A cost-free approach to evaluating vertebral body bone density and height loss in lung transplant recipients using routine chest CT.

BACKGROUND: To assess changes in bone density and vertebral body height of patients undergoing lung transplant surgery using computed tomography (CT). METHODS: This institutional review board (IRB) approved retrospective observational study enrolled patients with a history of lung transplant who had at least two chest CT scans. Vertebral body bone density (superior, middle, and inferior sections) and height (anterior, middle, and posterior sections) were measured at T1-T12 at baseline and follow up CT scans. Changes in the mean bone density, mean vertebral height, vertebral compression ratio (VBCR), percentage of anterior height compression (PAHC), and percentage of middle height compression (PMHC) were calculated and analyzed. RESULTS: A total of 93 participants with mean age of 58 ± 12.3 years were enrolled. The most common underlying disease that led to lung transplants was interstitial lung diseases (57 %). The inter-scan interval was 34.06 ± 24.8 months. There were significant changes (p-value < 0.05) in bone density at all levels from T3 to T12, with the greatest decline at the T10 level from 163.06 HU to 141.84 HU (p-value < 0.05). The average VBCR decreased from 96.91 to 96.15 (p-value < 0.05). CONCLUSION: Routine chest CT scans demonstrate a gradual decrease in vertebral body bone density over time in lung transplant recipients, along with evident anatomic changes such as vertebral body bone compression. This study shows that utilizing routine chest CT for lung transplant recipients can be regarded as a cost-free tool for assessing the vertebral body bone changes in these patients and potentially aiding in the prevention of complications related to osteoporosis.

What is New in Osteoarthritis Imaging?

Osteoarthritis (OA) is the leading joint disorder globally, affecting a significant proportion of the population. Recent studies have changed our understanding of OA, viewing it as a complex pathology of the whole joint with a multifaceted etiology, encompassing genetic, biological, and biomechanical elements. This review highlights the role of imaging in diagnosing and monitoring OA. Today's role of radiography is discussed, while also elaborating on the advances in computed tomography and magnetic resonance imaging, discussing semiquantitative methods, quantitative morphologic and compositional techniques, and giving an outlook on the potential role of artificial intelligence in OA research.

Diagnostic performance and inter-reader reliability of bone reporting and data system (Bone-RADS) on computed tomography.

OBJECTIVE: To evaluate the diagnostic performance and inter-reader reliability of the Bone Reporting and Data System (Bone-RADS) for solitary bone lesions on CT. MATERIALS AND METHODS: This retrospective analysis included 179 patients (mean age, 56 ± 18 years; 94 men) who underwent bone biopsies between March 2005 and September 2021. Patients with solitary bone lesions on CT and sufficient histopathology results were included. Two radiologists categorized the bone lesions using the Bone-RADS (1, benign; 4, malignant). The diagnostic performance of the Bone-RADS was calculated using histopathology results as a standard reference. Inter-reader reliability was calculated. RESULTS: Bone lesions were categorized into two groups: 103 lucent (pathology: 34 benign, 12 intermediate, 54 malignant, and 3 osteomyelitis) and 76 sclerotic/mixed (pathology: 46 benign, 2 intermediate, 26 malignant, and 2 osteomyelitis) lesions. The Bone-RADS for lucent lesions had sensitivities of 95% and 82%, specificities of 11% and 11%, and accuracies of 57% and 50% for readers 1 and 2, respectively. The Bone-RADS for sclerotic/mixed lesions had sensitivities of 75% and 68%, specificities of 27% and 27%, and accuracies of 45% and 42% for readers 1 and 2, respectively. Inter-reader reliability was moderate to very good (κ = 0.744, overall; 0.565, lucent lesions; and 0.851, sclerotic/mixed lesions). CONCLUSION: Bone-RADS has a high sensitivity for evaluating malignancy in lucent bone lesions and good inter-reader reliability. However, it has poor specificity and accuracy for both lucent and sclerotic/mixed lesions. A possible explanation is that proposed algorithms heavily depend on clinical features such as pain and history of malignancy.

Validation of the self-reported diagnosis of diabetes mellitus, hypercholesterolemia, and hypertension in Iran; STEPS 2016.

Purpose: As a part of STEPwise approach to risk factor Surveillance (STEPS) study, our aim was to evaluate the validity of the self-reported diagnosis of diabetes (DM), hypertension (HTN), and hypercholesterolemia (Hyper-Chol) in the Iranian population. Methods: Using systematic proportional to size cluster sampling, 27,232 participants were included in our study. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to assess the validity of self-reported diagnoses. Furthermore, logistic regression was employed to examine the relationship between the validity of self-reported diagnoses and sociodemographic and lifestyle factors. All analyses were performed using STATA version 14. Results: The PPV for self-report of DM, HTN, and Hyper-Chol were estimated to be 69%, 74% and 80%, and NPV measured up to 95%, 84%, and 50%, respectively. Positive/negative self-reports were more accurate among older (younger) individuals. Age had a negative correlation with the validity of self-reported Hyper-Chol but a positive correlation with the validity of self-reported DM and hypertension HTN. Additionally, an increase in BMI was associated with an increase/decrease in PPV and a decrease/increase in NPV across all diseases. Conclusion: Self-report studies hold value in situations where direct in-person interaction is not feasible, either due to prohibitive costs or restrictions imposed by infectious diseases (COVID-19). Self-report surveys are valuable tools in studying the epidemiology of diseases; however, the type of the disease, the study purpose, either finding sick people or healthy people, the age subgroups, and socioeconomic status should be taken into consideration.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiation of soft tissue sarcoma from benign lesions: a systematic review of literature.

OBJECTIVE: To systematically review the literature assessing the role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the differentiation of soft tissue sarcomas from benign lesions. MATERIALS AND METHODS: A comprehensive literature search was performed with the following keywords: multiparametric magnetic resonance imaging, DCE-MR perfusion, soft tissue, sarcoma, and neoplasm. Original studies evaluating the role of DCE-MRI for differentiating benign soft-tissue lesions from soft-tissue sarcomas were included. RESULTS: Eighteen studies with a total of 965 imaging examinations were identified. Ten of twelve studies evaluating qualitative parameters reported improvement in discriminative power. One of the evaluated qualitative parameters was time-intensity curves (TIC), and malignant curves (TIC III, IV) were found in 74% of sarcomas versus 26.5% benign lesions. Six of seven studies that used the semiquantitative approach found it relatively beneficial. Four studies assessed quantitative parameters including Ktrans (contrast transit from the vascular compartment to the interstitial compartment), Kep (contrast return to the vascular compartment), and Ve (the volume fraction of the extracellular extravascular space) in addition to other parameters. All found Ktrans, and 3 studies found Kep to be significantly different between sarcomas and benign lesions. The values for Ve were variable. Additionally, eight studies assessed diffusion-weighted imaging (DWI), and 6 of them found it useful. CONCLUSION: Of different DCE-MRI approaches, qualitative parameters showed the best evidence in increasing the diagnostic performance of MRI. Semiquantitative and quantitative approaches seemed to improve the discriminative power of MRI, but which parameters and to what extent is still unclear and needs further investigation.

Automatic MRI-based rotator cuff muscle segmentation using U-Nets.

BACKGROUND: The rotator cuff (RC) is a crucial anatomical element within the shoulder joint, facilitating an extensive array of motions while maintaining joint stability. Comprised of the subscapularis, infraspinatus, supraspinatus, and teres minor muscles, the RC plays an integral role in shoulder functionality. RC injuries represent prevalent, incapacitating conditions that impose a substantial impact on approximately 8% of the adult population in the USA. Segmentation of these muscles provides valuable anatomical information for evaluating muscle quality and allows for better treatment planning. MATERIALS AND METHODS: We developed a model based on residual deep convolutional encoder-decoder U-net to segment RC muscles on oblique sagittal T1-weighted images MRI. Our data consisted of shoulder MRIs from a cohort of 157 individuals, consisting of individuals without RC tendon tear (N=79) and patients with partial RC tendon tear (N=78). We evaluated different modeling approaches. The performance of the models was evaluated by calculating the Dice coefficient on the hold out test set. RESULTS: The best-performing model's median Dice coefficient was measured to be 89% (Q1:85%, Q3:96%) for the supraspinatus, 86% (Q1:82%, Q3:88%) for the subscapularis, 86% (Q1:82%, Q3:90%) for the infraspinatus, and 78% (Q1:70%, Q3:81%) for the teres minor muscle, indicating a satisfactory level of accuracy in the model's predictions. CONCLUSION: Our computational models demonstrated the capability to delineate RC muscles with a level of precision akin to that of experienced radiologists. As hypothesized, the proposed algorithm exhibited superior performance when segmenting muscles with well-defined boundaries, including the supraspinatus, subscapularis, and infraspinatus muscles.

Current Status and Future of Artificial Intelligence in MM Imaging: A Systematic Review.

Artificial intelligence (AI) has attracted increasing attention as a tool for the detection and management of several medical conditions. Multiple myeloma (MM), a malignancy characterized by uncontrolled proliferation of plasma cells, is one of the most common hematologic malignancies, which relies on imaging for diagnosis and management. We aimed to review the current literature and trends in AI research of MM imaging. This study was performed according to the PRISMA guidelines. Three main concepts were used in the search algorithm, including "artificial intelligence" in "radiologic examinations" of patients with "multiple myeloma". The algorithm was used to search the PubMed, Embase, and Web of Science databases. Articles were screened based on the inclusion and exclusion criteria. In the end, we used the checklist for Artificial Intelligence in Medical Imaging (CLAIM) criteria to evaluate the manuscripts. We provided the percentage of studies that were compliant with each criterion as a measure of the quality of AI research on MM. The initial search yielded 977 results. After reviewing them, 14 final studies were selected. The studies used a wide array of imaging modalities. Radiomics analysis and segmentation tasks were the most popular studies (10/14 studies). The common purposes of radiomics studies included the differentiation of MM bone lesions from other lesions and the prediction of relapse. The goal of the segmentation studies was to develop algorithms for the automatic segmentation of important structures in MM. Dice score was the most common assessment tool in segmentation studies, which ranged from 0.80 to 0.97. These studies show that imaging is a valuable data source for medical AI models and plays an even greater role in the management of MM.

Editorial on Special Issue "Skeletal Radiology".

Musculoskeletal (MSK) disorders are among the top five contributors to disability-adjusted life years (DALYs) worldwide [...].

Imaging Features of Intraosseous Schwannoma: A Case Series and Review of the Literature.

To characterize the imaging features of patients with pathologically confirmed intraosseous schwannoma (IOS), institutional pathology and imaging databases were searched for IOS cases over a period of 17 years. A musculoskeletal radiologist evaluated all imaging studies. Additionally, a literature search was performed to identify IOS cases that had imaging findings of at least two modalities. Six patients (one female, five males, mean age of 50 ± 14 years) with IOS were identified, with all lesions localized to the lumbosacral region. Radiographic imaging was available in four patients, while all patients underwent CT and MR imaging. Radiographs depicted lytic lesions, and CT depicted heterogeneous expansile lesions with centrally hypodense areas and peripheral sclerosis. All cases involved extra-osseous extension, producing a mass effect on adjacent soft tissues and nerve roots. On MRI, the neoplasms displayed iso- to- slightly- low signal intensity on T1-weighted images and hyperintense signal intensity on T2-weighted images with heterogeneous enhancement. The literature review resulted in 102 IOS cases, which to the best of our knowledge, is the largest review on IOS, and the imaging findings of the previously published cases were the same as our cases. IOSs are rare benign neoplasms that should be considered in the differential diagnosis of well-defined expansile lytic lesions with sclerotic borders. This is particularly important in middle-aged adults with mandibular, sacral, or vertebral body mass.

The effectiveness of percutaneous ultrasound-guided needle tenotomy compared to alternative treatments for chronic tendinopathy: a systematic review.

OBJECTIVES: To compare percutaneous ultrasound-guided needle tenotomy (PUNT) to alternative treatments for chronic tendinopathy. MATERIALS AND METHODS: A systematic literature search was performed with the following combination of keywords: ultrasound-guided, percutaneous, needling, tenotomy, Tenex, tendinopathy, and fasciotomy. Original studies comparing PUNT to alternative treatments for chronic tendinopathy were included in this systematic review. RESULTS: Twelve (n = 12) studies with 481 subjects were included. Two (2/12) articles compared PUNT to surgical tenotomy and concluded that PUNT provides the same outcomes as surgical tenotomy. Six (6/12) studies compared PUNT to platelet-rich plasma (PRP) injections, and two of them found both treatment modalities effective with no significant between-group differences. Three trials claimed that PUNT followed by PRP injections showed superior clinical outcomes compared to PUNT alone. However, the difference at long-term follow-up was statistically significant only in one of them. One study found PUNT superior to PUNT + PRP injection at short-term follow-up, although there were no between-group differences at long-term follow-up. Four (4/12) studies compared PUNT to steroid injection (SI) and showed that SI causes fast (2 weeks) but temporary pain relief, PUNT results in persistent but relatively slower improvement to SI, and the combined procedure has a more rapid and steady reduction in symptoms. CONCLUSION: PUNT is an effective treatment technique for chronic tendinopathy and should be considered when non-invasive treatments have failed. Effects of PRP and SI are transient and dissipate over time and do not contribute to long-term outcome.