Impact of a content-based image retrieval system on the interpretation of chest CTs of patients with diffuse parenchymal lung disease.

OBJECTIVES: Content-based image retrieval systems (CBIRS) are a new and potentially impactful tool for radiological reporting, but their clinical evaluation is largely missing. This study aimed at assessing the effect of CBIRS on the interpretation of chest CT scans from patients with suspected diffuse parenchymal lung disease (DPLD). MATERIALS AND METHODS: A total of 108 retrospectively included chest CT scans with 22 unique, clinically and/or histopathologically verified diagnoses were read by eight radiologists (four residents, four attending, median years reading chest CT scans 2.1± 0.7 and 12 ± 1.8, respectively). The radiologists read and provided the suspected diagnosis at a certified radiological workstation to simulate clinical routine. Half of the readings were done without CBIRS and half with the additional support of the CBIRS. The CBIRS retrieved the most likely of 19 lung-specific patterns from a large database of 6542 thin-section CT scans and provided relevant information (e.g., a list of potential differential diagnoses). RESULTS: Reading time decreased by 31.3% (p < 0.001) despite the radiologists searching for additional information more frequently when the CBIRS was available (154 [72%] vs. 95 [43%], p < 0.001). There was a trend towards higher overall diagnostic accuracy (42.2% vs 34.7%, p = 0.083) when the CBIRS was available. CONCLUSION: The use of the CBIRS had a beneficial impact on the reading time of chest CT scans in cases with DPLD. In addition, both resident and attending radiologists were more likely to consult informational resources if they had access to the CBIRS. Further studies are needed to confirm the observed trend towards increased diagnostic accuracy with the use of a CBIRS in practice. KEY POINTS: • A content-based image retrieval system for supporting the diagnostic process of reading chest CT scans can decrease reading time by 31.3% (p < 0.001). • The decrease in reading time was present despite frequent usage of the content-based image retrieval system. • Additionally, a trend towards higher diagnostic accuracy was observed when using the content-based image retrieval system (42.2% vs 34.7%, p = 0.083).

Increased RLS prevalence in children and adolescents with migraine: a case-control study.

BACKGROUND: Previous studies have reported an increased frequency of restless legs syndrome (RLS) in adult migraine patients. Until now, the frequency of RLS in pediatric patients has not been investigated. We set out to assess the frequency of RLS in children and adolescents with migraine compared to headache-free controls. METHODS: We investigated 111 consecutive patients with a sole diagnosis of migraine with or without aura presenting to the Headache Unit at the Department of Child and Adolescent Psychiatry and 73 headache-free controls for the presence of RLS using a semistructured interview. In addition, we assessed the level of daytime sleepiness by means of the Epworth sleepiness scale (ESS). A second group of headache-free controls was screened for the presence of RLS using an online questionnaire. RESULTS: The frequency of RLS in migraine patients was significantly higher than in controls (22% vs. 5% (p < 0.001) and 8% (p < 0.001)). DISCUSSION: This is the first study suggesting an association between RLS and migraine in the pediatric population. Future studies are needed to determine the extent of sleep disruption in children and adolescents with migraine and comorbid RLS.

Association analysis of STX1A gene variants in common forms of migraine.

OBJECTIVES: To examine the association of genetic variants in the syntaxin 1A gene (STX1A) with common forms of migraine, and perform a combined analysis of the data from the current study and previously published reports. METHODS: We investigated the parent-to-offspring transmission of rs6951030, rs4363087 and rs2293489 in 191 family trios, each with a proband with childhood-onset migraine, and performed a case-control analysis between the probands and 223 unrelated controls. In addition, we performed a combined data analysis with an overall sample of 567 migraine patients and 720 unrelated controls and performed a migraine-specific gene-network analysis. RESULTS: The transmission disequilibrium test revealed significant transmission distortion of rs4363087 in migraine overall (OR = 1.56, p = 0.006; p = 0.01 after correction for multiple testing) and migraine without aura (OR = 1.58, p = 0.01; corrected p = 0.04). Two-marker haplotype analysis revealed transmission distortion of A-G (rs6951030-rs4363087; OR = 1.47, p = 0.01) and A-C (rs4363087-rs2293489; OR = 0.66, p = 0.01). Combined analysis showed significant association of rs941298 with migraine overall (OR = 1.28, p = 0.004) and migraine without aura (OR = 1.3, p = 0.008). Network analysis identified 24 genes relating STX1A to other migraine candidate genes, including KCNK18 (TRESK channel) involved in the cytoplasmatic calcium signalling together with syntaxin 1A. CONCLUSION: Our results provide support for the hypothesis that STX1A represents a susceptibility gene for migraine.

No association between bipolar disorder risk polymorphisms in ANK3 and CACNA1C and common migraine.

BACKGROUND: Migraine and bipolar disorder are characterized by a high level of co-morbidity, and a common familial-genetic basis has recently been hypothesized for the 2 disorders. Genome-wide association studies have reported strong evidence of association between the polymorphisms rs10994336[T] in the ANK3 gene and rs1006737[A] in the CACNA1C gene and risk of bipolar disorder. OBJECTIVE: The aim of this study was to evaluate the hypothesis of a genetic linkage between migraine and bipolar disorder by investigating the familial transmission of the 2 bipolar disorder risk polymorphisms, in a sample of family trios with probands with childhood migraine, and unrelated controls. METHODS: Our sample comprised 192 family trios, each with a proband with childhood migraine (137 migraine without aura, 44 migraine with aura) and 228 unrelated controls. The markers rs10994336 and rs1006737 were genotyped using a TaqMan single nucleotide polymorphism Genotyping Assay. The transmission disequilibrium test analysis for the family trios and the case-control analysis were performed using the program UNPHASED. RESULTS: The allelic and genotypic transmission disequilibrium test analysis did not show any evidence of transmission distortion of the 2 markers in both migraine overall (rs10994336: OR = 1.61, P = .11; rs1006737: OR = 1.12, P = .49) and in the migraine without aura and migraine with aura subgroups. Likewise, the case-control analysis of alleles and genotypes frequencies did not show any evidence of association. CONCLUSION: In the present study, we did not find evidence for association between the bipolar disorder risk polymorphisms rs10994336 in the ANK3 gene and rs1006737 in the CACNA1C gene in migraine. However, as these are variants that have a small effect on the risk of bipolar disorder (OR < 1.5), we cannot exclude a similar small effect on migraine susceptibility with the present sample size.