Exploring the Topography of the Obturator Artery and Corona Mortis: a Detailed Analysis with Surgical Implications.

INTRODUCTION AND HYPOTHESIS: The obturator artery (ObA) is described as a branch of the anterior division of the internal iliac artery. It arises close to the origin of the umbilical artery, where it is crossed by the ureter. The main goal of the present study was to create an anatomical map of the ObA demonstrating the most frequent locations of the vessel's origin and course. METHODS: In May 2022, an evaluation of the findings from 75 consecutive patients who underwent computed tomography angiography studies of the abdomen and pelvis was performed. RESULTS: The presented results are based on a total of 138 arteries. Mostly, ObA originated from the anterior trunk of the internal iliac artery (79 out of 138; 57.2%). The median ObA diameter at its origin was found to be 3.34 mm (lower quartile [LQ] = 3.00; upper quartile [UQ] = 3.87). The median cross-sectional area of the ObA at its origin was found to be 6.31 mm2 (LQ = 5.43; UQ = 7.32). CONCLUSIONS: Our study developed a unique arterial anatomical map of the ObA, showcasing its origin and course. Moreover, we have provided more data for straightforward intraoperative identification of the corona mortis through simple anatomical landmarks, including the pubic symphysis. Interestingly, a statistically significant difference (p < 0.05) between the morphometric properties of the aberrant ObAs and the "normal" ObAs originating from the internal iliac artery was found. It is hoped that our study may aid in reducing the risk of serious hemorrhagic complications during various surgical procedures in the pelvic region.

Use of superpixels for improvement of inter-rater and intra-rater reliability during annotation of medical images.

In the context of automatic medical image segmentation based on statistical learning, raters' variability of ground truth segmentations in training datasets is a widely recognized issue. Indeed, the reference information is provided by experts but bias due to their knowledge may affect the quality of the ground truth data, thus hindering creation of robust and reliable datasets employed in segmentation, classification or detection tasks. In such a framework, automatic medical image segmentation would significantly benefit from utilizing some form of presegmentation during training data preparation process, which could lower the impact of experts' knowledge and reduce time-consuming labeling efforts. The present manuscript proposes a superpixels-driven procedure for annotating medical images. Three different superpixeling methods with two different number of superpixels were evaluated on three different medical segmentation tasks and compared with manual annotations. Within the superpixels-based annotation procedure medical experts interactively select superpixels of interest, apply manual corrections, when necessary, and then the accuracy of the annotations, the time needed to prepare them, and the number of manual corrections are assessed. In this study, it is proven that the proposed procedure reduces inter- and intra-rater variability leading to more reliable annotations datasets which, in turn, may be beneficial for the development of more robust classification or segmentation models. In addition, the proposed approach reduces time needed to prepare the annotations.

Body composition radiomic features as a predictor of survival in patients with non-small cellular lung carcinoma: A multicenter retrospective study.

OBJECTIVES: This study combined two novel approaches in oncology patient outcome predictions-body composition and radiomic features analysis. The aim of this study was to validate whether automatically extracted muscle and adipose tissue radiomic features could be used as a predictor of survival in patients with non-small cell lung cancer. METHODS: The study included 178 patients with non-small cell lung cancer receiving concurrent platinum-based chemoradiotherapy. Abdominal imaging was conducted as a part of whole-body positron emission tomography/computed tomography performed before therapy. Methods used included automated assessment of the volume of interest using densely connected convolutional network classification model - DenseNet121, automated muscle and adipose tissue segmentation using U-net architecture implemented in nnUnet framework, and radiomic features extraction. Acquired body composition radiomic features and clinical data were used for overall and 1-y survival prediction using machine learning classification algorithms. RESULTS: The volume of interest detection model achieved the following metric scores: 0.98 accuracy, 0.89 precision, 0.96 recall, and 0.92 F1 score. Automated segmentation achieved a median dice coefficient >0.99 in all segmented regions. We extracted 330 body composition radiomic features for every patient. For overall survival prediction using clinical and radiomic data, the best-performing feature selection and prediction method achieved areas under the curve-receiver operating characteristic (AUC-ROC) of 0.73 (P < 0.05); for 1-y survival prediction AUC-ROC was 0.74 (P < 0.05). CONCLUSION: Automatically extracted muscle and adipose tissue radiomic features could be used as a predictor of survival in patients with non-small cell lung cancer.

The inferior gluteal artery anatomy: a detailed analysis with implications for plastic and reconstructive surgery.

BACKGROUND: The inferior gluteal artery (IGA) is a large terminal branch of the anterior division of the internal iliac artery (ADIIA). There is a significant lack of data regarding the variable anatomy of the IGA. MATERIALS AND METHODS: A retrospective study was conducted to establish anatomical variations, their prevalence and morphometrical data on IGA and its branches. The results of 75 consecutive patients who underwent pelvic computed tomography angiography were analysed. RESULTS: The origin variation of each IGA was deeply analysed. Four origin variations have been observed. The most common type O1 occurred in 86 of the studied cases (62.3%). The median IGA length was set to be 68.50 mm (lower quartile [LQ]: 54.29; higher quartile [HQ]: 86.06). The median distance from the origin of the ADIIA to the origin of the IGA was set to be 38.22 mm (LQ: 20.22; HQ: 55.97). The median origin diameter of the IGA was established at 4.69 mm (LQ: 4.13; HQ: 5.45). CONCLUSIONS: The present study thoroughly analysed the complete anatomy of the IGA and the branches of the ADIIA. A novel classification system for the origin of the IGA was created, where the most prevalent origin was from the ADIIA (type 1; 62.3%). Furthermore, the morphometric properties (such as the diameter and length) of the branches of the ADIIA were analysed. This data may be incredibly useful for physicians performing operations in the pelvis, such as interventional intraarterial procedures or various gynaecological surgeries.

The topographical anatomy of the posterior auricular artery: a computed tomography angiography analysis with implications for reconstructive surgery.

BACKGROUND: The anatomy of the posterior auricular artery (PAA) is highly variable and relevant in various plastic and reconstructive procedures. MATERIALS AND METHODS: The results of 55 consecutive patients who underwent head and neck computed tomography angiography (CTA) were analyzed. A total of 78 hemifaces were evaluated. The analysis has been performed in 19 categories. RESULTS: Median PAA length was found to be 47.59 mm (LQ = 32.75; HQ = 56.16). The median PAA diameter (at its origin) was established at 2.55 mm (LQ = 2.29; HQ = 2.90). Moreover, the median PAA cross-sectional area (at its origin) was set to be 3.22 mm (LQ = 2.49; HQ = 4.13). Sexual dimorphism regarding all of the measured parameters was also evaluated. Statistically significant differences (p ≤ 0.05) were found in 13 of the measured categories. CONCLUSIONS: The present study demonstrated the complete anatomy of the PAA. The most frequent origin of the said artery was from the ECA, and its mean length was 45.07 mm; which did not differ between males and females significantly (p>0.05). Moreover, we have provided surgeons with tools to localize this artery pre- and intraoperatively using simple landmarks, namely the apex of the mastoid process and the center of the external acoustic meatus. The exact position of the origin of the PAA was also demonstrated by a heat map of the auricular region. Our findings have the potential to assist surgeons in developing a mental visualization of the arterial anatomy of the retroauricular region. This visualization can be instrumental in precisely identifying the location of the PAA during reconstructive surgeries, thereby minimizing complications and enhancing surgical outcomes.

The superior gluteal artery and the posterior division of the internal iliac artery: an analysis of their complete anatomy.

BACKGROUND: The superior gluteal artery (SGA) is the largest, terminating branch of the internal iliac artery (IIA). Knowledge about the anatomy of the SGA is extremely important when performing numerous reconstructive and endovascular procedures. MATERIALS AND METHODS: The results of 75 consecutive patients who underwent pelvic computed tomography angiography (CTA) were analyzed. RESULTS: A total of 145 SGA were analyzed. The origin variation of each SGA was deeply analyzed. Type O1 occurred in 79 SGA (56.4%). Furthermore, analogously, a branching pattern types were also established. Initially 19 branching variations were evaluated, of which types 1-7 constituted 76.5%. The median SGA length was set to be 54.88 mm (LQ = 49.63 ; HQ = 63.26). The median SGA origin diameter, in cases of SGA originating from PDIIA was set to be 6.27 mm (LQ = 5.56 ; HQ = 6.87). CONCLUSIONS: The origin of the said artery showed a low grade of variability, and the most prevalent origin type of the SGA was similar to the one presented by the major anatomical textbooks, namely, the PDIIA. However, the branching pattern of the SGA was highly variable. To present the anatomy of the SGA in a clear and straight-forward way, novel classification systems of the origin and branching patterns were made. Furthermore, the morphometric properties of the branches of the PDIIA were analyzed. It is hoped that the results of the present study may be useful for physicians performing numerous reconstructive and endovascular procedures.

The complete anatomy of the transverse facial artery: a computed tomography angiography analysis.

BACKGROUND: The transverse facial artery (TFA) provides blood supply to various structures of the lateral face, including the parotid gland, parotid duct, masseter muscle, and facial skin. Knowledge about its anatomy is of utmost importance in various plastic and reconstructive procedures. MATERIALS AND METHODS: The results of 55 (110 hemifaces) consecutive patients who underwent head and neck computed tomography angiography (CTA) in the Department of Radiology of the Jagiellonian University Medical College, Cracow, Poland, were evaluated in July 2022. RESULTS: TFA was found to originate from STA in 84 of the cases (95.5%), whereas from ECA only in 4 of the cases (4.5%). Median length of the TFA was found to be 43.39 mm (LQ = 38.53 ; UQ = 46.37). The median TFA diameter, at its origin, was established at 2.26 mm (LQ = 1.93 ; UQ = 2.54). Median TFA cross-sectional area, at its origin, was set to be 2.54 mm (LQ = 1.67 ; UQ = 3.10). CONCLUSIONS: The TFA has an important role in the arterial blood supply to the face, and the present study has demonstrated its stable prevalence in the lateral face region. The most frequent origin of the artery was from the STA; however, it also originated from the ECA in some cases. Moreover, the topographic relationships between the TFA and nearby arteries and anatomical landmarks were measured and analyzed.

Fully automated 3D body composition analysis and its association with overall survival in head and neck squamous cell carcinoma patients.

Objectives: We developed a method for a fully automated deep-learning segmentation of tissues to investigate if 3D body composition measurements are significant for survival of Head and Neck Squamous Cell Carcinoma (HNSCC) patients. Methods: 3D segmentation of tissues including spine, spine muscles, abdominal muscles, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and internal organs within volumetric region limited by L1 and L5 levels was accomplished using deep convolutional segmentation architecture - U-net implemented in a nnUnet framework. It was trained on separate dataset of 560 single-channel CT slices and used for 3D segmentation of pre-radiotherapy (Pre-RT) and post-radiotherapy (Post-RT) whole body PET/CT or abdominal CT scans of 215 HNSCC patients. Percentages of tissues were used for overall survival analysis using Cox proportional hazard (PH) model. Results: Our deep learning model successfully segmented all mentioned tissues with Dice's coefficient exceeding 0.95. The 3D measurements including difference between Pre-RT and post-RT abdomen and spine muscles percentage, difference between Pre-RT and post-RT VAT percentage and sum of Pre-RT abdomen and spine muscles percentage together with BMI and Cancer Site were selected and significant at the level of 5% for the overall survival. Aside from Cancer Site, the lowest hazard ratio (HR) value (HR, 0.7527; 95% CI, 0.6487-0.8735; p = 0.000183) was observed for the difference between Pre-RT and post-RT abdomen and spine muscles percentage. Conclusion: Fully automated 3D quantitative measurements of body composition are significant for overall survival in Head and Neck Squamous Cell Carcinoma patients.

Performance of Fully Automated Algorithm Detecting Bone Marrow Edema in Sacroiliac Joints.

This study evaluates the performance of a fully automated algorithm to detect active inflammation in the form of bone marrow edema (BME) in iliac and sacral bones, depending on the quality of the coronal oblique plane in patients with axial spondyloarthritis (axSpA). The results were assessed based on the technical correctness of MRI examination of the sacroiliac joints (SIJs). A total of 173 patients with suspected axSpA were included in the study. In order to verify the correctness of the MRI, a deviation angle was measured on the slice acquired in the sagittal plane in the T2-weighted sequence. This angle was located between the line drawn between the posterior edges of S1 and S2 vertebrae and the line that marks the actual plane in which the slices were acquired in T1 and STIR sequences. All examinations were divided into quartiles according to the deviation angle measured in degrees as follows: 1st group [0; 2.2], 2nd group (2.2; 5.7], 3rd group (5.7; 10] and 4th group (10; 29.2]. Segmentations of the sacral and iliac bones were acquired manually and automatically using the fully automated algorithm on the T1 sequence. The Dice coefficient for automated bone segmentations with respect to reference manual segmentations was 0.9820 (95% CI [0.9804, 0.9835]). Examinations of BME lesions were assessed using the SPARCC scale (in 68 cases SPARCC > 0). Manual and automatic segmentations of the lesions were performed on STIR sequences and compared. The sensitivity of detection of BME ranged from 0.58 (group 1) to 0.83 (group 2) versus 0.76 (total), while the specificity was equal to 0.97 in each group. The study indicates that the performance of the algorithm is satisfactory regardless of the deviation angle.

Topographic anatomy of the submental artery and its clinical implications for reconstructive surgery.

Knowledge about the anatomy of the submental artery (SA) is of immense importance when performing plastic and reconstructive procedures. A retrospective study was performed to analyze the topographic anatomy of the SA. The measurements were performed on 80 consecutive patients who underwent head and neck computed tomography angiography (CTA). The SA was present in 131 out of 137 hemifaces (95.6%). The vessel originated from the facial artery in all cases (100.0%). Moreover, the SA was found to have 0-4 branches. However, most commonly, the said artery had no branches of considerable size (51.1%). Due to the high variability of the course of the said artery, the authors of the present study created a novel classification system presenting the most prevalent courses of the SA in the submental region. The current study utilized 131 hemifaces of 80 (CTA) to create a heat map of the SA, illustrating its precise origin and course in the submental region. The findings of this study could assist surgeons in developing a mental map of the arterial anatomy of the submental region, potentially improving the efficiency of localizing the SA and reducing the risk of complications during plastic and reconstructive procedures.

The arterial anatomy of the posterior duodenum - A computed tomography angiography analysis with implications for abdominal surgery.

The main objective of the present study was to clarify the anatomical characteristics of the GDA. In order to fulfill this objective, novel classification systems of both the origin and branching pattern of the said vessel were created. Being aware of the variable anatomy of the GDA is of great importance when performing hepatopancreaticobilliary procedures. The results of 75 consecutive patients who underwent abdomen computed tomography angiography (CTA) were analyzed. A total of 74 GDA were analyzed. Of these, 42 were from women (56.8%) and 32 were from men (43.2%). The most common direction of origin of the GDA was inferior (n = 38; 51.4%). The origin variation of each GDA was deeply analyzed. Initially, eight types of origin variations were evaluated, of which types 1-3 constituted 83.8%. Furthermore, analogously, branching pattern types were also established. Initially, 11 branching variations were evaluated, of which types 1-3 constituted 87.8%. The GDA is subject to numerous variations, both in the origin and in the branching pattern of the vessel. In order to clarify the anatomical characteristics of this vessel, novel classifications of the origin and branching patterns were made, presenting the most frequent patterns. Our results may be of great use for surgeons performing hepatopancreaticobilliary surgeries, such as the Whipple procedure or vascular reconstructions after cholangiocarcinoma resections. Being aware of the anatomical variations of relevant structures associated with a surgical procedure may help reduce potential intraoperative and/or postoperative complications.

Synovial plica of the elbow - detailed measurements and how to implicate its relevance in clinical practice.

PURPOSE: The synovial plica of the elbow is a fold of synovial tissue, which is said to be a remnant of the embryonic septa of normal articular development and is located around the radiocapitellar joint. The objective of the present study was to provide morphometric properties of the synovial plica of the elbow and its relation to surrounding structures in asymptomatic patients. METHODS: A retrospective study was conducted to establish the morphometric characteristics of the synovial plica of the elbow. The results of 216 consecutive patients, who for different reasons during the five year period of time underwent magnetic resonance imaging (MRI) of an elbow, were analyzed. RESULTS: Plica was found in a total of 161 of 216 elbows (74.5%). The mean width of the plica was set to be 3.00 mm (SD: 1.39). The mean length of the plica was established at 2.91 mm (SD: 1.13). An analysis of sexual dimorphism was also included. Potential correlations were analyzed for each of the categories and age. CONCLUSIONS: The synovial plica of the elbow is a clinically relevant anatomical structure. Analyzing the morphometric parameters of the synovial plica is necessary to properly evaluate synovial plica syndrome, which can commonly be confused with other sources of lateral elbow pain such as tennis elbow, oppression of the radial and/or posterior interosseous nerve, or snapping of the triceps tendon. The authors suggest that the thickness of the plica may not be the golden diagnostic feature as there are no statistically significant differences in this parameter between symptomatic and asymptomatic patients. A precise and accurate diagnosis of synovial fold syndrome and/or differentiation from other sources of lateral elbow pain must be performed, as the surgical treatment, even if performed properly, will be unsuccessful because of a misdiagnosed source of pain.

A 3D map of the lingual artery-The perfect tool for transoral robotic surgeries on the base of tongue.

BACKGROUND: Knowledge about the anatomy of the lingual artery (LA) is of immense importance when performing procedures on the base of tongue (BOT). METHODS: A retrospective analysis was performed to establish morphometric data of the LA. The measurements were performed on 55 consecutive patients who underwent head and neck computed tomography angiographies (CTA). RESULTS: A total of 96 LAs were analyzed. Additionally, a three-dimensional heat map (showing the oropharyngeal region from the lateral, anterior, and superior point of view) of the occurrence of the LA and its branches was created. CONCLUSION: The length of the main trunk of the LA was measured to be 31.94 ± 11.44 mm. This reported distance is thought to be a surgical safe zone when performing transoral robotic surgery (TORS) on the BOT because it represents the area where the LA does not give off any major branches.

The thyrocervical trunk: an analysis of its morphology and variations.

The number of studies on the variations of the branching of the TT is scarce, and those works that treat about the different types of the said trunk are oftentimes inconsistent. Therefore, the authors of the present study would like to propose a set of five types of TT, which were created based on observations of 41 computed tomography angiographies (82 TTs). To establish the anatomical variations, their prevalence, and morphometrical data regarding the TT and its branches, a retrospective study was performed. The results of 55 consecutive patients who underwent neck and thoracic computed tomography angiography (CTA) were analyzed. The analysis was performed on a total of 82 TTs of 41 patients, aged 15 to 82 years (mean age: 46 years; SD: 18.4), of which 16 (39.0%) were females, and 25 (61.0%) were males. Initially, 11 types of variations were evaluated, of which types 1-4 constituted 89.0%. Furthermore, a new method of classification of the anatomical variations of the TTs has been established. In this study, the variety of the branching and morphology of the TT was presented, proposing its novel classification based on the five most commonly prevalent types. Types 1 and 2 were the most common, with a prevalence of 26.8% each. This work also provides physicians with crucial data about the morphology of the TT and its branches, which can surely be of use when performing endovascular or reconstructive procedures in the cervical region.

The thoracoacromial trunk: a detailed analysis.

PURPOSE: The thoracoacromial trunk (TAT) originates from the second part of the axillary artery and curls around the superomedial border of the pectoralis minor, subsequently piercing the costocoracoid membrane. Knowledge about the location, morphology, and variations of the TAT and its branches is of great surgical importance due to its frequent use in various reconstructive flaps. METHODS: A retrospective study was conducted to establish anatomical variations, their prevalence, and morphometric data on TAT and its branches. The results of 55 consecutive patients who underwent neck and thoracic computed tomography angiography were analyzed. A qualitative evaluation of each TAT was performed. RESULTS: A total of 15 morphologically different TAT variants were initially established. The median length of the TAT was set at 7.74 mm (LQ 3.50; HQ 13.65). The median maximum diameter of the TAT was established at 4.19 mm (LQ 3.86; HQ 4.90). The median TAT ostial area was set to 13.97 mm (LQ 11.70; HQ 18.86). To create a heat map of the most frequent location of the TAT, measurements of the relating structures were made. CONCLUSION: In this study, the morphology and variations of the branching pattern of the TAT were presented, proposing a new classification system based on the four most commonly prevalent types. The prevalence of each branch arising directly from the TAT was also analyzed. It is hoped that the results of the present anatomical analysis can help to minimize potential complications when performing plastic or reconstructive procedures associated with TAT.

The costocervical trunk: A detailed review.

The number of studies on the anatomy of the costocervical trunk (CCT) is scarce, and the actual prevalence of this structure is unknown. Therefore, the authors of the present study would like to propose a set of four types of CCT, which were created based on observations of computed tomography angiographies (75 CCTs). A retrospective study was conducted to establish variations and the morphometric properties of the CCT. The results of 55 consecutive patients who underwent neck and thoracic computed tomography angiography (CTA) were analyzed in March 2022. The analysis was performed on a total of 75 CCTs. Of these, 32 were from women (42.7%) and 43 were from men (57.3%). Branching variations of each CCT were thoroughly analyzed. A classification of the branching pattern of the CCTs was made and consisted of four types. In the present study, the variety of branching and morphology of CCT was analyzed, proposing its novel classification based on the four most frequently observed types. Type 1 was the most prevalent (76.1%), having a similar origin and branching pattern as described in the major anatomical books. CCT was found to be absent in 23.94% of the cases, making it a somewhat less consistent branch of the SA. Understanding the variability of the anatomy of the CCT can be a great tool for physicians performing endovascular procedures in the cervical region.

Benchmarking of Deep Architectures for Segmentation of Medical Images.

In recent years, there were many suggestions regarding modifications of the well-known U-Net architecture in order to improve its performance. The central motivation of this work is to provide a fair comparison of U-Net and its five extensions using identical conditions to disentangle the influence of model architecture, model training, and parameter settings on the performance of a trained model. For this purpose each of these six segmentation architectures is trained on the same nine data sets. The data sets are selected to cover various imaging modalities (X-rays, computed tomography, magnetic resonance imaging), single- and multi-class segmentation problems, and single- and multi-modal inputs. During the training, it is ensured that the data preprocessing, data set split into training, validation, and testing subsets, optimizer, learning rate change strategy, architecture depth, loss function, supervision and inference are exactly the same for all the architectures compared. Performance is evaluated in terms of Dice coefficient, surface Dice coefficient, average surface distance, Hausdorff distance, training, and prediction time. The main contribution of this experimental study is demonstrating that the architecture variants do not improve the quality of inference related to the basic U-Net architecture while resource demand rises.

Use of artificial intelligence in the imaging of sarcopenia: A narrative review of current status and perspectives.

Sarcopenia is a muscle disease which previously was associated only with aging, but in recent days it has been gaining more attention for its predictive value in a vast range of conditions and its potential link with overall health. Up to this point, evaluating sarcopenia with imaging methods has been time-consuming and dependent on the skills of the physician. The solution for this problem may be found in artificial intelligence, which may assist radiologists in repetitive tasks such as muscle segmentation and body-composition analysis. The major aim of this review was to find and present the current status and future perspectives of artificial intelligence in the imaging of sarcopenia. We searched the PubMed database to find articles concerning the use of artificial intelligence in diagnostic imaging and especially in body-composition analysis in the context of sarcopenia. We found that artificial-intelligence systems could potentially help with evaluating sarcopenia and better predicting outcomes in a vast range of clinical situations, which could get us closer to the true era of precision medicine.

Clinical Anatomy of the Posterior Meniscofemoral Ligament of Wrisberg: An Original MRI Study, Meta-analysis, and Systematic Review.

BACKGROUND: The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of the medial femoral condyle and passes posteriorly to the posterior cruciate ligament (PCL). The pMFL plays a role in recovery after PCL injuries and offers stability to the lateral meniscus, promoting normal knee function. PURPOSE/HYPOTHESIS: The aim of the magnetic resonance imaging (MRI) arm of this study was to evaluate the prevalence of the pMFL in Polish patients. The purpose of the systematic review and meta-analysis was to evaluate the clinical relevance of the pMFL in knee surgery. It was hypothesized that extensive variability exists in reports on the prevalence, function, and clinical significance of the pMFL. STUDY DESIGN: Cross-sectional study and systematic review; Level of evidence, 3. METHODS: A retrospective MRI investigation was conducted on 100 randomly selected lower limbs of Polish patients (56 male, 44 female) performed in 2019 to determine the prevalence of the pMFL. Additionally, an extensive literature search of major online databases was performed to evaluate all reported data on the pMFL. Assessments of article eligibility and data extraction were completed independently by 2 reviewers, and all disagreements were resolved via a consensus. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. RESULTS: In the MRI arm of this study, the pMFL was observed in 73 of the 100 limbs. In the meta-analysis, 47 studies were included, totaling 4940 lower limbs. The pooled prevalence of the pMFL was found to be 70.4% (95% CI, 63.4%-76.9%); the mean length was 27.7 mm (95% CI, 24.8-30.5 mm) and the mean widths were 4.5, 6.1, and 4.1 mm for the meniscal and femoral attachments and midportion, respectively. The mean pMFL thickness was 2.3 mm (95% CI, 1.8-2.7 mm). CONCLUSION: Despite the variability in the literature, the pMFL was found to be a prevalent and large anatomic structure in the knee joint. The shared features of this ligament with the PCL necessitate the consideration of its value in planning and performing arthroscopic procedures of the knee.

The semi-automated algorithm for the detection of bone marrow oedema lesions in patients with axial spondyloarthritis.

The aim of the study was to create the efficient tool for semi-automated detection of bone marrow oedema lesions in patients with axial spondyloarthritis (axSpA). MRI examinations of 22 sacroiliac joints of patients with confirmed axSpA-related sacroiliitis (median SPARCC score: 14 points) were included into the study. Design of our algorithm is based on Maksymowych et al. evaluation method and consists of the following steps: manual segmentation of bones (T1W sequence), automated detection of reference signal region, sacroiliac joint central lines and ROIs, a division of ROIs into quadrants, automated detection of inflammatory changes (STIR sequence). As a gold standard, two sets of manual lesion delineations were created. Two approaches to the performance assessment of lesion detection were considered: pixel-wise (detections compared pixel by pixel) and quadrant-wise (quadrant to quadrant). Statistical analysis was performed using Spearman's correlation coefficient. Correlation coefficient obtained for pixel-wise comparison of semi-automated and manual detections was 0.87 (p = 0.001), while for quadrant-wise analysis was 0.83 (p = 0.001). The correlation between two sets of manual detections was 0.91 for pixel-wise comparison (p = 0.001) and 0.88 (p = 0.001) for quadrant-wise approach. Spearman's correlation between two manual assessments was not statistically different from the correlation between semi-automated and manual evaluations, both for pixel- (p = 0.14) and quadrant-wise (p = 0.17) analysis. Average single slice processing time: 0.64 ± 0.30 s. Our method allows for objective detection of bone marrow oedema lesions in patients with axSpA. The quantification of affected pixels and quadrants has comparable reliability to manual assessment.