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OBJECTIVES: This study evaluated the feasibility of a model-based iterative reconstruction technique (MBIR) tuned for the myocardium on myocardial computed tomography late enhancement (CT-LE). METHODS: Twenty-eight patients who underwent myocardial CT-LE and late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) within 1 year were retrospectively enrolled. Myocardial CT-LE was performed using a 320-row CT with low tube voltage (80 kVp). Myocardial CT-LE images were scanned 7 min after CT angiography (CTA) without additional contrast medium. All myocardial CT-LE images were reconstructed with hybrid iterative reconstruction (HIR), conventional MBIR (MBIR_cardiac), and new MBIR tuned for the myocardium (MBIR_myo). Qualitative (5-grade scale) scores and quantitative parameters (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) were assessed as image quality. The sensitivity, specificity, and accuracy of myocardial CT-LE were evaluated at the segment level using an American Heart Association (AHA) 16-segment model, with LGE-MRI as a reference standard. These results were compared among the different CT image reconstructions. RESULTS: In 28 patients with 448 segments, 160 segments were diagnosed with positive by LGE-MRI. In the qualitative assessment of myocardial CT-LE, the mean image quality scores were 2.9 ± 1.2 for HIR, 3.0 ± 1.1 for MBIR_cardiac, and 4.0 ± 1.0 for MBIR_myo. MBIR_myo showed a significantly higher score than HIR (P < 0.001) and MBIR_cardiac (P = 0.018). In the quantitative image quality assessment of myocardial CT-LE, the median image SNR was 10.3 (9.1-11.1) for HIR, 10.8 (9.8-12.1) for MBIR_cardiac, and 16.8 (15.7-18.4) for MBIR_myo. The median image CNR was 3.7 (3.0-4.6) for HIR, 3.8 (3.2-5.1) for MBIR_cardiac, and 6.4 (5.0-7.7) for MBIR_myo. MBIR_myo significantly improved the SNR and CNR of CT-LE compared to HIR and MBIR_cardiac (P < 0.001). The sensitivity, specificity, and accuracy for the detection of myocardial CT-LE were 70%, 92%, and 84% for HIR; 71%, 92%, and 85% for MBIR_cardiac; and 84%, 92%, and 89% for MBIR_myo, respectively. MBIR_myo showed significantly higher image quality, sensitivity, and accuracy than the others (P < 0.05). CONCLUSIONS: MBIR tuned for myocardium improved image quality and diagnostic performance for myocardial CT-LE assessment.
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Layered intercalation compounds, where atoms or molecules (intercalants) are inserted into layered materials (hosts), hold great potential for diverse applications. However, the lack of a systematic understanding of stable host-intercalant combinations poses challenges in materials design due to the vast combinatorial space. In this study, we performed first-principles calculations on 9024 compounds, unveiling a novel linear regression equation based on the principle of hard and soft acids and bases. This equation, incorporating the intercalant ion formation energy and ionic radius, quantitatively reveals the stability factors. Additionally, employing machine learning, we predicted regression coefficients from host properties, offering a comprehensive understanding and a predictive model for estimating the intercalation energy. Our work provides valuable insights into the energetics of layered intercalation compounds, facilitating targeted materials design.
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Coronary artery disease (CAD) is a common condition caused by the accumulation of atherosclerotic plaques. It can be classified into stable CAD or acute coronary syndrome. Coronary computed tomography angiography (CCTA) has a high negative predictive value and is used as the first examination for diagnosing stable CAD, particularly in patients at intermediate-to-high risk. CCTA is also adopted for diagnosing acute coronary syndrome, particularly in patients at low-to-intermediate risk. Myocardial ischemia does not always co-exist with coronary artery stenosis, and the positive predictive value of CCTA for myocardial ischemia is limited. However, CCTA has overcome this limitation with recent technological advancements such as CT perfusion and CT-fractional flow reserve. In addition, CCTA can be used to assess coronary artery plaques. Thus, the indications for CCTA have expanded, leading to an increased demand for radiologists. The CAD reporting and data system (CAD-RADS) 2.0 was recently proposed for standardizing CCTA reporting. This RADS evaluates and categorizes patients based on coronary artery stenosis and the overall amount of coronary artery plaque and links this to patient management. In this review, we aimed to review the major trials and guidelines for CCTA to understand its clinical role. Furthermore, we aimed to introduce the CAD-RADS 2.0 including the assessment of coronary artery stenosis, plaque, and other key findings, and highlight the steps for CCTA reporting. Finally, we aimed to present recent research trends including the perivascular fat attenuation index, artificial intelligence, and the advancements in CT technology.
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Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana , Humanos , Angiografia por Tomografia Computadorizada/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagemRESUMO
The present study investigated the differences between digital [18F]-Fluorodeoxyglucose (FDG) positron emission tomography [PET]/computed tomography [CT] (dPET/CT) and conventional PET/CT (cPET/CT) in delineating the clinical target volume (CTV) in patients with advanced lung cancer in the involved field radiation therapy (IFRT) era. Patients with advanced lung cancer were scanned using two dual-imaging protocols (dPET/CT and cPET/CT). Two virtual delineations contoured with reference to dPET/CT and cPET/CT images were created for each patient by five radiation oncologists. Changes in the delineation of target volumes in each patient were examined. A total of 10 patients [male/female, 9/1; median age, 65 years (range, 58-80 years)] were enrolled between April 2020 and September 2020. Significant changes in the delineation of CTVs were uncommon between dPET/CT and cPET/CT. A notable increase in CTVn was observed in 10% of the patients (1/10; P<0.05; Smirnov-Grubbs analysis). In this patient, a node that was not assessed as lymph node metastasis when cPET/CT was used was assessed as lymph node metastasis when dPET/CT was used and was included in the CTVn by all five radiation oncologists. In patients with advanced lung cancer, notable changes in CTV delineations are uncommon, regardless of whether dPET/CT or cPET/CT is used. However, in some cases, CTVn delineation with reference to dPET/CT may improve the treatment outcomes of IFRT for advanced lung cancer.
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BACKGROUND: Single-center studies have shown that single photon emission computed tomography myocardial blood flow (MBF) measurement is accurate compared with MBF measured with microspheres in a porcine model, positron emission tomography, and angiography. Clinical implementation requires consistency across multiple sites. The study goal is to determine the intersite processing repeatability of single photon emission computed tomography MBF and the additional camera time required. METHODS: Five sites (Canada, Italy, Japan, Germany, and Singapore) each acquired 25 to 35 MBF studies at rest and with pharmacological stress using technetium-99m-tetrofosmin on a pinhole-collimated cadmium-zinc-telluride-based cardiac single photon emission computed tomography camera with standardized list-mode imaging and processing protocols. Patients had intermediate to high pretest probability of coronary artery disease. MBF was measured locally and at a core laboratory using commercially available software. The time a room was occupied for an MBF study was compared with that for a standard rest/stress myocardial perfusion study. RESULTS: With motion correction, the overall correlation in MBF between core laboratory and local site was 0.93 (range, 0.87-0.97) at rest, 0.90 (range, 0.84-0.96) at stress, and 0.84 (range, 0.70-0.92) for myocardial flow reserve. The local-to-core difference in global MBF (bias-MBF) was 5.4% (-3.8% to 14.8%; median [interquartile range]) at rest and 5.4% (-6.2% to 19.4%) at stress. Between the 5 sites, bias-MBF ranged from -1.6% to 11.0% at rest and from -1.9% to 16.3% at stress; the interquartile range in bias-MBF was between 9.3% (4.8%-14.0%) and 22.3% (-10.3% to 12.0%) at rest and between 17.0% (-11.3% to 5.6%) and 33.3% (-10.4% to 22.9%) at stress and was not significantly different between most sites. Both bias and interquartile range were like previously reported interobserver variability and less than the SD of the test-retest difference of 30%. The overall difference in myocardial flow reserve was 1.52% (-10.6% to 11.3%). There were no significant differences between with and without motion correction. The average additional acquisition time varied between sites from 44 to 79 minutes. CONCLUSIONS: The average bias-MBF and bias-MFR values were small with standard deviations substantially less than the test-retest variability. This demonstrates that MBF can be measured consistently across multiple sites and further supports that this technique can be reliably implemented. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03427749.
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Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Animais , Humanos , Doença da Artéria Coronariana/diagnóstico por imagem , Circulação Coronária , Estudos de Viabilidade , Coração , Imagem de Perfusão do Miocárdio/métodos , Tomografia por Emissão de Pósitrons/métodos , Suínos , Tomografia Computadorizada de Emissão de Fóton Único/métodosRESUMO
PURPOSE: Thyroid hormone withdrawal (THW) in preparation for radioactive iodine therapy (RIT) may lead to hyponatremia and hyperkalemia because hypothyroidism reduces the glomerular filtration rate. Using recombinant human thyrotropin (rhTSH) may avoid these changes; however, these two preparation methods have not been compared in the literature. The purpose of this study was to reveal whether THW and rhTSH as preparation methods for RIT affect serum electrolytes differently. We also evaluated clinical factors influencing the onset of hyponatremia and hyperkalemia during RIT. MATERIALS AND METHODS: From April 2005 to December 2020, we analyzed 278 patients with thyroid cancer who received RIT. The patients were classified into two groups based on the preparation method, and renal function and serum electrolytes were compared between the groups. We also evaluated clinical factors that may affect overt hyponatremia (serum sodium level < 134 mmol/L) and hyperkalemia (serum potassium level ≥ 5.0 mmol/L). RESULTS: Serum sodium and chloride levels in the THW group were significantly lower than those in the rhTSH group (p < 0.001 and p = 0.002, respectively). In contrast, the serum potassium level in the THW group was significantly higher than that in the rhTSH group (p = 0.008). As for clinical factors that may influence hyponatremia, age and estimated glomerular filtration rate (eGFR) were significantly associated with serum sodium level in the univariate analysis (p = 0.033 and p = 0.006, respectively). In the multivariate analysis, only age was significantly associated with serum sodium level (p = 0.030). Regarding hyperkalemia, distant metastases, the preparation method and eGFR were significantly associated with the serum potassium level in the univariate analysis (p = 0.005, p = 0.005 and p = 0.001, respectively). In the multivariate analysis, only eGFR was significantly associated with hyperkalemia (p = 0.019). CONCLUSION: THW and rhTSH affect serum sodium and potassium levels differently. Renal function may be risk factors for hyperkalemia, whereas older age may be a risk factor for hyponatremia.
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Hiperpotassemia , Hiponatremia , Neoplasias da Glândula Tireoide , Tirotropina Alfa , Humanos , Tirotropina Alfa/uso terapêutico , Radioisótopos do Iodo/efeitos adversos , Hiperpotassemia/induzido quimicamente , Hiperpotassemia/tratamento farmacológico , Hiponatremia/induzido quimicamente , Hiponatremia/tratamento farmacológico , Estudos Retrospectivos , Tireotropina/uso terapêutico , Potássio/uso terapêutico , Sódio/uso terapêutico , Eletrólitos/uso terapêuticoRESUMO
PURPOSE: To evaluate left atrial (LA) function in patients with hypertrophic cardiomyopathy (HCM) by LA strain assessment using cardiac computed tomography (CT-derived LA strain). MATERIALS AND METHODS: This was a retrospective study of 34 patients with HCM and 31 non-HCM patients who underwent cardiac computed tomography (CT) using retrospective electrocardiogram-gated mode. CT images were reconstructed every 5% (0-95%) of the RR intervals. CT-derived LA strain (reservoir [LASr], conduit [LASc], and booster pump strain [LASp]) were semi-automatically analyzed using a dedicated workstation. We also measured the left atrial volume index (LAVI) and left ventricular longitudinal strain (LVLS) for the left atrial and ventricular functional parameters to assess the relationship with CT-derived LA strain. RESULTS: CT-derived LA strain significantly correlated with LAVI: r = - 0.69, p < 0.001 for LASr; r = - 0.70, p < 0.001 for LASp; and r = - 0.35, p = 0.004 for LASc. CT-derived LA strain also significantly correlated with LVLS: r = - 0.62, p < 0.001 for LASr; r = - 0.67, p < 0.001 for LASc; and r = - 0.42, p = 0.013 for LASp. CT-derived LA strain in patients with HCM was significantly lower than that in non-HCM patients: LASr (20.8 ± 7.6 vs. 31.7 ± 6.1%, p < 0.001); LASc (7.9 ± 3.4 vs. 14.2 ± 5.3%, p < 0.001); and LASp (12.8 ± 5.7 vs. 17.6 ± 4.3%, p < 0.001). Additionally, CT-derived LA strain showed high reproducibility; inter-observer correlation coefficients were 0.94, 0.90, and 0.89 for LASr, LASc, and LASp, respectively. CONCLUSION: CT-derived LA strain is feasible for quantitative assessment of left atrial function in patients with HCM.
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Fibrilação Atrial , Cardiomiopatia Hipertrófica , Humanos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Átrios do Coração/diagnóstico por imagem , Cardiomiopatia Hipertrófica/diagnóstico por imagem , TomografiaRESUMO
BACKGROUND: Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) plays a crucial role in the optimal treatment strategy for patients with coronary heart disease. We tested the feasibility of feature extraction from MPI using a deep convolutional autoencoder (CAE) model. METHODS: Eight hundred and forty-three pairs of stress and rest myocardial perfusion images were collected from consecutive patients who underwent cardiac scintigraphy in our hospital between December 2019 and February 2022. We trained a CAE model to reproduce the input paired image data, so as the encoder to output a 256-dimensional feature vector. The extracted feature vectors were further dimensionally reduced via principal component analysis (PCA) for data visualization. Content-based image retrieval (CBIR) was performed based on the cosine similarity of the feature vectors between the query and reference images. The agreement of the radiologist's finding between the query and retrieved MPI was evaluated using binary accuracy, precision, recall, and F1-score. RESULTS: A three-dimensional scatter plot with PCA revealed that feature vectors retained clinical information such as percent summed difference score, presence of ischemia, and the location of scar reported by radiologists. When CBIR was used as a similarity-based diagnostic tool, the binary accuracy was 81.0%. CONCLUSION: The results indicated the utility of unsupervised feature learning for CBIR in MPI.
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Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Humanos , Imagem de Perfusão do Miocárdio/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Coração , Redes Neurais de Computação , Doença da Artéria Coronariana/diagnósticoRESUMO
BACKGROUND: Diagnostic guidelines for isolated cardiac sarcoidosis (iCS) were first proposed in 2016, but there are few reports on the imaging and prognosis of iCS. This study aimed to evaluate the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging in predicting iCS prognosis. METHODS AND RESULTS: We retrospectively reviewed the clinical and imaging data of 306 consecutive patients with suspected CS who underwent FDG PET/CT with a dedicated preparation protocol and included 82 patients (55 with systemic sarcoidosis including cardiac involvement [sCS], 27 with iCS) in the study. We compared the FDG PET/CT findings between the two groups. We examined the relationship between the CS type and the rate of adverse cardiac events. The iCS group had a significantly lower target-to-background ratio than the sCS group (P = 0.0010). The event-free survival rate was significantly lower in the iCS group than the sCS group (log-rank test, P < 0.0001). iCS was identified as an independent prognostic factor for adverse events (hazard ratio 3.82, P = 0.0059). CONCLUSION: iCS was an independent prognostic factor for adverse cardiac events in patients with CS. The clinical diagnosis of iCS based on FDG PET/CT and new guidelines may be important.
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Cardiomiopatias , Miocardite , Sarcoidose , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18 , Estudos Retrospectivos , Compostos Radiofarmacêuticos , Prognóstico , Tomografia por Emissão de Pósitrons/métodosRESUMO
PURPOSE: We applied a combination of compressed-sensing (CS) and retrospective motion correction to free-breathing cine magnetic resonance (MR) (FBCS cine MoCo). We validated FBCS cine MoCo by comparing it with breath-hold (BH) conventional cine MR. MATERIALS AND METHODS: Thirty-five volunteers underwent both FBCS cine MoCo and BH conventional cine MR imaging. Twelve consecutive short-axis cine images were obtained. We compared the examination time, image quality and biventricular volumetric assessments between the two cine MR. RESULTS: FBCS cine MoCo required a significantly shorter examination time than BH conventional cine (135 s [110-143 s] vs. 198 s [186-349 s], p < 0.001). The image quality scores were not significantly different between the two techniques (End-diastole: FBCS cine MoCo; 4.7 ± 0.5 vs. BH conventional cine; 4.6 ± 0.6; p = 0.77, End-systole: FBCS cine MoCo; 4.5 ± 0.5 vs. BH conventional cine; 4.5 ± 0.6; p = 0.52). No significant differences were observed in all biventricular volumetric assessments between the two techniques. The mean differences with 95% confidence interval (CI), based on Bland-Altman analysis, were - 0.3 mL (- 8.2 - 7.5 mL) for LVEDV, 0.2 mL (- 5.6 - 5.9 mL) for LVESV, - 0.5 mL (- 6.3 - 5.2 mL) for LVSV, - 0.3% (- 3.5 - 3.0%) for LVEF, - 0.1 g (- 8.5 - 8.3 g) for LVED mass, 1.4 mL (- 15.5 - 18.3 mL) for RVEDV, 2.1 mL (- 11.2 - 15.3 mL) for RVESV, - 0.6 mL (- 9.7 - 8.4 mL) for RVSV, - 1.0% (- 6.5 - 4.6%) for RVEF. CONCLUSION: FBCS cine MoCo can potentially replace multiple BH conventional cine MR and improve the clinical utility of cine MR.
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Coração , Imagem Cinética por Ressonância Magnética , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Estudos Retrospectivos , Coração/diagnóstico por imagem , Respiração , Imageamento por Ressonância Magnética/métodos , Suspensão da Respiração , Reprodutibilidade dos TestesRESUMO
Background: The present study aimed to investigate the efficacy of positron emission tomography with 18Fluoro-deoxyglucose (FDG-PET/CT) for predicting malignant intraductal papillary mucinous neoplasm (IPMN). Methods: The records of 88 patients pathologically diagnosed with IPMN after surgery at Ehime University Hospital and Ehime Prefectural Central Hospital from April 2009 to December 2020 were retrospectively reviewed. The patients' characteristics, blood chemistry, and imaging examinations were evaluated as potential predictors of malignant IPMN. Of the PET/CT results, the maximum standardized uptake value (SUVmax) of the tumor, the tumor-to-blood pool ratio of the SUV (TBR), and the tumor-to-liver ratio of the SUV (TLR) were compared. Results: On pathology, the diagnosis was adenoma (IPMA) in 40 patients, high-grade dysplasia (HGD) in 26 patients, and carcinoma (IPMC) in 22 patients. HGD and IPMC were defined as malignant IPMN. On multivariate analyses, TLR ≥ 1.3 and high-risk stigmata were independent predictors of malignant IPMN (P = .001 and P = .007, respectively). When both HRS and TLR ≥ 1.3 were present, the positive predictive value for malignancy was 88.2%. Furthermore, TLR was significantly higher for patients with IPMC than with HGD (P = .039). Conclusion: TLR can be a useful predictor for differentiating benign from malignant IPMN and may be associated with postoperative outcomes.
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Distal transradial approach (dTRA) for neuroendovascular procedures has received much attention in recent years as a newer and less invasive alternative to the conventional transfemoral or transradial approaches. We present the case of an 89-year-old woman with a basilar artery aneurysm requiring simultaneous catheterization of the bilateral vertebral arteries who was successfully embolized using bilateral dTRA. The aneurysm was accessed from the right vertebral artery using the right dTRA. Control angiograms during the procedure were performed from the left vertebral artery via the left dTRA. The operator's posture was ergonomically comfortable, and the catheters were easy to handle during the procedure. To the best of our knowledge, this is the first case of a bilateral dTRA used for neuroendovascular procedures. Bilateral dTRA is a safe and minimally invasive method for patients and ergonomically comfortable for operators.
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Aneurisma Intracraniano , Idoso de 80 Anos ou mais , Angiografia , Cateterismo , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Artéria Radial/diagnóstico por imagem , Artéria Radial/cirurgia , Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/cirurgiaRESUMO
We evaluated the feasibility of myocardial perfusion ratio to the aorta (MPR) in static computed tomography perfusion (CTP) for detecting myocardial perfusion abnormalities assessed by single-photon emission computed tomography (SPECT). Twenty-five patients with suspected coronary artery disease who underwent dynamic CTP and SPECT were retrospectively evaluated. CTP images scanned at a sub-optimal phase for detecting myocardial perfusion abnormalities were selected from dynamic CTP images and used as static CTP images in the present study. The diagnostic accuracy of MPR derived from static CTP was compared to those of visual assessment and conventional quantitative parameters such as myocardial CT attenuation (HU) and transmural perfusion ratio (TPR). The area under the curve of MPR (0.84; 95% confidence interval [CI], 0.76−0.90) was significantly higher than those of myocardial CT attenuation (0.73; 95% CI, 0.65−0.79) and TPR (0.76; 95% CI, 0.67−0.83) (p < 0.05). Sensitivity and specificity were 67% (95% CI, 54−77%) and 90% (95% CI, 86−92%) for visual assessment, 51% (95% CI, 39−63%) and 86% (95% CI, 82−89%) for myocardial CT attenuation, 63% (95% CI, 51−74%) and 84% (95% CI, 80−88%) for TPR, and 78% (95% CI, 66−86%) and 84% (95% CI, 80−88%) for MPR, respectively. MPR showed higher diagnostic accuracy for detecting myocardial perfusion abnormality compared with myocardial CT attenuation and TPR.
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BACKGROUND: This study aimed to quantitatively evaluate myocardial perfusion single-photon emission computed tomography (SPECT) using an original analysis tool in the compartment model for detecting regional significant coronary artery disease (CAD).MethodsâandâResults: This study analyzed 41 patients (median age, 76 years) with suspected or known CAD who underwent both dynamic SPECT using 99 mTc-tetrofosmin and invasive coronary angiography. The quantitative analysis was performed using a single-tissue compartment model to evaluate the diagnostic performance of the myocardial flow reserve (MFR) for regional significant CAD, excluding infarcted territories. In the regional analysis, 114 vessels were assessed, of which 31 were diagnosed as significant coronary lesions (≥70% stenosis and/or fraction flow reserve ≤0.8). The MFR of regional significant CAD was significantly lower than that of non-significant CAD (1.11 [0.97-1.31] vs. 1.74 [1.30-2.27]; P<0.001). In the receiver operating characteristic curve analysis, the MFR displayed an area under the curve (AUC) of 0.81. While analyzing each coronary artery territory, the diagnostic performance of the MFR value in the left anterior descending (LAD) artery territory was found to be significantly higher than that found in qualitative assessment (AUC: 0.84 vs. 0.61). CONCLUSIONS: A quantitative analysis of dynamic SPECT data facilitated detecting regional CAD. For the LAD artery, the MFR displayed a higher diagnostic performance than the qualitative assessment of conventional myocardial perfusion SPECT.
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Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Idoso , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Humanos , Imagem de Perfusão do Miocárdio/métodos , Perfusão , Curva ROC , Tomografia Computadorizada de Emissão de Fóton Único/métodosRESUMO
OBJECTIVE: We report our first experience of using a case-specific three-dimensional (3D) hologram for tumor resection in otolaryngology to show the proof of concept. In addition, a questionnaire was administered to assess the usefulness of the mixed reality technique in otolaryngology. METHODS: A case-specific 3D hologram was developed from enhanced images of dynamic computed tomography, with reference to contrast-enhanced magnetic resonance images, and used for preoperative planning and intraoperative image reference. To evaluate the usefulness of the 3D hologram with head mount displays (HMDs), 18 attendings and resident otolaryngologists completed a questionnaire with the Likert scale. RESULTS: The case-specific 3D hologram on HMDs was successfully used by means of easy gesture-handling without any monitors preoperatively and intraoperatively. The experience of picturing the tumor localization and evaluating the surgical approach was statistically better using the 3D hologram on HMDs than using the computer images (P < .01). Similarly, the holograms were observed to be better for intraoperative application and surgical education than computer images (P < .01). CONCLUSION: We demonstrated the use of a case-specific 3D hologram for tumor resection in otolaryngology. The technology may be useful for preoperative planning and intraoperative image reference, especially for challenging cases, and surgical education. LEVEL OF EVIDENCE: NA.
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OBJECTIVE: Albumin-globulin ratio (AGR), which is calculated by dividing serum albumin by serum globulin, is considered as a cancer-related inflammation biomarker. Although the prognosis of many solid cancers has been shown to be associated with AGR, there are no studies to demonstrate the association between the prognosis of thyroid cancer and AGR. The purpose of this study is to reveal the relationship between AGR and overall survival (OS) in patients with thyroid cancer who received radioactive iodine therapy (RIT). METHODS: Eighty-eight patients with thyroid cancer who had received RIT for the first time in our institution were included. The values before RIT were adopted as initial measurements for serum albumin, globulin, and thyroglobulin (Tg) and used for analysis. Patients were divided into two groups based on the AGR value. We analyzed the relationship between clinical factors and treatment outcome. RESULTS: The median follow-up period was 92.4 months (range: 30.1-173.9 months). The 5-year OS and progression-free survival (PFS) were 94% and 54%, respectively. Seventeen patients (< 65 years, 8; and ≥ 65 years, 9) died during the follow-up period. Low AGR was significantly associated with OS in both univariate and multivariate analyses (p = 0.0059 and p = 0.0120, respectively). As the 5-year OS was as high as 94%, there was no significant difference in survival rate between the two groups during the first 5 years. However, there seemed to be a remarkable difference in 10 years after the first RIT. On the other hand, Tg was significantly associated with PFS in both univariate and multivariate analyses (p = 0.0016 and p = 0.0441, respectively). In patients under the age of 65, the PFS rate was significantly lower in the low AGR group (p < 0.0001), while there was no difference in PFS rate between the two AGR groups in patients aged 65 years or older. CONCLUSIONS: AGR may be used as a prognostic factor in relatively younger patients with thyroid cancer treated with radioiodine, while it may be less useful in the older. Overall, it may be an independent prognostic factor for long-term survival in those with thyroid cancer.
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Neoplasias da Glândula Tireoide , Adulto , Idoso , Humanos , Radioisótopos do Iodo , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto JovemRESUMO
BACKGROUND: Feature tracking (FT) has become an established tool for cardiovascular magnetic resonance (CMR)-based strain analysis. Recently, the compressed sensing (CS) technique has been applied to cine CMR, which has drastically reduced its acquisition time. However, the effects of CS imaging on FT strain analysis need to be carefully studied. This study aimed to investigate the use of CS cine CMR for FT strain analysis compared to conventional cine CMR. METHODS: Sixty-five patients with different left ventricular (LV) pathologies underwent both retrospective conventional cine CMR and prospective CS cine CMR using a prototype sequence with the comparable temporal and spatial resolution at 3 T. Eight short-axis cine images covering the entire LV were obtained and used for LV volume assessment and FT strain analysis. Prospective CS cine CMR data over 1.5 heartbeats were acquired to capture the complete end-diastolic data between the first and second heartbeats. LV volume assessment and FT strain analysis were performed using a dedicated software (ci42; Circle Cardiovasacular Imaging, Calgary, Canada), and the global circumferential strain (GCS) and GCS rate were calculated from both cine CMR sequences. RESULTS: There were no significant differences in the GCS (- 17.1% [- 11.7, - 19.5] vs. - 16.1% [- 11.9, - 19.3; p = 0.508) and GCS rate (- 0.8 [- 0.6, - 1.0] vs. - 0.8 [- 0.7, - 1.0]; p = 0.587) obtained using conventional and CS cine CMR. The GCS obtained using both methods showed excellent agreement (y = 0.99x - 0.24; r = 0.95; p < 0.001). The Bland-Altman analysis revealed that the mean difference in the GCS between the conventional and CS cine CMR was 0.1% with limits of agreement between -2.8% and 3.0%. No significant differences were found in all LV volume assessment between both types of cine CMR. CONCLUSION: CS cine CMR could be used for GCS assessment by CMR-FT as well as conventional cine CMR. This finding further enhances the clinical utility of high-speed CS cine CMR imaging.
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Cardiopatias/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador , Imagem Cinética por Ressonância Magnética , Função Ventricular Esquerda , Remodelação Ventricular , Idoso , Feminino , Cardiopatias/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Estudos RetrospectivosRESUMO
BACKGROUND: This study evaluated corrected relative flow reserve (RFR) derived from 13N-ammonia positron emission tomography (PET) combined with coronary computed tomography angiography (CTA). METHODS: We analyzed 61 patients who underwent coronary CTA, 13N-ammonia PET, and invasive coronary angiography. Triple-vessel disease were excluded. Conventional RFRs were calculated as the ratio of hyperemic myocardial blood flow (hMBF) of hypoperfusion areas to those of non-ischemic lesions. Corrected RFRs were calculated using PET and coronary CTA to adjust coronary territories to their feeding vessels. Diagnostic performance was compared to detect obstructive coronary lesions. RESULTS: Of the 180 vessels analyzed, 50 were diagnosed as obstructive lesions (≥ 70% stenosis and/or fractional flow reserve value ≤ 0.8). The coronary flow reserve (CFR), hMBF, conventional RFR, and corrected RFR of obstructive lesions were significantly lower than those of non-obstructive lesions. In receiver operating characteristic curve analysis, these quantitative PET measurements had area under the curve of 0.67, 0.71, 0.89, and 0.92, respectively. Diagnostic performance differences between corrected and conventional RFR were not statistically significant. CONCLUSION: In patients with single or double vessel disease, indices of RFR, with or without coronary angiographic guidance of the reference coronary territory, are better discriminators of flow-limiting stenoses than hMBF and CFR.
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Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico por imagem , Reserva Fracionada de Fluxo Miocárdico/fisiologia , Radioisótopos de Nitrogênio , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Idoso , Doença da Artéria Coronariana/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos RetrospectivosRESUMO
We describe a 61-year-old woman with bilateral parkinsonism caused by unilateral infarction limited to the territory of the lenticulostriate arteries. Although dopamine transporter imaging with single-photon emission computed tomography (DaTSPECT) demonstrated reduced putaminal tracer binding concordant with the size and location of the vascular lesion, the specific binding ratio was within the normal range. Five months after onset, the patient was free from parkinsonism without the use of any antiparkinsonian agents. When patients show bilateral parkinsonism, it is important to consider infarction of the lenticulostriate arteries. Additionally, DaTSPECT might be useful for predicting the prognosis of parkinsonism caused by infarction.
RESUMO
BACKGROUND: Cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) is a valuable technique for detecting myocardial disorders and fibrosis. However, we sometimes observe a linear, mid-wall high intensity signal in the basal septum in the short axis view, which often presents diagnostic difficulties in the clinical setting. The purpose of this study was to compare the linear, mid-wall high intensity in the basal septum identified by LGE with the anterior septal perforator arteries identified by coronary computed tomography angiography (CorCTA). METHODS: We retrospectively selected 148 patients who underwent both CorCTA and CMR LGE within 1 year. In the interpretation of LGE, we defined a positive linear high intensity (LHI+) as follows: â LHI in the basal septum and â¡ observable for 1.5 cm or more. All other patients were defined as a negative LHI (LHI-). In LHI+ patients, we assessed the correlation between the LHI length and the septal perforator artery length on CorCTA. We also compared the length of the septal perforator artery on CorCTA between LHI+ patients and LHI- patients. RESULTS: A population of 111 patients were used for further analysis. Among these , there were 55 LHI+ patients and 56 LHI- patients. In LHI+ patients, linear regression analysis revealed that there was a good agreement between LGE LHI and septal perforator arteries by CorCTA in terms of length measurements. The measured length of the anterior septal perforator arteries was significantly shorter in LHI- patients than in LHI+ patients (10 ± 8 mm vs. 21 ± 8 mm; P < 0.05). CONCLUSIONS: The LHI observed in the basal septum on short axis LGE may reflect contrast enhancement of the anterior septal perforator arteries. It is important to interpret this septal LHI against knowledge of anatomic structure, to avoid misinterpretations of LGE and prevent misdiagnosis.