Chest Radiological Findings and Clinical Characteristics of Laboratory-Confirmed COVID-19 Patients from Saudi Arabia.

BACKGROUND Coronavirus disease 2019 (COVID-19) is a viral respiratory disease that first emerged in China in December 2019 and quickly spread worldwide. As the prevalence of COVID-19 increases, radiological examination is becoming an essential diagnostic tool for identifying and managing the disease's progression. Therefore, we aimed to identify the chest imaging features and clinical characteristics of patients with laboratory-confirmed COVID-19 in Saudi Arabia. MATERIAL AND METHODS In this retrospective study, data of laboratory-confirmed COVID-19 patients were collected from 4 hospitals in Jeddah, Saudi Arabia. Their common clinical characteristics, as well as imaging features of chest X-rays and computed tomography (CT) images, were analyzed. RESULTS A total of 297 patients with laboratory-confirmed COVID-19 who underwent chest imaging were investigated in this study. Of these patients, 77.9% were male and 22.2% were female. Their mean age was 48 years old. The most common clinical symptoms were fever (187 patients; 63%) and cough (174 patients; 58.6%). The predominant descriptive chest imaging findings were ground-glass opacities and consolidation. Locations of abnormalities were bilateral, mainly distributed peripherally, in the lower lung zones, and in the middle lung zones. CONCLUSIONS This study provides an understanding of the most common clinical and radiological features of patients with laboratory-confirmed COVID-19 in Saudi Arabia. The majority of COVID-19 patients in our study cohort had either stable or worse progression of lung lesions during follow-ups; thus, they presented moderate disease cases. Elderly males were more affected by COVID-19 than females, with fever and cough being the most common clinical symptoms.

The impact of hippocampal segmentation methods on correlations with clinical data.

BACKGROUND: In vivo measurement of hippocampal volume with magnetic resonance imaging (MRI) has become an important element in neuroimaging research. However, hippocampal volumetric findings and their relationship with cardiovascular risk factors and memory performance are still controversial and inconsistent for non-demented adults. PURPOSE: To compare total and regional hippocampal volumes from manual tracing and automated Freesurfer segmentation methods and their relationship with mid-life clinical data and late-life verbal episodic memory performance in older women. MATERIAL AND METHODS: This study used structural MRI datasets from 161 women who were scanned in 2012 and underwent neuropsychological assessments. Of these participants, 135 women had completed baseline measures of cardiovascular risk factors in 1992. RESULTS: Our results showed a significant correlation between manual tracing and automated Freesurfer output segmentations of total (r = 0.71), anterior (r = 0.65), and posterior (r = 0.38) hippocampal volumes. Mid-life Framingham Cardiovascular Risk Profile score is not associated with late-life hippocampal volumes, adjusted for intracranial volume, age, education, and apolipoprotein E gene ε4 status. Anterior hippocampal volume segmented either with manual tracing or automated Freesurfer software is sensitive to changes in mid-life high-density lipoprotein (HDL) cholesterol level, while posterior hippocampal volume is linked with verbal episodic memory performance in elderly women. CONCLUSION: These findings support the use of Freesurfer automated segmentation measures for large datasets as being highly correlated with the manual tracing method. In addition, our results suggest intervention strategies that target mid-life HDL cholesterol level in women.

Diagnostic Value of Imaging Modalities for COVID-19: Scoping Review.

BACKGROUND: Coronavirus disease (COVID-19) is a serious infectious disease that causes severe respiratory illness. This pandemic represents a serious public health risk. Therefore, early and accurate diagnosis is essential to control disease progression. Radiological examination plays a crucial role in the early identification and management of infected patients. OBJECTIVE: The aim of this review was to identify the diagnostic value of different imaging modalities used for diagnosis of COVID-19. METHODS: A comprehensive literature search was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases. The keywords diagnostic imaging, radiology, respiratory infection, pneumonia, coronavirus infection and COVID-19 were used to identify radiology articles focusing on the diagnosis of COVID-19 and to determine the diagnostic value of various imaging modalities, including x-ray, computed tomography (CT), ultrasound, and nuclear medicine for identification and management of infected patients. RESULTS: We identified 50 articles in the literature search. Studies that investigated the diagnostic roles and imaging features of patients with COVID-19, using either chest CT, lung ultrasound, chest x-ray, or positron emission topography/computed tomography (PET/CT) scan, were discussed. Of these imaging modalities, chest x-ray and CT scan are the most commonly used for diagnosis and management of COVID-19 patients, with chest CT scan being more accurate and sensitive in identifying COVID-19 at early stages. Only a few studies have investigated the roles of ultrasound and PET/CT scan in diagnosing COVID-19. CONCLUSIONS: Chest CT scan remains the most sensitive imaging modality in initial diagnosis and management of suspected and confirmed patients with COVID-19. Other diagnostic imaging modalities could add value in evaluating disease progression and monitoring critically ill patients with COVID-19.

Photoacoustic imaging in prostate cancer: A new paradigm for diagnosis and management.

The global health issue of prostate cancer (PCa) requires better diagnosis and treatment. Photoacoustic imaging (PAI) may change PCa management. This review examines PAI's principles, diagnostic role, and therapeutic guidance. PAI uses optical light excitation and ultrasonic detection for high-resolution functional and molecular imaging. PAI uses endogenous and exogenous contrast agents to distinguish cancerous and benign prostate tissues with greater sensitivity and specificity than PSA testing and TRUS-guided biopsy. In addition to diagnosing, PAI can guide and monitor PCa therapy. Its real-time imaging allows precise biopsies and brachytherapy seed placement. Photoacoustic temperature imaging allows non-invasive monitoring of thermal therapies like cryotherapy, improving treatment precision and success. Transurethral illumination probes, innovative contrast agents, integration with other imaging modalities, and machine learning analysis are being developed to overcome depth and data complexity restrictions. PAI could become an essential tool for PCa diagnosis and therapeutic guidance as the field advances.

Evaluation of Pediatric Imaging Modalities Practices of Radiologists and Technologists: A Survey-Based Study.

Introduction: Radiation protection for pediatric patients is the main concern in pediatric computed tomography (CT) due to their sensitive organs, such as the brain and the thyroid glands. Accordingly, an optimization of pediatric CT practices is vital to minimize the radiation dose for this population. Aim: To assess the pediatric CT practices of radiologists and technologists in a CT unit. Materials and Methods: The study was conducted among 26 hospitals, located in various regions in Saudi Arabia. A total of 200 hard copies of the questionnaire were distributed manually and were collected for analysis. In total, 117 completed surveys were gathered from technologies, while 49 were gathered from radiologists. Results: In the case of infants with hydrocephalus, 65% of the radiologists ordered an ultrasound (US), 24% ordered a head CT scan, and 10% ordered a magnetic resonance imaging (MRI) and general X-ray for diagnosis. For pediatric patients complaining of persistent headache, 59% and 27% of the radiologists recommended CT and MRI, respectively, for diagnosis. Conclusion: Most of the radiologists utilize CT head scan to diagnose persistent headache (by 59%) and ventriculoperitoneal shunt (VPS) malfunction (by 41%) in pediatric patients compared with the other modalities. The use of CT can increase the risk of later malignancy among pediatric patients due to radiation exposure. Alternative imaging modalities such as US and MRI (non-ionized radiation) should be considered to reduce the ionizing radiation hazards and optimize the current practices of radiologists. Most of the technologists follow radiation protection protocols in this study as 63% of the technologists used lead apron for pediatric patient's protection. Radiation awareness training for the technologists could improve the knowledge about the benefits of using lead apron and reduce the radiation risks in pediatric patients.

Dental Undergraduates and Interns' Awareness, Attitudes, and Perception of Radiological Protection.

Medical ionizing radiation is widely used in hospitals, in particular dental clinics, and in medical research to facilitate the diagnosis and treatment of patients. The awareness, attitude, and perception of ionizing radiation exposure among dental undergraduate students and interns in radiological investigations and dental care clinics were investigated. A cross-sectional study was conducted; 17 questions were designed online using the software "QuestionPro," which was licensed to the University of Imam Abdulrahman Bin Faisal. Participants included senior medical dental students from Imam Abdulrahman Bin Faisal University in their third to fifth years, as well as interns from King Fahad University Hospital and private dental care clinics. A total of 855 participants viewed, 360 started the questionnaire, and 258 (72%) completed it online. Overall, knowledge was lacking; 32% of respondents incorrectly believed that magnetic resonance imaging and ultrasound used ionizing radiation, while 38% were unsure. Dental X-rays were deemed harmful by 40% (n = 104) of respondents. According to 33% (n = 85) of participants, there is no radiation scatter during an X-ray or CT scan, while 30% (n = 76) are unsure. Respondents (44%; n = 104) were unaware of the radiation dose from a chest radiograph and (45%; n = 116) overestimated the radiation dose. The effects of ionizing radiation on healthy tissue are known to more than half of the participants (54%). According to 39% of respondents, digital radiography exposes them to less radiation than traditional radiography. In terms of radiation protection and hazard, 46% said personal monitoring badges should be always worn and 58% (n = 150) said lead aprons should be used on a regular basis. 63% of the subjects had received radiation protection education, such as formal lectures, tutorials, or workshops, while 37% (n = 95) had not. 53% of the respondents were not aware of the international recommendations from the International Commission on Radiological Protection. When asked if they would follow radiation protection protocols if they opened a private dental clinical practice in the future, 50% (n = 129) said they would.

The Actual Role of Iterative Reconstruction Algorithm Methods in Several Saudi Hospitals As A Tool For Radiation Dose Minimization of Ct Scan Examinations.

Background: Iterative reconstruction algorithm (IR) techniques were developed to maintain a lower radiation dose for patients as much as possible while achieving the required image quality and medical benefits. The main purpose of the current research was to assess the level and usage extent of IR techniques in computed tomographic (CT) scan exams. Also, the obligation of practitioners in several hospitals in Saudi Arabia to implement IR in CT exams was assessed. Material and Methodology: The recent research was based on two studies: data collection and a survey study. Data on the CT scan examinations were retrospectively collected from CT scanners. The survey was conducted using a questionnaire to evaluate radiographers' and radiologists' perceptions about IR and their practices with IR techniques. The statistical analysis results were performed to measure the usage strength level of IR methods. Results and Discussions: The IR strength level of 50% was selected for nearly 80% of different CT examinations and patients of different ages and weights. About 46% of the participants had not learned about IR methods during their college studies, and 54% had not received formal training in applying IR techniques. Only 32% of the participants had adequate experience with IR. Half of the participants were not involved in the updating process of the CT protocol. Conclusion: The results indicate that the majority of radiographer and radiologist at four different hospitals in Saudi Arabia have no explicit or understandable knowledge of selecting IR strength levels during the CT examination of patients. There is a need for more training in IR applications for both radiologists and radiographers. Training sessions were suggested to support radiographers and radiologists to efficiently utilize IR techniques to optimize image quality. Further studies are required to adjust CT exam protocols effectively to utilize the IR technique.

Artery of Percheron Infarction: A Characteristic Pattern of Ischemia and Variable Clinical Presentation: A Literature Review.

The Artery of Percheron (AOP) is an uncommon anatomic variant that provides arterial supply to the paramedian region of the thalami and bilaterally to the rostral part of the midbrain; it is a solitary arterial trunk that branches from a proximal segment of the posterior cerebral artery (PCA). Although AOP infarction results in a characteristic pattern of ischemia-namely bilateral paramedian thalamic infarct with or without midbrain involvement-it may cause diagnostic difficulties due to the variety of its clinical presentations and wide differentials, as well as its small diameter and the difficulty of obtaining visualization through diagnostic imaging. Early neuroimaging of AOP infarction and correct diagnosis are mandatory for early initiation of the appropriate treatment and better patient outcomes. In this study, we discuss imaging the patterns of AOP infarction and its differentials and clinical presentation.

Effects of a physical activity intervention on brain atrophy in older adults at risk of dementia: a randomized controlled trial.

Lack of physical activity is a risk factor for dementia, however, the utility of interventional physical activity programs as a protective measure against brain atrophy and cognitive decline is uncertain. Here we present the effect of a randomized controlled trial of a 24-month physical activity intervention on global and regional brain atrophy as characterized by longitudinal voxel-based morphometry with T1-weighted MRI images. The study sample consisted of 98 participants at risk of dementia, with mild cognitive impairment or subjective memory complaints, and having at least one vascular risk factor for dementia, randomized into an exercise group and a control group. Between 0 and 24 months, there was no significant difference detected between groups in the rate of change in global, or regional brain volumes.

The effect of midlife cardiovascular risk factors on white matter hyperintensity volume and cognition two decades later in normal ageing women.

Cerebral White Matter Hyperintensity (WMH) lesions have been identified as markers of cerebrovascular diseases and they are associated with increased risk of cognitive impairment. In this study, we investigated the relationship between midlife cardiovascular risk factors and late life WMH volumes two decades later, and examined their association with cognitive performance. 135 participants from the Women's Healthy Ageing Project had completed midlife cardiovascular risk measurement in 1992 and late life brain MRI scan and cognitive assessment in 2012. In these community-dwelling normal aging women, we found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater WMH volume two decades later, and was predominantly driven by the impact of HDL cholesterol level, controlling for age, education and APOE ε4 status. Structural equation modelling demonstrated that the relationship between midlife FCRP score and late life executive function was mediated by WMH volume. These findings suggest intervention strategies that target major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late life cognitive decline.

A decade of changes in brain volume and cognition.

Brain atrophy can occur several decades prior to onset of cognitive impairments. However, few longitudinal studies have examined the relationship between brain volume changes and cognition over a long follow-up period in healthy elderly women. In the present study we investigate the relationship between whole brain and hippocampal atrophy rates and longitudinal changes in cognition, including verbal episodic memory and executive function, in older women. We also examine whether baseline brain volume predicts subsequent changes in cognitive performance over a 10-year period. A total of 60 individuals from the population-based Women's Healthy Ageing Project with a mean age at baseline of 59 years underwent 3T MRI. Of these, 40 women completed follow-up cognitive assessments, 23 of whom had follow-up MRI scans. Linear regression analysis was used to examine the relationship between brain atrophy and changes in verbal episodic memory and executive function over a 10-year period. The results show that baseline measurements of frontal and temporal grey matter volumes predict changes in verbal episodic memory performance, whereas hippocampal volume at baseline is associated with changes in executive function performance over a 10-year period of follow-ups. In addition, higher whole brain and hippocampal atrophy rates are correlated with a decline in verbal episodic memory. These findings indicate that in addition to atrophy rate, smaller regional grey matter volumes even 10 years prior is associated with increased rates of cognitive decline. This study suggests useful neuroimaging biomarkers for the prediction of cognitive decline in healthy elderly women.