Early left ventricular microvascular dysfunction in diabetic pigs: a longitudinal quantitative myocardial perfusion CMR study.

BACKGROUND: Microvascular pathology is one of the main characteristics of diabetic cardiomyopathy; however, the early longitudinal course of diabetic microvascular dysfunction remains uncertain. This study aimed to investigate the early dynamic changes in left ventricular (LV) microvascular function in diabetic pig model using the cardiac magnetic resonance (CMR)-derived quantitative perfusion technique. METHODS: Twelve pigs with streptozotocin-induced diabetes mellitus (DM) were included in this study, and longitudinal CMR scanning was performed before and 2, 6, 10, and 16 months after diabetic modeling. CMR-derived semiquantitative parameters (upslope, maximal signal intensity, perfusion index, and myocardial perfusion reserve index [MPRI]) and fully quantitative perfusion parameters (myocardial blood flow [MBF] and myocardial perfusion reserve [MPR]) were analyzed to evaluate longitudinal changes in LV myocardial microvascular function. Pearson correlation was used to analyze the relationship between LV structure and function and myocardial perfusion function. RESULTS: With the progression of DM duration, the upslope at rest showed a gradually increasing trend (P = 0.029); however, the upslope at stress and MBF did not change significantly (P > 0.05). Regarding perfusion reserve function, both MPRI and MPR showed a decreasing trend with the progression of disease duration (MPRI, P = 0.001; MPR, P = 0.042), with high consistency (r = 0.551, P < 0.001). Furthermore, LV MPR is moderately associated with LV longitudinal strain (r = - 0.353, P = 0.022), LV remodeling index (r = - 0.312, P = 0.033), fasting blood glucose (r = - 0.313, P = 0.043), and HbA1c (r = - 0.309, P = 0.046). Microscopically, pathological results showed that collagen volume fraction increased gradually, whereas no significant decrease in microvascular density was observed with the progression of DM duration. CONCLUSIONS: Myocardial microvascular reserve function decreased gradually in the early stage of DM, which is related to both structural (but not reduced microvascular density) and functional abnormalities of microvessels, and is associated with increased blood glucose, reduced LV deformation, and myocardial remodeling.

Abdominal Diffusion-Weighted MRI With Simultaneous Multi-Slice Acquisition: Agreement and Reproducibility of Apparent Diffusion Coefficients Measurements.

BACKGROUND: Simultaneous multi-slice diffusion-weighted imaging (SMS-DWI) can shorten acquisition time in abdominal imaging. PURPOSE: To investigate the agreement and reproducibility of apparent diffusion coefficient (ADC) from abdominal SMS-DWI acquired with different vendors and different breathing schemes. STUDY TYPE: Prospective. SUBJECTS: Twenty volunteers and 10 patients. FIELD STRENGTH/SEQUENCE: 3.0 T, SMS-DWI with a diffusion-weighted echo-planar imaging sequence. ASSESSMENT: SMS-DWI was acquired using breath-hold and free-breathing techniques in scanners from two vendors, yielding four scans in each participant. Average ADC values were measured in the liver, pancreas, spleen, and both kidneys. Non-normalized ADC and ADCs normalized to the spleen were compared between vendors and breathing schemes. STATISTICAL TESTS: Paired t-test or Wilcoxon signed rank test; intraclass correlation coefficient (ICC); Bland-Altman method; coefficient of variation (CV) analysis; significance level: P < 0.05. RESULTS: Non-normalized ADCs from the four SMS-DWI scans did not differ significantly in the spleen (P = 0.262, 0.330, 0.166, 0.122), right kidney (P = 0.167, 0.538, 0.957, 0.086), and left kidney (P = 0.182, 0.281, 0.504, 0.405), but there were significant differences in the liver and pancreas. For normalized ADCs, there were no significant differences in the liver (P = 0.315, 0.915, 0.198, 0.799), spleen (P = 0.815, 0.689, 0.347, 0.423), pancreas (P = 0.165, 0.336, 0.304, 0.584), right kidney (P = 0.165, 0.336, 0.304, 0.584), and left kidney (P = 0.496, 0.304, 0.443, 0.371). Inter-reader agreements of non-normalized ADCs were good to excellent (ICCs ranged from 0.861 to 0.983), and agreement and reproducibility were good to excellent depending on anatomic location (CVs ranged from 3.55% to 13.98%). Overall CVs for abdominal ADCs from the four scans were 6.25%, 7.62%, 7.08, and 7.60%. DATA CONCLUSION: The normalized ADCs from abdominal SMS-DWI may be comparable between different vendors and breathing schemes, showing good agreement and reproducibility. ADC changes above approximately 8% may potentially be considered as a reliable quantitative biomarker to assess disease or treatment-related changes. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

LINC01002 functions as a ceRNA to regulate FRMD8 by sponging miR-4324 for the development of COVID-19.

BACKGROUND: Syndrome coronavirus-2 (SARS-CoV-2) has developed various strategies to evade the antiviral impact of type I IFN. Non-structural proteins and auxiliary proteins have been extensively researched on their role in immune escape. Nevertheless, the detailed mechanisms of structural protein-induced immune evasion have not been well elucidated. METHODS: Human alveolar basal epithelial carcinoma cell line (A549) was stimulated with polyinosinic-polycytidylic acid (PIC) and independently transfected with four structural proteins expression plasmids, including nucleocapsid (N), spike (S), membrane (M) and envelope (E) proteins. By RT-qPCR and ELISA, the structural protein with the most pronounced inhibitory effects on IFN-ß induction was screened. RNA-sequencing (RNA-Seq) and two differential analysis strategies were used to obtain differentially expressed genes associated with N protein inhibition of IFN-ß induction. Based on DIANA-LncBase and StarBase databases, the interactive competitive endogenous RNA (ceRNA) network for N protein-associated genes was constructed. By combining single-cell sequencing data (GSE158055), lncRNA-miRNA-mRNA axis was further determined. Finally, RT-qPCR was utilized to illustrate the regulatory functions among components of the ceRNA axis. RESULTS: SARS-CoV-2 N protein inhibited IFN-ß induction in human alveolar epithelial cells most significantly compared with other structural proteins. RNA-Seq data analysis revealed genes related to N protein inhibiting IFNs induction. The obtained 858 differentially expressed genes formed the reliable ceRNA network. The function of LINC01002-miR-4324-FRMD8 axis in the IFN-dominated immune evasion was further demonstrated through integrating single-cell sequencing data. Moreover, we validated that N protein could reverse the effect of PIC on LINC01002, FRMD8 and miR-4324 expression, and subsequently on IFN-ß expression level. And LINC01002 could regulate the production of FRMD8 by inhibiting miR-4324. CONCLUSION: SARS-CoV-2 N protein suppressed the induction of IFN-ß by regulating LINC01002 which was as a ceRNA, sponging miR-4324 and participating in the regulation of FRMD8 mRNA. Our discovery provides new insights into early intervention therapy and drug development on SARS-CoV-2 infection.

Safety of non-ionic contrast media in CT examinations for out-patients: retrospective multicenter analysis of 473,482 patients.

OBJECTIVES: This study aimed to explore the incidence of and potential risk factors for adverse drug reactions (ADRs) after non-ionic iodinated contrast media (NICM) administration for CT exams in out-patient settings in China. MATERIALS AND METHODS: A total of 473,482 out-patients who underwent intravenous NICM between January 1st, 2017, and Dec 31st, 2021, were retrospectively enrolled from three institutions. The occurrence of ADRs and clinical information were recorded. Chi-square test, Poisson regression, and logistic regression analyses were used to evaluate potential ADR risk factors and correlation with demographics, season, and NICM type. RESULTS: Among the 473,482 patients (mean age 55.22 ± 14.85; 253,499 male) who received intravenous NICM, the overall ADR incidence was 0.110% (522 of 473,482), with 0.099% acute-related drug reactions (469 of 473,482) and 0.0004% serious ADRs (two of 473,482). Iopromide was associated with a higher risk of acute ADRs. Late ADRs were more frequently observed with iodixanol 320. Multi-level logistic regression of patients with acute ADRs and a control group (matched 1:1 for age, gender, NICM, prescriber department, and institution) showed that summer (adjusted OR = 1.579; p = 0.035) and autumn (adjusted OR = 1.925; p < 0.001) were risk factors of acute ADRs. However, underlying disease and scanned body area were not related to a higher ADR incidence. CONCLUSION: The use of NICM for out-patients is in general safe with a low ADR incidence. The type of contrast medium (iopromide) and the seasons (summer and autumn) were associated with a higher risk of acute ADRs. Late ADRs were more often observed with iodixanol. CLINICAL RELEVANCE STATEMENT: In comparison to in-patients, out-patients may be exposed to higher risk due to a lack of extensive risk screening, less nursing care, and higher throughput pressure. Safety data about NICM from a large population may complement guidelines and avoid ambiguity. KEY POINTS: • The incidence and risk factors for adverse events after using non-ionic iodinated contrast media are complex in out-patients. • Non-ionic iodinated contrast media are safe for out-patients and the overall incidence of adverse drug reactions was 0.110%. • There is a higher risk of acute adverse drug reactions in summer and autumn.

Accelerated 3D MR neurography of the brachial plexus using deep learning-constrained compressed sensing.

OBJECTIVES: To explore the use of deep learning-constrained compressed sensing (DLCS) in improving image quality and acquisition time for 3D MRI of the brachial plexus. METHODS: Fifty-four participants who underwent contrast-enhanced imaging and forty-one participants who underwent unenhanced imaging were included. Sensitivity encoding with an acceleration of 2 × 2 (SENSE4x), CS with an acceleration of 4 (CS4x), and DLCS with acceleration of 4 (DLCS4x) and 8 (DLCS8x) were used for MRI of the brachial plexus. Apparent signal-to-noise ratios (aSNRs), apparent contrast-to-noise ratios (aCNRs), and qualitative scores on a 4-point scale were evaluated and compared by ANOVA and the Friedman test. Interobserver agreement was evaluated by calculating the intraclass correlation coefficients. RESULTS: DLCS4x achieved higher aSNR and aCNR than SENSE4x, CS4x, and DLCS8x (all p < 0.05). For the root segment of the brachial plexus, no statistically significant differences in the qualitative scores were found among the four sequences. For the trunk segment, DLCS4x had higher scores than SENSE4x (p = 0.04) in the contrast-enhanced group and had higher scores than SENSE4x and DLCS8x in the unenhanced group (all p < 0.05). For the divisions, cords, and branches, DLCS4x had higher scores than SENSE4x, CS4x, and DLCS8x (all p ≤ 0.01). No overt difference was found among SENSE4x, CS4x, and DLCS8x in any segment of the brachial plexus (all p > 0.05). CONCLUSIONS: In three-dimensional MRI for the brachial plexus, DLCS4x can improve image quality compared with SENSE4x and CS4x, and DLCS8x can maintain the image quality compared to SENSE4x and CS4x. CLINICAL RELEVANCE STATEMENT: Deep learning-constrained compressed sensing can improve the image quality or accelerate acquisition of 3D MRI of the brachial plexus, which should be benefit in evaluating the brachial plexus and its branches in clinical practice. KEY POINTS: •Deep learning-constrained compressed sensing showed higher aSNR, aCNR, and qualitative scores for the brachial plexus than SENSE and CS at the same acceleration factor with similar scanning time. •Deep learning-constrained compressed sensing at acceleration factor of 8 had comparable aSNR, aCNR, and qualitative scores to SENSE4x and CS4x with approximately half the examination time. •Deep learning-constrained compressed sensing may be helpful in clinical practice for improving image quality and acquisition time in three-dimensional MRI of the brachial plexus.

Systematic Evaluation of Ultrasonic In-Line Inspection Techniques for Oil and Gas Pipeline Defects Based on Bibliometric Analysis.

The global reliance on oil and gas pipelines for energy transportation is increasing. As the pioneering review in the field of ultrasonic defect detection for oil and gas pipelines based on bibliometric methods, this study employs visual analysis to identify the most influential countries, academic institutions, and journals in this domain. Through cluster analysis, it determines the primary trends, research hotspots, and future directions in this critical field. Starting from the current global industrial ultrasonic in-line inspection (ILI) detection level, this paper provides a flowchart for selecting detection methods and a table for defect comparison, detailing the comparative performance limits of different detection devices. It offers a comprehensive perspective on the latest ultrasonic pipeline detection technology from laboratory experiments to industrial practice.

[A Survey of the Current Status and the Needs of Medical Imaging Technicians in China]. / ä¸­å›½åŒ»å­¦å½±åƒæŠ€æœ¯ä»Žä¸šäººå‘˜çŽ°çŠ¶å’Œéœ€æ±‚è°ƒæŸ¥ç ”ç©¶.

Objective: To investigate the status quo and the needs of medical imaging technicians (MITs) in the radiology department of secondary and tertiary hospitals in China, so as to provide references and support for the development of the medical imaging technology industry and the relevant policymaking by health administrative departments. Methods: The questionnaire was developed by the Chinese Society of Imaging Technology. The radiology department of each hospital involved in the survey recommended one MIT to fill out the online questionnaire. The contents included: (a) the basic information of the hospital; (b) a general overview of the MITs in the hospital; (c) daily work; (d) career development and promotion; (e) research status and needs, etc. Differences in the number of MIT staff were compared using the Mann-Whitney U test and the chi-square test was used to compare the differences in the selected numbers of MITs in need between regions or between different levels of hospitals. Results: In this investigation, valid questionnaires were finally obtained from a total of 5403 hospitals in 31 provinces in China. The total number of MITs of the hospitals covered in the sample was 67481. The number of MITs in each hospital was 9 (5, 16). The male-to-female ratio was 1.41:1. MITs who were 20 to 40 years old accounted for 78%. The proportions of MITs who had completed doctorate, master's, undergraduate, junior college, and technical secondary school or lower level education were 0.6%, 3.3%, 60.7%, 30.8%, and 4.55%, respectively. The proportions of chief MITs, deputy chief MITs, supervisor MITs, primary MITs, assistant technician and those below were 1.0%, 4.21%, 22.1%, 51.8%, and 20.9%, respectively. The overall professional satisfaction of MITs was good. "Lack of opportunities for learning and communication" was quoted as the main problem MITs encountered in regard to improving their job-related competency. 59.2% of the respondents had not published any academic papers in the past five years, and only 7.0% of the respondents had published in journals included in the Science Citation Index (SCI) in the past five years. Conclusion: MITs in China are on average relatively young and the number of MITs has greatly increased. At this stage, more attention should be given to the cultivation of talents and continuing education of MITs and the construction of the discipline should be further strengthened, so as to provide strong support for the development of the medical imaging technology industry in China.

SUV39H1 is a novel biomarker targeting oxidative phosphorylation in hepatitis B virus-associated hepatocellular carcinoma.

BACKGROUND: As a histone methyltransferase, suppressor of variegation 3-9 homolog 1 (SUV39H1) plays an important role in the occurrence and development of cancer. To explore the mechanism and biological function of SUV39H1 in hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) can gain an insight into the pathogenesis of HBV-HCC. METHODS: The effect of HBV infection on SUV39H1 in hepatoma cells was detected. CCK-8, colony growth assay and wound healing assay were used to assess the proliferation and migration of HBV-positive hepatoma cells. RNA sequencing (RNA-seq) was applied to find differential genes and enriched pathways. The serum SUV39H1 level in HBV-HCC patients was detected and its correlation with clinical indicators was analyzed. RESULTS: SUV39H1 was increased by HBV infection and promoted the proliferation and migration of hepatoma cells. SUV39H1 could upregulate the expression of mitochondrial oxidative phosphorylation (OXPHOS) pathway-related genes. OXPHOS pathway inhibitors could reduce the capacity of proliferation and migration of hepatoma cells after overexpressing SUV39H1. Serum SUV39H1 levels were higher in chronic hepatitis B (CHB) patients than in healthy controls and higher in HBV-HCC patients than in CHB patients. In the diagnosis of HCC, the predictive value of SUV39H1 combined with alpha-fetoprotein (AFP) was better than that of AFP alone. CONCLUSION: SUV39H1 is regulated by HBV infection and promotes the proliferation and migration of hepatoma cells by targeting OXPHOS pathway. It indicates that SUV39H1 may be a new biomarker of the diagnosis of HCC.

Rapid 3D breath-hold MR cholangiopancreatography using deep learning-constrained compressed sensing reconstruction.

OBJECTIVES: To compare the image quality of three-dimensional breath-hold magnetic resonance cholangiopancreatography with deep learning-based compressed sensing reconstruction (3D DL-CS-MRCP) to those of 3D breath-hold MRCP with compressed sensing (3D CS-MRCP), 3D breath-hold MRCP with gradient and spin-echo (3D GRASE-MRCP) and conventional 2D single-shot breath-hold MRCP (2D MRCP). METHODS: In total, 102 consecutive patients who underwent MRCP at 3.0 T, including 2D MRCP, 3D GRASE-MRCP, 3D CS-MRCP, and 3D DL-CS-MRCP, were prospectively included. Two radiologists independently analyzed the overall image quality, background suppression, artifacts, and visualization of pancreaticobiliary ducts using a five-point scale. The signal-to-noise ratio (SNR) of the common bile duct (CBD), contrast-to-noise ratio (CNR) of the CBD and liver, and contrast ratio between the periductal tissue and CBD were measured. The Friedman test was performed to compare the four protocols. RESULTS: 3D DL-CS-MRCP resulted in improved SNR and CNR values compared with those in the other three protocols, and better contrast ratio compared with that in 3D CS-MRCP and 3D GRASE-MRCP (all, p < 0.05). Qualitative image analysis showed that 3D DL-CS-MRCP had better performance for second-level intrahepatic ducts and distal main pancreatic ducts compared with 3D CS-MRCP (all, p < 0.05). Compared with 2D MRCP, 3D DL-CS-MRCP demonstrated better performance for the second-order left intrahepatic duct but was inferior in assessing the main pancreatic duct (all, p < 0.05). Moreover, the image quality was significantly higher in 3D DL-CS-MRCP than in 3D GRASE-MRCP. CONCLUSION: 3D DL-CS-MRCP has superior performance compared with that of 3D CS-MRCP or 3D GRASE-MRCP. Deep learning reconstruction also provides a comparable image quality but with inferior main pancreatic duct compared with that revealed by 2D MRCP. KEY POINTS: • 3D breath-hold MRCP with deep learning reconstruction (3D DL-CS-MRCP) demonstrated improved image quality compared with that of 3D MRCP with compressed sensing or GRASE. • Compared with 2D MRCP, 3D DL-CS-MRCP had superior performance in SNR and CNR, better visualization of the left second-level intrahepatic bile ducts, and comparable overall image quality, but an inferior main pancreatic duct.

MRI-based multiregional radiomics for preoperative prediction of tumor deposit and prognosis in resectable rectal cancer: a bicenter study.

OBJECTIVE: To build T2WI-based multiregional radiomics for predicting tumor deposit (TD) and prognosis in patients with resectable rectal cancer. MATERIALS AND METHODS: A total of 208 patients with pathologically confirmed rectal cancer from two hospitals were prospectively enrolled. Intra- and peritumoral features were extracted separately from T2WI images and the least absolute shrinkage and selection operator was used to screen the most valuable radiomics features. Clinical-radiomics nomogram was developed by radiomics signatures and the most predictive clinical parameters. Prognostic model for 3-year recurrence-free survival (RFS) was constructed using univariate and multivariate Cox analysis. RESULTS: For TD, the area under the receiver operating characteristic curve (AUC) for intratumoral radiomics model was 0.956, 0.823, and 0.860 in the training cohort, test cohort, and external validation cohort, respectively. AUC for the peritumoral radiomics model was 0.929, 0.906, and 0.773 in the training cohort, test cohort, and external validation cohort, respectively. The AUC for combined intra- and peritumoral radiomics model was 0.976, 0.918, and 0.874 in the training cohort, test cohort, and external validation cohort, respectively. The AUC for clinical-radiomics nomogram was 0.989, 0.777, and 0.870 in the training cohort, test cohort, and external validation cohort, respectively. The prognostic model constructed by combining intra- and peritumoral radiomics signature score (radscore)-based TD and MRI-reported lymph nodes metastasis (LNM) indicated good performance for predicting 3-year RFS, with AUC of 0.824, 0.865, and 0.738 in the training cohort, test cohort and external validation cohort, respectively. CONCLUSION: Combined intra- and peritumoral radiomics model showed good performance for predicting TD. Combining intra- and peritumoral radscore-based TD and MRI-reported LNM indicated the recurrence risk. CLINICAL RELEVANCE STATEMENT: Combined intra- and peritumoral radiomics model could help accurately predict tumor deposits. Combining this predictive model-based tumor deposits with MRI-reported lymph node metastasis was associated with relapse risk of rectal cancer after surgery. KEY POINTS: • Combined intra- and peritumoral radiomics model provided better diagnostic performance than that of intratumoral and peritumoral radiomics model alone for predicting TD in rectal cancer. • The predictive performance of the clinical-radiomics nomogram was not improved compared with the combined intra- and peritumoral radiomics model for predicting TD. • The prognostic model constructed by combining intra- and peritumoral radscore-based TD and MRI-reported LNM showed good performance for assessing 3-year RFS.

Cardiovascular indicators associated with ventricular remodeling in chronic high-altitude disease: a cardiovascular MRI study.

OBJECTIVE: This study aimed to assess biventricular function and mechanics in patients with the chronic high-altitude disease (CHAD) using cardiovascular MRI and explore the possible risk factors associated with ventricular remodeling. METHODS: In this prospective study, consecutive CHAD patients and healthy controls at high-altitude (HA) and at sea level (SL) underwent cardiovascular MRI. Right ventricular (RV) and left ventricular (LV) function and global strain parameters were compared. To identify risk factors associated with ventricular remodeling, multiple linear regression analyses were used. RESULTS: A total of 33 patients with CHAD (42.97 years ± 11.80; 23 men), 33 HA (41.18 years ± 8.58; 21 men), and 33 SL healthy controls (43.48 years ± 13.40; 21 men) were included. A Significantly decreased biventricular ejection fraction was observed in patients (all p < 0.05). Additionally, the HA group displayed lower magnitudes of biventricular longitudinal peak strain (PS) (RV, - 13.67% ± 4.05 vs. - 16.22% ± 3.03; LV, - 14.68% ± 2.20 vs. - 16.19% ± 2.51; both p < 0.05), but a higher LV circumferential PS (- 20.74% ± 2.02 vs. - 19.17% ± 2.34, p < 0.05) than the SL group. Moreover, multiple linear regression analyses revealed that HGB (ß = 0.548) was related to the LV remodeling index, whereas BUN (ß = 0.570) was associated with the RV remodeling index. CONCLUSIONS: With the deterioration of RV function in patients with CHAD, LV function was also impaired concomitantly. Hypoxia-induced erythrocytosis may contribute to LV impairment, while BUN was considered an independent risk factor for RV remodeling. KEY POINTS: • A significantly lower biventricular ejection fraction was observed in patients, with a decreased magnitude of left ventricular (LV) peak systolic strain rate (radial and circumferential) and peak diastolic strain rate (all p < 0.05). • High-altitude healthy natives showed a lower biventricular longitudinal peak strain (all p < 0.05). • Hemoglobin was related to LV remodeling (ß = 0.548), while BUN (ß = 0.570) was independently associated with RV remodeling in CHAD patients.

Deep Learning-Based Motion Correction in Projection Domain for Coronary Computed Tomography Angiography: A Clinical Evaluation.

OBJECTIVE: This study aimed to evaluate the clinical performance of a deep learning-based motion correction algorithm (MCA) in projection domain for coronary computed tomography angiography (CCTA). METHODS: A total of 192 patients who underwent CCTA examinations were included and divided into 2 groups based on the average heart rate (HR): group 1, 82 patients with HR of <75 beats per minute; group 2, 110 patients with HR of ≥75 beats per minute. The CCTA images were reconstructed with and without MCA. The subjective image quality was graded in terms of vessel visualization, sharpness, diagnostic confidence, and overall image quality using a 5-point scale, where cases with all scores of ≥3 were deemed interpretable. Objective image quality was measured through signal-to-noise ratio and contrast-to-noise ratio in regions relative to the vessels. The image quality scores for 2 reconstructions and effective dose between 2 groups were compared. RESULTS: The mean effective dose was similar between 2 groups. Neither group showed significant difference on objective image quality for 2 reconstructions. Images reconstructed with and without MCA were both found interpretable for group 1, whereas the subjective image quality was significantly improved by the MCA for all 4 metrics in group 2, with the interpretability increased from 80.91% to 99.09%. Compared with group 1, group 2 showed similar interpretability and diagnostic confidence, despite inferior overall image quality. CONCLUSIONS: In CCTA examinations, the deep learning-based MCA is capable of improving the image quality and diagnostic confidence for patients with increased HR to a similar level as for those with low HR.

Feasibility of using software-aided selection of virtual monoenergetic level for optimal image quality of acute necrotising pancreatitis based on dual-energy computed tomography: a preliminary study.

OBJECTIVE: This study aimed to assess the feasibility of software-aided selection of monoenergetic level for acute necrotising pancreatitis (ANP) depiction compared to other automatic image series generated using dual-energy computed tomography (CT). METHODS: The contrast-enhanced dual-source dual-energy CT images in the portal venous phase of 48 patients with ANP were retrospectively analysed. Contrast-to-noise ratio (CNR) of pancreatic parenchyma-to-necrosis, signal-to-noise ratio (SNR) of the pancreas, image noise, and score of subjective diagnosis were measured, calculated, and compared among the CT images of 100 kV, Sn140 kV, weighted-average 120 kV, and optimal single-energy level for CNR. RESULTS: CNR of pancreatic parenchyma-to-necrosis in the images of 100 kV, Sn140 kV, weighted-average 120 kV, and the optimal single-energy level for CNR was 5.18 ± 2.39, 3.13 ± 1.35, 5.69 ± 2.35, and 9.99 ± 5.86, respectively; SNR of the pancreas in each group was 6.31 ± 2.77, 4.27 ± 1.56, 7.21 ± 2.69, and 11.83 ± 6.30, respectively; image noise in each group was 18.78 ± 5.20, 17.79 ± 4.63, 13.28 ± 3.13, and 9.31 ± 2.96, respectively; and score of subjective diagnosis in each group was 3.56 ± 0.50, 3.00 ± 0.55, 3.48 ± 0.55, and 3.88 ± 0.33, respectively. The four measurements of the optimal single-energy level for CNR images were significantly different from those of images in the other three groups (P < 0.05). CNR of pancreatic parenchyma-to-necrosis, SNR of the pancreas, and score of subjective diagnosis in the images of the optimal single-energy level for CNR were significantly higher, while the image noise was lower than those in the other three groups (all P = 0.000). CONCLUSION: Optimal single-energy level imaging for CNR of dual-source CT could improve quality of CT images in patients with ANP, enhancing the display of necrosis in the pancreas.

Developing online medical service quality indicators in China from the perspective of online and offline integration: a modified Delphi-analytic hierarchy process study.

Online medical services (OMSs) are developing rapidly worldwide, and policies encourage the integrated development of online and offline services in China. However, there is a lack of comprehensive and systematic quality indicators for OMSs to ensure patients' safety. This study aimed to construct a set of quality indicators from the perspective of online and offline integration to provide a basis for the evaluation and management of OMS quality. Based on the literature review, we included 53 potential indicators. In two rounds of consultations, we invited 21 and 19 experts, respectively, to rate the importance and feasibility of each indicator via email. We used the modified Delphi method and analytic hierarchy process to determine the final indicators and their weights. We used experts' positive coefficient, authority coefficient, and opinion coordination degree to test the reliability and validity of experts. After two rounds of Delphi consultation, the experts' positive coefficients were 90.48% and 89.47%, respectively, and the authoritative coefficients were both >0.7. An OMS quality index system for public hospitals in China was developed with 4 primary indicators, 13 secondary indicators, and 34 tertiary indicators. Among the primary indicators, the weights of structure, process, outcome, and integration quality were 0.22, 0.26, 0.34, and 0.18, respectively. We constructed the first set of OMS quality indicators for public hospitals in China from the perspective of online and offline integration. It could be applied as a standardized and meaningful guide for OMS evaluation and quality development.

Anomaly prediction of CT equipment based on IoMT data.

BACKGROUND: Large-scale medical equipment, which is extensively implemented in medical services, is of vital importance for diagnosis but vulnerable to various anomalies and failures. Most hospitals that conduct regular maintenance have been suffering from medical equipment-related incidents for years. Currently, the Internet of Medical Things (IoMT) has emerged as a crucial tool in monitoring the real-time status of the medical equipment. In this paper, we develop an IoMT system of Computed Tomography (CT) equipment in the West China Hospital, Sichuan University and collected the system status time-series data. Novel multivariate time-series classification models and frameworks are proposed to predict the anomalies of CT equipment. The important features that are closely related to the equipment anomalies are identified with the model. METHODS: We extracted the real-time CT equipment status time-series data of 11 equipment between May 19, 2020 and May 19, 2021 from the IoMT, which includes the equipment oil temperature, anode voltage, etc. The arcs are identified as labels of anomalies due to their relationship with decreased imaging quality and CT equipment failures. To improve prediction accuracy, the statistics and transformations of the raw historical time-series data segment in the sliding time window are used to construct new features. Due to the particularity of time-series data, two frameworks are proposed for splitting the training and test sets. Then the Decision Tree, Support Vector Machine, Logistic Regression, Naive Bayesian, and K-Nearest Neighbor classification models are used to classify the system status. We also compare our model to state-of-the-art models. RESULTS: The results show that the anomaly prediction accuracy and recall of our method are 79% and 77%, respectively. The oil temperature and anode voltage are identified as the decisive features that may lead to anomalies. The proposed model outperforms the others when predicting the anomalies of the CT equipment based on our dataset. CONCLUSIONS: The proposed method could predict the state of CT equipment and be used as a reference for practical maintenance, where unexpected anomalies of medical equipment could be reduced. It also brings new insights into how to handle non-uniform and imbalanced time series data in practical cases.

Deep learning-based motion correction algorithm for coronary CT angiography: Lowering the phase requirement for morphological and functional evaluation.

PURPOSE: To investigate the performance of a deep learning-based motion correction algorithm (MCA) at various cardiac phases of coronary computed tomography angiography (CCTA), and determine the extent to which it may allow for reliable morphological and functional evaluation. MATERIALS AND METHODS: The acquired image data of 53 CCTA cases, where the patient heart rate (HR) was ≥75 bpm, were reconstructed at 0, ±2, ±4, ±6, and ±8% deviations from each optimal systolic phase, with and without the MCA, yielding a total of 954 images (53 cases × 9 phases × 2 reconstructions). The overall image quality and diagnostic confidence were graded by two radiologists using a 5-point scale, with scores ≥3 being deemed clinically interpretable. Signal-to-noise ratio, contrast-to-noise ratio, vessel sharpness, and circularity were measured. The CCTA-derived fractional flow reserve (CT-FFR) was calculated in 38 vessels on 24 patients to identify functionally significant stenosis, using the invasive fractional flow reserve (FFR) as reference. All metrics were compared between two reconstructions at various phases. RESULTS: Inferior image quality was observed as the phase deviation was enlarged. However, MCA significantly improved the image quality at nonoptimal phases and the optimal phase. Coronary artery evaluation was feasible within 4% phase deviation using MCA, with interpretable overall image quality and high diagnostic confidence. With MCA, the performance of identifying functionally significant stenosis via CT-FFR was increased for images at various phase deviations. However, obvious decrease in accuracy, as compared to the image at the optimal phase, was found on those with deviations >4%. CONCLUSION: The deep learning-based MCA allows up to 4% phase deviation in acquiring CCTA for reliable morphological and functional evaluation on patients with high HRs.

Synthesis of geopolymer using municipal solid waste incineration fly ash and steel slag: Hydration properties and immobilization of heavy metals.

In this study, a novel method for the disposal of municipal solid waste incineration fly ash (MSWIFA) was proposed. By applying geopolymer technology, steel slag (SS) and MSWIFA were used together as precursors to synthesize a cementitious material with sufficient strength that is useable in construction. The effects of the dosages of SS and alkaline activator on the properties of the geopolymer were investigated. Compressive testing was used to characterize the mechanical properties of the geopolymer. X-ray diffraction (XRD), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were used for microscopic analysis. Leaching tests were performed to assess the immobilization effect of the geopolymer on heavy metals. The results showed that the compressive strength of the geopolymer reached 23.03 MPa at 56 d with 20% SS and 11% Na2O admixture. Highly polymerized hydration products, such as C-(A)-S-H gels and N-A-S-H gels, contributed to the compact microstructure, which provided mechanical strength and limited the migration and leaching of heavy metals in the geopolymer matrix. In terms of the results, this work is significant for the development of MSWIFA management.

Quantitative evaluation of disease severity in connective tissue disease-associated interstitial lung disease by dual-energy computed tomography.

BACKGROUND: High-resolution computed tomography (HRCT) is recommended diagnosing and monitoring connective tissue disease-associated interstitial lung disease (CTD-ILD). Quantitative computed tomography has the potential to precisely assess the radiological severity of CTD-ILD, but has still been under study. OBJECTIVE: To investigate whether dual-energy computed tomography (DECT), a novel quantitative technique, can be used for quantitative severity assessment in CTD-ILD. METHODS: This cross sectional study recruited adult CTD-ILD patients who underwent DECT scans from the ICE study between October 2019 and November 2021. DECT parameters, including effective atomic number (Zeff), lung (lobe) volume, and monochromatic CT number (MCTN) of each lung lobe, were evaluated. CTD-ILD was classified into extensive CTD-ILD and limited CTD-ILD by staging algorithm using combined forced vital capacity (FVC)%predicted and total extent of ILD (TEI) on CT. Dyspnea, cough, and life quality were scored by Borg dyspnea score, Leicester cough questionnaire (LCQ), and short-form 36 health survey questionnaire (SF-36), respectively. RESULTS: There was a total of 147 patients with DECT scans enrolled. Higher Zeff value (3.104 vs 2.256, p < 0.001), higher MCTN (- 722.87 HU vs - 802.20 HU, p < 0.001), and lower lung volume (2309.51cm3 vs 3475.21cm3, p < 0.001) were found in extensive CTD-ILD compared with limited CTD-ILD. DECT parameters had significant moderate correlations with FVC%predicted (|r|= 0.542-0.667, p < 0.01), DLCO%predicted (|r|= 0.371-0.427, p < 0.01), and TEI (|r|= 0.485-0.742, p < 0.01). Receiver operating characteristic (ROC) analysis indicated MCTN averaged over the whole lung had the best performance for extensive CTD-ILD discrimination (AUC = 0.901, cut-off: - 762.30 HU, p < 0.001), with a sensitivity of 82.1% and a specificity of 85.4%. The Zeff value was the independent risk factor for dyspnea (OR = 3.644, 95% CI: 1.846-7.192, p < 0.001) and cough (OR = 3.101, 95% CI: 1.528-6.294, p = 0.002), and lung volume significantly contributed to the mental component summary (MCS) in SF-36 (standardized ß = 0.198, p < 0.05). CONCLUSIONS: DECT can be applied to evaluate the severity of CTD-ILD.

Association Between Heart Failure With Preserved Left Ventricular Ejection Fraction and Impaired Left Atrial Phasic Function in Hypertrophic Cardiomyopathy: Evaluation by Cardiac MRI Feature Tracking.

BACKGROUND: The majority of heart failure (HF) in hypertrophic cardiomyopathy (HCM) manifests as a phenotype with preserved left ventricular (LV) ejection fraction; however, the exact contribution of left atrial (LA) phasic function to HF with preserved ejection fraction (HFpEF) in HCM remains unresolved. PURPOSE: To define the association between LA function and HFpEF in HCM patients using cardiac magnetic resonance imaging (MRI) feature tracking. STUDY TYPE: Retrospective. POPULATION: One hundred and fifty-four HCM patients (HFpEF vs. non-HF: 55 [34 females] vs. 99 [43 females]). FIELD STRENGTH/SEQUENCE: 3.0 T/balanced steady-state free precession. ASSESSMENT: LA reservoir function (reservoir strain [εs ], total ejection fraction [EF]), conduit function (conduit strain [εe ], passive EF), booster-pump function (booster strain [εa ] and active EF), LA volume index, and LV global longitudinal strain (LV GLS) were evaluated in HCM patients. STATISTICAL TESTS: Chi-square test, Student's t-test, Mann-Whitney U test, multivariate linear regression, logistic regression, and net reclassification analysis were used. Two-sided P < 0.05 was considered statistically significant. RESULTS: No significant difference was found in LV GLS between the non-HF and HFpEF group (-10.67 ± 3.14% vs. -10.14 ± 4.01%, P = 0.397), whereas the HFpEF group had more severely impaired LA phasic strain (εs : 27.40 [22.60, 35.80] vs. 18.15 [11.98, 25.90]; εe : 13.80 [9.20, 18.90] vs. 7.95 [4.30, 14.35]; εa : 13.50 [9.90, 17.10] vs. 7.90 [5.40, 14.15]). LA total EF (37.91 [29.54, 47.94] vs. 47.49 [39.18, 55.01]), passive EF (14.70 [7.41, 21.49] vs. 18.07 [9.32, 24.78]), and active EF (27.19 [17.79, 36.60] vs. 36.64 [26.63, 42.71]) were all significantly decreased in HFpEF patients compared with non-HF patients. LA reservoir (ß = 0.90 [0.85, 0.96]), conduit (ß = 0.93 [0.87, 0.99]), and booster (ß = 0.86 [0.78, 0.95]) strain were independently associated with HFpEF in HCM patients. The model including reservoir strain (Net Reclassification Index [NRI]: 0.260) or booster strain (NRI: 0.325) improved the reclassification of HFpEF based on LV GLS and minimum left atrial volume index (LAVImin ). DATA CONCLUSION: LA phasic function was severely impaired in HCM patients with HFpEF, whereas LV function was not further impaired compared with non-HF patients. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 3.

Image quality and diagnostic performance evaluation in transcatheter aortic valve implantation candidates with atrial fibrillation using a whole-heart coverage CT scanner.

OBJECTIVE: To evaluate the image quality and diagnostic performance for obstructive coronary artery disease of transcatheter aortic valve implantation (TAVI) patients with atrial fibrillation (AF) during TAVI planning CT using a whole-heart coverage CT scanner. METHODS: Eighty-eight consecutive TAVI candidates with AF (50 men, 74 ± 6 years) who underwent both TAVI planning CT and invasive coronary catheter angiography (ICA) were retrospectively analyzed. With ICA results as the reference standard, the accuracy of TAVI planning CT for lesion detection on a per-vessel and per-patient level was calculated. Meanwhile, image quality, contrast volume, and effective dose (ED) were evaluated. A 5-point visual scale (1-5) was used to assess the subjective image quality. The CT value and signal-to-noise ratio were measured for the left main coronary artery (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA). RESULTS: The ED for CCTA was 3.25 ± 1.39 mSv and contrast volume was 58.14 ± 12.34 mL. A total of 1371 (1371/1408 = 97.4%) segments with diameter > 1.5 mm were analyzed. For the subjective evaluation, the mean score was 3.99 ± 0.96 for overall image quality. The mean CT values in LM, RCA, LCX, and LAD were all above 400 HU. For the detection of > 50% stenosis, TAVI planning CT provided on the per-vessel and per-patient basis 97.06% and 100% in sensitivity, 96.23% and 89.06% in specificity, 99.7% and 100% in negative predictive value, and 73.3% and 77.4% in positive predictive value, respectively. CONCLUSION: TAVI planning CT with whole-heart coverage demonstrates good CCTA image quality and a high sensitivity and NPV in excluding obstructive CAD in TAVI candidates with AF. KEY POINTS: • Transcatheter aortic valve implantation planning (TAVI) CT with whole-heart coverage enables good image quality of CCTA in TAVI candidates with atrial fibrillation. • Obstructive coronary artery disease may be excluded with high accuracy in transcatheter aortic valve implantation (TAVI) candidates with atrial fibrillation with the usage of whole-heart coverage TAVI planning CT.