproduction of P. operculella. Development experiments showed that the weight of P. operculella pupae reared on B. bassiana-colonized potato plants (4.25 mg) was significantly less than that of those reared on uninoculated control plants (8.89 mg). Compared with newly eclosed larvae fed on control plants, those fed on B. bassiana-inoculated plants had significantly lower survivorship, with only 17.8% developing to the adult stage. Oviposition of P. operculella females reared on B. bassiana endophytically colonized plants was significantly lower (35 eggs/female) than of those reared on uninoculated plants (115 eggs/female). This study demonstrates that endophytic B. bassiana can be a potential biological control agent for the control and management of P. operculella. Comparing pupal weights of P. operculella reared on potato plants inoculated with the B. bassiana strain GZGY-1-3 and on untreated control plants, pupae from the control plants were significantly heavier than those from treated plants.

The Impacts of Genetic and Environmental Factors on the Progression of Chronic Pancreatitis.

BACKGROUND & AIMS: Both environmental factors, such as alcohol consumption and smoking, and genetic factors are strongly associated with the risk of developing chronic pancreatitis (CP). However, comprehensive understanding of their impacts on the progression of CP remains elusive. METHODS: A prospective cohort study was performed on a large cohort of CP patients with known genetic backgrounds. The cumulative incidence of pancreatic insufficiency after the onset of CP was analyzed using Kaplan-Meier survival curves. Multivariate Cox proportional hazards regression analysis also was performed. RESULTS: A total of 798 patients were enrolled in the study and followed up for 10.5 years. Rare pathogenic genotypes in the SPINK1, PRSS1, CTRC, or CFTR genes were identified in 410 (51.4%) patients. The development of pancreatic insufficiency was significantly earlier in patients with a history of smoking and/or alcohol consumption in both the positive (P < .001) and negative (P = .001) gene mutation groups. However, the development of pancreatic insufficiency did not differ significantly between patients with and without gene mutations despite alcohol and/or smoking status, with P values of .064 and .115, respectively. Multivariate Cox regression analysis showed that age at onset of CP (hazard ratio, [HR], 1.02; P < .001) and alcohol consumption (HR, 1.86; P < .001) were independent risk factors for the development of diabetes, while male sex (HR, 1.84; P = .022) and smoking (HR, 1.56; P = .028) were predictors of steatorrhea. CONCLUSIONS: Although rare pathogenic mutations in the 4 major susceptibility genes for CP were not correlated significantly with the development of pancreatic insufficiency, environmental factors (either alcohol consumption or smoking) significantly accelerated disease progression (ClinicalTrials.gov: NCT04574297).

SPINK1 mutations and risk of pancreatic cancer in a Chinese cohort.

OBJECTIVE: The relationship between SPINK1 and pancreatic cancer (PC) remains controversial. The current study aimed to determine the effect of SPINK1 mutations on PC development among patients with chronic pancreatitis (CP). METHODS: This is a prospective observational study including a large cohort of 965 CP patients with 11-year follow-up. Patients' demographic characteristics and clinical CP outcomes were documented in detail. Genetic testing was performed. The effect of SPINK1 mutations on the clinical development of PC was explored using Cox proportional hazards regression. Subgroup analyses conducted included the consideration of gender, onset age of CP (early- and late-onset), etiologies of CP, smoking, and alcoholic drinking status. RESULTS: PC was diagnosed in 2.5% (24/965) of patients, and the cumulative incidence rates were 0.2%, 0.8%, and 1.5% at 3, 5, and 10 years since the onset of CP, respectively. In this cohort, SPINK1 c.194+2T > C was the most common variant with a proportion of 39.1%. And the risk of PC development varied marginally between patients with and without SPINK1 mutations (Cox HR 0.39(0.14-1.04), P = 0.059). In the subgroup analyses, patients carrying SPINK1 mutations had a significantly lower risk of PC (Cox HR 0.18(0.04-0.80), P = 0.025) in the non-smoking group. SPINK1 mutations showed no significant effect in the other subgroups considered. CONCLUSIONS: CP patients harboring SPINK1 mutations do not have an elevated risk of PC development compared to mutation-negative CP patients. On the contrary, SPINK1 mutations may be a protective factor in non-smoking patients with CP.

Factors associated with prior acute pancreatitis episodes among patients with chronic pancreatitis.

BACKGROUND: The relationship between chronic pancreatitis (CP) and acute pancreatitis (AP) is complex and not well understood. CP could be preceded by antecedent episodes of AP. AIMS: The aim of this study was to explore both genetic and environmental factors associated with AP episodes before the diagnosis of CP. METHODS: This was a cross-sectional study including 1022 patients. Detailed demographic, genetic, and clinical data were collected. Based on the presence of AP episode(s) before diagnosis of CP, patients were divided into AP group (further classified into single episode of AP group and recurrent AP group) and non-AP group. Related factors among these groups were assessed using multivariate logistic regression model. RESULTS: Before diagnosis of CP, 737 patients (72.1%) had a history of AP. Smoking(P = 0.005) and heavy alcohol consumption(P = 0.002) were risk factors for AP while age at CP onset(P < 0.001), harboring the SPINK1 mutation(P < 0.001), diabetes(P < 0.001) and steatorrhea(P < 0.001) were protective factors. Further, alcoholic CP(P = 0.019) was the only independent risk factor for recurrent AP attacks while age at onset of CP(P < 0.001), pancreatic stones(P = 0.024). and pseudocysts(P = 0.018) served as protective factors. CONCLUSIONS: SPINK1 mutations served as protective factor for AP episodes, suggesting SPINK1 mutation might play a pathogenic role in CP occurrence with occult clinical manifestations.

A global invasion by the thrip, Frankliniella occidentalis: Current virus vector status and its management.

Western flower thrip, Frankliniella occidentalis (Pergande), is among the most economically important agricultural pests globally, attacking a wide range of vegetable and horticultural crops. In addition to causing extensive crop damage, the species is notorious for vectoring destructive plant viruses, mainly belonging to the genera Orthotospovirus, Ilarvirus, Alphacarmovirus and Machlomovirus. Once infected by orthotospoviruses, thrips can remain virulent throughout their lifespan and continue transmitting viruses to host plants when and wherever they feed. These irruptive viral outbreaks in crops will permanently disrupt functional integrated pest management systems, and typically require a remedial treatment involving insecticides, contributing to further development of insecticide resistance. To mitigate against this continuing cycle, the most effective management is early and comprehensive surveillance of the pest species and recognition of plant viruses in the field. This review provides information on the pest status of F. occidentalis, discusses the current global status of the viruses vectored by this thrip species, examines the mechanisms involved in transmitting virus-induced diseases by thrips, and reviews different management strategies, highlighting the potential management tactics developed for various cropping systems. The early surveillance and the utilization of potential methods for control of both F. occidentalis and viruses are proposed.

Organic Regime Promotes Evenness of Natural Enemies and Planthopper Control in Paddy Fields.

Planthoppers (Nilaparvata lugens, Sogatella furcifera, and Laodelphax striatellus) (Hemiptera: Delphacidae) are the most important pests affecting rice production. Pesticide spraying for its control may cause harmful effects on human health and the environment, especially the loss of biodiversity. The consequences of these changes on biodiversity and ecological services are well studied in tropical irrigated paddy fields, but are largely unknown in subtropical areas. Organic regime provides an environment-friendly method for biodiversity conservation; however, it is unclear whether this regime can suppress planthopper populations effectively in paddy fields. Consequently, we compared species richness, abundance, community structure, and evenness of natural enemies and planthoppers between organic and conventional rice fields (n = 35) distributed across four sites in China. The results showed that species richness was higher in organic fields than in conventional fields. Shannon index and evenness of predators and parasitoids were higher in most of the organic fields than their conventional counterparts. Furthermore, planthopper density showed a significant negative relationship with increased richness and evenness for both predators and parasitoids. These results underscore the notion that management regimes influence biodiversity in rice field. Most importantly, this has direct implications on the efficacy of natural pest control services rendered by predators and parasitoids associated with planthoppers in China and potentially other rice production regions in Asia.

Prospectively ECG-triggered high-pitch 80 kVp coronary computed tomography angiography with 30 mL of 270 mg I/mL contrast material and iterative reconstruction.

BACKGROUND: The smallest diagnostically appropriate amount of contrast medium should be used in coronary computed tomography angiography (CCTA). PURPOSE: To investigate the feasibility of prospectively ECG-triggered high-pitch CCTA using 30 mL of 270 mg I/mL contrast material, 80 kVp, and iterative reconstruction (IR). MATERIAL AND METHODS: Eighty-two consecutive patients underwent CCTA with a prospectively ECG-triggered high-pitch protocol. Forty-three patients were examined at 100 kVp with filtered back projection after 60 mL of 370 mg I/mL contrast material was administered. Another 39 patients were examined at 80 kVp with IR after 30 mL of 270 mg I/mL contrast material was administered. Subjective and objective image quality was evaluated for each patient. Radiation doses were estimated and compared. RESULTS: Mean attenuation, noise and signal-to-noise ratio in 80 kVp group were significantly lower than in 100 kVp group (all P < 0.05), while there was no significant difference in contrast-to-noise ratio (CNR), although a trend towards a lower CNR in 80 kVp group was observed (P = 0.099). The subjective image quality between the two groups was not significantly different (P = 0.905). The effective dose and iodine load in 80 kVp group were reduced by 54% and 64%, respectively, when compared with 100 kVp group. CONCLUSION: Prospectively ECG-triggered high-pitch CCTA at 80 kVp with 30 mL of 270 mg I/mL contrast material and IR is feasible for patients with BMI less than 25 kg/m(2) and reduces radiation dose and iodine load when compared with the standard CCTA protocol.

Multimodality magnetic resonance imaging in hepatic encephalopathy: an update.

Hepatic encephalopathy (HE) is a neuropsychiatric complication of cirrhosis or acute liver failure. Currently, HE is regarded as a continuous cognitive impairment ranging from the mildest stage, minimal HE to overt HE. Hyperammonaemia and neuroinflammation are two main underlying factors which contribute to the neurological alterations in HE. Both structural and functional impairments are found in the white mater and grey mater involved in HE. Although the investigations into HE pathophysiological mechanism are enormous, the exact pathophysiological causes underlying HE remain controversial. Multimodality magnetic resonance imaging (MRI) plays an important role in helping to understand the pathological process of HE. This paper reviews the up-to-date multimodality MRI methods and predominant findings in HE patients with a highlight of the increasingly important role of blood oxygen level dependent functional MRI.

Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism.

OBJECTIVES: To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE). METHODS: This study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11-61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject. RESULTS: Of 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv). CONCLUSIONS: DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE. KEY POINTS: • Combined dual-energy CT lung ventilation/perfusion imaging is feasible. • Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information. • Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.

Dual-energy CT imaging of thoracic malignancies.

Computed tomography (CT) plays a pivotal role in the detection, characterization, and staging of lung cancer and other thoracic malignancies. Since the introduction of clinically viable dual-energy CT techniques, substantial evidence has accumulated on the use of this modality for imaging chest malignancies. This article describes the principles of dual-energy CT along with suitable image acquisition, reconstruction, and postprocessing strategies for oncologic applications in the chest. The potential of dual-energy CT techniques for the detection, characterization, staging, and surveillance of chest malignancy, as well as the limitations of this modality are discussed.

Digital subtraction CT angiography for detection of intracranial aneurysms: comparison with three-dimensional digital subtraction angiography.

PURPOSE: To evaluate the diagnostic accuracy of digital subtraction computed tomographic (CT) angiography in the detection of intracranial aneurysms compared with three-dimensional (3D) rotational digital subtraction angiography (DSA), as reference standard, in a large cohort in a single center. MATERIALS AND METHODS: The study was waived by the institutional review board because of its retrospective nature. A total of 513 patients clinically suspected of having or with known intracranial aneurysms and other cerebral vascular diseases underwent both digital subtraction CT angiography with a dual-source CT scanner and 3D DSA, with a median interval of 1 day; 436 patients (84.9%) had acute subarachnoid hemorrhage at presentation. The sensitivity, specificity, and accuracy of digital subtraction CT angiography in depicting aneurysm were analyzed on a per-patient and per-aneurysm basis, with 3D DSA as the reference standard. The sensitivity, specificity, and accuracy of digital subtraction CT angiography in depicting aneurysms of different diameter (ie, <3 mm, 3-5 mm, 5-10 mm, and >10 mm) and of aneurysms at different locations in the anterior and posterior circulation were calculated. Kappa statistics were calculated to quantify inter- and intrareader variability in detecting aneurysms by using digital subtraction CT angiography for 100 patients. RESULTS: Of 513 patients, 106 (20.7%) had no aneurysms, while 407 patients (79.3%) had 459 aneurysms at 3D DSA. Digital subtraction CT angiography correctly depicted 456 (99.3%) of the 459 aneurysms. By using 3D DSA as the standard of reference, the sensitivity and specificity of depicting intracranial aneurysms were 97.8% (398 of 407) and 88.7% (94 of 106), respectively, on a per-patient basis, and 96.5% (443 of 459) and 87.8% (94 of 107), respectively, on a per-aneurysm basis. Digital subtraction CT angiography had sensitivities of 91.3% (42 of 46), 94.0% (140 of 149), 98.4% (186 of 189), and 100% (75 of 75) in depicting aneurysms of less than 3 mm, between 3 mm but less than 5 mm, between 5 mm but less than 10 mm, and 10 mm or greater, respectively, and of 95.8% (276 of 288) and 97.7% (167 of 171) in depicting anterior circulation and posterior circulation aneurysms, respectively. Excellent inter- and intrareader agreement was found on a per-patient (κ=0.900 and 0.939, both P<.001) and per-aneurysm basis (κ=0.846 and 0.921, both P<.001) for the detection of intracranial aneurysms with digital subtraction CT angiography. CONCLUSION: Digital subtraction CT angiography has a high sensitivity and specificity in depicting intracranial aneurysms with different sizes and at different locations, compared with 3D DSA.

Automatic bone removal dual-energy CT angiography for the evaluation of intracranial aneurysms.

PURPOSE: To evaluate the diagnostic accuracy of dual-energy computed tomographic angiography (DE-CTA) in the detection of intracranial aneurysms and to determine whether DE-CTA provides adequate information to guide treatment choice. MATERIALS AND METHODS: Eighty patients (31 men and 49 women; mean [SD] ages of 52 [9] years) with spontaneous subarachnoid hemorrhage underwent DE-CTA. The performance of DE-CTA was compared with conventional CTA created from average weighted images and digital subtraction angiography (DSA). Sensitivity and specificity for aneurysm detection were determined on a per-patient and per-aneurysm basis. The treatment choice was assessed on the basis of aneurysm neck size and/or the dome/neck ratio. RESULTS: With DSA as reference standard (n = 61; 47 aneurysms in 41 patients), DE-CTA correctly detected 45 aneurysms in 41 patients corresponding to sensitivity and specificity of 100% and 95.0% on a per-patient basis versus 95.7% and 95.0% on a per-aneurysm basis, whereas conventional CTA correctly detected 43 aneurysms in 39 patients corresponding to sensitivity and specificity of 95.1% and 95.0% on a per-patient basis versus 91.5% and 95.0% on a per-aneurysm basis. No statistical difference between DE-CTA and conventional CTA was found for the diagnostic evaluation of intracranial aneurysms. Surgery was performed to treat 38 aneurysms, coiling in 26 aneurysms, stent in one patient, and follow-up in the remaining 5 aneurysms. Dual-energy CTA correctly predicted treatment choice in 44 aneurysms, with 15 aneurysms coiled and 29 aneurysms clipped. CONCLUSIONS: Compared with DSA, DE-CTA had a comparable diagnostic accuracy for the detection of intracranial aneurysms, visualization of the morphology of aneurysms at the skull base, and prediction of aneurysm treatment choice in most patients with spontaneous subarachnoid hemorrhage based on this study.

Diagnostic accuracy of dual-source CT coronary angiography: The effect of average heart rate, heart rate variability, and calcium score in a clinical perspective.

BACKGROUND: Dual-source CT coronary angiography (CTCA) has been used to detect coronary artery disease; however, the factors with potential to affect its diagnostic accuracy remain to be defined. PURPOSE: To prospectively evaluate the accuracy of dual-source CTCA in diagnosing coronary artery stenosis according to conventional coronary angiography (CAG), and the effect of average heart rate, heart rate variability, and calcium score on the accuracy of CTCA. MATERIAL AND METHODS: A total of 113 patients underwent both dual-source CTCA and CAG. The results were used to evaluate the findings in dual-source CTCA to assess the accuracy in the diagnosis of > or =50% (significant stenosis) and >75% (severe stenosis) of coronary artery according to those by CAG. Patients were divided into subgroups according to their heart rate (HR), HR variability (HRV), and calcium score, and the accuracy of CTCA was further evaluated. The chi-square test was used to analyze the difference in sensitivity and specificity for the detection of > or =50% and >75% coronary stenosis among subgroups. The generalized estimation equation method was used in per-vessel analysis to adjust for within-patient correlation. RESULTS: In all, 113 patients had 338 vessels and 1661 segments evaluated by CAG. Dual-source CTCA displayed 1527 segments (91.9%). Among them, 1468 segments (calcium score by CAG score 1, n=1018; score 2, n=270; score 3, n=180) were assessable in CTCA. On a per-patient analysis, the sensitivity and specificity of CTCA were 93.9% and 93.5% for significant stenosis and 86.9% and 98.1% for severe stenosis. On a per-vessel basis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. On a per-segment analysis, the sensitivity and specificity were 90.2% and 97.1% for significant and 83.3% and 98.1% for severe stenosis. Average HR had no effect on the sensitivity and specificity of CTCA (P>0.05); whereas HRV and calcium score had some effect on the sensitivity and specificity of CTCA (P<0.05). CONCLUSION: On a per-patient, per-vessel, and per-segment basis, dual-source CTCA has a high sensitivity and specificity for the diagnosis of coronary artery stenosis. Average HR has no effect on the diagnostic accuracy of CTCA, while HRV and calcium score have a statistically significant effect on the sensitivity and specificity of CTCA.

Liver virtual non-enhanced CT with dual-source, dual-energy CT: a preliminary study.

PURPOSE: To compare virtual non-enhanced liver CT (VNCT) from dual-energy CT (DECT) with true non-enhanced liver CT (TNCT) in patients. METHODS: A total of 102 patients underwent multi-phase abdominal CT. Liver arterial VNCT (VNCT(A)) and portovenous VNCT (VNCT(V)) images were derived from the arterial and portovenous DECT data. The mean CT number, signal to noise ratio (SNR), image quality, contrast to noise (CNR) of liver lesions, lesion detectability and radiation dose were compared. RESULTS: There was no difference in mean CT numbers of all organs (all P>0.05). SNR on VNCT images was higher than that of TNCT (all P<0.001). Image quality of VNCT was diagnostic but lower than that of TNCT (P<0.001). VNCT(A) images were superior to VNCT(V) (P<0.001). VNCT(A) and VNCT(V) detected 78 (91%) and 70 (81%) of 86 hepatic focal lesions visualised on TNCT. There was no difference in the size, attenuation and CNR of focal hepatic lesions (all P>0.05), but SNR of the lesions on VNCT was higher than that on TNCT (P<0.001). Radiation dose of biphase DECT was lower than that of routine triphase CT (P<0.001). CONCLUSION: VNCT(A) may potentially replace TNCT as part of a multi-phase liver imaging protocol with consequent saving in radiation dose.

Densitometric and geometric measurement of the proximal femur in elderly women with and without osteoporotic vertebral fractures by volumetric quantitative multi-slice CT.

There is a lack of research on volumetric multi-slice CT (MSCT) application in hip densitometric assessment and geometric measures in elderly women with osteoporotic vertebral fractures. A total of 237 elderly women were divided into three groups based on BMD values of the lumbar spine (AP-SPINE) and/or the femoral neck (NECK) by dual energy X-ray absorptiometry (DXA): osteoporosis with (OP_FX, 53 cases) or without vertebral fracture (OP_NONFX, 94 cases), or normal BMD (CONTROL, 90 cases). Volumetric BMD of trabecular bone (TRAB), integral bone (INTGL) and cortical bone (CORT) with neck axis length (NAL) and minimum cross-section area (mCSA) measures of the left femoral neck were calculated, respectively, by using OsteoCAD software based on MSCT scans of the abdominal-pelvic region of all participants, then the index of femoral neck strength (FNSI) was estimated. The values of TRAB, CORT and INTGL of OP_FX were significantly lower than those of OP_NONFX, with the decrease in 6.8-21.8%, as well as being lower than those in CONTROL, whereas no significant differences in the values of AP-SPINE and NECK were found between OP_FX and OP_NONFX. No significant difference of the value of mCSA was found among these three groups. The NAL value of OP_NONFX was larger than that of CONTROL. FNSI of femoral neck in OP_FX (0.42 ± 0.15 g(2)/cm(4)) was significantly lower than OP_NONFX (0.50 ± 0.14 g(2)/cm(4)) (p < 0.05). vQCT measurement seemed to be more effective than DXA in evaluating hip densitometric changes and discriminating osteoporotic elderly subjects with fractured vertebrae from the non-fractured in a group of Chinese women.

Dual source dual-energy computed tomography of acute myocardial infarction: correlation with histopathologic findings in a canine model.

PURPOSE: To evaluate the feasibility and value of dual-energy computed tomography myocardial iodine maps in the diagnosis of acute myocardial infarction. MATERIALS AND METHODS: In 6 dogs, arterial-phase myocardial dual-energy computed tomography imaging were performed 1 day prior to and 3 hours after the surgical ligation of the left anterior descending artery to generate 100 kVp, 140 kVp, average weighted images, and dual energy myocardial iodine maps. For each of the 17 segments of the left ventricle (LV, 102 total segments), the presence or absence myocardial infarction was determined by histopathology and correlated to blinded reader determination of infarcted and noninfarcted myocardium at computed tomography (CT). Statistical analysis for diagnostic accuracy of aforementioned techniques and inter-reader agreement was performed. RESULTS: The LV myocardial contrast enhancement at the average weighted images and iodine maps were uniform in all 6 dogs before surgery. Following anterior descending artery ligation, histopathology showed 40 infarcted left ventricular segments and 62 noninfarcted segments. For the postligation CT scans, 100 kVp, 140 kVp, average weighted images, and myocardial iodine maps showed 33, 28, 33, 34 infarcted segments and 53, 56, 56, 52 noninfarcted segments for both readers; corresponding to per-segment sensitivities of 83%, 70%, 80%, 92% and specificities of 85%, 90%, 92%, 80% for detecting myocardial infarction. No statistical difference was found for diagnostic accuracy of 100 kV, 140 kV, weighted average images, and iodine maps to detect myocardial infarct segments (all P > 0.05 for both readers). Good inter-reader agreement was seen for myocardial infarct detection using iodine maps (kappa = 0.80). CONCLUSIONS: Myocardial single- and dual-energy CT imaging shows high per-segment sensitivity and moderate specificity for detecting acute myocardial infarction in a canine model with histopathology as the standard of reference.

Dual-energy CT angiography in the evaluation of intracranial aneurysms: image quality, radiation dose, and comparison with 3D rotational digital subtraction angiography.

OBJECTIVE: The purpose of this study was to evaluate the image quality, radiation dose, and diagnostic accuracy of dual-energy CT angiography (CTA) compared with 3D rotational digital subtraction angiography (DSA) in the detection of intracranial aneurysms. SUBJECTS AND METHODS: Forty-six patients with clinically suspected intracranial aneurysms underwent dual-source dual-energy CTA and 3D DSA. For the analysis of the image quality and radiation dose of dual-energy CTA, 46 patients who underwent digital subtraction CTA were recruited as a control group. The image quality of dual-energy CTA and digital subtraction CTA was rated on a 4-point scale as excellent, good, moderate, or poor. The radiation dose of CTA was recorded according to patient protocol. Aneurysm detection with dual-energy CTA compared with 3D DSA was analyzed on a per-patient and on a peraneurysm basis. Sensitivity, specificity, and positive and negative predictive values for aneurysm presence were determined. The mean maximum diameter and dome and neck dimensions of aneurysms were measured on dual-energy CTA and 3D DSA images. Correlation analysis between the two techniques was performed. RESULTS: There was no statistical difference between the image quality of dual-energy CTA and that of digital subtraction CTA (p>0.05). Patients undergoing dual-energy CTA received a smaller radiation dose (volume CT dose index, 20.6+/-0.1 mGy [mean+/-SD]; dose-length product, 398.6+/-19.0 mGy x cm) than those undergoing digital subtraction CTA (volume CT dose index, 50.4+/-3.4 mGy; dose-length product, 1,095.6+/-114.2 mGyxcm) (p<0.05). Three-dimensional DSA showed no aneurysm in 11 patients and 40 aneurysms in 35 patients. The mean maximum diameter of the aneurysms was 6+/-3 mm; the dome measurement, 5+/-3 mm; and the neck dimension, 3+/-2 mm. With dual-energy CTA, 38 aneurysms in 34 patients were correctly detected, and two aneurysms in two patients were missed. With DSA as the standard of reference, the sensitivity, specificity, and positive and negative predictive values of dual-energy CTA in the detection of intracranial aneurysm were 97.1%, 100%, 100%, and 91.7% on a per-patient basis and 95.0%, 100%, 100%, and 99.7% on a per-aneurysm basis. Dual-energy CTA had sensitivities of 93.8%, 100%, and 80.0% and specificities of 100%, 100%, and 100% in the detection of aneurysms larger than 5 mm, those measuring 3.1-5 mm, and aneurysms 3 mm or smaller. At dual-energy CTA, the mean maximum diameter and dome and neck dimensions were 6+/-3 mm, 5+/-3 mm, and 3+/-2 mm. Excellent correlation was found between DSA and dual-energy CTA findings with respect to mean maximum diameter and dome and neck dimensions (r=0.969, 0.957, and 0.870; p = 0.000). CONCLUSION: On the basis of the findings in the small series of patients evaluated, contrast-enhanced dual-energy CTA had diagnostic image quality at a lower radiation dose than digital subtraction CTA and high diagnostic accuracy compared with 3D DSA in the detection of intracranial aneurysms.