Display colour scale effects on diagnostic performance and reader agreement in cardiac CT and prostate apparent diffusion coefficient assessment.

AIM: To investigate the effect of colour scale choice on diagnostic performance in the interpretation of medical images. MATERIALS AND METHODS: Twelve clinicians interpreted 210 myocardial computed tomography (CT) perfusion (CTP) examinations, and nine clinicians interpreted 165 magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) prostate images. In three separate sessions, each participant read the same image set using greyscale, hot-iron, and rainbow scales, respectively. Participants scored their level of confidence for tumour presence in the ADC study, and for ischaemia in the CTP study, from 0 to 100. The area under the receiver operating characteristic (ROC) curve (AUC) was used as the performance metric. For cases that scored >50, CTP readers' agreement on the ischaemic transmural extent was analysed, and ADC map readers' selected values and coordinates for the lowest ADC within the detected tumour were compared across different colour scales. RESULTS: For CTP detection, the AUC was up to 0.10 higher with greyscale, 0.67±0.02 (standard error), compared to rainbow, 0.56±0.02, and detection with hot-iron was in between (0.61±0.03). For ischaemic transmural lesion categorisation, observed inter-reader agreement was highest with greyscale for category 25-50%. There is a small tendency for rainbow and greyscale to outperform hot-iron in the detection of prostate tumours. The selected lowest ADC value and pixel localisation was similar with all colour scales. CONCLUSIONS: The present findings suggest that colour visualisation has a measurable effect on CTP and ADC performance. Further investigation is necessary to determine the magnitude of the effect in diagnostic tasks.

Fluoxetine interacts with the lipid bilayer of the inner membrane in isolated rat brain mitochondria, inhibiting electron transport and F1F0-ATPase activity.

The effects of fluoxetine on the oxidative phosphorylation of mitochondria isolated from rat brain and on the kinetic properties of submitochondrial particle F1F0-ATPase were evaluated. The state 3 respiration rate supported by pyruvate + malate, succinate, or ascorbate + tetramethyl-p-phenylenediamine (TMPD) was substantially decreased by fluoxetine. The IC50 for pyruvate + malate oxidation was approximately 0.15 mM and the pattern of inhibition was the typical one of the electron-transport inhibitors, in that the drug inhibited both ADP- and carbonyl cyanide m-chlorophenylhydrazone (CCCP)-stimulated respirations and the former inhibition was not released by the uncoupler. Fluoxetine also decreased the activity of submitochondrial particle F1F0-ATPase (IC50 approximately 0.08 mM) even though K0.5 and activity of Triton X-100 solubilized enzyme were not changed substantially. As a consequence of these effects, fluoxetine decreased the rate of ATP synthesis and depressed the phosphorylation potential of mitochondria. Incubation of mitochondria or submitochondrial particles with fluoxetine under the conditions of respiration or F1F0-ATPase assays, respectively, caused a dose-dependent enhancement of 1-anilino-8-naphthalene sulfonate (ANS) fluorescence. These results show that fluoxetine indirectly and nonspecifically affects electron transport and F1F0)-ATPase activity inhibiting oxidative phosphorylation in isolated rat brain mitochondria. They suggest, in addition, that these effects are mediated by the drug interference with the physical state of lipid bilayer of inner mitochondrial membrane.