CT features of vasculitides based on the 2012 international chapel hill consensus conference revised classification

International Nuclear Information System (INIS)

Hur, Jee Hye; Chun, Eun Ju; Kim, Hae Young; Kim, Jeong Jae; Lee, Kyung Won; Kwang, Hyon Joo; Yoo, Jin Young

2017-01-01

Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides

CT features of vasculitides based on the 2012 international chapel hill consensus conference revised classification

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Hur, Jee Hye; Chun, Eun Ju; Kim, Hae Young; Kim, Jeong Jae; Lee, Kyung Won [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kwang, Hyon Joo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Yoo, Jin Young [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

2017-09-15

Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides.

Intraductal papillary mucinous neoplasms of the pancreas: Correlation of helical CT features with pathologic findings

International Nuclear Information System (INIS)

Liu Yu; Lin Xiaozhu; Upadhyaya, Manavendra; Song Qi; Chen Kemin

2010-01-01

Objective: To evaluate the CT features of intraductal papillary mucinous neoplasms of the pancreas (IPMNs), and to compare with pathological findings in order to identify CT features that can be helpful in differentiating benign IPMNs from malignant IPMNs. Materials and methods: The CT findings in 25 patients were reviewed for tumor location, tumor type, dilatation of the main pancreatic duct (MPD), MPD involvement, mural node or solid attenuating component, tumor size in branch duct or mixed duct type, dilatation of common bile duct (CBD) and invasion of surrounding structures. The data was subjected to Chi-Square Tests or Fisher's Exact Test using SPSS13.0 software with p value < 0.05 indicating significant statistical difference. Results: Presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, dilatation of CBD was more common in malignant IPMNs (p < 0.05). None of tumor location, tumor type, dilatation of MPD, MPD involvement, tumor size, and invasion of surrounding structures was statistically significant in differentiating benign from malignant IPMNs. Conclusions: CT features suggestive of malignant or invasive IPMNs include presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, and dilatation of CBD.

CT features of abdominal plasma cell neoplasms

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Monill, J.; Pernas, J.; Montserrat, E.; Perez, C.; Clavero, J.; Martinez-Noguera, A.; Guerrero, R.; Torrubia, S.

2005-01-01

The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11). (orig.)

Differential Diagnosis between Benign and Malignant Bowel Lesions on Ultrasonogram and CT

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Suh, Chan Hae; Kim, Mi Young

1996-01-01

To evaluate the diagnostic criteria for differentiation between benign and malignant bowel wall lesions on ultrasonogram (US) and CT. We prospectively analyzed 55 bowel lesions on US and CT, including 29 cases of benign lesion and 26 cases of malignant lesion. The thickness and length of the lesions were measured and the bowel features were classified into four categories : a) obliteration of bowel wall layers, b) marginal irregularity, c)eccentric wall thickening, and d) heterogeneous perilesional fat changes. We analyzed the sensitivity, specificity, positive and negative predictive values of each criterion. The mean thickness of malignant bovel lesions was 1.77 / 1.84 cm on US/CT, and that of benign lesions was 0.71 / 0.80 cm on US/CT. There was statistically significant difference in thickness between benign and malignant lesions (P<.05). The statistical analysis of incremental study showed that the most sensitive and specific criteria for malignant lesions were more than 1.2cm in thickness and less than 5.0cm in length. Among feature criteria, bowel wall obliteration, irregular margin and eccentric contour were statistically and significantly different between benign and malignant lesions (P<.05). The most sensitive and specific feature criterion was the bowel wall obliteration. The most sensitive and specific criteria for differentiation between benign and malignant bowel lesions were thickness and obliteration of bowel wall layers. Particularly, US was useful for the detection of bowel wall layers

Goblet cell carcinoid neoplasm of the appendix: Clinical and CT features

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Lee, K.S., E-mail: kyungmouklee@alum.mit.edu [Department of Radiology Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Tang, L.H., E-mail: tangl@mskc.org [Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Shia, J., E-mail: shiaj@mskcc.org [Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Paty, P.B., E-mail: patyp@mskcc.org [Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Weiser, M.R., E-mail: weiser1@mskcc.org [Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Guillem, J.G., E-mail: guillemj@mskcc.org [Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Temple, L.K., E-mail: temple@mskcc.org [Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Nash, G.M., E-mail: nashg@mskcc.org [Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Reidy, D., E-mail: reidyd@mskcc.org [Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Saltz, L., E-mail: saltzl@mskcc.org [Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Gollub, M.J., E-mail: gollubm@mskcc.org [Department of Radiology Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States)

2013-01-15

Purpose: To describe the clinical and CT imaging features of goblet cell carcinoid (GCC) neoplasm of the appendix. Methods and materials: A computer search of pathology and radiology records over a 19-year period at our two institutions was performed using the search string “goblet”. In the patients with appendiceal GCC neoplasms who had abdominopelvic CT, imaging findings were categorized, blinded to gross and surgical description, as: “Appendicitis”, “Prominent appendix without peri-appendiceal infiltration”, “Mass” or “Normal appendix”. The CT appearance was correlated with an accepted pathological classification of: low grade GCC, signet ring cell adenocarcinoma ex, and poorly differentiated adenocarcinoma ex GCC group. Results: Twenty-seven patients (age range, 28–80 years; mean age, 52 years; 15 female, 12 male) with pathology-proven appendiceal GCC neoplasm had CT scans that were reviewed. Patients presented with acute appendicitis (n = 12), abdominal pain not typical for appendicitis (n = 14) and incidental finding (n = 1). CT imaging showed 9 Appendicitis, 9 Prominent appendices without peri-appendiceal infiltration, 7 Masses and 2 Normal appendices. Appendicitis (8/9) usually correlated with typical low grade GCC on pathology. In contrast, the majority of Masses and Prominent Appendices without peri-appendiceal infiltration were pathologically confirmed to be signet ring cell adenocarcinoma ex GCC. Poorly differentiated adenocarcinoma ex GCC was seen in only a small minority of patients. Hyperattenuation of the appendiceal neoplasm was seen in a majority of cases. Conclusions: GCC neoplasm of the appendix should be considered in the differential diagnosis in patients with primary appendiceal malignancy. Our cases demonstrated close correlation between our predefined CT pattern and the pathological classification.

Goblet cell carcinoid neoplasm of the appendix: Clinical and CT features

International Nuclear Information System (INIS)

Lee, K.S.; Tang, L.H.; Shia, J.; Paty, P.B.; Weiser, M.R.; Guillem, J.G.; Temple, L.K.; Nash, G.M.; Reidy, D.; Saltz, L.; Gollub, M.J.

2013-01-01

Purpose: To describe the clinical and CT imaging features of goblet cell carcinoid (GCC) neoplasm of the appendix. Methods and materials: A computer search of pathology and radiology records over a 19-year period at our two institutions was performed using the search string “goblet”. In the patients with appendiceal GCC neoplasms who had abdominopelvic CT, imaging findings were categorized, blinded to gross and surgical description, as: “Appendicitis”, “Prominent appendix without peri-appendiceal infiltration”, “Mass” or “Normal appendix”. The CT appearance was correlated with an accepted pathological classification of: low grade GCC, signet ring cell adenocarcinoma ex, and poorly differentiated adenocarcinoma ex GCC group. Results: Twenty-seven patients (age range, 28–80 years; mean age, 52 years; 15 female, 12 male) with pathology-proven appendiceal GCC neoplasm had CT scans that were reviewed. Patients presented with acute appendicitis (n = 12), abdominal pain not typical for appendicitis (n = 14) and incidental finding (n = 1). CT imaging showed 9 Appendicitis, 9 Prominent appendices without peri-appendiceal infiltration, 7 Masses and 2 Normal appendices. Appendicitis (8/9) usually correlated with typical low grade GCC on pathology. In contrast, the majority of Masses and Prominent Appendices without peri-appendiceal infiltration were pathologically confirmed to be signet ring cell adenocarcinoma ex GCC. Poorly differentiated adenocarcinoma ex GCC was seen in only a small minority of patients. Hyperattenuation of the appendiceal neoplasm was seen in a majority of cases. Conclusions: GCC neoplasm of the appendix should be considered in the differential diagnosis in patients with primary appendiceal malignancy. Our cases demonstrated close correlation between our predefined CT pattern and the pathological classification

Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features

International Nuclear Information System (INIS)

Kawakami, S.; Takashima, S.; Li, F.; Yang, Z.G.; Maruyama, Y.; Hasegawa, M.; Wang, J.C.; Sone, S.; Honda, T.

2001-01-01

We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers. (orig.)

Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features

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Kawakami, S.; Takashima, S.; Li, F.; Yang, Z.G.; Maruyama, Y.; Hasegawa, M.; Wang, J.C. [Dept. of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Sone, S. [Dept. of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Azumi General Hospital, Ikeda, Nagano (Japan); Honda, T. [Dept. of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto (Japan)

2001-05-01

We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers. (orig.)

Post-ischemic bowel stricture: CT features in eight cases

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Kim, Jin Sil [Dept. of Radiology, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul (Korea, Republic of); Kim, Hyun Jin; Hong, Sung Mo; Park, Seong Ho; Lee, Jong Seok; Kim, Ah Young; Ha, Hyun Kwon [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

2017-11-15

To investigate the characteristic radiologic features of post-ischemic stricture, which can then be implemented to differentiate that specific disease from other similar bowel diseases, with an emphasis on computed tomography (CT) features. Eight patients with a diagnosis of ischemic bowel disease, who were also diagnosed with post-ischemic stricture on the basis of clinical or pathologic findings, were included. Detailed clinical data was collected from the available electronic medical records. Two radiologists retrospectively reviewed all CT images. Pathologic findings were also analyzed. The mean interval between the diagnosis of ischemic bowel disease and stricture formation was 57 days. The severity of ischemic bowel disease was variable. Most post-ischemic strictures developed in the ileum (n = 5), followed by the colon (n = 2) and then the jejunum (n = 1). All colonic strictures developed in the “watershed zone.” The pathologic features of post-ischemic stricture were deep ulceration, submucosal/subserosal fibrosis and chronic transmural inflammation. The mean length of the post-ischemic stricture was 7.4 cm. All patients in this study possessed one single stricture. On contrast-enhanced CT, most strictures possessed concentric wall thickening (87.5%), with moderate enhancement (87.5%), mucosal enhancement (50%), or higher enhancement in portal phase than arterial phase (66.7%). Post-ischemic strictures develop in the ileum, jejunum and colon after an interval of several weeks. In the colonic segment, strictures mainly occur in the “watershed zone.” Typical CT findings include a single area of concentric wall thickening of medium length (mean, 7.4 cm), with moderate and higher enhancement in portal phase and vasa recta prominence.

Differential diagnosis of mechanical bowel obstruction and paralytic ileus on CT features

International Nuclear Information System (INIS)

Jeon, Yong Sun; Kim, Mi Young; Suh, Chang Hae; Chung, Won Kyun; Kim, Kyung Rae; Kim, Kyung Kook; Shin, Yong Woon

1997-01-01

To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained:1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall;2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon;3) the number of transitional zones, length and thickness and 4) associated ascites and its location. The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p<.05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ileus, and target-like enhancement was prominent in mechanical bowel obstruction(46%)(p<.05). The mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant(p<.05). A transitional zone was seen in 23 cases(96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus(3.4cm)(p<.05) The thickness of transitional zone and the presence of ascites and its locations were not significantly

Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

International Nuclear Information System (INIS)

Yang, Hyun Kyung; Kim, Young Hoon; Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho; Lee, Hye Seung

2015-01-01

Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination

Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

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Yang, Hyun Kyung [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Kim, Young Hoon, E-mail: yhkrad@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of)

2015-09-15

Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination.

CT on diagnosis and differential diagnosis of adrenal neuroblastoma from nephroblastoma in children

International Nuclear Information System (INIS)

Han Jingtian; Shen Guoqiang; Yang Huayuan

2000-01-01

Objective: To evaluate the effect of CT on diagnosis and differential diagnosis of children's adrenal neuroblastoma from nephroblastoma. Materials and Method: To analyse the CT manifestations on 36 cases of adrenal neuroblastoma and 32 cases of nephroblastoma both confirmed by postoperative pathologic diagnosis. Results: The adrenal neuroblastoma is a kind of extrarenal tumor, so the kidney kept its original form and showed some compressive features. The incidence of tumor calcification appeared mostly in rough and speckle-piece form was high. While the nephroblastoma is a renal tumor. The surrounding renal parenchyma showed a specific 'new-moon shape' intensification. Conclusion: CT is one of the most valuable and effective means of examination to diagnose adrenal neuroblastoma and differentiate it from nephroblastoma. It can provide important information for making correct diagnosis, planning proper therapy and assessing prognosis

Machine learning-based quantitative texture analysis of CT images of small renal masses: Differentiation of angiomyolipoma without visible fat from renal cell carcinoma.

Science.gov (United States)

Feng, Zhichao; Rong, Pengfei; Cao, Peng; Zhou, Qingyu; Zhu, Wenwei; Yan, Zhimin; Liu, Qianyun; Wang, Wei

2018-04-01

To evaluate the diagnostic performance of machine-learning based quantitative texture analysis of CT images to differentiate small (≤ 4 cm) angiomyolipoma without visible fat (AMLwvf) from renal cell carcinoma (RCC). This single-institutional retrospective study included 58 patients with pathologically proven small renal mass (17 in AMLwvf and 41 in RCC groups). Texture features were extracted from the largest possible tumorous regions of interest (ROIs) by manual segmentation in preoperative three-phase CT images. Interobserver reliability and the Mann-Whitney U test were applied to select features preliminarily. Then support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were adopted to establish discriminative classifiers, and the performance of classifiers was assessed. Of the 42 extracted features, 16 candidate features showed significant intergroup differences (P Machine learning analysis of CT texture features can facilitate the accurate differentiation of small AMLwvf from RCC. • Although conventional CT is useful for diagnosis of SRMs, it has limitations. • Machine-learning based CT texture analysis facilitate differentiation of small AMLwvf from RCC. • The highest accuracy of SVM-RFE+SMOTE classifier reached 93.9 %. • Texture analysis combined with machine-learning methods might spare unnecessary surgery for AMLwvf.

Analysis of the manifestation and feature of adrenal tumor on CT in 30 cases

International Nuclear Information System (INIS)

Xi Riquan; Xie Daohai; Guo Liang; Hu Chunhong; Fu Yingdi

2001-01-01

Objective: To analyze the manifestation and the feature of adrenal tumor with CT. Methods: The findings of various adrenal tumors with CT in 30 cases were analyzed retrospectively, the key to the diagnosis and differential diagnosis was suggested. Results: Usually, fibroxanthoma is inhomogeneous in density and moderate in size and was enhanced slightly after contrast medium administration. Pheochromocytoma is always larger and inhomogeneous in density and was enhanced markedly. The CT unit of myelo-lipoma simulated those of fluid or fat. Adrenal cyst has a low CT value and it showed cystic wall calcification. Aldosteronism adenoma was low in density and small in size, while cortisol adenoma was moderate in density and medium in size. Adrenocortical adenocarcinoma was the larger one with irregular margin and irregular hypodense areas inside. Metastatic carcinoma was larger and inhomogeneous in density. Conclusion: It is possible to increase the diagnostic rate by analysing the imaging feature of adrenal tumor

Parametric features of image textures in 18F-FDG PET/CT evaluation of lung nodules

International Nuclear Information System (INIS)

Wang Changmei; Guan Yihui; Zhang Wenqiang; Zuo Chuantao; Hua Fengchun

2013-01-01

Objective: To evaluate the parametric features of image textures on 18 F-FDG PET/CT for the differentiation between malignant and benign pulmonary nodules and compare the diagnostic performance of these parameters with SUV max . Methods: 18 F-FDG PET/CT images of 170 patients (102 males, 68 females, age range: 29-81 (mean 59) years) with pulmonary nodules were retrospectively evaluated. Eighty-nine pulmonary nodules (230 slices) were malignant and 81 (193 slices) were benign. The pulmonary nodules were contoured on CT images and mapped to the co-registered PET images. Thirteen parameters of textural features were extracted and SUV max was measured. Logistic regression analysis was used to identify the significant texture parameters and create a regression model. The efficacy of the textural features and SUV max to distinguish between malignant and benign pulmonary nodules was evaluated by ROC curve analysis. The textural features of squamous cell carcinoma and adenocarcinoma were compared via the Mann-Whitney u test. The sensitivity and specificity of the textural features and SUV max for the differential diagnosis were compared with χ 2 test. Results: Logistic regression model identified 4 textural features (skewness (β=1.7058), kurtosis (β=-1.0989), angular second moment (ASM, 3=-4.4140) and strength (β=0.5626); all P<0.05) to have significant correlation with the malignancy of lung nodules. The AUC of ROC curve was 0.775 (95% CI 0.732-0.819; P<0.001) with the sensitivity of 89.6% (206/230) and specificity of 50.8% (98/193). ASM and strength had statistically significant differences between squamous cell carcinoma and adenocarcinoma [ASM: 0.0303 (95% CI 0.0392-0.0724) vs 0.0594 (95% CI 0.0721-0.0947); strength: 2.4714 (95% CI 2.4632-4.1050) vs 1.5945 (95% CI 1.9003-2.4652); u=3082.0 and 3115.0, both P<0.01]. The AUC of SUV max -based diagnosis was 0.757 (95% CI 0.711-0.802; P<0.001) with the sensitivity of 80.9% (186/230) and specificity of 50.3% (97/193) at

CT features of intussusception through an Ileostomy

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Jung, Mi Ran; Park, Mi Hyun; Jee, Keum Nahn; Namgung, Hwan [Dankook University School of Medicine, Cheonan (Korea, Republic of)

2017-08-15

Intussusception of the small bowel through an ileostomy is very rare; when it causes necrosis of the bowel, immediate surgery is required. Computed tomography (CT) features of intussusception through an ileostomy have not been reported in the literature. Herein, we report the typical CT features of intussusception through an ileostomy, followed by a brief literature review.

CT features of appendiceal mucocele

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Yu, Won Jong; Byun, Jae Young; Jung, Jung Im; Lee, Hae Gyu; Park, Young Ha; Shin, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

1995-10-15

To evaluate the usefulness of CT features of appendiceal mucocele in the diagnosis and evaluation of complications. We retrospectively reviewed CT findings and compared with operative findings in 7 cases of pathologically proven appendiceal mucocele. CT findings such as location and extent of the lesion, tissue density, thickness or calcification of the wall, presence of adjacent inflammatory infiltration, and visualization of normal vermiform appendix were analyzed. Appendiceal mucocele was found as homogeneous low density cystic mass adjacent to the cecum, which has no surrounding inflammatory infiltration except in one case of perforation and one case of intussusception. Mean CT number measured in 4 cases was 21 Hounsfield unit. Thin curvilinear calcifications were noted along the cystic wall in 2 cases. Normal vermiform appendix couldn't be demonstrated in all cases. Appendiceal mucocele is characterized by homogeneously low density and thin walled cystic tumor adjacent to cecum without surrounding inflammatory infiltration, and absence of normal vermiform appendix on CT. Therefore, CT is valuable in preventing operative complications of appendiceal mucocele.

CT features of olivopontocerebellar atrophy in children

International Nuclear Information System (INIS)

Kumar, S.D.; Gururaj, A.K.; Jeans, W.D.

1995-01-01

Between 1990 and 1992, 14 children were seen in whom a clinical diagnosis of olivopontocerebellar atrophy (OPCA) had been made. The majority of patients presented with cerebellar ataxia and hypotonia. Five children had a family history of a similar illness in first-degree relatives. All cases had undergone clinical and neurologic examinations, routine laboratory tests and cranial CT. CT features were graded to quantitative the degree of atrophy in each cerebellar hemisphere, vermis and brain stem. All patients had varying degrees of atrophic changes of cerebellum, brain stem and cerebrum. These CT features appear to be distinctive enough to enable the diagnosis of OPCA to be made. (orig.)

Visualizing Typical Features of Breast Fibroadenomas Using Phase-Contrast CT: An Ex-Vivo Study

Science.gov (United States)

Grandl, Susanne; Willner, Marian; Herzen, Julia; Sztrókay-Gaul, Anikó; Mayr, Doris; Auweter, Sigrid D.; Hipp, Alexander; Birnbacher, Lorenz; Marschner, Mathias; Chabior, Michael; Reiser, Maximilian; Pfeiffer, Franz; Bamberg, Fabian; Hellerhoff, Karin

2014-01-01

Background Fibroadenoma is the most common benign solid breast lesion type and a very common cause for histologic assessment. To justify a conservative therapy, a highly specific discrimination between fibroadenomas and other breast lesions is crucial. Phase-contrast imaging offers improved soft-tissue contrast and differentiability of fine structures combined with the potential of 3-dimensional imaging. In this study we assessed the potential of grating-based phase-contrast CT imaging for visualizing diagnostically relevant features of fibroadenomas. Materials and Methods Grating-based phase-contrast CT was performed on six ex-vivo formalin-fixed breast specimens containing a fibroadenoma and three samples containing benign changes that resemble fibroadenomas using Talbot Lau interferometry and a polychromatic X-ray source. Phase-contrast and simultaneously acquired absorption-based 3D-datasets were manually matched with corresponding histological slices. The visibility of diagnostically valuable features was assessed in comparison with histology as the gold-standard. Results In all cases, matching of grating-based phase-contrast CT images and histology was successfully completed. Grating-based phase-contrast CT showed greatly improved differentiation of fine structures and provided accurate depiction of strands of fibrous tissue within the fibroadenomas as well as of the diagnostically valuable dilated, branched ductuli of the fibroadenomas. A clear demarcation of tumor boundaries in all cases was provided by phase- but not absorption-contrast CT. Conclusions Pending successful translation of the technology to a clinical setting and considerable reduction of the required dose, the data presented here suggest that grating-based phase-contrast CT may be used as a supplementary non-invasive diagnostic tool in breast diagnostics. Phase-contrast CT may thus contribute to the reduction of false positive findings and reduce the recall and core biopsy rate in population

CT findings and differential diagnosis of cystic neck masses

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Lee, Ji Yeon; Lee, Kil Jun; Jeong, Seong Ki; Han, Seong Nim; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

1995-10-15

The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were included. Ten congenital cystic masses were located in typical locations as branchial cleft cyst (5) in mandibular angle, thyroglossal duct cyst (3) in visceral space embeded within the strap muscles, cystic hygroma (1) and cavernous hemangioma (1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

Comparison of CT and MRI features in sinusitis

International Nuclear Information System (INIS)

Chong, V.F.H.; Fan, Y.F.

1998-01-01

Objective: To correlate the features of inflammatory changes in the paranasal sinuses on magnetic resonance imaging (MRI) with computed tomography (CT). Methods and patients: One hundred and fourteen patients with histologically proven nasopharyngeal carcinoma (NPC) were staged with both CT and MRI. All CT and MRI images of patients with mucosal thickening but no tumour involvement of the sinuses were retrospectively analysed. Results: There were inflammatory changes in 36 maxillary, 21 sphenoid and 16 ethmoid sinuses. These changes include mucosal thickening, retention cysts, retained secretions, inspissated secretions and dystrophic calcification. MRI is superior to CT in separating thickened mucosa, retained secretions and retentions cysts. Conclusion: It is important to appreciate CT changes of sinusitis and the corresponding spectrum of MRI features. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

On the CT-diagnosis of optic nerve lesions. Differential diagnostic criteria

International Nuclear Information System (INIS)

Unsoeld, R.

1982-01-01

Computed tomograms of 166 optic nerve lesions were analyzed: 97 were mainly orbital and 69 mainly intracranial. The criteria were clinical course, size, density and delineation of the optic nerve shadow, orbital and cerebral soft tissue abnormalities, and bony changes in the optic canal. Characteristic CT features are described of individual disease entities such as optic gliomas, optic nerve sheath meningiomas, neoplastic and inflammatory infiltrations. The differential diagnostic importance of individual CT criteria is evaluated and discussed. Simultaneous visualization of orbital and intracranial soft tissue changes as well as bony changes in the optic canal allow the location and identification of the majority of optic nerve lesions based on the criteria mentioned above, and optic nerve tumors can be differentiated. In 9 patients with optic neuritis due to clinically proven encephalitis and in 17 patients with total optic atrophy, no changes in the size of the optic nerve could be found. CT evaluation of the intraorbital portion of the optic nerve requires special examination techniques. Oblique computer reformations through the optic canal provide excellent visualization of bony changes in the optic canal. The exclusion of intracranial causes of optic nerve lesions requires intravenous injection of contrast material. (orig.) [de

Detectability index of differential phase contrast CT compared with conventional CT: a preliminary channelized Hotelling observer study

Science.gov (United States)

Tang, Xiangyang; Yang, Yi; Tang, Shaojie

2013-03-01

Under the framework of model observer with signal and background exactly known (SKE/BKE), we investigate the detectability of differential phase contrast CT compared with that of the conventional attenuation-based CT. Using the channelized Hotelling observer and the radially symmetric difference-of-Gaussians channel template , we investigate the detectability index and its variation over the dimension of object and detector cells. The preliminary data show that the differential phase contrast CT outperforms the conventional attenuation-based CT significantly in the detectability index while both the object to be detected and the cell of detector used for data acquisition are relatively small. However, the differential phase contrast CT's dominance in the detectability index diminishes with increasing dimension of either object or detector cell, and virtually disappears while the dimension of object or detector cell approaches a threshold, respectively. It is hoped that the preliminary data reported in this paper may provide insightful understanding of the differential phase contrast CT's characteristic in the detectability index and its comparison with that of the conventional attenuation-based CT.

Quantitative CT texture and shape analysis: Can it differentiate benign and malignant mediastinal lymph nodes in patients with primary lung cancer?

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Bayanati, Hamid; Thornhill, Rebecca E.; Souza, Carolina A.; Sethi-Virmani, Vineeta; Gupta, Ashish; Dennie, Carole [University of Ottawa, The Ottawa Hospital Research Institute, Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Box 232, Ottawa, ON (Canada); Maziak, Donna [University of Ottawa, The Ottawa Hospital Research Institute, Department of Surgery - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON (Canada); Amjadi, Kayvan [University of Ottawa, The Ottawa Hospital Research Institute, Department of Respiratory Medicine, The Ottawa Hospital, Ottawa, ON (Canada)

2014-09-13

To assess the accuracy of CT texture and shape analysis in the differentiation of benign and malignant mediastinal nodes in lung cancer. Forty-three patients with biopsy-proven primary lung malignancy with pathological mediastinal nodal staging and unenhanced CT of the thorax were studied retrospectively. Grey-level co-occurrence and run-length matrix textural features, as well as morphological features, were extracted from 72 nodes. Differences between benign and malignant features were assessed using Mann-Whitney U tests. Receiver operating characteristic (ROC) curves for each were constructed and the area under the curve (AUC) calculated with histopathology diagnosis as outcome. Combinations of features were also entered as predictors in logistic regression models and optimal threshold criteria were used to estimate sensitivity and specificity. Using optimum-threshold criteria, the combined textural and shape features identified malignant mediastinal nodes with 81 % sensitivity and 80 % specificity (AUC = 0.87, P < 0.0001). Using this combination, 84 % malignant and 71 % benign nodes were correctly classified. Quantitative CT texture and shape analysis has the potential to accurately differentiate malignant and benign mediastinal nodes in lung cancer. (orig.)

Three-dimensional CT features of occipital squama normal anatomy, anatomic variations and fractures

International Nuclear Information System (INIS)

Liu Jungang; Li Xin; Wang Chunxiang; Zhang Lin; Guo Wanhua

2013-01-01

Objective: To evaluate 3D CT features of normal anatomy, anatomic variations and fractures of occipital squama. Methods: The 3D CT features on MIP, VR images were analyzed retrospectively in 589 pediatric cases. The normal anatomy, anatomic variations and fractures of occipital squama were observed respectively, and the differential diagnostic features including the individual location, appearance and extension were analyzed. Results: Four hundred and thirty-three patients (75.2%) showed normal anatomy, including 154 patients with adult occipital anatomical features, 279 patients with posterior intraoccipital synchondrosis, and 37 patients with Kerckring-supraoccipital synchondrosis. When cases with recent trauma history were excluded, 113 patients (19.1%) showed anatomic variants, including unpenetrating sutures and penetrating sutures. The former could be subdivided to Mendosal sutures in 23 cases, superior median fissures in 19 cases, and midline supraoccipital fissures in 4 cases, while the latter could be subdivided to the interparietal bone variations in 54 cases, wormian bones in 23 cases, and accessory bones in 7 cases. Two or more variations coexisted in 33 cases. The occipital squama fractures were shown in 34 cases (5.6%), including linear fractures in 27 cases, comminuted fractures in 3 cases, with depression fracture in one case, separation of cranial sutures in 3 cases, and other fractures associated with variants in 3 cases. The fractures were sharp, or jagged, without limitation of the occification. Conclusion: There are different 3D CT features of normal anatomy, anatomic variations and fractures of occipital squama in children, which are important for making the accurate diagnosis. (authors)

CT imaging and histopathological features of renal epithelioid angiomyolipomas

International Nuclear Information System (INIS)

Cui, L.; Zhang, J.-G.; Hu, X.-Y.; Fang, X.-M.; Lerner, A.; Yao, X.-J.; Zhu, Z.-M.

2012-01-01

Aim: To describe computed tomography (CT) imaging and histopathological manifestations of renal epithelioid angiomyolipomas (EAMLs) for better understanding and cognition in the diagnosis of this new category of renal tumours. Materials and methods: Clinical data and CT images from 10 cases of EAML were retrospectively analysed. All patients underwent CT with and without contrast medium administration, with multiplanar reconstruction (MPR) when needed. Results: Plain CT manifestations of EAMLs were a higher density of mass (10–25 HU) than renal parenchyma, bulging contour of the involved kidney, absence of fat, distinct edges without a lobulate appearance. Contrast-enhanced CT features were markedly heterogeneous enhancement (from rapid wash-in to slow wash-out), large tumour size without lobular appearance, complete capsule with distinct margins and frequent mild necrotic areas. Histopathological features were epithelioid cells with eosinophilic cytoplasm, large and deeply stained nuclei, and dense arrangement of tumour cells with patchy necrosis; diffuse sheets of epithelioid cells were positive for HMB-45 (melanoma-associated antigen) and negative for epithelial membrane antigen (EMA) staining. Conclusion: Multiple specific CT features correlated well with the histopathology and may play an important role in the primary diagnosis of EAMLs.

Less common CT features of medulloblastoma

International Nuclear Information System (INIS)

Zee, C.S; Segall, H.D.; Miller, C.; Ahmad, J.; McComb, J.G.; Han, J.S.; Park, S.H.

1982-01-01

While many medulloblastomas have characteristic features on computed tomography (CT), a significant number have atypical features, including a cystic or necrotic component, calcification, hemorrhage, lack of contrast enhancement, and eccentric location, and/or direct supratentorial extension. Of 30 consecutive untreated cases reviewed by the authors, 14 (47%) had such findings. Failure to make the proper diagnosis will result in some cases if these features are not recognized as possible signs of medulloblastoma

Differential diagnosis of truly suprasellar space-occupying masses: synopsis of clinical findings, CT, and MRI

International Nuclear Information System (INIS)

Reul, J.; Weis, J.; Spetzger, U.; Isensee, C.; Thron, A.

1995-01-01

This review demonstrates the features of truly suprasellar masses in modern imaging based on the clinical, CT, and MRI findings of 42 patients with suprasellar masses in correlation to the histologic findings. The radiologic examinations were evaluated retrospectively to determine if diagnosis can be made based on specific imaging patterns. The most frequent clinical findings of space-occupying suprasellar masses were visual disturbances, diabetes insipidus, and symptoms and signs of occlusive hydrocephalus. There were no clinical features specific for any of the observed masses. Craniopharyngiomas were the most frequent tumors. They appeared in two different forms, as cystic and as solid enhancing masses. The cystic tumors could not be differentiated from cystic hamartomas or cystic gliomas by CT or MRI. The solid craniopharyngiomas were similar to meningiomas and hamartomas. In craniopharyngiomas of adults calcifications were not common. In CT and especially in MRI gliomas were characterized by the diffuse infiltration of the adjacent brain tissue or optic nerve. Except for meningiomas, all lesions were highly variable in appearance, making a reliable characterization by CT and MRI difficult in many cases. However, administration of contrast media in some cases resulted in a better tumor delineation. Compared with unenhanced MRI the enhanced scans did not increase diagnostic efficacy for neoplasms, but were helpful in the differentiation from inflammatory diseases. The MRI technique was superior to CT in demonstrating the anatomic relationships, thus facilitating evaluation of origin and extent of the lesions. The CT technique, of course, was more reliable in the detection of calcifications. Both CT and MRI are not tissue-specific, however, and suprasellar tumors as well as many other neoplasms cannot be classified using only one of these imaging techniques. (orig.)

Mycoplasma pneumoniae pneumonia: CT features in 16 patients

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Lee, Inho; Kim, Tae Sung; Yoon, Hye-Kyung [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)

2006-03-15

The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F=9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age <18 years) and the adult (age {>=}18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern. (orig.)

Mycoplasma pneumoniae pneumonia: CT features in 16 patients

International Nuclear Information System (INIS)

Lee, Inho; Kim, Tae Sung; Yoon, Hye-Kyung

2006-01-01

The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F=9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age <18 years) and the adult (age ≥18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern. (orig.)

Educational effect of a lecture on differential imaging features comparing ameloblastomas and keratocystic odontogenic tumors of the mandible presented to dental students

International Nuclear Information System (INIS)

Morita, Mitsuko; Ariji, Yoshiko; Kise, Yoshitaka; Goto, Masakazu; Izumi, Masahiro; Naitoh, Munetaka; Ariji, Eiichiro; Katsumata, Akitoshi

2011-01-01

The objective of this study was to clarify the educational effect of a lecture on differential imaging features comparing ameloblastomas and keratocystic odontogenic tumors of the mandibles presented to dental students. Panoramic and CT images of 10 ameloblastomas and 10 keratocystic odontogenic tumors were randomly presented 114 dental students. Test scores, correct answer ratios, identification index, and understanding of the imaging features contributing to a correct diagnosis were serially evaluated before and after the lecture on the differential imaging features comparing the two types of tumors. The mean and standard deviation of the scoring ratios of dental students diagnosing these lesions on panoramic and CT images were 48.8±10.8% and 52.5±12.9%, respectively. After the lecture on the differential imaging features comparing the two tumors, the scoring ratios improved significantly. After the lecture, both the numbers of patients whose images were correctly diagnosed and the identification indices increased. The lecture also increased the number of imaging features recognized as contributing to the correct diagnosis. A lecture on the differential imaging features comparing ameloblastomas and keratocystic odontogenic tumors of the mandibles contributed to the improvement of imaging diagnosis skills among dental students. (author)

Differentiation of large (≥5 cm) gastrointestinal stromal tumors from benign subepithelial tumors in the stomach: Radiologists’ performance using CT

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Choi, Ye Ra [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim7071@gmail.com [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Sun-Ah [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Shin, Cheong-il [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Hyung Jin; Kim, Seong Ho [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital (Korea, Republic of); The Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

2014-02-15

Purpose: To identify significant CT findings for the differentiation of large (≥5 cm) gastric gastrointestinal stromal tumors (GIST) from benign subepithelial tumors and to assess whether radiologists’ performance in differentiation is improved with knowledge of significant CT criteria. Materials and methods: One-hundred twenty patients with pathologically proven large (≥5 cm) GISTs (n = 99), schwannomas (n = 16), and leiomyomas (n = 5) who underwent CT were enrolled. Two radiologists (A and B) retrospectively reviewed their CT images in consensus for the location, size, degree and pattern of enhancement, contour, growth pattern and the presence of calcification, necrosis, surface ulceration, or enlarged lymph nodes. CT findings considered significant for differentiation were determined using uni- and multivariate statistical analyses. Thereafter, two successive review sessions for the differentiation of GIST from non-GIST were independently performed by two other reviewers (C and D) with different expertise of 2 and 9 years using a 5-point confidence scale. At the first session, reviewers interpreted CT images without knowledge of significant CT findings. At the second session, the results of statistical analyses were provided to the reviewers. To assess improvement in radiologists’ performance, a pairwise comparison of receiver operating curves (ROC) was performed. Results: Heterogeneous enhancement, presence of necrosis, absence of lymph nodes, and mean size of ≥6 cm were found to be significant for differentiating GIST from schwannoma (P < 0.05). Non-cardial location, heterogeneous enhancement, and presence of necrosis were differential CT features of GIST from leiomyoma (P < 0.05). Multivariate analyses indicated that absence of enlarged LNs was the only statistically significant variable for GIST differentiating from schwannoma. The area under the curve of both reviewers obtained using ROC significantly increased from 0.682 and 0.613 to 0.903 and 0

Angiomyolipoma with minimal fat: Differentiation from papillary renal cell carcinoma by helical CT

International Nuclear Information System (INIS)

Zhang, Y.-Y.; Luo, S.; Liu, Y.; Xu, R.-T.

2013-01-01

Aim: To evaluate whether helical computed tomography (CT) images can be used to differentiate angiomyolipomas (AMLs) with minimal fat from papillary renal cell carcinomas (PRCCs) based on their morphological characteristics and enhancement features. Materials and methods: This retrospective study was approved by the institutional review board. Informed consent was waived. Forty-four patients (21 with AMLs with minimal fat and 23 with PRCCs) who underwent enhanced helical CT before total or partial nephrectomy were included. Two radiologists, who were blinded to the histopathology results, read the CT images and recorded the attenuation value, morphological characteristics, and enhancement features of the tumours, which were subsequently evaluated. An independent samples t-test, χ 2 test, and rank sum test were performed between the tumours. The predictive value of a CT finding was determined by multivariate logistic regression analysis. Results: AML with minimal fat had an apparent female prevalence (p < 0.01). Intra-tumoural vessels were noted in 11 cases of AML with minimal fat and three PRCC cases (p < 0.01). The unenhanced attenuation characteristic was significantly different between the two diseases (p < 0.001). The absolute attenuation values (AAVs) and the corrected attenuation values (CAVs) of the AML with minimal fat group of unenhanced and two phases of enhanced images were greater compared with that of the PRCC group (p < 0.05). After contrast medium injection, the tumour enhancement value (TEV) of the AML with minimal fat group in the corticomedullary phase was greater than that of the PRCC group (p < 0.01). Most cases of both tumour types demonstrated early enhancement characteristics; the enhancement value of the AML with minimal fat group was greater compared with that of the PRCC group (p < 0.01). The unenhanced attenuation characteristic, intra-tumoural vessels, and CAVs of unenhanced and early excretory phase scans were valuable parameters to

Automatic Classification of Normal and Cancer Lung CT Images Using Multiscale AM-FM Features

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Eman Magdy

2015-01-01

Full Text Available Computer-aided diagnostic (CAD systems provide fast and reliable diagnosis for medical images. In this paper, CAD system is proposed to analyze and automatically segment the lungs and classify each lung into normal or cancer. Using 70 different patients’ lung CT dataset, Wiener filtering on the original CT images is applied firstly as a preprocessing step. Secondly, we combine histogram analysis with thresholding and morphological operations to segment the lung regions and extract each lung separately. Amplitude-Modulation Frequency-Modulation (AM-FM method thirdly, has been used to extract features for ROIs. Then, the significant AM-FM features have been selected using Partial Least Squares Regression (PLSR for classification step. Finally, K-nearest neighbour (KNN, support vector machine (SVM, naïve Bayes, and linear classifiers have been used with the selected AM-FM features. The performance of each classifier in terms of accuracy, sensitivity, and specificity is evaluated. The results indicate that our proposed CAD system succeeded to differentiate between normal and cancer lungs and achieved 95% accuracy in case of the linear classifier.

Abdominal lymphadenopathy in tuberculosis and lymphoma: Differentiation with CT

International Nuclear Information System (INIS)

Shin, Yong Moon; Choi, Byung Ihn; Han, Joon Koo; Han, Man Chung; Song, Chi Sung; Yang, Seoung Oh

1993-01-01

Tuberculosis and lymphoma, these 2 dieases can present with lymphadenopathy in anywhere of the body. Therefore differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma. All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for percolative lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans include 1) male preponderance (78%), 2) conglomeration of lymph nodes (39%), 3) homogeneous internal lymph node structure (83%). These results suggest that evaluation of the cahracteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculousis and lymphoma

A Sensitive ANN Based Differential Relay for Transformer Protection with Security against CT Saturation and Tap Changer Operation

OpenAIRE

KHORASHADI-ZADEH, Hassan; LI, Zuyi

2014-01-01

This paper presents an artificial neural network (ANN) based scheme for fault identification in power transformer protection. The proposed scheme is featured by the application of ANN to identifying system patterns, the unique choice of harmonics of positive sequence differential currents as ANN inputs, the effective handling of current transformer (CT) saturation with an ANN based approach, and the consideration of tap changer position for correcting secondary CT current. Performanc...

Machine learning-based quantitative texture analysis of CT images of small renal masses. Differentiation of angiomyolipoma without visible fat from renal cell carcinoma

International Nuclear Information System (INIS)

Feng, Zhichao; Rong, Pengfei; Zhou, Qingyu; Zhu, Wenwei; Yan, Zhimin; Liu, Qianyun; Wang, Wei; Cao, Peng

2018-01-01

To evaluate the diagnostic performance of machine-learning based quantitative texture analysis of CT images to differentiate small (≤ 4 cm) angiomyolipoma without visible fat (AMLwvf) from renal cell carcinoma (RCC). This single-institutional retrospective study included 58 patients with pathologically proven small renal mass (17 in AMLwvf and 41 in RCC groups). Texture features were extracted from the largest possible tumorous regions of interest (ROIs) by manual segmentation in preoperative three-phase CT images. Interobserver reliability and the Mann-Whitney U test were applied to select features preliminarily. Then support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were adopted to establish discriminative classifiers, and the performance of classifiers was assessed. Of the 42 extracted features, 16 candidate features showed significant intergroup differences (P < 0.05) and had good interobserver agreement. An optimal feature subset including 11 features was further selected by the SVM-RFE method. The SVM-RFE+SMOTE classifier achieved the best performance in discriminating between small AMLwvf and RCC, with the highest accuracy, sensitivity, specificity and AUC of 93.9 %, 87.8 %, 100 % and 0.955, respectively. Machine learning analysis of CT texture features can facilitate the accurate differentiation of small AMLwvf from RCC. (orig.)

Differentiating the grades of thymic epithelial tumor malignancy using textural features of intratumoral heterogeneity via (18)F-FDG PET/CT.

Science.gov (United States)

Lee, Hyo Sang; Oh, Jungsu S; Park, Young Soo; Jang, Se Jin; Choi, Ik Soo; Ryu, Jin-Sook

2016-05-01

We aimed to explore the ability of textural heterogeneity indices determined by (18)F-FDG PET/CT for grading the malignancy of thymic epithelial tumors (TETs). We retrospectively enrolled 47 patients with pathologically proven TETs who underwent pre-treatment (18)F-FDG PET/CT. TETs were classified by pathological results into three subgroups with increasing grades of malignancy: low-risk thymoma (LRT; WHO classification A, AB and B1), high-risk thymoma (B2 and B3), and thymic carcinoma (TC). Using (18)F-FDG PET/CT, we obtained conventional imaging indices including SUVmax and 20 intratumoral heterogeneity indices: i.e., four local-scale indices derived from the neighborhood gray-tone difference matrix (NGTDM), eight regional-scale indices from the gray-level run-length matrix (GLRLM), and eight regional-scale indices from the gray-level size zone matrix (GLSZM). Area under the receiver operating characteristic curve (AUC) was used to demonstrate the abilities of the imaging indices for differentiating subgroups. Multivariable logistic regression analysis was performed to show the independent significance of the textural indices. Combined criteria using optimal cutoff values of the SUVmax and a best-performing heterogeneity index were applied to investigate whether they improved differentiation between the subgroups. Most of the GLRLM and GLSZM indices and the SUVmax showed good or fair discrimination (AUC >0.7) with best performance for some of the GLRLM indices and the SUVmax, whereas the NGTDM indices showed relatively inferior performance. The discriminative ability of some of the GLSZM indices was independent from that of SUVmax in multivariate analysis. Combined use of the SUVmax and a GLSZM index improved positive predictive values for LRT and TC. Texture analysis of (18)F-FDG PET/CT scans has the potential to differentiate between TET tumor grades; regional-scale indices from GLRLM and GLSZM perform better than local-scale indices from the NGTDM. The SUVmax

Diagnostic value of CT features of the gallbladder in the prediction of gallstone pancreatitis

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Yie, Miyeon [Department of Radiology, Hallym University College of Medicine, 896 Pyungchon-dong, Dongan-gu, Anyang-city, Kyungki-do 431-070 (Korea, Republic of); Jang, Kyung Mi, E-mail: jkm7290@empal.com [Department of Radiology, Hallym University College of Medicine, 896 Pyungchon-dong, Dongan-gu, Anyang-city, Kyungki-do 431-070 (Korea, Republic of); Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Kim, Min Jeong; Lee, Yul [Department of Radiology, Hallym University College of Medicine, 896 Pyungchon-dong, Dongan-gu, Anyang-city, Kyungki-do 431-070 (Korea, Republic of); Choi, Dongil [Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)

2011-11-15

Purpose: The aim of this retrospective study was to evaluate the diagnostic value of CT features of the gallbladder in the prediction of gallstone pancreatitis. Materials and methods: Eighty-six patients who underwent a diagnostic computed tomography (CT) scan for acute pancreatitis were included. The readers assessed the presence of pericholecystic increased attenuation of the liver parenchyma, enhancement of gallbladder (GB) and common bile duct (CBD) wall, pericholecystic fat strands, GB wall thickening, stone in the GB or CBD, and focal or diffuse manifestations of pancreatitis on abdominal CT scans. In addition, the maximal transverse luminal diameters of the GB and CBD were measured. Results: The presence of pericholecystic increased attenuation of the liver parenchyma, GB wall enhancement and thickening, pericholecystic fat strands, stone in the GB or CBD, and diffuse manifestations of pancreatitis achieved statistical significance for differentiation of gallstone induced pancreatitis from non-biliary pancreatitis (p < 0.05). The mean values of maximal transverse luminal diameter of GB and CBD were significantly higher in gallstone induced pancreatitis group (39.67 {+-} 7.26 mm, 10.20 {+-} 4.13 mm) than non-biliary pancreatitis group (27.01 {+-} 6.14 mm, 3.85 {+-} 2.51 mm, p < 0.0001). Conclusion: Gallbladder features of CT in patients with pancreatitis could be the valuable clues for the diagnosis of gallstone induced pancreatitis.

CT features of focal organizing pneumonia: An analysis of consecutive histopathologically confirmed 45 cases

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Zhao, Feng [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 (China); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR (China); Yan, Sen-Xiang [Department of Radiation Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 (China); Wang, Gao-Feng [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 (China); Wang, Jin [Department of Pathology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 (China); Lu, Pu-Xuan [Department of Radiology, Shenzhen Third People' s Hospital, Guangdong Medical College, Shenzhen, 518020 (China); Chen, Bin [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 (China); Yuan, Jing [Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR (China); Zhang, Shi-Zheng, E-mail: shizhengzhang@hotmail.com [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 (China); Wang, Yi-Xiang J., E-mail: yixiang_wang@cuhk.edu.hk [Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR (China); Department of Radiology, Shenzhen Third People' s Hospital, Guangdong Medical College, Shenzhen, 518020 (China)

2014-01-15

Objective: To study the CT characteristics of solitary focal organizing pneumonia (FOP). Materials and methods: Chest CT of consecutive 45 patients (34 males and 11 females, median age: 56 years) with confirmed FOP were analyzed. The CT features between large FOP (>3 cm, n = 27) and small FOP (≤3 cm, n = 18) were compared. Results: FOP lesions predominately located in peripheral lungs (86.7%), with the right lower lobe being most common lobe (44.4%). No lesion mainly located in the inner 1/3 of lungs. All large lesions were polygon in shape and had an irregular margin, while small lesions were more likely to be round or oval with an irregular or smooth border. Air bronchogram or small bubble-like lucency was present in majority of the lesions. 42.2% of lesions had incompact internal structure with inhomogeneous density besides air component. Most lesions were associated with a contraction or convergence of surrounding vessels; while no pulmonary vessel was interrupted abruptly by a small FOP lesion. Majority of large lesions had broad contact with the pleura, while only one patient had mild pleural effusion. Mild mediastinal lymph nodes enlargement was present in about 1/5 of the patients. Conclusion: Compared with the known CT features of lung cancer, our results suggest differential diagnosis can often be made for large FOP, while small FOP may resemble lung cancer.

Spectral CT imaging in the differential diagnosis of necrotic hepatocellular carcinoma and hepatic abscess

International Nuclear Information System (INIS)

Yu, Y.; Guo, L.; Hu, C.; Chen, K.

2014-01-01

Aim: To explore the value of CT spectral imaging in the differential diagnosis of necrotic hepatocellular carcinoma (nHCC) and hepatic abscess (HA) during the arterial phase (AP) and portal venous phase (PP). Materials and methods: Sixty patients with 36 nHCCs and 24 HAs underwent spectral CT during AP and PP. Iodine or water concentration were measured and the normalized iodine concentration (NIC) and lesion-normal parenchyma iodine concentration ratio (LNR) were calculated. The two-sample t-test was used to compare quantitative parameters. Two readers qualitatively assessed lesion types according to imaging features. Sensitivity and specificity were compared between the qualitative and quantitative studies. Results: NIC and LNR in the AP for the wall of nHCC (0.14 ± 0.04 mg/ml; 2.77 ± 0.74) were higher than those of HA (0.13 ± 0.02 mg/ml; 1.4 ± 0.9). NIC and LNR in the PP for the wall of HA (0.66 ± 0.05 mg/ml; 1.2 ± 0.2) were higher than those of nHCC (0.5 ± 0.11 mg/ml; 0.94 ± 0.12). The differences in NIC in the AP were not significant but the differences in LNR in AP, and NIC and LNR in the PP were significant. The best quantitative parameter was LNR in AP, and a threshold of 1.52 would yield a sensitivity and specificity of 100% and 91.7%, respectively, for differentiating nHCC from HA. Conclusion: CT spectral imaging with quantitative iodine concentration analysis may help to increase the accuracy of differentiating nHCC from HA. - Highlights: • We preliminarily investigate the usefulness of CT spectral imaging in differentiating nHCC from HA. • CT spectral imaging may help differentiate necrotic hepatocellular carcinoma from hepatic abscess. • CT spectral imaging can evaluate the blood supply and necrotic degree of lesions. • Quantitative analysis of iodine concentration provides greater diagnostic confidence

SU-F-R-21: The Stability of Radiomics Features On 4D FDG-PET/CT Images

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Ma, C [Shandong Cancer Hospital and Institute, Jinan, Shandong (China)

2016-06-15

Purpose: The aim of our study was to perform a stability analysis of 4D PET-derived features in non-small cell lung carcinoma (NSCLC) based on six different respiratory phases. Methods: The 4D FDG-PET/CT respiratory phases were labeled as T0%, T17%, T33%,T50%, T67%, T83% phases, with the T0% phase approximately corresponding to the normal end-inspiration. Lesions were manually delineated based on fused PET-CT, using a standardized clinical delineation protocol. Six texture parameters were analyzed. Results: Results showed that the majority of assessed features had a low stability such as Homogeneity (0.385–0.416), Dissimilarity (3.707–3.861), Angular two moments (0.013–0.019), Contrast (39.782–49.562), Entropy(4.683–5.002) and Inverse differential moment (0.317–0.362) on different respiratory phases. Conclusion: This study suggest that further research of quantitative PET imaging features is warranted with respect to respiratory motion.

Localized thin-section CT with radiomics feature extraction and machine learning to classify early-detected pulmonary nodules from lung cancer screening

Science.gov (United States)

Tu, Shu-Ju; Wang, Chih-Wei; Pan, Kuang-Tse; Wu, Yi-Cheng; Wu, Chen-Te

2018-03-01

Lung cancer screening aims to detect small pulmonary nodules and decrease the mortality rate of those affected. However, studies from large-scale clinical trials of lung cancer screening have shown that the false-positive rate is high and positive predictive value is low. To address these problems, a technical approach is greatly needed for accurate malignancy differentiation among these early-detected nodules. We studied the clinical feasibility of an additional protocol of localized thin-section CT for further assessment on recalled patients from lung cancer screening tests. Our approach of localized thin-section CT was integrated with radiomics features extraction and machine learning classification which was supervised by pathological diagnosis. Localized thin-section CT images of 122 nodules were retrospectively reviewed and 374 radiomics features were extracted. In this study, 48 nodules were benign and 74 malignant. There were nine patients with multiple nodules and four with synchronous multiple malignant nodules. Different machine learning classifiers with a stratified ten-fold cross-validation were used and repeated 100 times to evaluate classification accuracy. Of the image features extracted from the thin-section CT images, 238 (64%) were useful in differentiating between benign and malignant nodules. These useful features include CT density (p  =  0.002 518), sigma (p  =  0.002 781), uniformity (p  =  0.032 41), and entropy (p  =  0.006 685). The highest classification accuracy was 79% by the logistic classifier. The performance metrics of this logistic classification model was 0.80 for the positive predictive value, 0.36 for the false-positive rate, and 0.80 for the area under the receiver operating characteristic curve. Our approach of direct risk classification supervised by the pathological diagnosis with localized thin-section CT and radiomics feature extraction may support clinical physicians in determining

CT differentiation of mucin-producing cystic neoplasms of the liver from solitary bile duct cysts.

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Kim, Hyoung Jung; Yu, Eun Sil; Byun, Jae Ho; Hong, Seung-Mo; Kim, Kyoung Won; Lee, Jong Seok; Kim, So Yeon

2014-01-01

The purpose of this study was to identify the CT features required for differentiating mucin-producing cystic neoplasms of the liver (mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct) from solitary bile duct cysts. CT images of pathologically confirmed mucinous cystic neoplasms (n = 15), cyst-forming intraductal papillary neoplasms of the bile duct (n = 16), and solitary bile duct cysts (n = 31) were reviewed. Analysis of the CT findings included shape, presence of septa, location of septa (peripheral vs central), thickness of septa (thin vs thick), mosaic pattern, mural nodules, intracystic debris, calcification, upstream bile duct dilatation, downstream bile duct dilatation, and communication between a cystic lesion and the bile duct. The maximum size of a cystic lesion and the maximum size of the largest mural nodule were measured. The presence of septa, central septa, mural nodules, upstream bile duct dilatation, and downstream bile duct dilatation were found to be significant CT findings for differentiating mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct from solitary bile duct cysts (p bile duct were 87% (27 of 31) and 87% (27 of 31), respectively. When two of these five criteria were used in combination, the sensitivity and specificity for diagnosing mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct were 87% (27 of 31) and 87% (27 of 31), respectively [corrected]. With the use of specific CT criteria, mucin-producing cystic neoplasms of the liver can be differentiated from solitary bile duct cysts with a high degree of accuracy.

CT findings of pleural lesions: differential diagnosis between malignant benign diseases

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Baek, Seung Yon; Lim, Tae Hwan; Kim, Woo Sun; Park, Kwang Gil [Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

1991-05-15

A number of benign and malignant diseases may cause pleural abnormalities. Since the resolution of computed tomography (CT) has been improved, the detailed anatomy of pleura can now be well delineated in various pleural diseases. We reviewed retrospectively the CT findings of 60 patients with pathologically proved pleural diseases in order to find out the differential points between benign and malignant diseases. Thirty-six patients had malignant diseases (20 adenocarcinoma, 8 squamous cell carcinoma, 4 small cell carcinoma, 2 lung metastasis, 1 large cell carcinoma, 1 small and large cell carcinoma), and 24 patients had benign diseases (16 tuberculosis including empyema, 3 bacterial empyema, 3 pneumonia, 1 lung abscess, 1 lung contusion). The CT features that suggested malignant pleural diseases were high-grade mediastinal involvement (57.9%, {rho} < 0.1), thick and irregular thickening with nodularity and mass formations (38.5%, {rho} < 0.1), Circumferential pleural thickening 132.1%, {rho} < 0.01), and aggressive pleural effusion 122.2%, {rho} < 0.05). Benign pleural lesions were typically represented by pleural calcification (50%) and extrapleural fat accumulation (45.8%)

CT features of primary epiploic appendagitis

International Nuclear Information System (INIS)

Ng, Keng Sin; Tan, Andrew Gee Seng; Chen, Kevin K'o Wen; Wong, Siew Kune; Tan, How Ming

2006-01-01

Objective: The aim of this study is to describe the computed tomography (CT) findings of primary epiploic appendagitis (PEA). Methods: We reviewed the clinical records and CT images of 14 consecutive patients in Singapore who presented with acute abdominal pain from July 2000 to April 2004 and had radiological signs of PEA. Results: Hyperattenuated ring with adjacent fat stranding was present in all the patients. The central high attenuation dot was seen in 42.9% (6/14) of the patients. We observed a lobulated fatty mass in 21.4% (3/14) of our patients. All patients recovered during clinical follow-up. Conclusions: We believe the lobulated appearance of PEA is due to two or more, contiguous infarcted epiploic appendages lying in close proximity. This appearance further aids in the diagnosis of PEA and helps differentiates the condition from omental infarction. Recognizing the CT signs of PEA should allow a confident diagnosis and avoid unnecessary surgery

Diagnostic performance and useful findings of ultrasound re-evaluation for patients with equivocal CT features of acute appendicitis.

Science.gov (United States)

Kim, Mi Sung; Kwon, Heon-Ju; Kang, Kyung A; Do, In-Gu; Park, Hee-Jin; Kim, Eun Young; Hong, Hyun Pyo; Choi, Yoon Jung; Kim, Young Hwan

2018-02-01

To evaluate the diagnostic performance of ultrasound and to determine which ultrasound findings are useful to differentiate appendicitis from non-appendicitis in patients who underwent ultrasound re-evaluation owing to equivocal CT features of acute appendicitis. 62 patients who underwent CT examinations for suspected appendicitis followed by ultrasound re-evaluation owing to equivocal CT findings were included. Equivocal CT findings were considered based on the presence of only one or two findings among the CT criteria, and ultrasound re-evaluation was done based on a predefined structured report form. The diagnostic performance of ultrasound and independent variables to discriminate appendicitis from non-appendicitis were assessed. There were 27 patients in the appendicitis group. The overall diagnostic performance of ultrasound re-evaluation was sensitivity of 96.3%, specificity of 91.2% and accuracy of 91.9%. In terms of the performance of individual ultrasound findings, probe-induced tenderness showed the highest accuracy (86.7%) with sensitivity of 74% and specificity of 97%, followed by non-compressibility (accuracy 71.7%, sensitivity 85.2% and specificity 60.6%). The independent ultrasound findings for discriminating appendicitis were non-compressibility (p = 0.002) and increased flow on the appendiceal wall (p = 0.001). Ultrasound re-evaluation can be used to improve diagnostic accuracy in cases with equivocal CT features for diagnosing appendicitis. The presence of non-compressibility and increased vascular flow on the appendix wall are useful ultrasound findings to discriminate appendicitis from non-appendicitis. Advances in knowledge: Ultrasound re-evaluation is useful to discriminate appendicitis from non-appendicitis when CT features are inconclusive.

An improved high order texture features extraction method with application to pathological diagnosis of colon lesions for CT colonography

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Song, Bowen; Zhang, Guopeng; Lu, Hongbing; Wang, Huafeng; Han, Fangfang; Zhu, Wei; Liang, Zhengrong

2014-03-01

Differentiation of colon lesions according to underlying pathology, e.g., neoplastic and non-neoplastic, is of fundamental importance for patient management. Image intensity based textural features have been recognized as a useful biomarker for the differentiation task. In this paper, we introduce high order texture features, beyond the intensity, such as gradient and curvature, for that task. Based on the Haralick texture analysis method, we introduce a virtual pathological method to explore the utility of texture features from high order differentiations, i.e., gradient and curvature, of the image intensity distribution. The texture features were validated on database consisting of 148 colon lesions, of which 35 are non-neoplastic lesions, using the random forest classifier and the merit of area under the curve (AUC) of the receiver operating characteristics. The results show that after applying the high order features, the AUC was improved from 0.8069 to 0.8544 in differentiating non-neoplastic lesion from neoplastic ones, e.g., hyperplastic polyps from tubular adenomas, tubulovillous adenomas and adenocarcinomas. The experimental results demonstrated that texture features from the higher order images can significantly improve the classification accuracy in pathological differentiation of colorectal lesions. The gain in differentiation capability shall increase the potential of computed tomography (CT) colonography for colorectal cancer screening by not only detecting polyps but also classifying them from optimal polyp management for the best outcome in personalized medicine.

Adenocarcinoma Prostate With Neuroendocrine Differentiation: Potential Utility of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT Over 68Ga-PSMA PET/CT.

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Parida, Girish Kumar; Tripathy, Sarthak; Datta Gupta, Shreya; Singhal, Abhinav; Kumar, Rakesh; Bal, Chandrasekhar; Shamim, Shamim Ahmed

2018-04-01

Ga-PSMA PET/CT is the upcoming imaging modality for staging, restaging and response assessment of prostate cancer. However, due to neuroendocrine differentiation in some of patients with prostate cancer, they express somatostatin receptors instead of prostate specific membrane antigen. This can be exploited and other modalities like Ga-DOTANOC PET/CT and F-FDG PET/CT should be used in such cases for guiding management. We hereby discuss a similar case of 67-year-old man of adenocarcinoma prostate with neuroendocrine differentiation, which shows the potential pitfall of Ga-PSMA PET/CT imaging and benefit of Ga-DOTANOC PET/CT and F-FDG PET/CT in such cases.

CT Features of pseudo tumoral bronchopulmonary tuberculosis

International Nuclear Information System (INIS)

Zidi, A.; Hantoux, S.; Mestiri, I.; Ben Miled-Mrad, K.

2006-01-01

Pulmonary tuberculosis may at times simulate lung carcinoma on bronchoscopic examination or imaging studies. Diagnosis can be delayed and lead to surgical resection. Based on review of 25 cases, the different CT features are reviewed. (author)

Mass-forming chronic pancreatitis : CT and ERCP features

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Jung, Dong Jin; Ha, Hyun Kwon; Lee, Yong Suk; Lee, Jin Hwa; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of)

1999-11-01

To describe the CT and ERCP findings of mass-forming chronic pancreatitis. CT and ERCP features were assessed in 13 patients suffering from mass-forming chronic pancreatitis. Diagnosis was on the basis of surgery (n=5), percutaneous needle biopsy (n=3), and clinical follow-up (n=5). Contrast-enhanced CT was available for all patients : five underwent dynamic study and ERCP was performed in 12. On CT and ERCP, both groups were evaluated with regard to the presence and degree of pancreatic ductal dilatation (greater or less than 50 % of total gland width), double duct sign, enhancement pattern, pancreatic parenchymal calcification (site and distribution pattern), mass identification, the direction of infiltration, pancreatic parenchymal atrophy, configuration at the site of obstruction in the pancreatic and common bile duct, lymphadenopathy, vascular encasement, and vascular engorgement or increased collateral vessels in the peripancreatic space. Seven of 13 patients had suffered chronic alcoholism. Serum CA19-9 levels were normal in all patients except one. Common CT and ERCP findings of mass-forming chronic pancreatitis included pancreatic duct dilatation (92.3%), double duct sign (69.2%), inhomogeneous enhancement of the mass (69.2%), and the presence of calcification (61.5%). Patterns of pancreatic duct dilation were irregular in five patients (38.4%) and smooth in three (23.1%). In all patients, duct dilatation was less than 50% of total gland width. Enhancement patterns of the pancreatic mass were inhomogeneous (69.2%), a nonenhancing low attenuation mass (15.3%), and homogeneous enhancement (15.3%). Configuration at the site of obstruction in the pancreatic duct was abrupt termination in two patients (15.4%) and smooth termination in two (15.4%). The common bile duct teminated abruptly in three patients (23.1%), and in four (30.8%) smooth narrowing was abserved. Common findings of mass-forming chronic pancreatitis were duct dilatation of less than 50% of total

Mass-forming chronic pancreatitis : CT and ERCP features

International Nuclear Information System (INIS)

Jung, Dong Jin; Ha, Hyun Kwon; Lee, Yong Suk; Lee, Jin Hwa; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho

1999-01-01

To describe the CT and ERCP findings of mass-forming chronic pancreatitis. CT and ERCP features were assessed in 13 patients suffering from mass-forming chronic pancreatitis. Diagnosis was on the basis of surgery (n=5), percutaneous needle biopsy (n=3), and clinical follow-up (n=5). Contrast-enhanced CT was available for all patients : five underwent dynamic study and ERCP was performed in 12. On CT and ERCP, both groups were evaluated with regard to the presence and degree of pancreatic ductal dilatation (greater or less than 50 % of total gland width), double duct sign, enhancement pattern, pancreatic parenchymal calcification (site and distribution pattern), mass identification, the direction of infiltration, pancreatic parenchymal atrophy, configuration at the site of obstruction in the pancreatic and common bile duct, lymphadenopathy, vascular encasement, and vascular engorgement or increased collateral vessels in the peripancreatic space. Seven of 13 patients had suffered chronic alcoholism. Serum CA19-9 levels were normal in all patients except one. Common CT and ERCP findings of mass-forming chronic pancreatitis included pancreatic duct dilatation (92.3%), double duct sign (69.2%), inhomogeneous enhancement of the mass (69.2%), and the presence of calcification (61.5%). Patterns of pancreatic duct dilation were irregular in five patients (38.4%) and smooth in three (23.1%). In all patients, duct dilatation was less than 50% of total gland width. Enhancement patterns of the pancreatic mass were inhomogeneous (69.2%), a nonenhancing low attenuation mass (15.3%), and homogeneous enhancement (15.3%). Configuration at the site of obstruction in the pancreatic duct was abrupt termination in two patients (15.4%) and smooth termination in two (15.4%). The common bile duct teminated abruptly in three patients (23.1%), and in four (30.8%) smooth narrowing was abserved. Common findings of mass-forming chronic pancreatitis were duct dilatation of less than 50% of total

Pulmonary aspergillosis in immunocompetent patients without air-meniscus sign and underlying lung disease: CT findings and histopathologic features

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Yoon, Soon Ho; Park, Chang Min; Goo, Jin Mo; Lee, Hyun Ju (Dept. of Radiology and Institute of Radiation Medicine, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: rosaceci@radiol.snu.ac.kr

2011-09-15

Background: Pulmonary aspergillosis in immunocompetent patients has been described as a saprophytic infection with pre-existing lung lesions showing an air-meniscus sign on chest radiograph or CT scans. There have been rare articles dealing with pulmonary aspergillosis in immunocompetent patients without pre-existing lung lesions. Purpose: To evaluate the CT findings of pulmonary aspergillosis in immunocompetent patients without air-meniscus and underlying lung disease and to correlate the CT findings and pathologic features of pulmonary aspergillosis in these patients. Material and Methods: A total of seven surgically proven pulmonary aspergillosis found in immunocompetent patients without an air-meniscus and underlying lung disease (M:F = 1:6; mean age 63.4 years) were included. On CT, the lesion shape, margin, type, location, diameter, presence of satellite nodules, presence of CT halo sign or hypodense sign, and interval growth were evaluated. Histopathologic features of each lesion were classified as one of the following; primary aspergilloma, chronic necrotizing pulmonary aspergillosis, or invasive pulmonary aspergillosis. Correlation between CT findings and pathological features was performed. Results: All lesions presented as a nodule or mass unable to differentiate from malignancy. Most lesions had well-defined margins (n = 4), appeared as solid lesions (n = 7), and were located in the upper lobe (n = 5). Mean diameter of lesions was 2.3 cm. Satellite nodules (n = 2), CT halo sign (n = 1), and hypodense sign (n = 4) were found. Only one lesion increased in size during follow-up. Lesions were pathologically classified as primary aspergilloma (n = 3) and chronic necrotizing pulmonary aspergillosis (n = 4). The hypodense sign on CT was pathologically proved as dense fungal hyphae filled in bronchus and CT halo sign as parenchymal hemorrhage. Conclusion: Pulmonary aspergillosis predominantly presented as a nodule or mass mimicking malignancy in the upper lobes

Pulmonary aspergillosis in immunocompetent patients without air-meniscus sign and underlying lung disease: CT findings and histopathologic features

International Nuclear Information System (INIS)

Yoon, Soon Ho; Park, Chang Min; Goo, Jin Mo; Lee, Hyun Ju

2011-01-01

Background: Pulmonary aspergillosis in immunocompetent patients has been described as a saprophytic infection with pre-existing lung lesions showing an air-meniscus sign on chest radiograph or CT scans. There have been rare articles dealing with pulmonary aspergillosis in immunocompetent patients without pre-existing lung lesions. Purpose: To evaluate the CT findings of pulmonary aspergillosis in immunocompetent patients without air-meniscus and underlying lung disease and to correlate the CT findings and pathologic features of pulmonary aspergillosis in these patients. Material and Methods: A total of seven surgically proven pulmonary aspergillosis found in immunocompetent patients without an air-meniscus and underlying lung disease (M:F = 1:6; mean age 63.4 years) were included. On CT, the lesion shape, margin, type, location, diameter, presence of satellite nodules, presence of CT halo sign or hypodense sign, and interval growth were evaluated. Histopathologic features of each lesion were classified as one of the following; primary aspergilloma, chronic necrotizing pulmonary aspergillosis, or invasive pulmonary aspergillosis. Correlation between CT findings and pathological features was performed. Results: All lesions presented as a nodule or mass unable to differentiate from malignancy. Most lesions had well-defined margins (n = 4), appeared as solid lesions (n = 7), and were located in the upper lobe (n = 5). Mean diameter of lesions was 2.3 cm. Satellite nodules (n = 2), CT halo sign (n = 1), and hypodense sign (n = 4) were found. Only one lesion increased in size during follow-up. Lesions were pathologically classified as primary aspergilloma (n = 3) and chronic necrotizing pulmonary aspergillosis (n = 4). The hypodense sign on CT was pathologically proved as dense fungal hyphae filled in bronchus and CT halo sign as parenchymal hemorrhage. Conclusion: Pulmonary aspergillosis predominantly presented as a nodule or mass mimicking malignancy in the upper lobes

CT features of liver abscesses caused by the fasciola hepatica infection

International Nuclear Information System (INIS)

Fan Dong; Li Peng; Sun Hua; Wang Zhihua; She Bo

2006-01-01

Objective: To study CT features of liver abscesses caused by the fasciola hepatica infection, and discuss its pathologic basis. Methods: CT images of 15 Patients were collected. All patients underwent both unenhanced and biphasic enhanced CT scanning, then its CT performances were analyzed. Results: round and nodular lesions were observed in 15 cases, branching and stripping lesions like dilated bile duct in 9 cases. The density of lesions was inhomogeneous, and the lesions were multifocal and multiform. The liver abscesses caused by the fasciola hepatica infection had no 'rim sign' or 'target' sign, Liver abscesses were less than 3.0 cm in diameter, and the dilation of the bile duct were not observed. Conclusion: Liver abscessed caused by the fasciola hepatica infection have characteristic CT features. Combined with clinical examination and laboratory test, the reliability of diagnosis will be considerably increased. (authors)

Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [{sup 18}F]FP-CIT PET/CT

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Park, Eunkyung; Hwang, Yu Mi; Lee, Channyoung; Oh, Sun Young; Kim, Young Chul; Choe, Jae Gol; Park, Kun Woo [Korea Univ., Seoul (Korea, Republic of); Kim, Sujin [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2014-06-15

It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [{sup 18}F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [{sup 18}F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [{sup 18}F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.

Addison's disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation

International Nuclear Information System (INIS)

Guo Yingkun; Yang Zhigang; Li Yuan; Ma Ensen; Deng Yuping; Min Pengqiu; Yin Longlin; Hu Jian; Zhang Xiaochun; Chen Tianwu

2007-01-01

Purpose: To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. Materials and methods: We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. Results: Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p < 0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p < 0.001). Conclusion: CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease

CT scanning in pediatric head trauma: correlation of clinical features with CT scan diagnosis

International Nuclear Information System (INIS)

Arkoncel, Mary Ann P.; Posadas, Ma. Belen A.

1997-01-01

A retrospective review was conducted on 205 cases of pediatric head trauma for which cranial computed tomography scans were done at the Makati Medical Center, to determine which clinical features might positively predict an abnormality on CT scan. The clinical findings of loss of consciousness, GCS < 12, vomiting headache, seizures, and focal abnormalities on Neurologic Examination were significantly associated with abnormal findings on CT scan. However, a significant discrepancy does exist as to how accurately clinical findings do in fact predict normal and abnormal CT scan findings. Such a discrepancy allows us to conclude that a more liberal use of CT Scanning in cases of pediatric head trauma must be stressed to insure proper diagnosis. This study shows that when a patient presents with the aforementioned positive signs and symptoms, or with a focal neurologic deficit, or in combination, a 60-100 % positive prediction of abnormal CT Scan can be made. However, prediction of normal CT Scan is only 0-40%. (Author)

Uncommon adrenal masses: CT and MRI features with histopathologic correlation

International Nuclear Information System (INIS)

Guo Yingkun; Yang Zhigang; Li Yuan; Deng Yuping; Ma Ensen; Min Pengqiu; Zhang Xiaochun

2007-01-01

Adrenal glands are common sites of diseases. With dramatically increased use of computed tomography (CT) and magnetic resonance (MR) imaging, more and more uncommon adrenal masses have been detected incidentally at abdominal examinations performed for other purposes. In this article, uncommon adrenal masses are classified as cystic masses (endothelial cysts, epithelial cysts, parasitic cysts, and pseudocysts), solid masses (ganglioneuroma, ganglioneuroblastoma, extramedullary plasmacytoma (EMP), neurilemmoma, and lymphoma), fat-containing masses (myelolipoma, teratoma), and infectious masses (tuberculoma), and the imaging features of these uncommon masses are demonstrated. Although most of these lesions do not have specific imaging features, some fat-containing masses and cystic lesions present with characteristic appearances, such as myelolipoma, teratoma, and hydatid. Combination with histopathologic characteristic of these uncommon masses of adrenal gland, radiological features of these lesions on CT and MR imaging can be accurately understood with more confidences. Moreover, CT and MRI are highly accurate in localization of uncommon adrenal masses, and useful to guide surgical treatments

Gastrointestinal involvement of recurrent renal cell carcinoma: CT findings and clinicpathologic features

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Park, Hyo Jung; Kim, Hyun Jin; Park, Seung Ho; Lee, Jong Seok; Kim, Ah Young [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ha, Hyun Kwon [Dept. of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

2017-06-15

To retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC). The medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications. The most common presentation was GI bleeding (66.7%). The average interval between nephrectomy and the detection of GI involvement was 30.4 ± 37.4 months. GI lesions were most commonly found in the ileum (36.8%) and duodenum (31.6%). A distant metastasis (80%) was more common than a direct invasion from metastatic lesions. The mean lesion size was 34.1 ± 15.0 mm. Intraluminal polypoid masses (63.2%) with hyperenhancement (78.9%) and heterogeneous enhancement (63.2%) were the most common findings. No patients had regional lymphadenopathy. Complications occurred in four patients, with one each of bowel obstruction, intussusception, bile duct dilatation, and pancreatic duct dilatation. GI involvement of recurrent RCC could be included in the differential diagnosis of patients with heterogeneous, hyperenhanced intraluminal polypoid masses in the small bowel on CT scans along with a relative paucity of lymphadenopathy.

CT features of legionella pneumonia, compared with streptococcal pneumonia. A collaborative study

International Nuclear Information System (INIS)

Tokuda, Hitoshi; Sakai, Fumikazu; Goto, Hajime

2007-01-01

Legionella pneumophila pneumonia (LPP) is of serious concern for chest physicians for its potential lethality and difficulty of diagnosis. In spite of widespread use of urine antigen detection method, it remains one of the most difficult-to-treat disease among community acquired pneumonia. We investigated CT images of 38 cases of LPP, comparing them with wide spread Streptococcus pneumoniae pneumonia (SPP). We find that sharply demarcated consolidation scattered in ground-glass opacity is the most striking and pathognomonic feature of LPP, which is rarely found in SPP. Bronchiolitis was not found in LPP, while it is a relatively common finding in SPP, which could be the second clue of differentiation of these two diseases. (author)

Pneumatosis intestinalis: CT findings and clinical features

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Kim, Hye Lin; Lee, Hae Kyung; Park, Seong Jin; Yi, Boem Ha; Ko, Bong Min; Hong, Hyun Sook; Paik, Sang Hyun [Soonchunhyang University Hospital Bucheon, Bucheon (Korea, Republic of)

2008-02-15

The purpose of this study is to evaluate the CT findings and clinical features of patients with pneumatosis intestinalis. From January 2001 to October 2007, 15 patients with pneumatosis intestinalis were diagnosed by the use of CT. We analyzed the clinical features and CT findings to assess the involvement site, the presence of portal and mesenteric vein gas, and the existence of accompanied ischemic change. Of the 15 patients, five patients had end stage renal disease (33.3%), two patients underwent a gastrectomy, one patient underwent a laminectomy, one patient had tuberculous enteritis, one patient had lung cancer and one patient had pneumonia. Four patients presented with no specific disease. There was portal or mesenteric venous gas in six cases, and strangulation or an ischemic change of the bowel in five cases. Otherwise, pneumatosis intestinalis was associated with hydropneumoperitoneum in two cases, pneumoperitoneum in one case and a single case of perforated appendicitis. Nine patients underwent surgery for ischemic change of the bowel, pneumoperitoneum, appendicitis, and a clinical sign of panperitonitis. Among the remaining six patients, three patients recovered and were discharged, and three patients expired during progression of the disease. End stage renal disease is the most common condition associated with pneumatosis intestinalis. The presence of portomesenteric venous gas, ischemic change of the bowel, and linear pneumatosis intestinalis are indicative of a poor prognosis.

Profiles of US and CT imaging features with a high probability of appendicitis

International Nuclear Information System (INIS)

Randen, A. van; Lameris, W.; Es, H.W. van; Hove, W. ten; Bouma, W.H.; Leeuwen, M.S. van; Keulen, E.M. van; Hulst, V.P.M. van der; Henneman, O.D.; Bossuyt, P.M.; Boermeester, M.A.; Stoker, J.

2010-01-01

To identify and evaluate profiles of US and CT features associated with acute appendicitis. Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between appendiceal imaging features and a final diagnosis of appendicitis were evaluated with logistic regression analysis. Appendicitis was assigned to 284 of 942 evaluated patients (30%). All evaluated features were associated with appendicitis. Imaging profiles were created after multivariable logistic regression analysis. Of 147 patients with a thickened appendix, local transducer tenderness and peri-appendiceal fat infiltration on US, 139 (95%) had appendicitis. On CT, 119 patients in whom the appendix was completely visualised, thickened, with peri-appendiceal fat infiltration and appendiceal enhancement, 114 had a final diagnosis of appendicitis (96%). When at least two of these essential features were present on US or CT, sensitivity was 92% (95% CI 89-96%) and 96% (95% CI 93-98%), respectively. Most patients with appendicitis can be categorised within a few imaging profiles on US and CT. When two of the essential features are present the diagnosis of appendicitis can be made accurately. (orig.)

Profiles of US and CT imaging features with a high probability of appendicitis

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Randen, A. van; Lameris, W. [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Es, H.W. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Hove, W. ten; Bouma, W.H. [Gelre Hospitals, Department of Surgery, Apeldoorn (Netherlands); Leeuwen, M.S. van [University Medical Centre, Department of Radiology, Utrecht (Netherlands); Keulen, E.M. van [Tergooi Hospitals, Department of Radiology, Hilversum (Netherlands); Hulst, V.P.M. van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Henneman, O.D. [Bronovo Hospital, Department of Radiology, The Hague (Netherlands); Bossuyt, P.M. [University of Amsterdam, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Boermeester, M.A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Stoker, J. [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

2010-07-15

To identify and evaluate profiles of US and CT features associated with acute appendicitis. Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between appendiceal imaging features and a final diagnosis of appendicitis were evaluated with logistic regression analysis. Appendicitis was assigned to 284 of 942 evaluated patients (30%). All evaluated features were associated with appendicitis. Imaging profiles were created after multivariable logistic regression analysis. Of 147 patients with a thickened appendix, local transducer tenderness and peri-appendiceal fat infiltration on US, 139 (95%) had appendicitis. On CT, 119 patients in whom the appendix was completely visualised, thickened, with peri-appendiceal fat infiltration and appendiceal enhancement, 114 had a final diagnosis of appendicitis (96%). When at least two of these essential features were present on US or CT, sensitivity was 92% (95% CI 89-96%) and 96% (95% CI 93-98%), respectively. Most patients with appendicitis can be categorised within a few imaging profiles on US and CT. When two of the essential features are present the diagnosis of appendicitis can be made accurately. (orig.)

Spiral CT features of abdomen after whipple's operation

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Kim, T. H.; Lee, K. Y.; Shin, K. H.; Jung, M. H.; Park, C. M.; Cha, I. H. [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

1997-04-01

To assess the CT features of postoperative anatomical changes, surgical complications, and patterns of tumor recurrence after Whipple's operation. 42 spiral CT scans of 31 patients who had undergone Whipple's operation were retrospectively reviewed. Postoperative diagnoses were distal CBD cancer in 13 patients, cancer of the ampulla of Vater in ten, cancer of the head of the pancreas in seven, and microcystic cystadenocarcinoma of the pancreas in one. Time intervals between surgery and CT ranged from 1 week to 5 years. CT features of postoperative anastomotic changes, surgical complications, and patterns of tumor recurrence were analyzed. Gastro- or duodeno-jejunal anastomosis was seen in 32 CT scans(74%), pancreaticojejunostomy in 27(64%), and choledochojejunostomy in 24(57%). Pneumobilia was seen in ten patients(34%). Abnormal fluid collections in the peripancreatic and perihepatic space were demonstrated in two patients who underwent CT scans within 3 weeks after operation. Other complications included wound abscess(n=2), and portal vein occlusion(n=1). The most common site of metastasis was the lymph node(n=8)(retroperitoneal:n=5; mesentery root:n=4; and celiac:n=2), followed by the liver(n=6), peritoneum(n=3), adrenal gland(n=2), and afferent loop(n=1). In three cases, there was local recurrence in the pancreatic bed. To reduce possible diagnostic errors during CT interpretation, a Knowledge of normal postoperative anatomy, common complications, and patterns of disease recurrence following Whipple's operation is important.

Profiles of US and CT imaging features with a high probability of appendicitis

NARCIS (Netherlands)

van Randen, A.; Laméris, W.; van Es, H.W.; ten Hove, W.; Bouma, W.H.; van Leeuwen, M.S.; van Keulen, E.M.; van der Hulst, V.P.M.; Henneman, O.D.; Bossuyt, P.M.; Boermeester, M.A.; Stoker, J.

2010-01-01

To identify and evaluate profiles of US and CT features associated with acute appendicitis. Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with

The significance of postangiographic CT for differentiation of hepatic masses

International Nuclear Information System (INIS)

Lee, Jae Kyo; Chang, Jae Chun; Chang, You Song

1994-01-01

To identify the long term hemodynamics of various hepatic masses and to determine any differential findings by using postangiograpic CT performed with increased amount of contrast media and time than conventional contrast CT. 50 confirmed masses consisted of 22 hepatocellular carcinoma, 10 cholangiocarcinoma, 9 metastasis, and 9 cavernous hemangioma were included. The changes of the density of internal viable tumor portion relative to surrounding normal liver parenchyma in postangiograhic CT from that in conventional CT were classified as 3 patients; no specific changes, increase, or decrease. In 22 cases of hepatocellular carcinoma, six cases showed no relative density change, four cases increase, and twelve cases decrease. In ten cases of cholangiocacinoma, one case showed no change, nine cases increase. In nine cases of metastasis, four cases showed no change, five cases increase. In nine cases of hemangioma, all cases showed increase. In postangiographic CT which emphasize the significance of postequilibrium and delayed phase, other hemodynamic changes undetected in angiography could more easily be comprehended. Considering the differing amount of consumed contrast media and time duration, and with reference of other imaging modalities, differential diagnosis of hepatic masses based on long term hemodynamics could easily be made

CT differential diagnosis of primary pelvic osteosarcoma, chondrosarcoma and Ewing's sarcoma

International Nuclear Information System (INIS)

Heller, M.; Heyer, D.; Spielmann, R.P.; Buecheler, E.

1990-01-01

The value of CT for the differential diagnosis of primary malignant tumours in the pelvis was investigated in the case of three types of tumour: Osteosarcomas, chondrosarcomas and Ewing's sarcomas. A total of 78 CT examinations in 29 patients was used. The results show that CT, using suitable techniques (high resolution etc.) constitutes a valuable diagnostic method for differentiating these bone tumours. This applies not only for the localisation of the tumour and for defining its extent, but also for showing the morphology of intra- and extra-osseous soft tissue components and their patterns of calcification. It is possible to recognise patterns of growth and of tissue destruction that are typical of individual tumours. (orig.) [de

Phase- and size-adjusted CT cut-off for differentiating neoplastic lesions from normal colon in contrast-enhanced CT colonography

International Nuclear Information System (INIS)

Luboldt, W.; Kroll, M.; Wetter, A.; Vogl, T.J.; Toussaint, T.L.; Hoepffner, N.; Holzer, K.; Kluge, A.

2004-01-01

A computed tomography (CT) cut-off for differentiating neoplastic lesions (polyps/carcinoma) from normal colon in contrast-enhanced CT colonography (CTC) relating to the contrast phase and lesion size is determined. CT values of 64 colonic lesions (27 polyps 0 . The slope m was determined by linear regression in the correlation (lesion ∝[xA + (1 - x)V]//H) and the Y-intercept y 0 by the minimal shift of the line needed to maximize the accuracy of separating the colonic wall from the lesions. The CT value of the lesions correlated best with the intermediate phase: 0.4A+ 0.6V(r=0.8 for polyps ≥10 mm, r=0.6 for carcinomas, r=0.4 for polyps <10 mm). The accuracy in the differentiation between lesions and normal colonic wall increased with the height implemented as divisor, reached 91% and was obtained by the dynamic cut-off described by the formula: cut-off(A,V,H) = 1.1[0.4A + 0.6V]/H + 69.8. The CT value of colonic polyps or carcinomas can be increased extrinsically by scanning in the phase in which 0.4A + 0.6V reaches its maximum. Differentiating lesions from normal colon based on CT values is possible in contrast-enhanced CTC and improves when the cut-off is adjusted (normalized) to the contrast phase and lesion size. (orig.)

Endometriosis of the rectum: CT findings

International Nuclear Information System (INIS)

Guo Yan; Huang Zhaomin; Liu Mingjuan; Zhong Juemin

2004-01-01

Objective: To investigate the CT manifestations of recto-endometriosis. Methods: Three pathologically proved cases of recto-endometriosis were reported, the CT features and clinical manifestations were investigated retrospectively with review of literatures. Results: The patients were all menstruating females (28, 34, and 45 years old, respectively), and anal pain emerged during menses in one case. Rectal examination revealed stiff immobile mass along the rectal wall in all three cases. All the cases showed solid masses on CT scan with moderate enhancement after contrast administration. Two of them confined to the rectal walls, another involved the rectum and peri-rectal aspect. One case was misdiagnosed as well-differentiated adenocarcinoma of rectum in frozen section by biopsy specimen. Conclusion: A solid mass was always found in recto-endometriosis. No characteristic CT feature was manifested. Attention should be paid to the differentiation from rectal tumors when making the diagnosis

CT features of gastric heterotopic pancreas

International Nuclear Information System (INIS)

Wu Guangyao; Tian Zhixiong; Zhang Zaipeng; Huang Xiong

2007-01-01

Objective: To analyze CT findings correlated with pathologic findings in ectopic pancreas of the stomach. Methods: CT scans of 15 surgically proven eases of ectopic pancreas of the stomach were reviewed, and enhanced CT scan was performed in 11 cases. CT findings were correlated with the pathologic findings. Results: All cases had single lesion, and all lesions showed homogeneous density on plain scans without cystic or malignant changes. The size ranged from 1.3 to 3.1 cm, with mean diameter of (1.9±0.2) cm. The lesions were round or oval in shape with broad base against the gastric wall. Two showed central umbilication sign. Only 2 cases were correctly diagnosed prior to operation and the rest were misdiagnosed or diagnosed indistinctly. The locations were in the gastric antrum in 11 cases, in the body in 3, and in fundus in one; The ectopic pancreas located in the greater curvature in 10, and in the lesser curvature in 5. Homogeneous or inhomogeneous strong enhancement similar to the pancreas was seen in 8 cases and they consisted mainly of pancreatic acini with the same histologic features as the pancreas. Three cases showed poor enhancement and consisted mainly of ducts and hypertrophied muscle, pancreatic acini were a minor component. Conclusion: Ectopic pancreas of the stomach showed characteristic locations with the findings of submucosal diseases. Different enhancing patterns were correlated with their pathologic findings. (authors)

Comparison of CT enterography and MR enterography imaging features of active Crohn disease in children and adolescents

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Gale, Heather I. [The Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital/Hasbro Children' s Children' s Hospital/Women and Infants Hospital, Providence, RI (United States); Sharatz, Steven M.; Nimkin, Katherine; Gee, Michael S. [MassGeneral Hospital for Children, Division of Pediatric Imaging, Department of Radiology, Harvard Medical School, Boston, MA (United States); Taphey, Mayureewan [Bumrungrad International Hospital, Bangkok (Thailand); Bradley, William F. [Cambridge Mobile Telematics, Cambridge, MA (United States)

2017-09-15

Assessment for active Crohn disease by CT enterography and MR enterography relies on identifying mural and perienteric imaging features. To evaluate the performance of established imaging features of active Crohn disease in children and adolescents on CT and MR enterography compared with histological reference. We included patients ages 18 years and younger who underwent either CT or MR enterography from 2007 to 2014 and had endoscopic biopsy within 28 days of imaging. Two pediatric radiologists blinded to the histological results reviewed imaging studies and scored the bowel for the presence or absence of mural features (wall thickening >3 mm, mural hyperenhancement) and perienteric features (mesenteric hypervascularity, edema, fibrofatty proliferation and lymphadenopathy) of active disease. We performed univariate analysis and multivariate logistic regression to compare imaging features with histological reference. We evaluated 452 bowel segments (135 from CT enterography, 317 from MR enterography) from 84 patients. Mural imaging features had the highest association with active inflammation both for MR enterography (wall thickening had 80% accuracy, 69% sensitivity and 91% specificity; mural hyperenhancement had 78%, 53% and 96%, respectively) and CT enterography (wall thickening had 84% accuracy, 72% sensitivity and 91% specificity; mural hyperenhancement had 76%, 51% and 91%, respectively), with perienteric imaging features performing significantly worse on MR enterography relative to CT enterography (P < 0.001). Mural features are predictors of active inflammation for both CT and MR enterography, while perienteric features can be distinguished better on CT enterography compared with MR enterography. This likely reflects the increased conspicuity of the mesentery on CT enterography and suggests that mural features are the most reliable imaging features of active Crohn disease in children and adolescents. (orig.)

Evaluation of PET/CT combined with HRCT in differentiating malignant from benign solitary pulmonary nodules

International Nuclear Information System (INIS)

Ge Quanxu; Zhu Renjuan; Liu Qingwei; Lv Shouchen; Yao Shuzhan; Li Xin

2005-01-01

Objective: To investigate the clinical value of 18 F-fluorodeoxyglucose (FDG) PET/CT combined with high resolution CT (HRCT) to differentiate solitary pulmonary nodule (SPN). Methods: 25 patients with 27 SPN were examined with 18 F-FDG PET/CT and HRCT, all of them were proved pathologically or by follow-up. The differential diagnosis of SPN were made using visual method and semi-quantitative method on PET/CT and morphological characteristics on HRCT. The results of 18 F-FDG PET/CT and 18 F-FDG PET/CT combined with HRCT were compared with pathological results. Results: 15 were malignant and 12 benign among the 27 SPN. 14 SPN were positive on PET/CT among 15 malignant SPN with only one negative less than 10 mm in size. 3 benign were positive on PET/CT, but 2 of them were correctly diagnosed as benign by PET/CT combined with HRCT. The specificity, negative predictive value and accuracy of 18 F-FDG PET/CT combined with HRCT were higher than that of PET/CT (91.7%, 93.3%, 91.7% and 93.7% vs 75.0%, 82.4%, 90.0% and 85.2% ). The sensitivity of PET/CT combined with HRCT and PET/CT alone was same (93.3%). Conclusion: 18 F-FDG PET/CT combined with HRCT is a effective no-invasive method in differentiating malignant SPN from benign. (authors)

Clinical analysis of CT features in 200 neonates with hypoxic-ischemic encephalopathy (HIE)

International Nuclear Information System (INIS)

Zhang Fan

2003-01-01

Objective: To analyze the CT features of HIE in neonates. Methods: CT scanning was performed in 200 neonates with HIE. Results: The CT features in 200 HIE were hypo-attenuated substantia alba, accompanied with intra-cranial hemorrhage, widened cavity of septum pellucidum and cerebral infarction. In total 200 cases, mild HIE was found in 118 cases, moderate HIE was revealed in 67 cases and severe condition was observed in 15 cases. Intra-cranial hemorrhage was noted in 87 cases. Conclusion: The cerebral injury should be diagnosed by the findings of hypo-attenuated substantia alba and intracranial hemorrhage on CT scan, combined with clinical histories and manifestations of intro-uterine neonate asphyxia

Radiographic features of Mycoplasma pneumoniae pneumonia: differential diagnosis and performance timing

International Nuclear Information System (INIS)

Miyashita, Naoyuki; Sugiu, Tadaaki; Kawai, Yasuhiro; Oda, Keiko; Yamaguchi, Tetsuya; Ouchi, Kazunobu; Kobashi, Yoshihiro; Oka, Mikio

2009-01-01

The Japanese Respiratory Society guidelines propose a differential diagnosis for atypical pneumonia and bacterial pneumonia using a scoring system for the selection of appropriate antibiotic. In order to improve this scoring system, the guidelines are seeking new specific parameter. The purpose of this study was to clarify the pattern of abnormalities with Mycoplasma pneumoniae pneumonia on chest computed tomography (CT) and whether the radiographic findings could distinguish M. pneumoniae pneumonia from Streptococcus pneumoniae pneumonia. A retrospective review was performed of the CT findings of 64 cases and 68 cases where M. pneumoniae and S. pneumoniae, respectively, were the only pathogen identified by the panel of diagnostic tests used. Of the 64 patients with M. pneumoniae pneumonia, bronchial wall thickening was observed most frequently (81%), followed by centrilobular nodules (78%), ground-glass attenuation (78%), and consolidation (61%). Bronchial wall thickening and centrilobular nodules were observed more often in M. pneumoniae patients than in S. pneumoniae patients (p < 0.0001). The presence of bilateral bronchial wall thickening or centrilobular nodules was only seen in patients with M. pneumoniae pneumonia. Using the scoring system of the Japanese Respiratory Society guidelines and chest CT findings, 97% of M. pneumoniae patients were suspected to be M. pneumoniae pneumonia without serology. When comparing the CT findings between early stage and progressed stage in the same patients with severe pneumonia, the radiographic features of early stage M. pneumoniae pneumonia were not observed clearly in the progressed stage. The present results indicate that the diagnosis of M. pneumoniae pneumonia would appear to be reliable when found with a combination of bronchial wall thickening and centrilobular nodules in the CT findings. However, these CT findings are not observed in progressed severe M. pneumoniae pneumonia patients

Xanthogranulomatous cholecystitis: Diagnostic performance of CT to differentiate from gallbladder cancer

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Goshima, Satoshi, E-mail: gossy@par.odn.ne.j [Department of Radiology, University of Pittsburgh Medical Center, Lothrop St., Pittsburgh, PA 15213 (United States); Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Chang, Samuel; Wang, Jin Hong [Department of Radiology, University of Pittsburgh School of Medicine, 3362 Fifth Ave., Pittsburgh, PA15213 (United States); Kanematsu, Masayuki [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Department of Radiology Services, Gifu University School of Medicine, 1-1- Yanagido, Gifu 501-1194 (Japan); Bae, Kyongtae T. [Department of Radiology, University of Pittsburgh School of Medicine, 3362 Fifth Ave., Pittsburgh, PA15213 (United States); Federle, Michael P. [Department of Radiology, University of Pittsburgh Medical Center, Lothrop St., Pittsburgh, PA 15213 (United States); Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305-5105 (United States)

2010-06-15

Purpose: To retrospectively evaluate CT findings of xanthogranulomatous cholecystitis (XGC) and to measure diagnostic performance for distinguishing it from gallbladder (GB) cancer. Methods and materials: Our institutional review board approved this retrospective study. Three blinded radiologists, first independently and then in consensus, retrospectively evaluated postcontrast CT images of 35 patients with histopathologically proved XGC and GB cancer, all of whom subsequently had cholecystectomy. These included 18 patients with XGC (13 male, 5 female; age range, 35-84, mean 63 years) and 17 with GB cancer (6 male, 11 female; age range, 45-95, mean 69). Differences in CT findings between XGC and GB cancer and diagnostic performances for each CT finding were calculated. Sensitivity, specificity, and accuracy were calculated for each radiologist and observer performance was also determined by receiver-operating-characteristic curve analysis. Results: Five CT findings showed significant differences between XGC and GB cancer. Sensitivity, specificity, and accuracy of each finding for the differentiation of XGC were 89%, 65%, 77% with diffuse GB wall thickening, 67%, 82%, 74% with a continuous mucosal line, 61%, 71%, 66% with intra-mural hypo-attenuated nodules, 72%, 77%, 74% with absence of macroscopic hepatic invasion, and 67%, 71%, 69% with absence of intra-hepatic bile duct dilatation, respectively. When at least three of these five CT findings were observed in combination, sensitivity, specificity, and accuracy were 83%, 100% and 91%, respectively. Sensitivities, specificities and Az values for the differentiation of XGC from GB cancer were 83%, 88%, 0.94 for reader 1, 78%, 88%, 0.93 for reader 2, and 78%, 82%, 0.84 for reader 3. Conclusions: The combination of three of the five CT findings that are common with XGC can provide excellent accuracy for the differentiation of XGC and GB cancer.

SU-D-BRA-05: Toward Understanding the Robustness of Radiomics Features in CT

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Mackin, D; Zhang, L; Yang, J; Jones, A; Court, L [UT MD Anderson Cancer Center, Houston, TX (United States); Fave, X; Fried, D [UTH-GSBS, Houston, TX (United States); Taylor, B [Baylor College of Medicine, Houston, TX (United States); Rodriguez-Rivera, E [Houston Methodist Hospital, Houston, TX (United States); Dodge, C [Texas Children’s Hospital, Houston, TX (United States)

2015-06-15

Purpose: To gauge the impact of inter-scanner variability on radiomics features in computed tomography (CT). Methods: We compared the radiomics features calculated for 17 scans of the specially designed Credence Cartridge Radiomics (CCR) phantom with those calculated for 20 scans of non–small cell lung cancer (NSCLC) tumors. The scans were acquired at four medical centers using General Electric, Philips, Siemens, and Toshiba CT scanners. Each center used its own routine thoracic imaging protocol. To produce a large dynamic range of radiomics feature values, the CCR phantom has 10 cartridges comprising different materials. The features studied were derived from the neighborhood gray-tone difference matrix or image intensity histogram. To quantify the significance of the inter-scanner variability, we introduced the metric “feature noise”, which compares the ratio of inter-scanner variability and inter-patient variability in decibels, positive values indicating substantial noise. We performed hierarchical clustering based to look for dependence of the features on the scan acquisition parameters. Results: For 5 of the 10 features studied, the inter-scanner variability was larger than the inter-patient variability. Of the 10 materials in the phantom, shredded rubber seemed to produce feature values most similar to those of the NSCLC tumors. The feature busyness had the greatest feature noise (14.3 dB), whereas texture strength had the least (−14.6 dB). Hierarchical clustering indicated that the features depended in part on the scanner manufacturer, image slice thickness, and pixel size. Conclusion: The variability in the values of radiomics features calculated for CT images of a radiomics phantom can be substantial relative to the variability in the values of these features calculated for CT images of NSCLC tumors. These inter-scanner differences and their effects should be carefully considered in future radiomics studies.

SU-D-BRA-05: Toward Understanding the Robustness of Radiomics Features in CT

International Nuclear Information System (INIS)

Mackin, D; Zhang, L; Yang, J; Jones, A; Court, L; Fave, X; Fried, D; Taylor, B; Rodriguez-Rivera, E; Dodge, C

2015-01-01

Purpose: To gauge the impact of inter-scanner variability on radiomics features in computed tomography (CT). Methods: We compared the radiomics features calculated for 17 scans of the specially designed Credence Cartridge Radiomics (CCR) phantom with those calculated for 20 scans of non–small cell lung cancer (NSCLC) tumors. The scans were acquired at four medical centers using General Electric, Philips, Siemens, and Toshiba CT scanners. Each center used its own routine thoracic imaging protocol. To produce a large dynamic range of radiomics feature values, the CCR phantom has 10 cartridges comprising different materials. The features studied were derived from the neighborhood gray-tone difference matrix or image intensity histogram. To quantify the significance of the inter-scanner variability, we introduced the metric “feature noise”, which compares the ratio of inter-scanner variability and inter-patient variability in decibels, positive values indicating substantial noise. We performed hierarchical clustering based to look for dependence of the features on the scan acquisition parameters. Results: For 5 of the 10 features studied, the inter-scanner variability was larger than the inter-patient variability. Of the 10 materials in the phantom, shredded rubber seemed to produce feature values most similar to those of the NSCLC tumors. The feature busyness had the greatest feature noise (14.3 dB), whereas texture strength had the least (−14.6 dB). Hierarchical clustering indicated that the features depended in part on the scanner manufacturer, image slice thickness, and pixel size. Conclusion: The variability in the values of radiomics features calculated for CT images of a radiomics phantom can be substantial relative to the variability in the values of these features calculated for CT images of NSCLC tumors. These inter-scanner differences and their effects should be carefully considered in future radiomics studies

CT findings of orbital inflammatory diseases

International Nuclear Information System (INIS)

Kim, Jang Min; Shin, Hyun Joon; Kim, Jung Hyuk; Suh, Won Hyuck

1991-01-01

Twenty-nine patients with orbital inflammatory disease (OIDs) were retrospectively reviewed in order to analyze detailed CT findings which might aid in differentiating OIDs. This study comprised 18 pseudotumors, 5 thyroid ophthalmopathies, and 6 cases of orbital cellulitis. CT scans of the pseudotumors showed various findings such as exophthalmos, scleritis, myositis of the extraocular muscle (MOM), and bone lesion. Bone lesions of the pseudo tumors, which have been rarely reported, were present in 7 cases in our series. Bilateral exophthalmos, myositis, and retrobulbar fat deposition were readily detected by CT in thyroid ophthalmopathy, and, in addition, we found bone erosions involving the orbital apices in 2 cases. In orbital cellulitis, extraorbital soft tissue swelling and lateral displacement of the medial rectus muscle in cases with ethmoiditis were the most conspicuous features. In summary, because of the overlapping CT findings in OIDs, careful examination of CT findings regarding the mode of EOM involvement and the presence or absence of scleritis or sinusitis might help narrow down the differential diagnosis. A pseudotumor with bone lesions could be mistaken as a malignant lesion, and therefore it is necessary to correlate clinical features with CT findings for an accurate diagnosis

Predictive features of CT for risk stratifications in patients with primary gastrointestinal stromal tumour

International Nuclear Information System (INIS)

Zhou, Cuiping; Zhang, Xiang; Duan, Xiaohui; Hu, Huijun; Wang, Dongye; Shen, Jun

2016-01-01

To determine the predictive CT imaging features for risk stratifications in patients with primary gastrointestinal stromal tumours (GISTs). One hundred and twenty-nine patients with histologically confirmed primary GISTs (diameter >2 cm) were enrolled. CT imaging features were reviewed. Tumour risk stratifications were determined according to the 2008 NIH criteria where GISTs were classified into four categories according to the tumour size, location, mitosis count, and tumour rupture. The association between risk stratifications and CT features was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. CT imaging features including tumour margin, size, shape, tumour growth pattern, direct organ invasion, necrosis, enlarged vessels feeding or draining the mass (EVFDM), lymphadenopathy, and contrast enhancement pattern were associated with the risk stratifications, as determined by univariate analysis (P < 0.05). Only lesion size, growth pattern and EVFDM remained independent risk factors in multinomial logistic regression analysis (OR = 3.480-100.384). ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.806 (95 % CI: 0.727-0.885). CT features including lesion size, tumour growth pattern, and EVFDM were predictors of the risk stratifications for GIST. (orig.)

CT features of nonfunctioning islet cell carcinoma

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Eelkema, E.A.; Stephens, D.H.; Ward, E.M.; Sheedy, P.F. II

1984-11-01

To determine the computed tomographic (CT) characteristics of nonfunctioning islet cell carcinoma of the pancreas, the CT scans of 27 patients with that disease were reviewed. The pancreatic tumor was identified as a mass in 26 patients (96%) Of the 25 tumors evaluated with contrast enhancement, 20 became partially diffusely hyperdense relative to nearby normal pancreatic tissue. Hepatic metastases were identified in 15 patients (56%), regional lymphadenopathy in 10 (37%), atrophy of the gland proximal to the tumor in six (22%), dilatation of the biliary ducts in five (19%), and dilatation of the pancreatic duct in four (15%). The CT appearances of the nonfunctioning islet cell tumors were compared with those of 100 ordinary (ductal) pancreatic adenocarcinomas. Although the two types of tumors were sometimes indistinguishable, features found to be more characteristic of islet cell carcinoma included a pancreatic mass of unusually large size, calcification within the tumor, and contrast enhancement of either the primary tumor or hepatic metastases. Involvement of the celiac axis or proximal superior mesenteric artery was limited to ductal carcinoma.

CT differentiation of invasive thymoma and thymic carcinoma

International Nuclear Information System (INIS)

Lee, Eun Jung; Jung, Gyoo Sik; Kim, Seong Min; Huh, Jin Do; Joh, Young Duk; Shin, Mi Jung; Kim, Jung Sik; Suh, Soo Jhi

1998-01-01

In order to determine the differential points between them, we analyzed the CT findings of invasive thymoma and thymic carcinoma. We retrospectively reviewed the CT scans of 14 patients with invasive thymoma and 15 with thymic carcinoma, confirmed by surgery(n=3D19) or percutaneous needle aspiration(n=3D10) between 1988 and 1996. CT findings were evaluated in each group for intrathoracic spread(posterior, direct posterior, and anterolateral), obliteration of the fat plane between the mass and vascular structures, vessel encasement, invasion of adjacent mediastinal structures, pleural implants, mediastinal nodes and distant metastasis. Direct posterior spread was more common in thymic carcinoma than invasive thymoma;it was seen in one case (7%) of invasive thymoma and 12(80%) of thymic carcinoma(p=3D0.00). Posterior spread was seen in six cases (43%) of in vasive thymoma and nine (60%) of thymic carcinoma. Anterolateral spread was seen only in two cases (13%) of thymic carcinoma. Obliteration of the fat plane was seen in nine cases (64%) of invasive thymoma and 14 (93%) of thymic carcinoma, while vessel encasement was seen in two cases (14%) of invasive thymoma and 13(87%) of thymic carcinoma(p=3D0.00). Invasion of adjacent structures was seen in two cases (14%) of invasive thymoma and eight (53%) of thymic carcinoma. Pleural implants were more common in invasive thymoma than thymic carcinoma, being seen in six cases (43%) of the former and one (7%) of the latter(p=3D0.04). Mediastinal lymphadenopathy was seen in three cases (21%) of invasive thymoma and ten (67%) of thymic carcinoma. Distant metastases were observed only in six cases (40%) of thymic carcinoma(p=3D0.02). Although differentiation between invasive thymoma and thymic carcinoma is difficult on the basis of CT findings, there are certain differential points. Thymic carcinomas showed a higher rate of direct posterior intrathoracic spread, vessel encasement, mediastinal nodes and distant metastases than

Differential diagnosis of primary nasopharyngeal lymphoma and nasopharyngeal carcinoma focusing on CT, MRI, and PET/CT.

Science.gov (United States)

Cho, Kyu-Sup; Kang, Dae-Woon; Kim, Hak-Jin; Lee, Jong-Kil; Roh, Hwan-Jung

2012-04-01

No study has done a comparative analysis of radiologic imaging findings between primary nasopharyngeal lymphoma (PNL) and nasopharyngeal carcinoma (NPC). The purpose of this study was to analyze computed tomography (CT) and magnetic resonance (MR) images and to evaluate the maximum standardized uptake value (SUV max) of positron emission tomography (PET)/CT between PNL and NPC, knowing the imaging features that distinguish PNL from NPC. Cross-sectional study. University tertiary care facility. The authors analyzed the features on CT, MR imaging, and PET/CT of 16 patients diagnosed with PNL and 32 patients diagnosed with NPC histopathologically. Patients with PNL had a larger tumor volume and showed symmetry of tumor shape than did patients with NPC. Patients with PNL also had higher tumor homogeneity than NPC patients on CT, T2-weighted, and postcontrast MR images. All PNL patients showed a high degree of enhancement without invasion to the adjacent deep structure. The involvement of the Waldeyer ring was significantly higher in PNL patients. Cervical and retropharyngeal lymphadenopathy and PET/CT SUV max showed no significant difference between PNL and NPC. If the images present a bulky, symmetric nasopharyngeal mass with marked homogeneity, a high degree of enhancement, and a higher Waldeyer ring involvement combined with no invasion into the deep structure, PNL should be considered over NPC.

Idiopathic hypereosinophilic syndrome involving the liver: CT features vs. peripheral eosinophilia

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Kim, Kyung Sook; Lee, Moon Gyu; Won, Young Chul; Lee, Eun Hye; Noh, Han Na; Ha, Hyun Kwon; Kim, Pyo Nyun; Auh, Yong Ho [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

1997-10-01

To correlate CT features with peripheral eosinophilia in patients with idiopathic hypereosinophilic syndrome involving the liver. During the last three years, features of liver involvement in nine of 20 patients with idiopathic hypereosinophilic syndrome were evaluated on CT. The shape and distribution of intrahepatic low densities and the presence of hepatomegaly and/or splenomegaly were reviewed on CT, and the percentage of eosinophils in peripheral blood was also determined. In seven cases, interval change in hepatic lesion and the percentage of eosinophils were reviewed on follow-up examination. On initial CT, varying low-density patterns were seen in the liver in all cases; hepatomegaly was seen in four cases, and hepatosplenomegaly in two. The percentage of eosinophils was 89% in a case with diffuse patch low densities in the liver, 65-85% in three cases with numerous nodular low density lesions, 12-29% in four cases with multiple (below ten) nodular or small geographic hypodense lesions, and 24% in a case with a single nodular hypodense lesion. On follow-up CT, seven patients showed a decrease in the percentage of eosinophils, and in six, improved intrahepatic low densities were seen. On CT, intrahepatic low densities were seen in patients with idiopathic hypereosinophilic syndrome, and these were distributed more extensively when peripheral eosinophilia was more severe. With improvement in peripheral eosinophilia, the low densities also improved.

Idiopathic hypereosinophilic syndrome involving the liver: CT features vs. peripheral eosinophilia

International Nuclear Information System (INIS)

Kim, Kyung Sook; Lee, Moon Gyu; Won, Young Chul; Lee, Eun Hye; Noh, Han Na; Ha, Hyun Kwon; Kim, Pyo Nyun; Auh, Yong Ho

1997-01-01

To correlate CT features with peripheral eosinophilia in patients with idiopathic hypereosinophilic syndrome involving the liver. During the last three years, features of liver involvement in nine of 20 patients with idiopathic hypereosinophilic syndrome were evaluated on CT. The shape and distribution of intrahepatic low densities and the presence of hepatomegaly and/or splenomegaly were reviewed on CT, and the percentage of eosinophils in peripheral blood was also determined. In seven cases, interval change in hepatic lesion and the percentage of eosinophils were reviewed on follow-up examination. On initial CT, varying low-density patterns were seen in the liver in all cases; hepatomegaly was seen in four cases, and hepatosplenomegaly in two. The percentage of eosinophils was 89% in a case with diffuse patch low densities in the liver, 65-85% in three cases with numerous nodular low density lesions, 12-29% in four cases with multiple (below ten) nodular or small geographic hypodense lesions, and 24% in a case with a single nodular hypodense lesion. On follow-up CT, seven patients showed a decrease in the percentage of eosinophils, and in six, improved intrahepatic low densities were seen. On CT, intrahepatic low densities were seen in patients with idiopathic hypereosinophilic syndrome, and these were distributed more extensively when peripheral eosinophilia was more severe. With improvement in peripheral eosinophilia, the low densities also improved

FDG-PET/CT and FLT-PET/CT for differentiating between lipid-poor benign and malignant adrenal tumours

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Nakajo, Masatoyo; Jinguji, Megumi; Fukukura, Yoshihiko; Nakabeppu, Yoshiaki; Nakamura, Fumihiko; Yoshiura, Takashi [Kagoshima University, Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima (Japan); Kajiya, Yoriko; Tani, Atushi; Nakajo, Masayuki [Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Arimura, Hiroshi; Nishio, Yoshihiko [Kagoshima University, Department of Diabetes and Endocrine Medicine, Graduate School of Medical and Dental Sciences, Kagoshima (Japan)

2015-12-15

To compare F-18-fluorodeoxyglucose (FDG) and F-18-fluorothymidine (FLT) PET/CT examinations for differentiating between benign and malignant adrenal tumours. Thirty lipid-poor benign and 11 malignant tumours of 40 patients were included. FDG- and FLT-based indices including visual score, maximum standardized uptake value (SUVmax) and FDG adrenal lesion/liver SUVmax (A/L SUVmax) or FLT adrenal lesion/back muscle SUVmax (A/B SUVmax) ratio were compared between benign and malignant tumours using the Mann-Whitney's U or Wilcoxon signed-rank test, and their diagnostic performances were evaluated by means of the area under the curve (AUC) values derived from the receiver operating characteristic analysis. All indices were significantly higher in malignant than benign tumours on both images (p < 0.05 each). On FDG-PET/CT, the sensitivity, specificity, and accuracy were 91 %, 63 % and 71 % for visual score, 91 %, 67 % and 73 % for SUVmax, and 100 %, 70 % and 78 % for A/L SUVmax ratio, respectively. On FLT-PET/CT, they were 100 %, 97 % and 98 % for visual score, SUVmax and A/B SUVmax ratio, respectively. All FLT indices were significantly higher than those of FDG in AUC (p < 0.05 each). FLT-PET/CT may be superior to FDG-PET/CT in differentiating lipid-poor benign from malignant adrenal tumours because of higher specificity and accuracy. (orig.)

In vitro differentiation of renal stone composition using dual-source, dual-energy CT

International Nuclear Information System (INIS)

Zhou Changsheng; Zhang Longjiang; Xu Feng; Qi Li; Zhao Yan'e; Zheng Ling; Huang Wei; Liu Youhuang; Lu Guangming

2012-01-01

Objective: To evaluate the ability of dual-source. dual-energy CT in differentiating uric acid stones from non-uric acid stones with infrared spectroscopy as reference standard. Materials and Methods: Urinary calculus from 308 patients were scanned in first generation dual-source CT with dual-energy mode between July 2011 and June 2012. Renal Stone application was used to analyze their composition. The uric acid stones color were coded red and non-uric acid stones were blue. CT values were measured in 60 selective urinary calculus including 30 uric acid stones and 30 non-uric acid stones. The accuracy of dual energy CT to differentiate uric acid and no-uric acid stones was calculated. Results: Of 308 patients, 60 patients had uric acid stones and 248 non-uric acid stones. No difference was found for uric acid stone at 80 kV and 140 kV (375.8±69.2 HU vs. 374.1±69.4 HU; t=-0.217, P=0.830), while CT values of non-uric acid stones were higher at 80 kV than those at 140 kV (1455.1±312.4 HU vs. 1039.6±194.4 HU; t=-12.16. P<0.001). CT values of non-uric acid stones at 80 kV, 140 kV, and average weighted images (1455.1±312.4 HU, 1 039.6±194.4 HU, and 882.0±176.4 HU, respectively) were higher than those of uric acid stones (375.8±69.2 HU, 374.1±69.4 HU, and 366.3±80.1 HU, respectively; P<0.001). With infrared spectrum findings as reference standard, the accuracy of dual energy CT in differentiating uric acid stones from non-uric acid stones was 100%. Conclusions: Dual-source, dual-energy CT can accurately differentiate uric acid stones from non-uric acid stones, and plays an important role in treatment planning of renal stones. (authors)

Crescentic and ring-shaped opacities. CT features in two cases of bronchiolitis obliterans organizing pneumonia (BOOP)

International Nuclear Information System (INIS)

Voloudaki, A.E.; Bouros, D.E.; Froudarakis, M.E.; Datseris, G.E.; Apostolaki, E.G.; Gourtsoyiannis, N.C.

1996-01-01

Two cases of idiopathic bronchilitis obliterans organizing pneumonia (BOOP) with unusual CT findings are presented. On CT both cases exhibited crescentic and ring-shaped opacities, surrounding areas of groundglass attenuation, and associated with a nodular pattern in one patient and airspace consolidations in the second patient. CT-pathologic correlation dislosed that the central areas of groundglass attenuation corresponded to alveolar septal inflammation, in contrast to the denser periphery where granulomatous tissue in peripheral airspaces predominated. In the broad spectrum of CT findings, BOOP can exhibit specific CT features with regard to the crescentic or ring-shaped opacities with a central groundglass attenuation area. Since these features have not been described in any other disease, they might be characteristic features for the diagnosis of BOOP. (orig.)

Diagnosis and differential diagnosis of cerebro-vascular malformations by CT

International Nuclear Information System (INIS)

Schumacher, M.; Stoeter, P.; Voigt, K.

1980-01-01

In 38 patients, the diagnosis of a cerebrovascular malformation (17 arteriovenous angiomas including one low-flow- and two venous angiomas; 10 aneurysms; 4 arteriovenous fistulae of the cavernous sinus, the tentorium and one of the Great Vein of Galen; 6 megadolical basilar arteries) was initially made by computertomographic (CT) examination, including contrast enhancement. The characteristic and pathognomonic CT findings are described and compared with those of cerebral angiography also done in these cases. The problems of differential diagnosis and the reasons for a false CT diagnosis in 5 other patients with a cerebro-vascular malformation are investigated; and the diagnostic value of cerebral angiography and CT is discussed and their complementary functions are being pointed out. (orig.) 891 MG/orig. 892 MKO [de

Differentiation between tuberculosis and primary tumors in the adrenal gland: evaluation with contrast-enhanced CT

International Nuclear Information System (INIS)

Yang, Zhi-Gang; Guo, Ying-Kun; Li, Yuan; Min, Peng-Qiu; Yu, Jian-Qun; Ma, En-Sen

2006-01-01

The aim of the present study is to determine imaging criteria for differentiating tuberculosis from primary tumors in the adrenal gland on contrast-enhanced CT. Non-contrast and contrast-enhanced CT features in 108 patients with adrenal tuberculosis (n=34) and primary tumor (n=74) were retrospectively assessed for the location, size, calcification and enhancement patterns. The primary tumors included 41 adenomas, 11 pheochromocytomas, 4 carcinomas, 3 lymphomas, 6 myelolipomas, 6 ganglioneuromas, 2 neurilemmomas and 1 ganglioneuroblastoma. Biochemical investigation was performed for all patients. Of the tuberculosis cases, 31 (91%) invaded with bilateral involvement, while 7 (9%) of the primary tumors invaded with bilateral involvement (P<0.001). Tuberculosis often showed calcification (20 of 34; 59%), whereas primary tumors infrequently showed calcification (6 of 74; 8%; P<0.001). Low attenuation in the center with peripheral rim enhancement was more commonly seen in tuberculosis (16 of 34; 47%) than in primary tumors (7 of 74; 9%; P<0.001). In the determination of tuberculosis, the highest sensitivity (91%) and accuracy (91%) were obtained with bilateral involvement, and the highest specificity (99%) was obtained with the contour preserved. In the determination of primary tumors using a combination of having unilateral involvement and being mass-like, the outcome was a sensitivity of 91%, specificity of 94% and accuracy of 92%. CT findings can differentiate tuberculosis from a primary tumor of the adrenal glands with high sensitivity and an acceptable specificity when combined with the endocrinological examination. (orig.)

Pulmonary nodule characterization, including computer analysis and quantitative features.

Science.gov (United States)

Bartholmai, Brian J; Koo, Chi Wan; Johnson, Geoffrey B; White, Darin B; Raghunath, Sushravya M; Rajagopalan, Srinivasan; Moynagh, Michael R; Lindell, Rebecca M; Hartman, Thomas E

2015-03-01

Pulmonary nodules are commonly detected in computed tomography (CT) chest screening of a high-risk population. The specific visual or quantitative features on CT or other modalities can be used to characterize the likelihood that a nodule is benign or malignant. Visual features on CT such as size, attenuation, location, morphology, edge characteristics, and other distinctive "signs" can be highly suggestive of a specific diagnosis and, in general, be used to determine the probability that a specific nodule is benign or malignant. Change in size, attenuation, and morphology on serial follow-up CT, or features on other modalities such as nuclear medicine studies or MRI, can also contribute to the characterization of lung nodules. Imaging analytics can objectively and reproducibly quantify nodule features on CT, nuclear medicine, and magnetic resonance imaging. Some quantitative techniques show great promise in helping to differentiate benign from malignant lesions or to stratify the risk of aggressive versus indolent neoplasm. In this article, we (1) summarize the visual characteristics, descriptors, and signs that may be helpful in management of nodules identified on screening CT, (2) discuss current quantitative and multimodality techniques that aid in the differentiation of nodules, and (3) highlight the power, pitfalls, and limitations of these various techniques.

CT differentiation of infiltrating renal cell carcinoma and renal urothelial tumor

International Nuclear Information System (INIS)

Choi, Hyo Kyeong; Goo, Dong Erk; Bang, Sun Woo; Lee, Moon Gyu; Cho, Kyoung Sik; Auh, Yong Ho

1994-01-01

It may be difficult to differentiate renal cell carcinoma involving collecting system from renal urothelial tumor invading into renal parenchyma. The purpose of this study was to assess the differences of CT findings between two conditions. CT findings of 5 cases of renal cell carcinoma involving the renal collecting systems and 10 cases of renal urothelial tumors invading the renal parenchyma were compared, and analyzed about the presence or absence of hydronephrosis, normal or abnormal CT nephrogram, renal contour changes due to mass and tentative diagnosis. The diagnoses were confirmed at surgery. Renal cell carcinoma showed hydronephrosis in only 20% and normal CT nephrogram and outward contour bulging in all cases. In contrast, renal urothelial tumor showed hydronephrosis(70%), abnormal CT nephrogram(60%), and preservation of reinform shape(100%). Renal contour changes and CT nephrogram may be useful in distinguishing both disease entities

CT findings of diffuse pleural diseases: differentiation of malignant disease from tuberculosis

International Nuclear Information System (INIS)

Roh, In Gye; Kook, Shin Ho; Lee, Young Rae; Chin, Seung Bum; Park, Yoon Ok; Park, Hae Won

1997-01-01

To evaluate whether or not previously known CT criteria for differentiating malignant and benign pleural diseases are useful in the differentiation of diffuse malignant pleural diseases and tuberculosis. We retrospectively analyzed CT scans of 42 patients comprising 20 cases of malignant pleural diseases and 22 cases of tuberculous pleural diseases, according to previously known CT criteria for differentiating malignant and benign pleural diseases. The most common shape of pleural effusion was crescentic in malignant pleural diseases and loculated in tuberculosis. The aggressive nature of pleural effusion, pleural rind, and pleura thickening was 1.5 times more frequently observed in malignant pleural diseases than in tuberculosis. Smooth thickening or smooth nodular pleural thickening and extrapleural deposition of fat were 1.5 times more frequently found in tuberculous than in malignant pleural diseases. Interruption of pleural thickening was found twice as frequently in malignant pleural diseases as in tuberculosis. Decreased lung volume was found twice as frequently in tuberculous as in malignant pleural diseases. Anatomical mediastinal pleural involvement was three times, and irregular nodular pleural thickening nine times more frequent in malignant pleural diseases than in tuberculosis. The sensitivity and specificity of CT findings above 70%, and thus suggesting malignant pleural diseases, were as follows : 1) aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung (51.5%, 75%); 2) involvement of anatomical mediastinal pleura (69.2%, 73.7%); 3) irregular nodular pleural thickening (87.5%, 69%). Although there in overlap between previously known CT criteria for the differentiation of benign and malignant pleural diseases, the aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung, the involvement of anatomical mediastinal pleura and irregular nodular

comparison of clinical features and CT findings between atypical thymoma and thymic carcinoma

International Nuclear Information System (INIS)

Wang Xiangyang; Tan Ye; Chen Juan; Wei Jiahu; Pan Jishun; Du Jun; Zhou Cheng

2011-01-01

statistically significant (P=0.000). CT features: the average long diameter of tumor in type C group was (6.4±2.1) cm, significantly longer than that in type B3 group, which was (4.6±2.3) cm (t=-2.778, P=0.008), and the contour of tumor in type C group usually showed irregularity (13/17, 76.5%), while it usually showed lobulated (18/30, 60.0%) in type B3 group (P=0.019), more necrosis found in C group (15/17, 88.2%) than B3 group (17/30, 56.7%), compared with type B3 group on enhanced CT, more tumor in type C group showed heterogeneous enhancement (P=0.042), and more great vessel invasion (15/17, 88.2%, P=0.001) and more distant metastasis (8/17, 47.0%, P=0.028) occurred in type C group. Conclusion: Most of type B3 and type C thymoma have a certain significant difference in clinical factor, prognosis and CT findings, which are helpful for differentiation. (authors)

Tuberculous adenitis: comparison of CT and MRI findings with histopathological features

International Nuclear Information System (INIS)

Backer, A.I. de; Mortele, K.J.; Heuvel, E. van den; Vanschoubroeck, I.J.; Kockx, M.M.; Vyvere, M. van de

2007-01-01

Our aim was to investigate the relationship between the various histopathological features and the CT and MRI findings in routinely submitted histopathological specimens for the diagnosis of tuberculous lymphadenopathy. Twelve formalin-fixed, paraffin-embedded tissue blocks from ten patients who were clinically suspected of having tuberculous lymphadenopathy were evaluated. We assessed the presence of histopathological features including granuloma formation, caseous necrosis, and presence of Langhans-type giant cells, calcifications, fibrosis or normal lymphoid tissue. We performed polymerase chain reaction (PCR)-based assay for mycobacterial DNA and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Findings were compared with those of CT and MRI, including signal intensities on unenhanced MR images, lymph node homogeneity, attenuation values on contrast-enhanced CT and enhancement patterns on MRI. Based on CT and MRI findings, four lymph node types could be defined: (1) homogeneous nodes, visible on both pre- and post-contrast images and corresponding histopathologically to granulation tissue without or with minimal caseation necrosis (n = 2); (2) heterogeneous nodes, showing heterogeneous enhancement patterns with central non-enhancing areas and corresponding to minor or moderate intranodal caseation/liquefaction necrosis (n = 3); (3) nodes showing peripheral rim enhancement and corresponding to moderate or extensive intranodal caseation/liquefaction necrosis (n = 5); (4) heterogeneous nodes showing intranodal hyperdensities on CT and hypointense areas on T1- and T2-weighted images and corresponding to fibrosis and calcifications (n = 2). On CT and MRI, the findings reflect different stages of the tuberculous process. Imaging findings depend on the presence and the degree of granuloma formation, caseation/liquefaction necrosis, fibrosis and calcifications. (orig.)

Background area effects on feature detectability in CT and uncorrelated noise

International Nuclear Information System (INIS)

Swensson, R.G.; Judy, P.F.

1987-01-01

Receiver operating characteristic curve measures of feature detectability decrease substantially when the surrounding area of uniform-noise background is small relative to that of the feature itself. The effect occurs with both fixed and variable-level backgrounds, but differs in form for CT and uncorrelated noise. Cross-correlation image calculations can only predict these effects by treating feature detection as the discrimination of a local change (a ''feature'') from the estimated level of an assumed-uniform region of background

MRI and CT features of hyperplastic callus in osteogenesis imperfecta tarda

International Nuclear Information System (INIS)

Dobrocky, I.; Seidl, G.; Grill, F.

1999-01-01

We describe the MRI and CT findings of hyperplastic callus formation simulating a tumour of pelvis in patient with osteogenesis imperfecta tarda. Possible differential diagnoses and the impact of different imaging techniques on the correct diagnosis are discussed. (orig.)

Differentiation between right tubo-ovarian abscess and appendicitis using CT-A diagnostic challenge

International Nuclear Information System (INIS)

Eshed, I.; Halshtok, O.; Erlich, Z.; Mashiach, R.; Hertz, M.; Amitai, M.M.; Portnoy, O.; Guranda, L.; Hiller, N.; Apter, S.

2011-01-01

Aim: To determine CT features that can potentially differentiate right tubo-ovarian abscess (TOA) from acute appendicitis (AA; including abscess formation). Materials and methods: The abdominal computed tomography (CT) images of 48 patients with right-sided TOA (average age 39.3 ± 9.8 years) and 80 patients (average age 53.5 ± 19.9 years) with AA (24 with peri-appendicular abscess) were retrospectively evaluated. Two experienced radiologists evaluated 12 CT signs (including enlarged, thickened wall ovary, appendix diameter and wall thickness, peri-appendicular fluid collection, adjacent bowel wall thickening, fat stranding, free fluid, and extraluminal gas) in consensus to categorize the studies as either TOA or AA. The diagnosis and the frequency of each of the signs were correlated with the surgical and clinical outcome. Results: Reviewers classified 92% cases correctly (TOA = 85%, AA = 96.3%), 3% incorrectly (TOA = 6.3%, AA = 1.3%); 5% were equivocal (TOA = 8.3%, AA = 2.5%). In the peri-appendicular abscess group reviewers were correct in 100%. Frequent findings in the TOA group were an abnormal ovary (87.5%), peri-ovarian fat stranding (58.3%), and recto-sigmoid wall thickening (37.5%). An abnormal appendix was observed in 2% of TOA patients. Frequent findings in the AA group were a thickened wall (32.5%) and distended (80%) appendix. Recto-sigmoid wall thickening was less frequent in AA (12.5%). The appendix was not identified in 45.8% of the TOA patients compared to 15% AA. Conclusions: In the presence of a right lower quadrant inflammatory mass, peri-ovarian fat stranding, thickened recto-sigmoid wall, and a normal appearing caecum, in young patients favour the diagnosis of TOA. An unidentified appendix does not contribute to the differentiation between TOA and peri-appendicular abscess.

Differentiation between right tubo-ovarian abscess and appendicitis using CT-A diagnostic challenge

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Eshed, I., E-mail: iriseshed@gmail.com [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Halshtok, O. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Erlich, Z. [Computer Science Department, Open University, Tel Aviv (Israel); Mashiach, R. [Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Hertz, M.; Amitai, M.M.; Portnoy, O.; Guranda, L. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel); Hiller, N. [Department of Radiology, Hadassah-Hebrew University Medical Center, Mount Scopus (Israel); Apter, S. [Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv (Israel)

2011-11-15

Aim: To determine CT features that can potentially differentiate right tubo-ovarian abscess (TOA) from acute appendicitis (AA; including abscess formation). Materials and methods: The abdominal computed tomography (CT) images of 48 patients with right-sided TOA (average age 39.3 {+-} 9.8 years) and 80 patients (average age 53.5 {+-} 19.9 years) with AA (24 with peri-appendicular abscess) were retrospectively evaluated. Two experienced radiologists evaluated 12 CT signs (including enlarged, thickened wall ovary, appendix diameter and wall thickness, peri-appendicular fluid collection, adjacent bowel wall thickening, fat stranding, free fluid, and extraluminal gas) in consensus to categorize the studies as either TOA or AA. The diagnosis and the frequency of each of the signs were correlated with the surgical and clinical outcome. Results: Reviewers classified 92% cases correctly (TOA = 85%, AA = 96.3%), 3% incorrectly (TOA = 6.3%, AA = 1.3%); 5% were equivocal (TOA = 8.3%, AA = 2.5%). In the peri-appendicular abscess group reviewers were correct in 100%. Frequent findings in the TOA group were an abnormal ovary (87.5%), peri-ovarian fat stranding (58.3%), and recto-sigmoid wall thickening (37.5%). An abnormal appendix was observed in 2% of TOA patients. Frequent findings in the AA group were a thickened wall (32.5%) and distended (80%) appendix. Recto-sigmoid wall thickening was less frequent in AA (12.5%). The appendix was not identified in 45.8% of the TOA patients compared to 15% AA. Conclusions: In the presence of a right lower quadrant inflammatory mass, peri-ovarian fat stranding, thickened recto-sigmoid wall, and a normal appearing caecum, in young patients favour the diagnosis of TOA. An unidentified appendix does not contribute to the differentiation between TOA and peri-appendicular abscess.

ROLE OF CT IN DIFFERENTIATION OF MUCINOUS AND NON-MUCINOUS CARCINOMAS OF THE RECTUM

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Piyush Joshi

2017-01-01

Full Text Available BACKGROUND Colorectal carcinomas can broadly be classified as either non-mucinous or mucinous. Usually, mucinous adenocarcinomas present at a more advanced stage, have more aggressive local spread and have an increased incidence of lymph node involvement. Those cancers occurring in the rectum are considered more aggressive and require careful planning for treatment. Screening Computed Tomography (CT is widely used for the initial evaluation of these tumours. The aim of the study is to retrospectively analyse the CT images of rectal adenocarcinomas and suggest parameters to aid differentiation of mucinous and non-mucinous tumours. MATERIALS AND METHODS The CT images of 24 cases of mucinous and 26 cases of non-mucinous adenocarcinoma were retrospectively reviewed and evaluated for parameters like morphology, wall thickness, size, pattern and degree of enhancement and the presence or absence of calcification. Also, evaluated was involvement of adjacent structures, lymph nodes and distant metastases. RESULTS All the parameters were analysed for significance using the chi-square test. Mucinous adenocarcinomas of the rectum showed a greater propensity for eccentric bowel thickening, heterogenous enhancement and calcification with a p value less than 0.05. Heterogenous enhancement showed the greatest sensitivity (75% and calcification the greatest specificity (83.3%. The other parameters did not show any difference between the two groups. CONCLUSION CT features most likely to suggest rectal mucinous carcinoma are heterogenous contrast enhancement, eccentric wall thickening and intratumoural calcification. As mucinous carcinomas follow an aggressive course, if a diagnosis of mucinous carcinoma of the rectum can be suggested on the staging CT, it may influence patient management.

In Vivo Differentiation of Complementary Contrast Media at Dual-Energy CT

Science.gov (United States)

Mongan, John; Rathnayake, Samira; Fu, Yanjun; Wang, Runtang; Jones, Ella F.; Gao, Dong-Wei

2012-01-01

Purpose: To evaluate the feasibility of using a commercially available clinical dual-energy computed tomographic (CT) scanner to differentiate the in vivo enhancement due to two simultaneously administered contrast media with complementary x-ray attenuation ratios. Materials and Methods: Approval from the institutional animal care and use committee was obtained, and National Institutes of Health guidelines for the care and use of laboratory animals were observed. Dual-energy CT was performed in a set of iodine and tungsten solution phantoms and in a rabbit in which iodinated intravenous and bismuth subsalicylate oral contrast media were administered. In addition, a second rabbit was studied after intravenous administration of iodinated and tungsten cluster contrast media. Images were processed to produce virtual monochromatic images that simulated the appearance of conventional single-energy scans, as well as material decomposition images that separate the attenuation due to each contrast medium. Results: Clear separation of each of the contrast media pairs was seen in the phantom and in both in vivo animal models. Separation of bowel lumen from vascular contrast medium allowed visualization of bowel wall enhancement that was obscured by intraluminal bowel contrast medium on conventional CT scans. Separation of two vascular contrast media in different vascular phases enabled acquisition of a perfectly coregistered CT angiogram and venous phase–enhanced CT scan simultaneously in a single examination. Conclusion: Commercially available clinical dual-energy CT scanners can help differentiate the enhancement of selected pairs of complementary contrast media in vivo. © RSNA, 2012 PMID:22778447

CT imaging features of tuberculous spondylitis in children

International Nuclear Information System (INIS)

Song Min; Liu Wen; Fang Weijun; Wang Fukang; Li Ziping

2009-01-01

Objective: To investigate CT imaging features of tuberculous spondylitis in children. Methods: The CT imagings of two groups of patients with Tuberculous Spondylitis between January 2004 and March 2008 were retrospectively reviewed. One group included 28 children from 0 to 14 years old. Another group included 159 adults. All the patients were diagnosed as tuberculous spondylitis by pathology or biopsy, or by anti-turboelectric therapy. The CT imagings of the two groups were read retrospectively, including infections of vertebras and its appendix, the proportion of the total length of paravertebral abscess to the height of relative vertebra, the information of paravertebral abscess and dura mate of spinal cord and nerve root compression. Results The ratio of kyphosis in children group was 75% (21/28), higher than that in adults'. Tuberculous spondylitis in children was most often involved thoracic vertebra (53.7%,51/95). In children, involvement was more often seen than that of cervical vertebra and lumbar. The ratio of tuberculous spondylitis of children's cervical vertebrae was 10.5% (10/95)and of lumbar was 31.6% (30/95, while in adults that of cervical vertebrae was 3.3% (16/479)and of lumbar was 44.5% (213/479). There was statistical difference between them. The percentages of central type of tuberculous vertebral osteitis in chlidren was 57.1% (16/28)and was different with that in adults'(P=0.001 0.05). The incidence of dura mate of spinal cord or nerve root compression in children was 78.6%(22/28), much higher than that in adults (49.7%(79/159), P=0.005 <0.05). Conclusion: Special features of tuberculous spondylitis in childrencan be observed on CT imaging, kyphosis is often seen. The incidence of tuberculous spondylitis of thoracic vertebra and cervical vertebrae is high, central type of tuberculous vertebral osteitis in children is more popular than that in adults, but there is higher ratio of dura mate of spinal cord or nerve root compression in children

CT and MRI characteristics of vertebral tuberculosis (34 cases)

International Nuclear Information System (INIS)

Lu Wenbing; Liao Qinghou; Wu Shiqiang; Huang Tao; Deng Yufang; Liu Jianming

2007-01-01

Objective: To explore CT and MRI characteristics of vertebral tuberculosis. Methods: 34 patients with vertebral tuberculosis proved by clinic or pathology were analyzed retrospectively. Of these patients, 20 were performed with CT examination and 24 with MRI, 10 with both CT and MRI. The results were compared mutually. Results: The CT features of vertebral tuberculosis were bone destruction, paraspinal abscess, spinal canal involvement. The MRI features of vertebral tuberculosis were bone destruction, intervertebral disc destruction, paraspinal abscess, spinal canal involvement, sub-ligamental spread. Conclusion: Vertebral tuberculosis showed multiple characteristics on CT and MRI. CT is useful in showing sequester and calcification, and MRI is useful in showing sub-ligamental spread, epidural and spinal cord involvement. Combining CT with and MRI is helpful for the diagnosis and differential diagnosis of vertebral tuberculosis. (authors)

The linear attenuation coefficients as features of multiple energy CT image classification

International Nuclear Information System (INIS)

Homem, M.R.P.; Mascarenhas, N.D.A.; Cruvinel, P.E.

2000-01-01

We present in this paper an analysis of the linear attenuation coefficients as useful features of single and multiple energy CT images with the use of statistical pattern classification tools. We analyzed four CT images through two pointwise classifiers (the first classifier is based on the maximum-likelihood criterion and the second classifier is based on the k-means clustering algorithm) and one contextual Bayesian classifier (ICM algorithm - Iterated Conditional Modes) using an a priori Potts-Strauss model. A feature extraction procedure using the Jeffries-Matusita (J-M) distance and the Karhunen-Loeve transformation was also performed. Both the classification and the feature selection procedures were found to be in agreement with the predicted discrimination given by the separation of the linear attenuation coefficient curves for different materials

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT.

Science.gov (United States)

Zhang, Xirong; Duan, Haifeng; Yu, Yong; Ma, Chunling; Ren, Zhanli; Lei, Yuxin; He, Taiping; Zhang, Ming

2018-01-01

To investigate the value of spectral CT in the differential diagnosis of benign from malignant pleural effusion. 14 patients with benign pleural effusion and 15 patients with malignant pleural effusion underwent non-contrast spectral CT imaging. These patients were later verified by the combination of disease history, clinical signs and other information with the consensus of surgeons and radiologists. Various Spectral CT image parameters measured for the effusion were as follows: CT numbers of the polychromatic 140kVp images, monochromatic images at 40keV and 100keV, the material density contents from the water, fat and blood-based material decomposition images, the effective atomic number and the spectral curve slope. These values were statistically compared with t test and logistic regression analysis between benign and malignant pleural effusion. The CT value of benign and malignant pleural effusion in the polychromatic 140kVp images showed no differences (12.61±3.39HU vs. 14.71±5.03HU) (P>0.05), however, they were statistically different on the monochromatic images at 40keV (43.15±3.79 vs. 39.42±2.60, p = 0.005) and 100keV (9.11±1.38 vs. 6.52±2.04, p<0.001). There was difference in the effective atomic number value between the benign (7.87±0.08) and malignant pleural effusion (7.90±0.02) (P = 0.02). Using 6.32HU as the threshold for CT value measurement at 100keV, one could obtain sensitivity of 100% and specificity of 66.7% with area-under-curve of 0.843 for differentiating benign from malignant effusion. In addition, age and disease history were potential confounding factors for differentiating malignant pleural effusion from benign, since the older age (61.13±12.51 year-old vs48.57±12.33 year-old) as well as longer disease history (70.00±49.28 day vs.28.36±21.64 day) were more easily to be found in the malignant pleural effusion group than those in the benign pleural effusion group. By combining above five factors, one could obtain sensitivity

Analysis on CT features of tumor-like gastric schwannomas

International Nuclear Information System (INIS)

Zhang Yu; Chen Jie

2011-01-01

Objective: To analyze CT imaging features of tumor-like gastric schwannomas. Methods: Ten patients with gastric schwannomas were retrospectively analyzed. All were scanned with pre-and pro-enhanced CT. Analysis of the CT findings included evaluation of the volume, number, location, contour, growth pattern, border, enhancement pattern, and enhancement grade as well as the presence of surface dimpling, integrity of overlying mucosa. All cases were confirmed by pathology. Results: In every case, simple tumor was present. The largest was about 5.7 cm in the diameter, the smallest was 2.3 cm. All tumors were round or oval, and one tumor was slightly lobulated. Endoluminal growth pattern was defined in two cases, exoluminal growth pattern was defined in one case, and a mixed growth pattern was noted in the rest. The borders of tumors were clear. In arterial phase, no visible enhancement was present in eight cases and mild enhancement in two cases. All cases were constantly enhanced in portal phase. Superficial ulcers were present in four cases. Conclusion: CT findings of tumor-like gastric schwannomas are distinctive to a certain degree. It can be used to guide clinical therapy. (authors)

MRI and CT features of hyperplastic callus in osteogenesis imperfecta tarda

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Dobrocky, I. [Diagnostic Center Meidling, Vienna (Austria); Seidl, G. [Diagnostic Center Meidling, Vienna (Austria)]|[Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Grill, F. [Orthopaedisches Spital Wien Speising, Vienna (Austria)

1999-05-01

We describe the MRI and CT findings of hyperplastic callus formation simulating a tumour of pelvis in patient with osteogenesis imperfecta tarda. Possible differential diagnoses and the impact of different imaging techniques on the correct diagnosis are discussed. (orig.) With 3 figs., 5 refs.

Learning with distribution of optimized features for recognizing common CT imaging signs of lung diseases

Science.gov (United States)

Ma, Ling; Liu, Xiabi; Fei, Baowei

2017-01-01

Common CT imaging signs of lung diseases (CISLs) are defined as the imaging signs that frequently appear in lung CT images from patients. CISLs play important roles in the diagnosis of lung diseases. This paper proposes a novel learning method, namely learning with distribution of optimized feature (DOF), to effectively recognize the characteristics of CISLs. We improve the classification performance by learning the optimized features under different distributions. Specifically, we adopt the minimum spanning tree algorithm to capture the relationship between features and discriminant ability of features for selecting the most important features. To overcome the problem of various distributions in one CISL, we propose a hierarchical learning method. First, we use an unsupervised learning method to cluster samples into groups based on their distribution. Second, in each group, we use a supervised learning method to train a model based on their categories of CISLs. Finally, we obtain multiple classification decisions from multiple trained models and use majority voting to achieve the final decision. The proposed approach has been implemented on a set of 511 samples captured from human lung CT images and achieves a classification accuracy of 91.96%. The proposed DOF method is effective and can provide a useful tool for computer-aided diagnosis of lung diseases on CT images.

Feature-based US to CT registration of the aortic root

Science.gov (United States)

Lang, Pencilla; Chen, Elvis C. S.; Guiraudon, Gerard M.; Jones, Doug L.; Bainbridge, Daniel; Chu, Michael W.; Drangova, Maria; Hata, Noby; Jain, Ameet; Peters, Terry M.

2011-03-01

A feature-based registration was developed to align biplane and tracked ultrasound images of the aortic root with a preoperative CT volume. In transcatheter aortic valve replacement, a prosthetic valve is inserted into the aortic annulus via a catheter. Poor anatomical visualization of the aortic root region can result in incorrect positioning, leading to significant morbidity and mortality. Registration of pre-operative CT to transesophageal ultrasound and fluoroscopy images is a major step towards providing augmented image guidance for this procedure. The proposed registration approach uses an iterative closest point algorithm to register a surface mesh generated from CT to 3D US points reconstructed from a single biplane US acquisition, or multiple tracked US images. The use of a single simultaneous acquisition biplane image eliminates reconstruction error introduced by cardiac gating and TEE probe tracking, creating potential for real-time intra-operative registration. A simple initialization procedure is used to minimize changes to operating room workflow. The algorithm is tested on images acquired from excised porcine hearts. Results demonstrate a clinically acceptable accuracy of 2.6mm and 5mm for tracked US to CT and biplane US to CT registration respectively.

Enhanced dual-phase spiral CT features of polypoid ampullary carcinoma

International Nuclear Information System (INIS)

Zeng Mengsu; Yan Fuhua; Zhou Kangrong; Chen Huiming; Chen Gang; Chen Jin

2001-01-01

Objective: To understand CT features of polypoid ampullary carcinoma by enhanced dual-phase spiral CT. Methods: 15 cases of polypoid ampullary carcinoma (PAC) confirmed by surgical and pathological results were studied with thin slice enhanced dual-phase spiral CT (including arterial and portal phase scanning)with retrospective analysis, the scanning parameters were 5 mm thickness and 1.0 pitch for arterial phase scanning, and 5 mm thickness and 5 mm space for portal phase scanning. Results: All cases could display an enhanced mass as local filling defect at the site of the duodenal Vater's ampulla during arterial and portal phase scanning, the tumors ranged in size from 1 cm to 5 cm with mean of 2.3 cm, all were accompanied with dilated intrahepatic and common bile duct, enlarged gallbladder and dilated pancreatic duct, except one case which had marked atrophy of the pancreatic body and tail. Conclusion: The thin slices enhanced dual-phase spiral CT could not only accurately define the level of obstruction, but also demonstrate an enhanced mass as direct CT sign of the PAC, which is crucial for diagnosis of the PAC

Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features

International Nuclear Information System (INIS)

Zhou, Hua; Lou, Hai Yan; Wang, Yi Xiang J.; Xu, Xiao Jun; Zhang, Min Ming

2014-01-01

To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.

Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features

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Zhou, Hua; Lou, Hai Yan [Dept. of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wang, Yi Xiang J. [Dept. of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Xu, Xiao Jun; Zhang, Min Ming [Dept. of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China)

2014-04-15

To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.

Spectral CT imaging in differential diagnosis of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms

International Nuclear Information System (INIS)

Lin Xiaozhu; Chen Kemin; Wu Zhiyuan; Tao Ran; Guo Yan; Zhang Jing; Li Jianying; Shen Yun

2011-01-01

Objective: To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods: From Feb. 2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy, effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results: Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV (with 10 keV increment) in late arterial phase [(36±13) HU vs. (62±23) HU, (26±8) HU vs. (40±15) HU, and (19±6) HU vs. (27±10) HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [(43±14) HU vs. (61±25) HU and (30±10) HU vs. (40±16) HU respectively], effective-Z (late arterial phase 7.80± 0.16 vs. 8.05±0.21, and portal venous phase 7.87±0.15 vs 8.02±0.22), concentration of calcium (water) [late arterial phase (5±3) g/L vs. (11±4) g/L, t=-3.836, P=0.001 and portal venous phase (7±3) g/L vs. (10±5) g/L, t=-2.071, P=0.049] and iodine (water) [late arterial phase (0.38±0.24) g/L vs. (0.78±0.32) g/L, t=-3.755, P=0.001 and portal venous phase (0.48± 0.24) g/L vs. (0

Prognostic Value and Reproducibility of Pretreatment CT Texture Features in Stage III Non-Small Cell Lung Cancer

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Fried, David V. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhou, Shouhao [Division of Quantitative Sciences, Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mawlawi, Osama [Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Ibbott, Geoffrey [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Court, Laurence E., E-mail: LECourt@mdanderson.org [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States)

2014-11-15

Purpose: To determine whether pretreatment CT texture features can improve patient risk stratification beyond conventional prognostic factors (CPFs) in stage III non-small cell lung cancer (NSCLC). Methods and Materials: We retrospectively reviewed 91 cases with stage III NSCLC treated with definitive chemoradiation therapy. All patients underwent pretreatment diagnostic contrast enhanced computed tomography (CE-CT) followed by 4-dimensional CT (4D-CT) for treatment simulation. We used the average-CT and expiratory (T50-CT) images from the 4D-CT along with the CE-CT for texture extraction. Histogram, gradient, co-occurrence, gray tone difference, and filtration-based techniques were used for texture feature extraction. Penalized Cox regression implementing cross-validation was used for covariate selection and modeling. Models incorporating texture features from the 33 image types and CPFs were compared to those with models incorporating CPFs alone for overall survival (OS), local-regional control (LRC), and freedom from distant metastases (FFDM). Predictive Kaplan-Meier curves were generated using leave-one-out cross-validation. Patients were stratified based on whether their predicted outcome was above or below the median. Reproducibility of texture features was evaluated using test-retest scans from independent patients and quantified using concordance correlation coefficients (CCC). We compared models incorporating the reproducibility seen on test-retest scans to our original models and determined the classification reproducibility. Results: Models incorporating both texture features and CPFs demonstrated a significant improvement in risk stratification compared to models using CPFs alone for OS (P=.046), LRC (P=.01), and FFDM (P=.005). The average CCCs were 0.89, 0.91, and 0.67 for texture features extracted from the average-CT, T50-CT, and CE-CT, respectively. Incorporating reproducibility within our models yielded 80.4% (±3.7% SD), 78.3% (±4.0% SD), and 78

Prognostic Value and Reproducibility of Pretreatment CT Texture Features in Stage III Non-Small Cell Lung Cancer

International Nuclear Information System (INIS)

Fried, David V.; Tucker, Susan L.; Zhou, Shouhao; Liao, Zhongxing; Mawlawi, Osama; Ibbott, Geoffrey; Court, Laurence E.

2014-01-01

Purpose: To determine whether pretreatment CT texture features can improve patient risk stratification beyond conventional prognostic factors (CPFs) in stage III non-small cell lung cancer (NSCLC). Methods and Materials: We retrospectively reviewed 91 cases with stage III NSCLC treated with definitive chemoradiation therapy. All patients underwent pretreatment diagnostic contrast enhanced computed tomography (CE-CT) followed by 4-dimensional CT (4D-CT) for treatment simulation. We used the average-CT and expiratory (T50-CT) images from the 4D-CT along with the CE-CT for texture extraction. Histogram, gradient, co-occurrence, gray tone difference, and filtration-based techniques were used for texture feature extraction. Penalized Cox regression implementing cross-validation was used for covariate selection and modeling. Models incorporating texture features from the 33 image types and CPFs were compared to those with models incorporating CPFs alone for overall survival (OS), local-regional control (LRC), and freedom from distant metastases (FFDM). Predictive Kaplan-Meier curves were generated using leave-one-out cross-validation. Patients were stratified based on whether their predicted outcome was above or below the median. Reproducibility of texture features was evaluated using test-retest scans from independent patients and quantified using concordance correlation coefficients (CCC). We compared models incorporating the reproducibility seen on test-retest scans to our original models and determined the classification reproducibility. Results: Models incorporating both texture features and CPFs demonstrated a significant improvement in risk stratification compared to models using CPFs alone for OS (P=.046), LRC (P=.01), and FFDM (P=.005). The average CCCs were 0.89, 0.91, and 0.67 for texture features extracted from the average-CT, T50-CT, and CE-CT, respectively. Incorporating reproducibility within our models yielded 80.4% (±3.7% SD), 78.3% (±4.0% SD), and 78

Usefulness of texture analysis in differentiating transient from persistent part-solid nodules(PSNs: a retrospective study.

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Sang Hwan Lee

Full Text Available BACKGROUND: Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features. METHODS: This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed. RESULTS: Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05 C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9% showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%. (P =  0.004. CONCLUSION: Texture analysis of

Spiral CT features and anatomic basis of posterior pararenal space involvement in acute pancreatitis

International Nuclear Information System (INIS)

Min Pengqiu; Yan Zhihan; Yang Hengxuan; Liu Zaiyi; Song Bin; Wu Bing; Zhang Jin; Liu Rongbo

2005-01-01

Objective: To evaluate spiral CT features and anatomic basis of the posterior pararenal space (PPS) involvement in acute pancreatitis (AP). Methods: CT images of 87 cases with AP were retrospectively studied with focus on spiral CT features, incidence of the PPS involvement, and its correlations with the posterior renal fascia or lateroconal fascia. Results: Our study showed that the incidence of the PPS involvement was 47% (41/87), with Grade A 53% (46/87), Grade B 24%(21/87), and Grade C 23% (20/87), and Grade 0 53% (46/87), Grade I 22% (19/87), and Grade II 25% (22/87), respectively. The pancreatitis fluid collection in the PPS was continuous with that in the anterior pararenal space or with the fluid between the two laminae of the posterior renal fascia. In 3 follow-up cases, pseudocysts in the PPS were continuous with that in anterior pararenal space below the cone of renal fascia. Conclusion: Spiral CT features of the PPS involvement varies from mild inflammatory changes to fluid collection or phlegmonous mass. Fluid within anterior pararenal space in AP flows into the PPS by three routes. (authors)

Application of CT texture analysis in predicting histopathological characteristics of gastric cancers

International Nuclear Information System (INIS)

Liu, Shunli; Liu, Song; Ji, Changfeng; Zheng, Huanhuan; Pan, Xia; Zhang, Yujuan; He, Jian; Zhou, Zhengyang; Guan, Wenxian; Chen, Ling; Guan, Yue; Li, Weifeng; Ge, Yun

2017-01-01

To explore the application of computed tomography (CT) texture analysis in predicting histopathological features of gastric cancers. Preoperative contrast-enhanced CT images and postoperative histopathological features of 107 patients (82 men, 25 women) with gastric cancers were retrospectively reviewed. CT texture analysis generated: (1) mean attenuation, (2) standard deviation, (3) max frequency, (4) mode, (5) minimum attenuation, (6) maximum attenuation, (7) the fifth, 10th, 25th, 50th, 75th and 90th percentiles, and (8) entropy. Correlations between CT texture parameters and histopathological features were analysed. Mean attenuation, maximum attenuation, all percentiles and mode derived from portal venous CT images correlated significantly with differentiation degree and Lauren classification of gastric cancers (r, -0.231 ∝-0.324, 0.228 ∝ 0.321, respectively). Standard deviation and entropy derived from arterial CT images also correlated significantly with Lauren classification of gastric cancers (r = -0.265, -0.222, respectively). In arterial phase analysis, standard deviation and entropy were significantly lower in gastric cancers with than those without vascular invasion; however, minimum attenuation was significantly higher in gastric cancers with than those without vascular invasion. CT texture analysis held great potential in predicting differentiation degree, Lauren classification and vascular invasion status of gastric cancers. (orig.)

Application of CT texture analysis in predicting histopathological characteristics of gastric cancers

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Liu, Shunli; Liu, Song; Ji, Changfeng; Zheng, Huanhuan; Pan, Xia; Zhang, Yujuan; He, Jian; Zhou, Zhengyang [The Affiliated Hospital of Nanjing University Medical School, Department of Radiology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province (China); Guan, Wenxian [The Affiliated Hospital of Nanjing University Medical School, Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, Nanjing (China); Chen, Ling [The Affiliated Hospital of Nanjing University Medical School, Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province (China); Guan, Yue; Li, Weifeng; Ge, Yun [Nanjing University, School of Electronic Science and Engineering, Nanjing (China)

2017-12-15

To explore the application of computed tomography (CT) texture analysis in predicting histopathological features of gastric cancers. Preoperative contrast-enhanced CT images and postoperative histopathological features of 107 patients (82 men, 25 women) with gastric cancers were retrospectively reviewed. CT texture analysis generated: (1) mean attenuation, (2) standard deviation, (3) max frequency, (4) mode, (5) minimum attenuation, (6) maximum attenuation, (7) the fifth, 10th, 25th, 50th, 75th and 90th percentiles, and (8) entropy. Correlations between CT texture parameters and histopathological features were analysed. Mean attenuation, maximum attenuation, all percentiles and mode derived from portal venous CT images correlated significantly with differentiation degree and Lauren classification of gastric cancers (r, -0.231 ∝-0.324, 0.228 ∝ 0.321, respectively). Standard deviation and entropy derived from arterial CT images also correlated significantly with Lauren classification of gastric cancers (r = -0.265, -0.222, respectively). In arterial phase analysis, standard deviation and entropy were significantly lower in gastric cancers with than those without vascular invasion; however, minimum attenuation was significantly higher in gastric cancers with than those without vascular invasion. CT texture analysis held great potential in predicting differentiation degree, Lauren classification and vascular invasion status of gastric cancers. (orig.)

Differentiation and diagnosis of benign and malignant testicular lesions using 18F-FDG PET/CT.

Science.gov (United States)

Shao, Dan; Gao, Qiang; Tian, Xu-Wei; Wang, Si-Yun; Liang, Chang-Hong; Wang, Shu-Xia

2017-08-01

The purpose of this study was to evaluate the differential diagnostic value of 18 F-fluorodeoxy glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for benign and malignant testicular lesions. The PET/CT scans of 53 patients with testicular lesions confirmed by biopsy or surgical pathology were retrospectively analyzed. There were 32 cases of malignant tumors and 21 cases of benign lesions. Differences in the maximum standardized uptake value (SUVmax) measurements and the SUVmax lesion/background ratios between benign and malignant lesions were analyzed. The diagnostic value of this PET/CT modality for the differential diagnosis of benign versus malignant testicular lesions was calculated. The differences in the SUVmax measurements and the SUVmax lesion/background ratios between benign and malignant lesions were statistically significant (SUVmax: Z=-4.295, p=0.000; SUVmax lesion/background ratio: Z=-5.219, p=0.000); specifically, both of these indicators were higher in malignant lesions compared to benign lesions. An SUVmax of 3.75 was the optimal cutoff value to differentiate between benign and malignant testicular lesions. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this PET/CT modality in the differential diagnosis of benign versus malignant testicular lesions were 90.6%, 80.9%, 86.8%, 87.9%, and 85.0%, respectively. 18 F-FDG PET/CT can accurately identify benign and malignant testicular lesions. Copyright © 2017 Elsevier B.V. All rights reserved.

CT texture features of liver parenchyma for predicting development of metastatic disease and overall survival in patients with colorectal cancer.

Science.gov (United States)

Lee, Scott J; Zea, Ryan; Kim, David H; Lubner, Meghan G; Deming, Dustin A; Pickhardt, Perry J

2018-04-01

To determine if identifiable hepatic textural features are present at abdominal CT in patients with colorectal cancer (CRC) prior to the development of CT-detectable hepatic metastases. Four filtration-histogram texture features (standard deviation, skewness, entropy and kurtosis) were extracted from the liver parenchyma on portal venous phase CT images at staging and post-treatment surveillance. Surveillance scans corresponded to the last scan prior to the development of CT-detectable CRC liver metastases in 29 patients (median time interval, 6 months), and these were compared with interval-matched surveillance scans in 60 CRC patients who did not develop liver metastases. Predictive models of liver metastasis-free survival and overall survival were built using regularised Cox proportional hazards regression. Texture features did not significantly differ between cases and controls. For Cox models using all features as predictors, all coefficients were shrunk to zero, suggesting no association between any CT texture features and outcomes. Prognostic indices derived from entropy features at surveillance CT incorrectly classified patients into risk groups for future liver metastases (p < 0.001). On surveillance CT scans immediately prior to the development of CRC liver metastases, we found no evidence suggesting that changes in identifiable hepatic texture features were predictive of their development. • No correlation between liver texture features and metastasis-free survival was observed. • Liver texture features incorrectly classified patients into risk groups for liver metastases. • Standardised texture analysis workflows need to be developed to improve research reproducibility.

Imaging features of primary Sarcomas of the great vessels in CT, MRI and PET/CT: a single-center experience

International Nuclear Information System (INIS)

Falck, Christian von; Meyer, Bernhard; Fegbeutel, Christine; Länger, Florian; Bengel, Frank; Wacker, Frank; Rodt, Thomas

2013-01-01

To investigate the imaging features of primary sarcomas of the great vessels in CT, MRI and 18 F-FDG PET/CT. Thirteen patients with a primary sarcoma of the great vessels were retrospectively evaluated. All available images studies including F-18 FDG PET(/CT) (n = 4), MDCT (n = 12) and MRI (n = 6) were evaluated and indicative image features of this rare tumor entity were identified. The median interval between the first imaging study and the final diagnosis was 11 weeks (0–12 weeks). The most frequently observed imaging findings suggestive of malignant disease in patients with sarcomas of the pulmonary arteries were a large filling defect with vascular distension, unilaterality and a lack of improvement despite effective anticoagulation. In patients with aortic sarcomas we most frequently observed a pedunculated appearance and an atypical location of the filling defect. The F-18 FDG PET(/CT) examinations demonstrated an unequivocal hypermetabolism of the lesion in all cases (4/4). MRI proved lesion vascularization in 5/6 cases. Intravascular unilateral or atypically located filling defects of the great vessels with vascular distension, a pedunculated shape and lack of improvement despite effective anticoagulation are suspicious for primary sarcoma on MDCT or MRI. MR perfusion techniques can add information on the nature of the lesion but the findings may be subtle and equivocal. F-18 FDG PET/CT may have a potential role in these patients and may be considered as part of the imaging workup

Inflammatory pseudotumor of the liver: CT findings

International Nuclear Information System (INIS)

Lee, Kang Mo; Yoon, Kwon Ha; Rho, Ji Young; Park, Ki Han; Yun, Ki Jung; Kim, Chang Keun; Won, Jong Jin; Ha, Hyun Kwon; Suh, Jae Hee; Auh, Yong Ho

1998-01-01

To evaluate the CT features of inflammatory pseudotumor of the liver with histopathologic correlation. The CT features of 14 cases (ten patients) with pathologically proven inflammatory hepatic pseudotumor were retrospectively analyzed and correlated with resected and biopsy specimens. The size of lesions ranged between 2.0 and 7.0cm (mean, 3.7 cm); On unenhanced CT, the masses were seen as ill-defined hypodense lesions, while on contrast-enhanced CT they were heterogeneous and multiseptated, with enhancement of internal septa and peripheral wall (n=3D10). In four lesions, central low density and peripheral homogeneous enhancement were seen. On histopathological correlation, the central hypoattenuated area corresponded to chronic inflammatory cell infiltrates with foamy histiocytes, plasmacytes, and lymphocytes, while the hyperattenuated peripheral wall and internal septa represented dense fibrosis. In patients in whon CT shows a heterogeneous enhancing mass, inflammatory pseudotumor of the liver should be included in differential diagnosis

Predicting IDH mutation status of intrahepatic cholangiocarcinomas based on contrast-enhanced CT features

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Zhu, Yong [Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Department of Radiology, Nanjing, Jiangsu Province (China); Chen, Jun [Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Department of Pathology, Nanjing, Jiangsu Province (China); Kong, Weiwei [Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Department of Oncology, Nanjing, Jiangsu Province (China); Mao, Liang; Qiu, Yudong [Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Department of Hepatopancreatobiliary Surgery, Nanjing, Jiangsu Province (China); Kong, Wentao [Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Department of Ultrasonography, Nanjing, Jiangsu Province (China); Zhou, Qun [Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Department of Radiology, Nanjing, Jiangsu Province (China); Zhou, Zhengyang; Zhu, Bin; He, Jian [Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Department of Radiology, Nanjing, Jiangsu Province (China); Wang, Zhongqiu [Jiangsu Province Hospital of Traditional Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Radiology, Nanjing, Jiangsu Province (China)

2018-01-15

To explore the difference in contrast-enhanced computed tomography (CT) features of intrahepatic cholangiocarcinomas (ICCs) with different isocitrate dehydrogenase (IDH) mutation status. Clinicopathological and contrast-enhanced CT features of 78 patients with 78 ICCs were retrospectively analysed and compared based on IDH mutation status. There were 11 ICCs with IDH mutation (11/78, 14.1%) and 67 ICCs without IDH mutation (67/78, 85.9%). IDH-mutated ICCs showed intratumoral artery more often than IDH-wild ICCs (p = 0.023). Most ICCs with IDH mutation showed rim and internal enhancement (10/11, 90.9%), while ICCs without IDH mutation often appeared diffuse (26/67, 38.8%) or with no enhancement (4/67, 6.0%) in the arterial phase (p = 0.009). IDH-mutated ICCs showed significantly higher CT values, enhancement degrees and enhancement ratios in arterial and portal venous phases than IDH-wild ICCs (all p < 0.05). The CT value of tumours in the portal venous phase performed best in distinguishing ICCs with and without IDH mutation, with an area under the curve of 0.798 (p = 0.002). ICCs with and without IDH mutation differed significantly in arterial enhancement mode, and the tumour enhancement degree on multiphase contrast-enhanced CT was helpful in predicting IDH mutation status. (orig.)

Influenza A H1N1 pneumonia: radiograph and CT features of children

International Nuclear Information System (INIS)

Cheng Hua; Duan Xiaomin; Peng Yun; Zeng Jinjin; Sun Guoqiang

2010-01-01

Objective: To explore the imaging features on chest radiograph and CT in children with Influenza A H1N1 pneumonia. Methods: The imaging data of chest radiograph and CT in six children with Influenza A H1N1 pneumonia confirmed by real-time RT-PCR assay was retrospectively analysis. All patients had chest radiograph at first examination and 4 of them re-examed. One children took CT. Results: All cases showed thick lung markings with varied degrees of pulmonary infiltration and interstitial changes on chest radiograph. Among them, 3 cases showed bilateral pulmonary infiltration and 3 cases showed infiltration in left lung; enlarged hilar was observed in 3 cases. The imaging findings of the pneumonia changed quickly during the follow-up accompanied with the improvement of clinical symptoms. The only one chest CT examination showed bilateral infiltration, multiple ground-glass opacities, small subpleural nodulars, right pleural effusion and lymphadenopathy of lung hila and mediastinum. Conclusions: Chest radiograph and CT revealed certain typical imaging features in the children with influenza A H1N1 pneumonia. However, the final diagnosis of influenza A H1N1 pneumonia still should be made based on epidemiology and laboratory examination. (authors)

Classifying features in CT imagery: accuracy for some single- and multiple-species classifiers

Science.gov (United States)

Daniel L. Schmoldt; Jing He; A. Lynn Abbott

1998-01-01

Our current approach to automatically label features in CT images of hardwood logs classifies each pixel of an image individually. These feature classifiers use a back-propagation artificial neural network (ANN) and feature vectors that include a small, local neighborhood of pixels and the distance of the target pixel to the center of the log. Initially, this type of...

Differential diagnosis between ameloblastoma and odontogenic keratocyst using computed tomography

Energy Technology Data Exchange (ETDEWEB)

Kawazu, Toshiyuki; Yoshiura, Kazunori; Yuasa, Kenji; Kanda, Shigenobu; Ohzeki, Satoru; Shinohara, Masanori [Kyushu Univ., Fukuoka (Japan). Faculty of Dentistry; Araki, Kazuyuki; Higuchi, Yoshinori

1997-09-01

Radiographic features of ameloblastoma and odontogenic keratocyst are similar although their biological behaviors are different. Therefore, it is very important to differentiate these lesions before treatment. The aim of this study was to differentiate between the two lesions based on characteristic CT findings. Fifty-three patients diagnosed histopathologically as having ameloblastoma (29 cases) or odontogenic keratocyst (24 cases) and who underwent CT were evaluated radiologically, and some characteristic radiological features to differentiate both lesions were assessed. Ameloblastomas tended to be more than 40 mm in long diameter and 0.5 short/long diameter ratio, whereas odontogenic keratocysts were less than 40 mm and 0.5, respectively (P<0.05: Chi-square test). Buccal expansion of the cortex was seen more often in ameloblastomas than in odontogenic keratocysts (P<0.05: Chi-square test). Together with these features and internal high density structure, which was only seen in odontogenic keratocysts, differential diagnostic criteria between ameloblastomas and odontogenic keratocysts were proposed. Diagnostic accuracy based on these criteria was 84.9%. These results that our criteria to differentiate ameloblastomas from odontogenic keratocysts using CT are clinically useful prior to treatment. (author)

Differential diagnosis between ameloblastoma and odontogenic keratocyst using computed tomography

International Nuclear Information System (INIS)

Kawazu, Toshiyuki; Yoshiura, Kazunori; Yuasa, Kenji; Kanda, Shigenobu; Ohzeki, Satoru; Shinohara, Masanori; Araki, Kazuyuki; Higuchi, Yoshinori

1997-01-01

Radiographic features of ameloblastoma and odontogenic keratocyst are similar although their biological behaviors are different. Therefore, it is very important to differentiate these lesions before treatment. The aim of this study was to differentiate between the two lesions based on characteristic CT findings. Fifty-three patients diagnosed histopathologically as having ameloblastoma (29 cases) or odontogenic keratocyst (24 cases) and who underwent CT were evaluated radiologically, and some characteristic radiological features to differentiate both lesions were assessed. Ameloblastomas tended to be more than 40 mm in long diameter and 0.5 short/long diameter ratio, whereas odontogenic keratocysts were less than 40 mm and 0.5, respectively (P<0.05: Chi-square test). Buccal expansion of the cortex was seen more often in ameloblastomas than in odontogenic keratocysts (P<0.05: Chi-square test). Together with these features and internal high density structure, which was only seen in odontogenic keratocysts, differential diagnostic criteria between ameloblastomas and odontogenic keratocysts were proposed. Diagnostic accuracy based on these criteria was 84.9%. These results that our criteria to differentiate ameloblastomas from odontogenic keratocysts using CT are clinically useful prior to treatment. (author)

Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

Energy Technology Data Exchange (ETDEWEB)

Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2012-07-15

To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

International Nuclear Information System (INIS)

Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin

2012-01-01

To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

MRI features of myositis ossificans with X-ray and CT findings

International Nuclear Information System (INIS)

Gu Xiang; Bai Rongjie; Qu Hui; Cheng Xiaoguang; Li Yuang

2009-01-01

Objective: To investigate the MRI features of myositis ossificans, and to address the correlation with X-ray radiography and CT findings. Methods: X-ray films, CT and MRI of 36 documented cases of myositis ossificans were retrospectively analyzed, and the literatures were reviewed. Results: Of the 36 cases, 4 cases occurred in the elbow joint, 4 in the shoulder joint, 15 in the hip joint, 6 in the tibiofibula, 5 in the femur, 1 in the metatarsal bones, and 1 in the ilium, respectively. Irregular patchy or lamellar high density calcification or ossification could be seen in the soft tissue parenchym on X-ray films and CT scan. Cortical bone integrity was preserved in diaphysis. CT enhanced scan showed that the swollen parenchyma was not enhanced and there was no parenchyma mass. On the early and middle stages, MR T 1 WI and T 2 WI showed slice-shaped low signal in the peripheral parenchyma, but patchy high signal was found around the low signal on T 2 WI. STIR showed mixed high and low signals in the swollen parenchyma with unclear demarcation. The lesions showed low signal on MR T 1 WI and T 2 WI in the late stage, and there was no edema in peripheral parenehyma. MRI enhanced scan found that the swollen parenchyma showed no enhancement in all stages. Conclusions: The imaging features of myositis ossificans have some characteristics. Misdiagnosis could be avoided when the disease was evaluated with the course. (authors)

Chest CT features of cystic fibrosis in Korea: Comparison with non-cystic fibrosis diseases

International Nuclear Information System (INIS)

Yang, So Yeon; Lee, Kyung Soo; Kim, Tae Jung; Kim, Tae Sung; Cha, Min Jae; Yoon, Hyun Jung

2017-01-01

Cystic fibrosis (CF) is a rare congenital disease in Korea, and its clinical and imaging findings are unclear. The objective of our study was to describe the clinical and CT features of CF in Korea and compare its features with those of other diseases mimicking CF. From November 1994 to December 2014, a presumptive diagnosis of CF was made in 23 patients based on clinical or radiological examination. After the exclusion of 10 patients without diagnostic confirmation, 13 patients were included in the study. A diagnosis of CF was made with the CF gene study. CT findings were evaluated for the presence and distribution of parenchymal abnormalities including bronchiectasis, tree-in-bud (TIB) pattern, mucus plugging, consolidation, and mosaic attenuation. Of the 13 patients, 7 (median age, 15 years) were confirmed as CF, 4 (median age, 19 years) had primary ciliary dyskinesia, 1 had bronchiectasis of unknown cause, and 1 had chronic asthma. CT of patients with CF showed bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging in all patients, with upper lung predominance (57%). In CT of the non-CF patients, bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging were also predominant features, with lower lung predominance (50%). Korean patients with CF showed bilateral bronchiectasis, cellular bronchiolitis, mucus plugging, and mosaic attenuation, which overlapped with those of non-CF patients. CF gene study is recommended for the definitive diagnosis of CF in patients with these clinical and imaging features

Chest CT features of cystic fibrosis in Korea: Comparison with non-cystic fibrosis diseases

Energy Technology Data Exchange (ETDEWEB)

Yang, So Yeon; Lee, Kyung Soo; Kim, Tae Jung; Kim, Tae Sung [Dept. of Radiology, and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Cha, Min Jae [Dept. of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of); Yoon, Hyun Jung [Dept. of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2017-01-15

Cystic fibrosis (CF) is a rare congenital disease in Korea, and its clinical and imaging findings are unclear. The objective of our study was to describe the clinical and CT features of CF in Korea and compare its features with those of other diseases mimicking CF. From November 1994 to December 2014, a presumptive diagnosis of CF was made in 23 patients based on clinical or radiological examination. After the exclusion of 10 patients without diagnostic confirmation, 13 patients were included in the study. A diagnosis of CF was made with the CF gene study. CT findings were evaluated for the presence and distribution of parenchymal abnormalities including bronchiectasis, tree-in-bud (TIB) pattern, mucus plugging, consolidation, and mosaic attenuation. Of the 13 patients, 7 (median age, 15 years) were confirmed as CF, 4 (median age, 19 years) had primary ciliary dyskinesia, 1 had bronchiectasis of unknown cause, and 1 had chronic asthma. CT of patients with CF showed bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging in all patients, with upper lung predominance (57%). In CT of the non-CF patients, bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging were also predominant features, with lower lung predominance (50%). Korean patients with CF showed bilateral bronchiectasis, cellular bronchiolitis, mucus plugging, and mosaic attenuation, which overlapped with those of non-CF patients. CF gene study is recommended for the definitive diagnosis of CF in patients with these clinical and imaging features.

CT and MR features of xanthogranulomatous cholecystitis: An analysis of consecutive 49 cases

International Nuclear Information System (INIS)

Zhao, Feng; Lu, Pu-Xuan; Yan, Sen-Xiang; Wang, Gao-Feng; Yuan, Jing; Zhang, Shi-Zheng; Wang, Yi-Xiang J.

2013-01-01

Objective: To study the CT and MR features of xanthogranulomatous cholecystitis (XGC). Materials and methods: 49 patients had pathologically confirmed XGC. All patients underwent contrast enhanced CT, and 10 patients had additional plain MRI. The CT and MRI results were retrospectively analyzed. Results: On CT, all patients had thickening of gallbladder wall, with 87.8% cases showed diffuse thickening. 85.7% cases had intramural hypo-attenuated nodules in the thickened wall. Continuous mucosal line and luminal surface enhancement were noted in 79.6% and 85.7% cases, respectively. Gallbladder stones were seen in 69.4% patients. The coexistence of the above 5 CT features was seen in 40% cases, and 80% cases had the coexistence of ≥4 features. Diffused gallbladder wall thickening in XGC is more likely to have disrupted mucosal line, and XGC with disrupted mucosal line is more likely to be associated with liver infiltration. In 60% patients the inflammatory process extended beyond gallbladder, with the interface between gallbladder and liver and/or the surrounding fat blurred. 40% cases had an early enhancement of liver parenchyma. Infiltration to other surrounding tissues included bowel (n = 3), stomach (n = 2), and abdominal wall (n = 1). On MR images, 7 of 9 intramural nodules in 7 subjects with T1-weighted dual echo MR images showed higher signal intensity on in-phase images than out-of-phase images. Conclusion: Coexisting of diffuse gallbladder wall thickening, hypo-attenuated intramural nodules, continuous mucosal line, luminal surface enhancement, and gallbladder stone highly suggest XGC. XGC frequently infiltrate liver and surrounding fat. Chemical-shift MRI helps classifying intramural nodules in the gallbladder wall

CT and MR features of xanthogranulomatous cholecystitis: An analysis of consecutive 49 cases

Energy Technology Data Exchange (ETDEWEB)

Zhao, Feng [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016 (China); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Lu, Pu-Xuan [Department of Radiology, Shenzhen Third People' s Hospital, Guangdong Medical College, Shenzhen 518020 (China); Yan, Sen-Xiang [Department of Radiation Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003 (China); Wang, Gao-Feng [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016 (China); Yuan, Jing [Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Zhang, Shi-Zheng, E-mail: shizhengzhang@hotmail.com [Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016 (China); Wang, Yi-Xiang J., E-mail: yixiang_wang@cuhk.edu.hk [Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (China); Department of Radiology, Shenzhen Third People' s Hospital, Guangdong Medical College, Shenzhen 518020 (China)

2013-09-15

Objective: To study the CT and MR features of xanthogranulomatous cholecystitis (XGC). Materials and methods: 49 patients had pathologically confirmed XGC. All patients underwent contrast enhanced CT, and 10 patients had additional plain MRI. The CT and MRI results were retrospectively analyzed. Results: On CT, all patients had thickening of gallbladder wall, with 87.8% cases showed diffuse thickening. 85.7% cases had intramural hypo-attenuated nodules in the thickened wall. Continuous mucosal line and luminal surface enhancement were noted in 79.6% and 85.7% cases, respectively. Gallbladder stones were seen in 69.4% patients. The coexistence of the above 5 CT features was seen in 40% cases, and 80% cases had the coexistence of ≥4 features. Diffused gallbladder wall thickening in XGC is more likely to have disrupted mucosal line, and XGC with disrupted mucosal line is more likely to be associated with liver infiltration. In 60% patients the inflammatory process extended beyond gallbladder, with the interface between gallbladder and liver and/or the surrounding fat blurred. 40% cases had an early enhancement of liver parenchyma. Infiltration to other surrounding tissues included bowel (n = 3), stomach (n = 2), and abdominal wall (n = 1). On MR images, 7 of 9 intramural nodules in 7 subjects with T1-weighted dual echo MR images showed higher signal intensity on in-phase images than out-of-phase images. Conclusion: Coexisting of diffuse gallbladder wall thickening, hypo-attenuated intramural nodules, continuous mucosal line, luminal surface enhancement, and gallbladder stone highly suggest XGC. XGC frequently infiltrate liver and surrounding fat. Chemical-shift MRI helps classifying intramural nodules in the gallbladder wall.

CT features of the subtypes of thymic epithelial tumors on the basis of the world health organization classification

International Nuclear Information System (INIS)

Guo Xiaoyu; Yu Hong; Xiao Xiangsheng

2013-01-01

Thymic epithelial tumors including thymomas and thymic carcinomas have well-known heterogeneous oncologic behaviors and variable histologic features. They show variable and unpredictable evolutions ranging from an indolent non-invasive feature to a highly infiltrative and metastasising one. Currently, CT is a common and efficient imaging method for assessing thymic epithelial tumors. CT evaluation is the main reference for preoperative clinic staging and histological classification. CT features of subtypes of thymic epithelial tumors on the basis of the World Health Organization classification provide the foundation for the diagnosis and predicting prognosis. (authors)

A study on CT features of intrahepatic bile duct abscess

International Nuclear Information System (INIS)

Min Pengqiu; Li Peng; He Zhiyan; Chen Weixia; Liu Yan

2001-01-01

Objective: To evaluate CT features of intrahepatic bile duct abscess (IBDA) and its pathologic basis. Methods: The CT imaging data of 31 consecutive cases of intrahepatic bile duct abscess proved by surgery or clinical treatments from October 1989 to February 1999 were retrospectively studied. The causes included acute obstructive suppurative cholangitis and retrograde infection due to different etiologies. For all the cases, the CT manifestations of liver abscess, bile duct abnormalities, and their relationship were observed respectively. Results: Manifestations of liver abscess were revealed in all cases (31/31, 100%). The CT manifestations of bile duct abnormalities included signs of etiologies caused bile duct obstruction and other signs including cholangiectasis (29/31, 93.5%), the dilated bile ducts communicated with (5/31, 16.1%) or abut on (8/31, 25.8%) the abscesses, and gas collection in bile ducts (10/31, 32.2%). The signs showing the relationship between liver abscess and bile duct abnormalities were that the abscesses complied with the obstructive site and the dilated bile ducts (15/31, 48.4%), and the liver abscesses located in different (7/31, 22.6%) or same (4/31, 12.9%) liver lobes or segments with gas collection in the dilated bile ducts. Conclusion: The CT manifestations of IBDA included signs of liver abscess, abnormalities of bile ducts, and signs showing their relationship. CT scanning was helpful in making comprehensive and accurate diagnosis of IBDA

CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

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Yun, Ji Young; Byun, Jae Young; Lee, Sang Hoon; Kwon, Tae Ahn; Kim, Yeon Kil; Kim, Young Ok; Song, Kyung Sup [The Catholic Univ. of Korea College of Medicine, Seoul (Korea, Republic of)

1999-01-01

To evaluate the CT findings of peritonitis associated with continuous ambulatory peritoneal dialysis(CAPD). We retrospectively analyzed CT scans of 14 symptomatic patients with peritonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomiting in one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, we evaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern of enhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omental change. On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainly in the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity(n=13), including the lesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anterior peritoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five. Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five of these, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticular opacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, and cocoon formation appear to be CT features of CAPD peritonitis.

CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

International Nuclear Information System (INIS)

Yun, Ji Young; Byun, Jae Young; Lee, Sang Hoon; Kwon, Tae Ahn; Kim, Yeon Kil; Kim, Young Ok; Song, Kyung Sup

1999-01-01

To evaluate the CT findings of peritonitis associated with continuous ambulatory peritoneal dialysis(CAPD). We retrospectively analyzed CT scans of 14 symptomatic patients with peritonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomiting in one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, we evaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern of enhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omental change. On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainly in the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity(n=13), including the lesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anterior peritoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five. Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five of these, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticular opacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, and cocoon formation appear to be CT features of CAPD peritonitis

CT and MRI features of acinar cell carcinoma of the pancreas with pathological correlations

International Nuclear Information System (INIS)

Hsu, M.-Y.; Pan, K.-T.; Chu, S.-Y.; Hung, C.-F.; Wu, R.-C.; Tseng, J.-H.

2010-01-01

Aim: To document the computed tomography (CT) and magnetic resonance imaging (MRI) features of acinar cell carcinoma of the pancreas and to correlate them with pathological findings to determine the unique imaging manifestations of this rare subtype tumour of the pancreas. Materials and methods: From January 1986 to August 2008, six patients (five men and one woman, mean age 61.3 years) with histologically proven acinar cell carcinoma of the pancreas underwent CT (n = 6) and MRI (n = 4) examinations. The imaging features of each tumour were documented and compared with pathological findings. Results: The tumours were distributed in the head (n = 4), body (n = 1), and tail (n = 1) of the pancreas. Four masses (67%) were uniformly or partially well-defined with thin, enhancing capsules. Central cystic components were found in five tumours (83%). Two tumours (33%) exhibited intratumoural haemorrhage, and one tumour (17%) had amorphous intratumoural calcification. In both CT and MRI, the tumours enhanced less than the adjacent normal pancreatic parenchyma. The signal intensity on MRI was predominantly T1 hypointense and T2 iso- to hyperintense. Conclusion: Acinar cell carcinoma of the pancreas has distinct imaging features, and both CT and MRI are useful and complementary imaging methods.

TU-CD-BRB-01: Normal Lung CT Texture Features Improve Predictive Models for Radiation Pneumonitis

International Nuclear Information System (INIS)

Krafft, S; Briere, T; Court, L; Martel, M

2015-01-01

Purpose: Existing normal tissue complication probability (NTCP) models for radiation pneumonitis (RP) traditionally rely on dosimetric and clinical data but are limited in terms of performance and generalizability. Extraction of pre-treatment image features provides a potential new category of data that can improve NTCP models for RP. We consider quantitative measures of total lung CT intensity and texture in a framework for prediction of RP. Methods: Available clinical and dosimetric data was collected for 198 NSCLC patients treated with definitive radiotherapy. Intensity- and texture-based image features were extracted from the T50 phase of the 4D-CT acquired for treatment planning. A total of 3888 features (15 clinical, 175 dosimetric, and 3698 image features) were gathered and considered candidate predictors for modeling of RP grade≥3. A baseline logistic regression model with mean lung dose (MLD) was first considered. Additionally, a least absolute shrinkage and selection operator (LASSO) logistic regression was applied to the set of clinical and dosimetric features, and subsequently to the full set of clinical, dosimetric, and image features. Model performance was assessed by comparing area under the curve (AUC). Results: A simple logistic fit of MLD was an inadequate model of the data (AUC∼0.5). Including clinical and dosimetric parameters within the framework of the LASSO resulted in improved performance (AUC=0.648). Analysis of the full cohort of clinical, dosimetric, and image features provided further and significant improvement in model performance (AUC=0.727). Conclusions: To achieve significant gains in predictive modeling of RP, new categories of data should be considered in addition to clinical and dosimetric features. We have successfully incorporated CT image features into a framework for modeling RP and have demonstrated improved predictive performance. Validation and further investigation of CT image features in the context of RP NTCP

The cryptogenic organizing pneumonia: the analysis of CT features

International Nuclear Information System (INIS)

Zhu Xiaohua; Li Tiannv; You Zhengqian; Ma Jun; Jiang Sen

2007-01-01

Objective: To improve our understanding concerning radiographic manifestations of cryptogenic organizing pneumonia (COP). Methods: The diagnosis of cryptogenic organizing pneumonia was made based on clinical and radiological features, and was verified with lung biopsy and pathological examination in 23 cases. All data were analyzed and relevant literatures were reviewed. Results: CT scans revealed multi- patch shadows, patchy air-space consolidations in 15 cases, often located in predominantly subpleural and(or) both inferior lungs, with or ground-glass opacities, bronchiectasis, and cords. Lesion sites changed over time in some patients. Corticosteroid treatment led to significant improvement in most cases. Conclusions: The diagnosis of cryptogenic organizing pneumonia required the converging evidence from clinical and radiological manifestations as well as pathologies. It is important to appreciate CT manifestations of COP. (authors)

Focal hepatic steatosis: ultrasound and CT scan features may mimick carcinoma of the liver

International Nuclear Information System (INIS)

Monnin, J.L.; Blanc, F.; Guiry, P.; Bruel, J.M.; Monnin, E.; Ciurana, A.J.

1988-01-01

Ultrasound and CT scan features of focal hepatic steatosis (FHS) may closely resemble those of primary or secondary malignant hepatic tumors. Three cases of FHS in chronic alcoholics are reported. In two cases, the area of steatosis was hyperechogenic upon ultrasonography. In all three patients, CT scan demonstrated a hypodense image, with poor enhancement following opacification and no mass effect. Diagnosis of FHS was ascertained upon hepatic biopsy under CT scan guidance in all three patients [fr

CT features of peritonitis carcinomatosa

International Nuclear Information System (INIS)

Ishii, Chikako; Kaneko, Kenji; Kato, Hitonari; Tada, Shinpei

1988-01-01

Fifty patients with peritonitis carcinomatosa were evaluated with computed tomography (CT). CT findings included evidence of mesenteric thickening (60 %), solid mass (20 %), loculated ascites (16 %), ascites (14 %), partly dilated intestine (10 %). Mesenteric thickening showed both intraperitoneal and subperitoneal metastasis. Arrested flow of ascitic fluid (loculated ascites) was one of the most predicting findings of peritonitis carcinomatosa. The seven false negative cases related to small metastatic foci, long distance between autopsy and the last CT examination, or paucity of intraabdominal fat. (author)

CT features and clinical of diffuse axonal injury (with report of 41 cases)

International Nuclear Information System (INIS)

Zhang Yixing

2005-01-01

Objective: To evaluate CT imaging in the diagnosis of diffuse axonal injury (DAI) in correlation with the clinical manifestations. Methods: CT images and clinical data of 41 DAI cases were reviewed retrospectively, including 30 males and 11 females, 15 to 67 years old (average age was 30.5 years). According to the clinical features, all cases were classified into three groups: mild, moderate and severe injury. Results: In 10 cases of mild injury, the major CT findings were cerebral edema, slight cerebral hemorrhage in unilateral hemisphere or sub-arachnoid hemorrhage. Another 15 cases were classified as moderate injury: diffuse cerebral edema and hemorrhage in central brain gray matter were found on CT images. 16 cases with severe injury: severe diffuse cerebral edema accompanied with hemorrhage along the white-gray matter junction as well as epidural hematoma and/or subdural hematoma was demonstrated on CT images. Conclusion: CT scan is valuable in diagnosis of DAI and the anticipation of prognosis. (authors)

The value of contrast-enhanced 64-row CT in differentiating benign from malignant serous ovarian neoplasms

International Nuclear Information System (INIS)

Dong Tianfa; Wu Meixian; Zhang Jiayun; Song Ting

2009-01-01

Objective: To assess the diagnostic value of contrast-enhanced 64-row CT scanning in deciding benign or malignant serous ovarian tumors. Methods: Fifty-eight cases of serous ovarian tumors proved pathologically were reviewed, including 25 malignant tumors, 25 benign, 8 borderline tumors. All patients underwent 64-row CT scanning, including plain scanning and contrast-enhance scanning. The tumors' shape, density, blood supply and enhancement features were evaluated. Results: Twenty-five cases of benign serous cystic adenoma were mostly unicameral, and showed a moderate mural enhancement only in 4 cases (16%) due to chronic pelvic infection and the others (21/25, 84%) had no of slight enhancement. Malignant tumors were cystic-solid mass with unclear margin, irregular shape and septa. Twenty-two cases of serous cystadenocarcinoma out of 25 cases (88%) appeared obvious enhancement and other 3 cases no enhancement. And 7 cases out of 8 (87.5%) borderlined serous cystadenomas showed different enhancement patterns. Conclusion: Benign ovarian serous neoplasms were mostly unicameral and no strong mural enhancement, suggesting a lack of blood supply. While, there were obvious enhancement in the ovarian serous cystadenocarcinoma and borderline serous cystadenoma with malignant potential. The 64-row CT is helpful for differentiating the nature of the serous ovarian neoplasm. (authors)

Evaluation of Shape and Textural Features from CT as Prognostic Biomarkers in Non-small Cell Lung Cancer.

Science.gov (United States)

Bianconi, Francesco; Fravolini, Mario Luca; Bello-Cerezo, Raquel; Minestrini, Matteo; Scialpi, Michele; Palumbo, Barbara

2018-04-01

We retrospectively investigated the prognostic potential (correlation with overall survival) of 9 shape and 21 textural features from non-contrast-enhanced computed tomography (CT) in patients with non-small-cell lung cancer. We considered a public dataset of 203 individuals with inoperable, histologically- or cytologically-confirmed NSCLC. Three-dimensional shape and textural features from CT were computed using proprietary code and their prognostic potential evaluated through four different statistical protocols. Volume and grey-level run length matrix (GLRLM) run length non-uniformity were the only two features to pass all four protocols. Both features correlated negatively with overall survival. The results also showed a strong dependence on the evaluation protocol used. Tumour volume and GLRLM run-length non-uniformity from CT were the best predictor of survival in patients with non-small-cell lung cancer. We did not find enough evidence to claim a relationship with survival for the other features. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

CT features of pulmonary mycobacterial disease in patients with acquired immunodeficiency syndrome

International Nuclear Information System (INIS)

Zhu Ying; Zhang Zhiyong; Shi Yuxin; Feng Feng

2013-01-01

Objective: To study the CT features of pulmonary non-tuberculous mycobacteria (NTM) disease in patients with acquired immunodeficiency syndrome (AIDS) and explore the different CT appearances between AIDS-NTM and AIDS-TB. Methods: CT findings of pulmonary NTM disease in 27 AIDS patients (NTM group) were retrospectively analyzed and compared with that of tuberculosis in 30 AIDS patients (TB group). The results were statistically analyzed using Fisher's exact test. Results: CT findings of NTM appeared significantly more than that of TB as follows: high-density nodules (n = 18 vs 1, P < 0.01), ground-glass opacities (n = 10 vs 0, P < 0.01), fibrotic band (n = 17 vs 3, P < 0.01), bronchiectasis (9 vs 2, P = 0.012). CT findings of NTM appeared significantly less than that of TB as follows: miliary nodules (0 vs 6, P = 0.016), air space consolidations (n = 2 vs 11, P < 0.01), pleural effusion (n = 1 vs 9, P < 0.01). Conclusion: Nodule and fibrotic band accompanied with bronchiectasis were the main CT manifestations of pulmonary NTM disease in AIDS patients, while air space consolidation accompanied with pleural effusion and miliary nodules were the predominate CT findings of pulmonary tuberculosis in AIDS patients. (authors)

Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

International Nuclear Information System (INIS)

Jairam, Pushpa M.; Jong, Pim A. de; Mali, Willem P.T.M.; Isgum, Ivana; Graaf, Yolanda van der

2015-01-01

Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

Energy Technology Data Exchange (ETDEWEB)

Jairam, Pushpa M. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Jong, Pim A. de; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Isgum, Ivana [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: PROVIDI study-group

2015-06-01

Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

Comparison of the prognostic values of {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor

Energy Technology Data Exchange (ETDEWEB)

Sharma, Punit; Naswa, Niraj; Kc, Sudhir Suman; Yadav, Yashwant; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Alvarado, Luis Andres; Dwivedi, Alok Kumar [Texas Tech University Health Sciences Center, Division of Biostatistics and Epidemiology, El Paso, TX (United States); Ammini, Ariachery C. [All India Institute of Medical Sciences, Department of Endocrinology and Metabolism, New Delhi (India)

2014-12-15

To determine the prognostic value of {sup 68}Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of {sup 18}F-FDG PET/CT and other conventional clinicopathological prognostic factors. Data from 37 consecutive patients (age 46.6 ± 13.5 years, 51 % men) with well-differentiated NET who underwent {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease. {sup 68}Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and {sup 18}F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 - 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on {sup 68}Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on {sup 68}Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 - 16.976; P = 0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, {sup 18}F-FDG PET/CT status (positive/negative), SUVmax on {sup 18}F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on {sup 68}Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026). SUVmax measured on {sup 68}Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and

Differentiating lung abscess and empyema: radiography and computed tomography

International Nuclear Information System (INIS)

Stark, D.D.; Federle, M.P.; Goodman, P.C.; Podrasky, A.E.; Webb, W.R.

1983-01-01

Conventional chest radiographs and computed tomographic (CT) scans of 70 inflammatory thoracic lesions in 63 patients were reviewed and scored for diagnostic features. Pathologic confirmation of the final diagnosis was available in 42% (5/12) of lung abscesses and 31% (18/58) of empyemas. CT alone was sufficient to correctly diagnose 100% (70/70) of cases. Diagnostic information not available from conventional chest radiographs was obtained in 47% (33/70) of cases; in an additional 34% of patients, CT more accurately defined the extent of disease. The most reliable CT features for the differential diagnosis of lung abscess and empyema were wall characteristics, pleural separation, and lung compression. Conventional radiographic features such as size, shape, and the angle of the lesion with the chest wall were less helpful, though also best assessed by CT

Diagnostic Accuracy of Ultrasound, Contrast-enhanced CT, and Conventional MRI for Differentiating Leiomyoma From Leiomyosarcoma.

Science.gov (United States)

Gaetke-Udager, Kara; McLean, Karen; Sciallis, Andrew P; Alves, Timothy; Maturen, Katherine E; Mervak, Benjamin M; Moore, Andreea G; Wasnik, Ashish P; Erba, Jake; Davenport, Matthew S

2016-10-01

This study aimed to determine whether uterine leiomyoma can be distinguished from uterine leiomyosarcoma on ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging (MRI) without diffusion-weighted imaging. Institutional review board approval was obtained and informed consent was waived for this Health Insurance Portability and Accountability Act-compliant retrospective case-control diagnostic accuracy study. All subjects with resected uterine leiomyosarcoma diagnosed over a 17-year period (1998-2014) at a single institution for whom pre-resection US (n = 10), CT (n = 11), or MRI (n = 7) was available were matched by tumor size and imaging modality with 28 subjects with resected uterine leiomyoma. Six blinded radiologists (three attendings, three residents) assigned 5-point Likert scores for the following features: (1) margins, (2) necrosis, (3) hemorrhage, (4) vascularity, (5) calcifications, (6) heterogeneity, and (7) likelihood of malignancy (primary end point). Mean suspicion scores were calculated and receiver operating characteristic curves were generated. The ability of individual morphologic features to predict malignancy was assessed with logistic regression. Mean suspicion scores were 2.5 ± 1.2 (attendings) and 2.4 ± 1.3 (residents) for leiomyoma, and 2.7 ± 1.3 (attendings) and 2.7 ± 1.4 (residents) for leiomyosarcoma. The areas under the receiver operating characteristic curves (range: 0.330-0.685) were not significantly different from chance, either overall (P = .36-.88) or by any modality (P = .28-.96), for any reader. Reader experience had no effect on diagnostic accuracy. No morphologic parameter was significantly predictive of malignancy (P = .10-.97). Uterine leiomyoma cannot be differentiated accurately from leiomyosarcoma on US, CT, or MRI without diffusion-weighted imaging. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

How to differentiate acute pelvic inflammatory disease from acute appendicitis? A decision tree based on CT findings

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El Hentour, Kim; Millet, Ingrid; Pages-Bouic, Emmanuelle; Curros-Doyon, Fernanda; Taourel, Patrice [Lapeyronie Hospital, Department of Medical Imaging, Montpellier (France); Molinari, Nicolas [UMR 5149 IMAG, CHU, Department of Medical Information and Statistics, Montpellier (France)

2018-02-15

To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome. This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA. Surgical and laboratory data were used for the PID and AA reference standard. Appropriate tests were performed to compare PID and AA and a CT decision tree using the classification and regression tree (CART) algorithm was generated. The median patient age was 28 years (interquartile range, 22-39 years). According to the decision tree, an appendiceal diameter ≥ 7 mm was the most discriminating criterion for differentiating acute PID and AA, followed by a left tubal diameter ≥ 10 mm, with a global accuracy of 98.2 % (95 % CI: 96-99.4). Appendiceal diameter and left tubal thickening are the most discriminating CT criteria for differentiating acute PID from AA. (orig.)

How to differentiate acute pelvic inflammatory disease from acute appendicitis? A decision tree based on CT findings

International Nuclear Information System (INIS)

El Hentour, Kim; Millet, Ingrid; Pages-Bouic, Emmanuelle; Curros-Doyon, Fernanda; Taourel, Patrice; Molinari, Nicolas

2018-01-01

To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome. This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA. Surgical and laboratory data were used for the PID and AA reference standard. Appropriate tests were performed to compare PID and AA and a CT decision tree using the classification and regression tree (CART) algorithm was generated. The median patient age was 28 years (interquartile range, 22-39 years). According to the decision tree, an appendiceal diameter ≥ 7 mm was the most discriminating criterion for differentiating acute PID and AA, followed by a left tubal diameter ≥ 10 mm, with a global accuracy of 98.2 % (95 % CI: 96-99.4). Appendiceal diameter and left tubal thickening are the most discriminating CT criteria for differentiating acute PID from AA. (orig.)

CT predictors of mortality in pathology confirmed ARDS

Energy Technology Data Exchange (ETDEWEB)

Chung, Jonathan H.; Greene, Reginald E.; Shepard, Jo-Anne O.; Digumarthy, Subba R. [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States); Kradin, Richard L. [Massachusetts General Hospital, Department of Pathology and Pulmonary Medicine, Boston, MA (United States)

2011-04-15

To identify CT findings that predict mortality in acute respiratory distress syndrome (ARDS) and to identify CT findings that differentiate diffuse alveolar damage (DAD) from DAD with prominent histopathological features of organizing pneumonia (DAD-OP). Twenty-eight patients with ARDS (corroborated by open biopsy) and chest CT within 2 weeks of biopsy were included in our study. Differences in CT findings in patients with survivors versus nonsurvivors as well as for DAD versus DAD-OP were compared using Fisher's exact test. Lung involvement of greater than 80%, RA/LA ratio >1, and varicoid traction bronchiectasis were statistically more common in nonsurvivors than in survivors (respective p values of 0.001, 0.008, and 0.038). PA dilation greater than 3 cm and RV/LV ratio greater than 0.9 were also more common in nonsurvivors than in survivors but these factors did not achieve significance. CT findings did not differentiate DAD from DAD-OP. Our study suggests that >80% of lung involvement, RA/LA ratio >1, and varicoid bronchiectasis predict mortality in patients with ARDS/DAD. Signs of right-sided heart failure (PA dilation greater than 3 cm and RV/LV ratio greater than 0.9) approached significance. CT findings did not differentiate DAD from DAD-OP. (orig.)

Isoattenuating insulinomas at biphasic contrast-enhanced CT: frequency, clinicopathologic features and perfusion characteristics

Energy Technology Data Exchange (ETDEWEB)

Zhu, Liang; Xue, Hua-dan; Sun, Hao; Wang, Xuan; He, Yong-lan; Jin, Zheng-yu [Peking Union Medical College Hospital, Department of Radiology, Beijing (China); Zhao, Yu-pei [Peking Union Medical College Hospital, Department of General Surgery, Beijing (China)

2016-10-15

We aimed to determine the frequency of isoattenuating insulinomas, to investigate their clinicopathological features and to assess their regional pancreatic perfusion characteristics. Institutional review board approval was obtained, and patient informed consent was waived. From July 2010 to June 2014, 170 patients (66 male, 104 female) with endogenous hyperinsulinemic hypoglycemia underwent biphasic contrast-enhanced CT before surgery, and 129 of those patients also received preoperative whole-pancreas CT perfusion. A total of 181 tumours were proved histopathologically after surgery. Enhancement pattern and regional pancreatic perfusion characteristics were analyzed. Clinical features, tumour size and pathological grading were investigated. The frequency of isoattenuating tumours was 24.9 %. Tumour size and WHO grading was not significantly different between isoattenuating and hyperattenuating tumours. Tumour-free regions had identical blood flow (BF) regardless of their location (p = 0.35). Isoattenuating tumour-harbouring regions had lower BF compared with hyperattenuating tumour-harbouring regions; both showed higher BF compared with tumour-free neighbourhood regions (all p < 0.01). For patients with isoattenuating tumours, the overall hospital stay was longer (p < 0.01). A substantial subset of insulinomas were isoattenuating on biphasic CT. CT perfusion showed higher BF in tumour-harbouring regions compared to tumour-free regions, providing a clue for tumour regionalization. (orig.)

CT features of lung cancer associated with idiopathic pulmonary fibrosis

International Nuclear Information System (INIS)

Kim, Jun Hyoung; Song, Koun Sik; Lee, Deok Hee; Kim, Jin Suh; Lim, Tae Hwan

1996-01-01

It is well known that the incidence of lung cancer is high in patients with idiopathic pulmonary fibrosis(IPF). We analyzed the CT features of lung cancer associated with IPF. Retrospective analyzed the CT features of lung cancer associated with IPF. Retrospective analysis was performed in 23 patients with lung cancer(24 lung cancers) associated with IPF. The diagnosis of IPF was made by clinical and CT findings, and lung cancer was confirmed pathologically. We divided the location of lung cancer by lobar distribution and central or peripheral lung zone, and measured the size of mass. We classified the mediastinal lymph node enlargement by American Thoracic Society (ATS) mapping scheme. We evaluated the CT pattern of IPF. The subjects consisted of 6 cases of small cell carcinoma and 18 cases of non-small cell lung cancer. Non-small cell lung cancers were located in the right upper lobe in 5 cases, left upper lobe in 6 cases, right middle lobe in 1 case, right lower lobe in 9 cases, and left lower lobe in 3 cases. Twenty cancers(85%) were located in the peripheral lung zone. Eighteen cancers(73%) were surrounded by fibrotic lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3 cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung cancers. CT patterns of underlying IPF were honey-combing in 18 patients(78%) and mixed honey-combing and ground-glass opacity in 5 patients(22%). The lung cancer associated with IPF shows variable cell types. Most of the lung cancers were located peripherally, surrounded by end-stage fibrosis, and were associated with mediastinal lymph node enlargement

CT features of lung cancer associated with idiopathic pulmonary fibrosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Jun Hyoung; Song, Koun Sik; Lee, Deok Hee; Kim, Jin Suh; Lim, Tae Hwan [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

1996-01-01

It is well known that the incidence of lung cancer is high in patients with idiopathic pulmonary fibrosis(IPF). We analyzed the CT features of lung cancer associated with IPF. Retrospective analyzed the CT features of lung cancer associated with IPF. Retrospective analysis was performed in 23 patients with lung cancer(24 lung cancers) associated with IPF. The diagnosis of IPF was made by clinical and CT findings, and lung cancer was confirmed pathologically. We divided the location of lung cancer by lobar distribution and central or peripheral lung zone, and measured the size of mass. We classified the mediastinal lymph node enlargement by American Thoracic Society (ATS) mapping scheme. We evaluated the CT pattern of IPF. The subjects consisted of 6 cases of small cell carcinoma and 18 cases of non-small cell lung cancer. Non-small cell lung cancers were located in the right upper lobe in 5 cases, left upper lobe in 6 cases, right middle lobe in 1 case, right lower lobe in 9 cases, and left lower lobe in 3 cases. Twenty cancers(85%) were located in the peripheral lung zone. Eighteen cancers(73%) were surrounded by fibrotic lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3 cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung cancers. CT patterns of underlying IPF were honey-combing in 18 patients(78%) and mixed honey-combing and ground-glass opacity in 5 patients(22%). The lung cancer associated with IPF shows variable cell types. Most of the lung cancers were located peripherally, surrounded by end-stage fibrosis, and were associated with mediastinal lymph node enlargement.

Differential Aging Signals in Abdominal CT Scans.

Science.gov (United States)

Orlov, Nikita V; Makrogiannis, Sokratis; Ferrucci, Luigi; Goldberg, Ilya G

2017-12-01

Changes in the composition of body tissues are major aging phenotypes, but they have been difficult to study in depth. Here we describe age-related change in abdominal tissues observable in computed tomography (CT) scans. We used pattern recognition and machine learning to detect and quantify these changes in a model-agnostic fashion. CT scans of abdominal L4 sections were obtained from Baltimore Longitudinal Study of Aging (BLSA) participants. Age-related change in the constituent tissues were determined by training machine classifiers to differentiate age groups within male and female strata ("Younger" at 50-70 years old vs "Older" at 80-99 years old). The accuracy achieved by the classifiers in differentiating the age cohorts was used as a surrogate measure of the aging signal in the different tissues. The highest accuracy for discriminating age differences was 0.76 and 0.72 for males and females, respectively. The classification accuracy was 0.79 and 0.71 for adipose tissue, 0.70 and 0.68 for soft tissue, and 0.65 and 0.64 for bone. Using image data from a large sample of well-characterized pool of participants dispersed over a wide age range, we explored age-related differences in gross morphology and texture of abdominal tissues. This technology is advantageous for tracking effects of biological aging and predicting adverse outcomes when compared to the traditional use of specific molecular biomarkers. Application of pattern recognition and machine learning as a tool for analyzing medical images may provide much needed insight into tissue changes occurring with aging and, further, connect these changes with their metabolic and functional consequences. Published by Elsevier Inc.

An Accurate CT Saturation Classification Using a Deep Learning Approach Based on Unsupervised Feature Extraction and Supervised Fine-Tuning Strategy

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Muhammad Ali

2017-11-01

Full Text Available Current transformer (CT saturation is one of the significant problems for protection engineers. If CT saturation is not tackled properly, it can cause a disastrous effect on the stability of the power system, and may even create a complete blackout. To cope with CT saturation properly, an accurate detection or classification should be preceded. Recently, deep learning (DL methods have brought a subversive revolution in the field of artificial intelligence (AI. This paper presents a new DL classification method based on unsupervised feature extraction and supervised fine-tuning strategy to classify the saturated and unsaturated regions in case of CT saturation. In other words, if protection system is subjected to a CT saturation, proposed method will correctly classify the different levels of saturation with a high accuracy. Traditional AI methods are mostly based on supervised learning and rely heavily on human crafted features. This paper contributes to an unsupervised feature extraction, using autoencoders and deep neural networks (DNNs to extract features automatically without prior knowledge of optimal features. To validate the effectiveness of proposed method, a variety of simulation tests are conducted, and classification results are analyzed using standard classification metrics. Simulation results confirm that proposed method classifies the different levels of CT saturation with a remarkable accuracy and has unique feature extraction capabilities. Lastly, we provided a potential future research direction to conclude this paper.

Predicting CT Image From MRI Data Through Feature Matching With Learned Nonlinear Local Descriptors.

Science.gov (United States)

Yang, Wei; Zhong, Liming; Chen, Yang; Lin, Liyan; Lu, Zhentai; Liu, Shupeng; Wu, Yao; Feng, Qianjin; Chen, Wufan

2018-04-01

Attenuation correction for positron-emission tomography (PET)/magnetic resonance (MR) hybrid imaging systems and dose planning for MR-based radiation therapy remain challenging due to insufficient high-energy photon attenuation information. We present a novel approach that uses the learned nonlinear local descriptors and feature matching to predict pseudo computed tomography (pCT) images from T1-weighted and T2-weighted magnetic resonance imaging (MRI) data. The nonlinear local descriptors are obtained by projecting the linear descriptors into the nonlinear high-dimensional space using an explicit feature map and low-rank approximation with supervised manifold regularization. The nearest neighbors of each local descriptor in the input MR images are searched in a constrained spatial range of the MR images among the training dataset. Then the pCT patches are estimated through k-nearest neighbor regression. The proposed method for pCT prediction is quantitatively analyzed on a dataset consisting of paired brain MRI and CT images from 13 subjects. Our method generates pCT images with a mean absolute error (MAE) of 75.25 ± 18.05 Hounsfield units, a peak signal-to-noise ratio of 30.87 ± 1.15 dB, a relative MAE of 1.56 ± 0.5% in PET attenuation correction, and a dose relative structure volume difference of 0.055 ± 0.107% in , as compared with true CT. The experimental results also show that our method outperforms four state-of-the-art methods.

CT of abdominal abscesses

International Nuclear Information System (INIS)

Korobkin, M.T.

1987-01-01

The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed

Solitary fibrous tumour of pleura: CT differentiation of benign and malignant types.

Science.gov (United States)

Gupta, A; Souza, C A; Sekhon, H S; Gomes, M M; Hare, S S; Agarwal, P P; Kanne, J P; Seely, J M

2017-09-01

10 patients with benign SFTP. No definite imaging feature to differentiate benign from malignant SFTP was found. Large size, lobulate borders, presence of calcification, and ipsilateral pleural effusion were the only CT features predictive of malignancy. In suspected cases, core biopsies should be performed rather than fine-needle aspiration. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

CT and MR features of the intracranial Schwannomas

International Nuclear Information System (INIS)

Jung, So Lyung; Ro, Hee Jeong; Lee, Hong Jae; Jung, Seung Eun; Byun, Jae Young; Yang, Il Kwon; Lee, Han Jin; Choi, Kyu Ho; Kim, Jong Woo; Shinn, Kyung Sub

1996-01-01

To evaluate CT and MR findings of the intracranial schwannomas arising from variable cranial nerves. The authors retrospectively analyzed CT (n=21) and MR (n=15) findings of 24 cases in 23 patients (M : 7, F : 16) who had suffered from surgically-proven intracranial schwannomas over the previous five years. Schwannomas arose from the acoustic nerve(n=18), the trigeminal nerve(n=2), the glossopha-ryngeal-vagal-accessory nerve complex (n=2), and the olfactory nerve(n=1). Intracranial schwannomas were well defined, ,lobulated and inhomogeneously or homogeneously enhancing masses on CT and MR, and were located along the course of the specific cranial nerve. Acoustic schwannomas involved both the internal auditory canal(IAC) and the cerebellopontive angle(CPA) in 14 case, the IAC in three, and the SPA in two. Two trigeminal schwannomas involved both middle and posterior cranial fossa and were in the shape of a dumbbell. One of the two schwannomas that invelved lower cranial nerve complex(9-11th) was located in the medullary cistern and jugular foramen ; the other was located in the central posterior cranial fossa. A case of olfactory schwannoma was located in the right cribriform plate. The precontrast CT scan showed low density in 13 cases (62%), isodensity in seven(33%) and high density in one(5%). on postcontrast CT scan, enhancement was seen in 20 cases(95%). Of the 15 cases with MR, 2 had low signal intensity on T1 weighted image and 14 had high signal intensity on T2 weighted image. MR imaging after Gd-DTPA infusion showed enhancement in 14 cases. Enhancement was inhomogeneous in 14 cases on CT and in 13 on MR. Of 24 cases, intratumoral necrosis was seen in 19, ring enhancement in five and severe cystic change in one. Other findings were in tratumoral calcification (21%), hemorrhage(8%), pressure bony erosion(70.8%), midline shift(58%), peritumoral edema(29%) and hydrocephalus(33%). On MR, there was in all 15 cases a peritumoral low signal intensity rim on T1-and

Benign versus malignant osseous lesions in spine: differentiation by means of bone SPECT/CT fused image

International Nuclear Information System (INIS)

Yao Zhiming; Qu Wanying

2004-01-01

This study compared the efficiency of SPECT-CT fused image with planar bone scan, bone SPECT and CT in differentiating malignant from benign lesions and detecting metastases to the spine. Methods. Total 144 patients with spinal lesions underwent planar bone scan (WB), single photon tomography (SPECT), CT and SPECT-CT fused image by a SPECT/CT system. The malignant or benign nature of lesions was proved by radiological Methods, histological findings, 6-24 month follow-up, or all of these. The diagnostic results was divided into 4 types, i.e., normal, benign, doubtful malignant and malignant. Results. There were 137 malignant and 252 benign lesions in 144 patients, respectively. The percentages of doubtful malignant diagnosed by WB, SPECT, CT and fused image are 22.6%, 5.1%, 9.5% and 0%, respectively, p < 0.01-0.001, except for the comparison between the percentages of SPECT and CT. Sensitivities in detection of malignant lesions by WB, SPECT, CT and fused image are 75.2%, 94.2%, 96.6% and 99.3%, respectively, P < 0.001, excepting for the comparisons between those of SPECT and CT, and between those of CT and fused image. The sensitivities m detection of benign lesions by WB, SPECT, CT and fused image are, 56.7%, 86.5%, 90.1% and 96.8%, respectively, P < 0.005 - 0.001, excepting for the comparison between those of SPECT and CT. The specificities in detection of maliganant lesions by WB, SPECT, CT and fused image are 70.6%, 88.9%, 97.2% and 97.6%, respectively, P < 0.001, excepting for the comparison between those of CT and fused image. Conclusion. Bone SPECT-CT fused image has highest diagnostic and differentiating diagnostic values in detection of spinal abnormalities over the planar bone scanning and SPECT. The CT by present SPECT/CT system can complement planar bone scanning and SPECT and is clinically valuable in detection of spinal abnormalities. (authors)

CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

International Nuclear Information System (INIS)

Macari, M.; Faust, M.; Liang, H.; Pachter, H.L.

2007-01-01

Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient

Clinical application and progress of PET and PET-CT for differential diagnosis of the benign or malignant pulmonary nodules

International Nuclear Information System (INIS)

Wang Xuemei; Wang Meiling; Wang Xiangcheng

2010-01-01

To differential diagnosis the benign or malignant of pulmonary nodules is a medical difficult problem. As the development of medical imaging equipment and technology, PET-CT can identified benign or malignant lesions of pulmonary nodules though changes of metabolism. Researches about PET-CT for differential diagnosis pulmonary nodules benign or malignant are reviewed. (authors)

Warthin's Tumor of the Parotid Gland: CT and MR Features

International Nuclear Information System (INIS)

Lee, Yun Hee; Yu, In Kyu; Lee, Byung Hee; Kim, Min Sun; Han, Moon Hee; Song, Chang Joon

2009-01-01

In this study, we have evaluated the imaging features of Warthin's tumor of the parotid gland with the use of CT and MR imaging. CT (n = 30) and MR (n = 7) images of 26 patients (M:F=23:3; age range, 38-76 years; mean age, 58 years) with surgically-proven Warthin's tumor (n = 37) were reviewed with a focus on bilaterality, multiplicity, location, size, demarcation, margin, enhancement pattern and MR signal intensity. Lesions were bilateral in seven patients (27%), multiple in nine patients (35%) and unilateral multiple in four patients (15%). Tumors were located in the superficial lobe (65%), deep lobe (24%) and both lobes (11%) of the parotid gland. Most tumors had a clear (95%) and smooth margin (95%) with a round or oval shape. Tumors mainly showed a solid and cystic composition (n = 24, 65%) and all solid stroma showed poor or weak enhancement on both CT and MR images. Papillary projections from the peripheral wall were clearly seen (n = 6, 86%). Warthin's tumor is frequently seen in the parotid superficial lobe of older males with a higher bilateral and multiple tendency. Warthin's tumor shows cystic portions with papillary projections at the wall on CT images and focal high signal intensity (SI) on T1-weighted images with dense nodular enhancement on MR images

CT features of invasion of sublingual space by malignant oropharyngeal tumors

International Nuclear Information System (INIS)

Wei Yi; Xiao Jiahe; Zhou Xiangping; Deng Kaihong

2003-01-01

Objective: To investigate the CT features of the invasion of sublingual space by malignant oropharyngeal tumors in order to provide more accurate information for clinical treatment. Methods: Fifty-eight cases of pathologically proven malignant oropharyngeal tumors were collected and retrospectively analyzed. Results: Among all the cases, invasion of sublingual space by malignant oropharyngeal tumors could be seen in 14 cases, of which, 7 cases got access to sublingual space through tongue base, 3 cases through parapharyngeal space, 2 cases through pterygomandibular raphe, 2 cases through uncertain routes. Invasion of sublingual space manifested on CT scan as obliteration of fat plane in sublingual space and involvement of the sublingual vessels in the space. Conclusion: Malignant oropharyngeal tumors can invade the adjacent sublingual space via tongue base, pterygomandibular raphe, and parapharyngeal space. The invasion of sublingual space by malignant oropharyngeal tumors manifests in CT as effacement of sublingual fat plane and envelopment of hyoid artery

Pulmonary spheral tuberculosis: features and clinical significance of spiral dynamic CT

International Nuclear Information System (INIS)

Xie Ruming; Ma Daqing; Li Tieyi; Chen Yi; Lu Fudong; Zhou Xinhua

2001-01-01

Objective: To assess the features and clinical significance of spiral dynamic CT in patients with pulmonary spheral tuberculosis. Methods: The 54 foci in 42 patients with pulmonary spheral tuberculosis were studied. Thin-sections at 2 mm thickness and 2 mm interval through the nodular center were obtained before and after administration of contrast material. Results: In 54 pulmonary spheral tuberculosis, maximum enhanced CT value in 51 (94.4%, 51/54) foci was less than 20 HU, and more than 20 HU in the other 3(5.6%, 3/54) foci. 27(50.0%, 27/54) foci showed no any enhancement, 24, (44%, 24/54) foci showed capsular enhancement, 1(1.9%, 1/54) focus showed peripheral enhancement and 2(3.7%, 2/54) foci showed extensive enhancement. The accuracy of the correct diagnosis was 25.9% in terms of plain CT and 94.4% in terms of enhanced CT scanning. The difference was significant (x 2 = 50.1, P < 0.05). The curative effect of extensive enhanced foci and peripheral enhanced foci was optimal, capsular enhanced foci was second, and non-enhanced foci was barely satisfactory. Conclusion: Spiral dynamic CT technique may improve the accuracy of diagnosing pulmonary spheral tuberculosis. No enhancement and/or capsular enhancement were suggestive of tuberculosis. The enhancing character of foci might contribute to assess the curative effect of anti-tuberculosis

CT classification of chronic pancreatitis and the significance for differential diagnosis

International Nuclear Information System (INIS)

Hu Xueling

2006-01-01

Objective: To study the CT characteristics of chronic pancreatitis and a classification based on the CT manifestations was established. Methods: In total 59 patients with chronic pancreatitis, 43 males and 16 females, with an average age of 40 years old were enrolled in the study. History of acute pancreatitis was positive in 36 patients. Non contrast enhanced and contrast enhanced CT scans were performed. The sizes of lesions, contour of pancreas, as well as the number, density and margin of lesions were investigated on the CT images. Results: Atrophy of the entire pancreas was revealed in 27 patients (46%), complicated with different degree of calcification. Solitary cyst with amorphous wall calcification was demonstrated in 13 patients (22%); multiple intra-pancreatic and peri-pancreatic pseudo-cysts were shown in 7 patients (12%); dilated pancreatic duct was seen in 7 patients (12%); and regional well demarcated bulging of pancreas was presented in 5 patients (8%). Conclusion: The CT findings of chronic pancreatitis in our study could be classified into 5 types: atrophy type, solitary cystic type, multicystic type, pure pancreatic duct dilatation type and mass type. The classification had certain significance for the differential diagnosis and the etiological analysis of chronic pancreatitis. (authors)

TH-E-BRF-04: Characterizing the Response of Texture-Based CT Image Features for Quantification of Radiation-Induced Normal Lung Damage

International Nuclear Information System (INIS)

Krafft, S; Court, L; Briere, T; Martel, M

2014-01-01

Purpose: Radiation induced lung damage (RILD) is an important dose-limiting toxicity for patients treated with radiation therapy. Scoring systems for RILD are subjective and limit our ability to find robust predictors of toxicity. We investigate the dose and time-related response for texture-based lung CT image features that serve as potential quantitative measures of RILD. Methods: Pre- and post-RT diagnostic imaging studies were collected for retrospective analysis of 21 patients treated with photon or proton radiotherapy for NSCLC. Total lung and selected isodose contours (0–5, 5–15, 15–25Gy, etc.) were deformably registered from the treatment planning scan to the pre-RT and available follow-up CT studies for each patient. A CT image analysis framework was utilized to extract 3698 unique texture-based features (including co-occurrence and run length matrices) for each region of interest defined by the isodose contours and the total lung volume. Linear mixed models were fit to determine the relationship between feature change (relative to pre-RT), planned dose and time post-RT. Results: Seventy-three follow-up CT scans from 21 patients (median: 3 scans/patient) were analyzed to describe CT image feature change. At the p=0.05 level, dose affected feature change in 2706 (73.1%) of the available features. Similarly, time affected feature change in 408 (11.0%) of the available features. Both dose and time were significant predictors of feature change in a total of 231 (6.2%) of the extracted image features. Conclusion: Characterizing the dose and time-related response of a large number of texture-based CT image features is the first step toward identifying objective measures of lung toxicity necessary for assessment and prediction of RILD. There is evidence that numerous features are sensitive to both the radiation dose and time after RT. Beyond characterizing feature response, further investigation is warranted to determine the utility of these features as

CT and MRI features in bipolaris fungal sinusitis

International Nuclear Information System (INIS)

Aribandi, M.; Bazan III, C.

2007-01-01

Bipolaris is an increasingly recognized cause of fungal sinusitis. Reports of imaging features are sparse. Our purpose was to review the imaging features in patients with Bipolaris fungal sinusitis. A review of our data showed seven patients with culture-proven Bipolaris fungal sinusitis. Computed tomography of the paranasal sinuses in all the patients and MRI in five patients were analysed for the location, nature, extent of the disease and density/ signal characteristics on CT/MRI. The sphenoid and posterior ethmoid sinuses were most often involved (six of seven), followed by the anterior ethmoid sinus (five of seven), frontal sinus (four of seven) and maxillary sinus (three of seven) involvement. Five of seven cases had bilateral disease. Secretions were seen to fill the sinus and were expansile in nature in six of seven cases. Bony erosion was noted in all the patients. Air-fluid levels and bony sclerosis were rarely seen. Computed tomography showed central hyperdensity in all the cases. In the corresponding MR images (n = 5), the sinus contents appeared hyperintense on T1-weighted images and hypointense on T2-weighted images. Extension into the nasal cavity was found in six of seven cases. Five of seven cases had intracranial (extradural) spread. Intraorbital extension was seen in three of seven cases, with associated optic nerve compression in two. All the patients responded to surgical debridement, and systemic antifungal therapy was not required. Bipolaris fungal sinusitis typically presents with an allergic fungal sinusitis picture with expansile sinus opacification and bony erosions. There is central hyperdensity on CT scan, which appears hyperintense on T1-weighted and hypointense on T2-weighted MR images

Chordoma versus chondrosarcoma of the central skull base: MR and CT findings

International Nuclear Information System (INIS)

Choi, Guk Myeong; Han, Moon Hee; Chang, Kee Hyun; Kim, Hong Dae; Yeon, Kyung Mo; Kim, Sam Soo

1998-01-01

It is known that due to both their imaging and pathologic features, the accurate differentiation of chondrosarcoma from chordoma is difficult. Through an analysis of MR and CT finding, this study aims to determine the differential points between these two tumors. In 21 patients, CT and MR imaging studies of chordoma (n=12) and chondrosarcoma (n=9) at the base of the skull were retrospectively reviewed. Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomas were subclassified as conventional and one as chondroid ; eight chondrosarcoma were conventional and one was myxoid. Four chordoma patients underwent CT and MR ; in six, only MR was in one, only CT was performed. All scans were retrospectively evaluated for the location (midline/off-midline), direction of extension, margin and shape, bony destruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcification was graded from I to II. Although MR and CT findings were similar in both types of tumor, location and degree of calcification may be features which usefully distinguish chordoma from chondrosarcoma. (author). 17 refs., 2 tabs., 5 figs

Medulloblastoma in children: CT and MRI findings

International Nuclear Information System (INIS)

Tortori-Donati, P.; Fondelli, M.P.; Rossi, A.; Cama, A.; Caputo, L.; Andreussi, L.; Garre, M.L.

1996-01-01

Our purpose was to determine whether medulloblastoma (MB) shows specific neuroradiological features which may be employed in differential diagnosis from other common posterior cranial fossa tumours in childhood. Preoperative MRI was performed on 20 children with MB, and preoperative CT in 17 of them. All underwent surgery and histopathological diagnosis. There was a constant relationship between high density on CT and low signal on T1-weighted images. Signal behaviour on T2-weighted images and the degree of contrast enhancement were more variable. Most tumours arose in the midline, from the cerebellar vermis, involving the fourth ventricle, but hemisphere and extra-axial neoplasms were also seen. The combination of high density on CT and low signal on T1-weighted images is highly suggestive of MB and may assist preoperative differential diagnosis from other posterior cranial fossa tumours. (orig.). With 9 figs., 2 tabs

The CT diagnosis and differential diagnosis of malignant tumours of the paranasal sinuses

International Nuclear Information System (INIS)

Graber, H.R.; Zaunbauer, W.; Haertel, M.

1986-01-01

The CT appearances of malignant tumours of the paranasal sinuses are illustrated on the basis of 15 patients, and the differential diagnosis discussed. Malignant soft tissue tumours in the paranasal sinuses are characterised on CT by their non-homogeneous structure; they may destroy the bony margins of the sinus and infiltrate neighbouring regions in certain preferred directions, and they may enhance following the administration of contrast. Precise definition of the malignant tumour by CT permits their exact staging, may help to determine therapy and is valuable for serial observation. It remains to be seen, however, whether the improved radiological diagnosis results in improved prognosis of malignant tumours of the paranasal sinuses. (orig.) [de

Prominent papilla of vater at CT: differentiation between benign and malignant lesion

International Nuclear Information System (INIS)

Park, Sun Won; Han, Joon Koo; Choi, Byung Ihn and others

1998-01-01

To establish the criteria for differential diagnosis between malignant tumor and benign prominence of papilla of Vater, as seen on CT. Sixteen consecutive patients with prominent patilla of Vater, as seen on CT during a ten-month period were included in this study. Final diagnosis was papilla of Vater cancer (n=3D5), chronic inflammation (n=3D3), benign tumor (n=3D3), or and normal (n=3D5), and this was confirmed by surgery in 11 cases, and endoscopy in five. Papilla size and attenuation, the presence of accompanied dilatation of the bile or pancreatic duct, and lymph node enlargement were analyzed by two experienced radiologists, who reached a concensus. A past history of stone disease, laboratory findings such as serum bilirubin, serum alkaline phosphatase, or endoscopic findings of duodenal diverticulum were additionally analyzed. Papilla size was the only significantly different CT finding between malignant and benign lesions, and serum alkaline phosphatase levels were also significantly different between the two groups. The smallest malignant tumor was 18 mm and the largest benign lesion was 15 mm. The presence of bile or pancreatic duct dilatation, serum bilirubin level, attenuation of the mass, a history of stone disease, and lymph node enlargement were not significantly different between the two groups. In patients with prominent papilla of Vater, as seen on CT, a mass larger than 18 mm is the only reliable radiologic finding to indicate malignant tumor of papilla of Vater. Serum alkaline phosphatase levels can, in addition, be helpful for the differential diagnosis of benign and malignant lesions.=20

Multilevel binomial logistic prediction model for malignant pulmonary nodules based on texture features of CT image

International Nuclear Information System (INIS)

Wang Huan; Guo Xiuhua; Jia Zhongwei; Li Hongkai; Liang Zhigang; Li Kuncheng; He Qian

2010-01-01

Purpose: To introduce multilevel binomial logistic prediction model-based computer-aided diagnostic (CAD) method of small solitary pulmonary nodules (SPNs) diagnosis by combining patient and image characteristics by textural features of CT image. Materials and methods: Describe fourteen gray level co-occurrence matrix textural features obtained from 2171 benign and malignant small solitary pulmonary nodules, which belongs to 185 patients. Multilevel binomial logistic model is applied to gain these initial insights. Results: Five texture features, including Inertia, Entropy, Correlation, Difference-mean, Sum-Entropy, and age of patients own aggregating character on patient-level, which are statistically different (P < 0.05) between benign and malignant small solitary pulmonary nodules. Conclusion: Some gray level co-occurrence matrix textural features are efficiently descriptive features of CT image of small solitary pulmonary nodules, which can profit diagnosis of earlier period lung cancer if combined patient-level characteristics to some extent.

Differences in clinical features and computed tomographic findings between embolic and non-embolic acute ischemic stroke. A quantitative differential diagnosis

International Nuclear Information System (INIS)

Takano, Kentaro; Yamaguchi, Takenori; Minematsu, Kazuo; Sawada, Tohru; Omae, Teruo

1998-01-01

A diagnosis based on the presumed mechanism of stroke onset is useful for management strategies in acute ischemic stroke. Ninety-two patients with embolic (cardiac or artery-to-artery) and 107 with non-embolic (thrombotic or hemodynamic) stroke were diagnosed on strict cerebral angiographic criteria alone. To clearly discriminate between these two groups, the neurological and computed tomographic (CT) findings were then compared. Rapidity of onset, vomiting, urinary incontinence, level of consciousness, cervical bruit, anisocoria, tongue deviation, sensory disturbance, and CT findings (location of hypodense area, findings of brain edema and hemorrhagic transformation) were discriminatory factors between the two groups (p<0.01). According to these 11 items, we prepared a numerical table for quantitative differential diagnosis. A diagnostic accuracy of 98.9% for embolic and 87.9% for non-embolic stroke in internal verification, and 90.0% and 82.9%, respectively, in external verification was observed. The differences in clinical features and CT findings between embolic and non-embolic stroke may reflect the pathophysiological mechanisms of the occlusive process of cerebral artery as well as the extent and severity of ischemia. (author)

Differences in clinical features and computed tomographic findings between embolic and non-embolic acute ischemic stroke. A quantitative differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Takano, Kentaro; Yamaguchi, Takenori; Minematsu, Kazuo; Sawada, Tohru; Omae, Teruo [National Cardiovascular Center, Suita, Osaka (Japan)

1998-02-01

A diagnosis based on the presumed mechanism of stroke onset is useful for management strategies in acute ischemic stroke. Ninety-two patients with embolic (cardiac or artery-to-artery) and 107 with non-embolic (thrombotic or hemodynamic) stroke were diagnosed on strict cerebral angiographic criteria alone. To clearly discriminate between these two groups, the neurological and computed tomographic (CT) findings were then compared. Rapidity of onset, vomiting, urinary incontinence, level of consciousness, cervical bruit, anisocoria, tongue deviation, sensory disturbance, and CT findings (location of hypodense area, findings of brain edema and hemorrhagic transformation) were discriminatory factors between the two groups (p<0.01). According to these 11 items, we prepared a numerical table for quantitative differential diagnosis. A diagnostic accuracy of 98.9% for embolic and 87.9% for non-embolic stroke in internal verification, and 90.0% and 82.9%, respectively, in external verification was observed. The differences in clinical features and CT findings between embolic and non-embolic stroke may reflect the pathophysiological mechanisms of the occlusive process of cerebral artery as well as the extent and severity of ischemia. (author)

Spindle epithelial tumor with thymus-like differentiation of the thyroid gland: A case report with ultrasonography and CT features, cytological findings and histopathological results

Energy Technology Data Exchange (ETDEWEB)

Kang, Dong Joo; Lee, Yoo Jin; Kim, Dong Wook; Jung, Soo Jin [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2016-11-15

Spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid gland is a very rare tumor. It is believed to originate from ectopic thymus tissue within the thyroid gland or from branchial pouch remnants that differentiate along the thymic line. A few reports of SETTLE have been presented, but to the best of our knowledge, there is no case report in which detailed preoperative imaging features of SETTLE have been described. In addition, there are no case reports of SETTLE in Korean patients. Thus, we report a case of SETTLE with detailed preoperative ultrasonography and computed tomography features, cytological findings and histopathological results.

Spindle epithelial tumor with thymus-like differentiation of the thyroid gland: A case report with ultrasonography and CT features, cytological findings and histopathological results

International Nuclear Information System (INIS)

Kang, Dong Joo; Lee, Yoo Jin; Kim, Dong Wook; Jung, Soo Jin

2016-01-01

Spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid gland is a very rare tumor. It is believed to originate from ectopic thymus tissue within the thyroid gland or from branchial pouch remnants that differentiate along the thymic line. A few reports of SETTLE have been presented, but to the best of our knowledge, there is no case report in which detailed preoperative imaging features of SETTLE have been described. In addition, there are no case reports of SETTLE in Korean patients. Thus, we report a case of SETTLE with detailed preoperative ultrasonography and computed tomography features, cytological findings and histopathological results

18F FDG PET/CT in differential diagnosis of Parkinsonian disorders

International Nuclear Information System (INIS)

Deepa; Moon, S.; Mahajan, S.; Thapa, P.; Gupta, P.; Sahana; Tripathi, M.; Sharma, R.; Mondal, A.; Batla, A.; Nehru, R.; Kushwaha, S.; Mishra, A.K.

2010-01-01

Full text: Differential diagnosis of Parkinsonian disorders can be challenging in the early phase of disease course. Positron Emission Tomography (PET) imaging with 18 F Fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of glucose metabolism in patients with idiopathic Parkinson's Disease (PD) as well as variant forms of Parkinsonism such as Multisystem Atrophy (MSA), Progressive Supranuclear Palsy (PSP) and cortico basal ganglionic degeneration (CBGD). In this study we assessed the utility of 18 F FDG PET/CT in the differential diagnosis Parkinsonian syndromes. 66 Parkinsonian patients with a mean age of 59.6 ± 11.50 years, male: female ratio of 3.12:1, age range of 35-84 years with a disease duration of 2.6 ± .68 years were referred for FDG PET to determine whether their scan patterns could distinguish idiopathic Parkinsons from the Parkinson plus syndromes. Approximately 60 minutes following intravenous injection of 370 MBq of 18 F-FDG, PET/CT scan of the brain was acquired in a whole-body Full Ring PET/CT scanner (Discovery STE16 camera). A low dose CT was obtained on the same area without IV contrast for attenuation correction and coregistration. Images were reconstructed using a 3D VUE algorithm and slices were reformatted into transaxial, coronal and sagittal views. Subsequently the images were processed and visually analyzed on Xeleris workstation. Images were classified by visual analysis into the various subgroups, those with normal to increased basal ganglia uptake were classified into Idiopathic Parkinson's (40/45) and when basal ganglia uptake was decreased they were Parkinsons Plus (19/21). The study demonstrates that 18 F FDG PET performed at the time of initial referral for parkinsonism could accurately classify patients into Parkinson's disease and Parkinson plus subtypes

Acute solitary localized pneumonia: CT diagnosis

International Nuclear Information System (INIS)

Li Tieyi

1999-01-01

Objective: To evaluate CT in the differential diagnosis of solitary localized pneumonia. Method: Only plain CT without contrast study was done because of different types of CT scanners weed. There were 25 cases with localized pneumonia with initial diagnosis as suspected peripheral bronchogenic carcinoma. All patients were over forty years of age, 84% 50-80 years, 13(52%) patients were asymptomatic, 5(20%) patients had bloody sputum. Results: The CT features were divided into three patterns: (1) irregular nodule with relatively well-defined margin, ground-glass opacity and a few punctuate high densities. (2) irregular nodule with sharply circumscribed, spiculate border and homogeneous density. (3) regular nodule with relatively well-defined margin, and homogeneous density. The third type was most frequent (60%) with predilection for the dorsal segments of the lower lobes, or the posterior basal segments. Of the 25 patients 3 had operation, the remaining cases were treated as pneumonia, the lesions were resolved in 18(82%) patients in 2-3 weeks. Conclusions: Sometimes it is very difficult to differentiate localized pneumonia from peripheral lung cancer on the basis of clinical presentation and imaging. The spiculate margins of irregular nodule shown on CT could be indeterminate on chest radiography, and as a result chest radiograph is helpful in differential diagnosis of localized pneumonia. Change in size of the lesion as observed at the same cross-section scan, smaller at mediastinal window than at lung window is in favor of localized pneumonia, however, with the exception of alveolar carcinoma, treatment with antibiotic therapy for a period of 2-3 weeks, helps differentiate these diseases

Automated detection of acute haemorrhagic stroke in non-contrasted CT images

International Nuclear Information System (INIS)

Meetz, K.; Buelow, T.

2007-01-01

An efficient treatment of stroke patients implies a profound differential diagnosis that includes the detection of acute haematoma. The proposed approach provides an automated detection of acute haematoma, assisting the non-stroke expert in interpreting non-contrasted CT images. It consists of two steps: First, haematoma candidates are detected applying multilevel region growing approach based on a typical grey value characteristic. Second, true haematomas are differentiated from partial volume artefacts, relying on spatial features derived from distance-based histograms. This approach achieves a specificity of 77% and a sensitivity of 89.7% in detecting acute haematoma in non-contrasted CT images when applied to a set of 25 non-contrasted CT images. (orig.)

Evaluation of dynamic enhanced CT scanning in the differentiation of adrenal lipid-poor adenomas with metastases

International Nuclear Information System (INIS)

Fang Xiangming; Hu Chunhong; Hu Xiaoyun; Chen Hongwei; Wu Liyuan; Zou Xinnong; Qian Pingyan

2006-01-01

Objective: To evaluate dynamic enhanced CT in differentiating adrenal metastases from adrenal lipid-poor adenomas(ALPA). Methods: Both plain and dynamic enhanced CT scanning was performed in 9 metastases with 13 masses and 28 lipid-poor adenoma with 30 masses. The types of time-density curve according to peak time(PT) and relative washout percentage(Washr) besides shape, size, margin, internal structure, surrounding status and enhanced pattern of each lesion were measuerd and compared between the two groups of metastases and ALPA. Results: There is difference between metastases and ALPA in the aspects of shape, density, neighboring structure and the type of enhancement. The type of TDC of matastases was characterized by fast-washin and fast-washout, which was quite differed from the type of TDC of ALPA characterized by fast-washin and slow-washout. According to this, the sensitiveity and specificity for differentiating metastases from ALPA were 96.7%, 92.3%. Conclusion: The types of TDC of dynamic enhanced CT is of great value in differentiating metastases from ALPA. (authors)

Diagnostic difficulties in the differentiation of neurogenic tumors of the parapharyngeal space in helical CT evaluations: A case report

International Nuclear Information System (INIS)

Czerniewicz-Kaminska, A.; Nowicki, J.; Jazwiec, P.; Kedzierski, B.; Janeczek, T.; Wilczynski, K.; Prudlak, E.

2005-01-01

Computerized tomography (CT) with contrast infusion and magnetic resonance imaging (MRI) play important roles in establishing the place of origin of neurogenic tumors. In this article we do not compare these two methods, but focus on the crucial role of CT imaging in the estimation and differential diagnosis of these tumors. We present the case of a 50-year-old man with clinical symptoms of peritonsillar abscess, which appeared to be a neurogenic tumor. The images obtained were deemed ambiguous. The possibility of a parotid gland tumor or a tumor of neurogenic origin was assumed. In this case we observed atypical clinical and radiological symptoms. The final diagnosis was based on a combination of radiological, clinical, and microbiological features of the tumor. Thanks to the cooperation of many professionals, we managed to establish the diagnosis of neuroangiofibroma, which exemplifies a tumor of the borderline, including elements of the neurogenic sheath and connective and chromaffin tissue. (author)

CT findings of hepatoblastoma before and after chemotherapy : correlation with pathologic features

International Nuclear Information System (INIS)

Seo, Joon Beom; Kim, Woo Sun; Kim, In One; Jang, Ja June; Kim, Chong Jai; Ahn, Hyo Seop; Yeon, Kyung Mo

1998-01-01

The purpose of this study was to analyze the CT findings of hepatoblastoma before and after chemotherapy, and to compare them with surgical and pathologic features. Twelve hepatoblastoma patients underwent chemotherapy prior to surgery; in all cases, CT scanning was performed before and after chemotherapy. We reviewed the findings with special attention to changes in tumor volume, the extent and pattern of contrast enhancement, the extent of low-attenuation area in the tumor, the presence of a septum, and calcification or ossification or ossification within the mass before and after chemotherapy. Post-chemotherapy CT findings were compared with operative and pathologic findings. After chemotheapy, the volume of the tumor mass decreased in all patients, and the extent of involved segments decreased in nine (75%), the non-enhancing area within the mass, on the other hand, increased in nine (75 %). On pre-chemotherapy CT, calcifications were detected in seven patients (58%), and on post-chemotherapy CT, in nine (75%); the extent of calcification were detected in seven patients. On the basis of CT findings, viable tumor and necrosis areas could not be distinguished. Massive calcification or osteoid mixed with loose connective tissue was noted in the mesenchymal component of the tumor; the whirling pattern of enhancement within the area of low density seen on CT scanning corresponded to osteoid mixed with loose connective tissue, which contained rich blood vessels. We describe the CT findings of hepatoblastoma both before and after chemotherapy, highlighting the changes which occurred. An understanding of these changes is helpful for the proper management of this condition. (author). 18 refs., 1 tab., 5 figs

CT manifestation of the carcinoma of ovary: diagnosis and differential diagnosis

International Nuclear Information System (INIS)

Liu Mingjuan; Guo Yan; Zhang Ling; Huang Zhaomin

2007-01-01

Objective: To study the CT manifestations of carcinoma of ovary and the CT findings that mimic the carcinoma of ovary. Methods: CT findings were retrospectively studied in 47 cases of pelvic masses including 42 cases of carcinoma of ovary and 5 misdiagnosed as carcinoma of ovary. Misdiagnosis was made in 8 of the 42 cases of carcinoma of ovary. Non-contrast and enhanced CT scan were performed in all cases. Results: Pelvic or abdominal-pelvic masses were demonstrated in 92.4% cases. The lesions were parenchymatous, cystic, or cystic-parenchymatous masses, in which the parenchyma and septum were remarkably enhanced after the contrast agent was given intravenously. No mass was found in 7.6% cases, in which the ascites and thickening of the omentum were noted on CT images. Ascites was shown in 57.2% cases. Calicification was manifested in 19.0% cases. Abscess or tuberculosis located in pelvis could have the similar CT findings with cystic carcinoma of ovary, while these infectious lesions presented with regular or smooth wall and septum, instead of mural nodule. Another characteristic sign of abscess or tuberculosis was air density identified within the cavity of the cysts. Chocolate cysts with recent hemorrhage or subserous leiomyoma uteri with cystic degeneration were cystic-parenchymatous mass during the non-contrast enhanced scan. No enhancement could be revealed in parenchyma of the former and slight enhancement could be identified in the parenchymatous component of the latter. Conclusion: Contrast enhanced CT scan can demonstrate the structure of the mass and the adjacent organs, and reveal the enhancement of the lesions, which plays a valuable role in diagnosis or differential diagnosis of carcinoma of ovary with atypical CT findings. (authors)

Benign pulmonary nodule. Morphological features and contrast enhancement evaluated with contiguous thin-section CT

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Matsuo, Hisayasu; Murata, Kiyoshi; Takahashi, Masashi; Morita, Rikushi [Shiga Univ. of Medical Science, Otsu (Japan)

1998-10-01

The morphological changes in 54 benign lung nodules, including 8 histologically proven nodules of tuberculoma, 10 of focal organizing pneumonia (FOP), 1 of lung abscess and 35 other benign nodules, were evaluated with contiguous thin-section (3 mm) CT. In addition, incremental dynamic studies were carried out in 25 of these nodules. The three-dimensional shapes of the nodules were found to be quite varied and were classified into four types: round mass (n=18), polygonal mass with concave or straight margins (n=20), oval or band-like mass extending along the bronchovascular bundle (n=7), and oval mass attached to the pleura with broad contact (n=9). Forty-two (78%) of the 54 nodules were located along the bronchovascular bundle. The maximum increments in CT values over 20 HU were observed after contrast enhancement in 18 (72%) of the 25 benign nodules, among which all tuberculomas showed little or no contrast enhancement. The number of small vessels quantified microscopically in the center of the nodules were minimal in tuberculomas with little enhancement and plentiful in lesions of FOP and abscess which showed marked enhancement. Our results suggest that the differentiation between benign and malignant pulmonary nodules is not possible simply on the basis of the degree of contrast enhancement. Therefore, morphological features and the anatomical relation to the bronchovascular bundles should also be taken into consideration in the diagnosis of pulmonary nodules. (author)

Benign pulmonary nodule. Morphological features and contrast enhancement evaluated with contiguous thin-section CT

International Nuclear Information System (INIS)

Matsuo, Hisayasu; Murata, Kiyoshi; Takahashi, Masashi; Morita, Rikushi

1998-01-01

The morphological changes in 54 benign lung nodules, including 8 histologically proven nodules of tuberculoma, 10 of focal organizing pneumonia (FOP), 1 of lung abscess and 35 other benign nodules, were evaluated with contiguous thin-section (3 mm) CT. In addition, incremental dynamic studies were carried out in 25 of these nodules. The three-dimensional shapes of the nodules were found to be quite varied and were classified into four types: round mass (n=18), polygonal mass with concave or straight margins (n=20), oval or band-like mass extending along the bronchovascular bundle (n=7), and oval mass attached to the pleura with broad contact (n=9). Forty-two (78%) of the 54 nodules were located along the bronchovascular bundle. The maximum increments in CT values over 20 HU were observed after contrast enhancement in 18 (72%) of the 25 benign nodules, among which all tuberculomas showed little or no contrast enhancement. The number of small vessels quantified microscopically in the center of the nodules were minimal in tuberculomas with little enhancement and plentiful in lesions of FOP and abscess which showed marked enhancement. Our results suggest that the differentiation between benign and malignant pulmonary nodules is not possible simply on the basis of the degree of contrast enhancement. Therefore, morphological features and the anatomical relation to the bronchovascular bundles should also be taken into consideration in the diagnosis of pulmonary nodules. (author)

CT differential diagnosis between angiomyolipoma and carcinoma of kidney

International Nuclear Information System (INIS)

Tang Guangjian; Xu Yan

2004-01-01

Objective: To investigate the formation of the cup sign and split sign in renal neoplasms and to evaluate the significance of these signs in CT differential diagnosis between angiomyolipoma (AML) and carcinoma of the kidney. Methods: Thirty cases of AMLs of kidney less than 5 cm in diameter confirmed pathologically or by the fat component shown in CT, and 26 cases of primary renal carcinomas less than 4 cm in diameter confirmed by operation and pathology were included in this study. The positive rates of cup sign and split sign of AML group and renal carcinoma group were calculated respectively and studied with blind method and pathologic comparison. Results: Of the 30 AMLs, cup sign was positive in 25 cases (83.3%) and split sign in 22 (73.3%). Of the 26 small renal carcinomas, cup sign was positive in 6 cases (23.1%) and split sign in 5 (19.2%). 7 AMLs without fat component or with too little fat to be seen with CT showed positive findings of cup sign in 6 (85.7%) and split sign in 5 (71.4%), respectively. The statistical results showed that the differences between the results of the writer and blind method, as well as between the imaging observation and pathologic findings were not significant (χ 2 =2.333, P>0.1; χ 2 =0.177, P>0.5). Conclusion: To some extent, the cup sign and split sign on CT reflect the biologic character of AMLs, and the signs are helpful in making the specific diagnosis of AML combined with other imaging manifestations. (authors)

Micro-CT features of intermediate gunshot wounds severely damaged by fire.

Science.gov (United States)

Fais, Paolo; Giraudo, Chiara; Boscolo-Berto, Rafael; Amagliani, Alessandro; Miotto, Diego; Feltrin, Giampietro; Viel, Guido; Ferrara, S Davide; Cecchetto, Giovanni

2013-03-01

Incineration or extensive burning of the body, causing changes in the content and distribution of fluids, fixation and shrinking processes of tissues, can alter the typical macroscopic and microscopic characteristics of firearm wounds, hampering or at least complicating the reconstruction of gunshot fatalities. The present study aims at evaluating the potential role of micro-computed tomography (micro-CT) for detecting and quantifying gunshot residue (GSR) particles in experimentally produced intermediate-range gunshot wounds severely damaged by fire. Eighteen experimental shootings were performed on 18 sections of human calves surgically amputated for medical reasons at three different firing distances (5, 15 and 30 cm). Six stab wounds produced with an ice pick were used as controls. Each calf section underwent a charring cycle, being placed in a wood-burning stove for 4 min at a temperature of 400 °C. At visual inspection, the charred entrance wounds could not be differentiated from the exit lesions and the stab wounds. On the contrary, micro-CT analysis showed the presence of GSR particles in all burnt entrance gunshot wounds, while GSR was absent in the exit and stab wounds. The GSR deposits of the firearm lesions inflicted at very close distance (5 cm) were mainly constituted of huge particles (diameter >150 μm) with an irregular shape and well-delineated edges; at greater distances (15 and 30 cm), agglomerates of tiny radiopaque particles scattered in the epidermis and dermis layers were evident. Statistical analysis demonstrated that also in charred firearm wounds the amount of GSR roughly correlates with the distance from which the gun was fired. The obtained results suggest that micro-CT analysis can be a valid screening tool for identifying entrance gunshot wounds and for differentiating firearm wounds from sharp-force injuries in bodies severely damaged by fire.

Papillary thyroid carcinoma: comparison between CT features and pathologic findings

International Nuclear Information System (INIS)

Tan Hongna; Gu Yajia; Peng Weijun; Yang Wentao; Huang Dan

2009-01-01

Objective: To evaluate the relationship between the CT imaging features and pathologic findings of papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC), as well as the CT appearances of Non-papillary thyroid carcinoma(N-PTC). Methods: CT features of 229 PTC, 42 PTMC and 36 N-PTC patients with 264, 57 and 41 lesions respectively were analyzed retrospectively, and comparison was made with the pathologic findings. All data were analyzed by X 2 test. Results: (1) Of PTC lesions, 25.4% (67/264)of the lesions and 2.9% (24/828) of metastatic lymph nodes showed cystic changes. Cyst formation with intracystic high density papillary-like nodules were found in 31.3% (21/67)of the PTC lesions and 37.5% (9/24) of metastatic lymph nodes. The histologic appearances of these tumors demonstrated fibrous tissue forming the wall of cyst, and papillary-like tumor tissue. (2) 75.2% (112/149) of PTC and 33.3% (5/15) of PTMC showed multiple small granular and fine calcifications, and there was statiscally significant difference between the two (P 0.05). However, the degree of enhancement in PTC lesions were less than that of N-PTC, 36.6% (94/257) of PTC and 54.1% (20/37)of N-PTC lesions showed significant enhancement, and there was statistically significant difference (P<0.05). 75.1% of PTC (172/229) and 52.8% of (19/36)N-PTC had cervical lymph node metastases, with a propensity fbr PTC to have more VI region metastatic lymph nodes, 80.8% (139/172)vs 57.9% (11/19), which was statistically significant (both P<0.05). (4)Distant metastases to bone or lung were rare, but N-PTC (5/36) were more likely to produce distant metastases than PTC (5/229), and there was statistically significant difference (P<0.01). Conclusion Multiple, small granular and fine calcifications were found more frequently in PTC than PTMC. Compared with N-PTC, the papillary-like mural nodules of PTC showed less enhancement on post-contrast CT and cervical lymph node metastases were more

CT of hepatocellular carcinoma

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Nakamura, H; Tanaka, T; Sai, H; Kawamoto, S; Morimoto, K [Osaka Univ. (Japan). Faculty of Medicine

1982-06-01

CT was investigated in 125 cases of hepatocelluar carcinoma and 47 cases of metastatic hepatic neoplasm. The entire contour of each tumor was traced and the average CT value in the tumor was estimated. As a result, the CT value for hepatocellular carcinoma tended to be higher on plain CT and also after contrast enhancement. The CT findings seen frequently were as follows: capsule in 76 cases (60.8%) and septum in 67 cases (53.6%); tumor thrombus in portal vein in 39 cases (31.2%) and that in inferior vena cava in 3 cases (2.4%); localized enlargement of hepatic bile duct in 24 cases (19.2%). These findings were rarely seen in the cases of metastatic hepatic neoplasm. As a relatively outstanding feature of hepatic metastases, a double contour, like concentric circles or contour lines, with a relatively large inner circle or contour line, was found in 21 cases (44.7%). By paying attention to the change of CT value on contrast enhancement and the characteristic image of each case, hepatocellular carcinoma could be differentiated from metastatic hepatic neoplasm with high probability.

Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

Energy Technology Data Exchange (ETDEWEB)

Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: ines.m.califano@gmail.com [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)

2013-06-15

Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

CT and ERCP diagnosis of obstructive jaundice

International Nuclear Information System (INIS)

Wang Dongfang; Cao Ran

2003-01-01

Objective: To evaluate some specific CT and ERCP findings for differentiating the nature of biliary obstructive diseases. Methods: In total 85 cases of obstructive jaundice verified by pathology were selected. The CT findings in 45 cases and ERCP features in 68 cases were retrospectively analyzed. Results: Mild dilatation of intrahepatic bile ducts were usually found in benign diseases, while moderately or severely dilated intrahepatic bile ducts were revealed in malignancies. Dilatation of intrahepatic bile ducts in vine pattern was one of the characteristic signs of malignant lesions, while 'withered branches' dilatation was usually found in benign diseases. Dilated extra-hepatic bile duct abruptly narrowed or obstructed was a typical finding in malignancies, while gradual tapering of common bile duct at the obstructed level usually indicated benign nature of the disease. Conclusion: Both CT and ERCP are valuable modalities in locating and differential diagnosis of biliary obstruction. A combined evaluation improves the accuracy of diagnosis

Imaging of bronchiectasis: the great value of high-resolution CT in differential diagnosis; Differenzialdiagnose der Bronchiektasen: High-resolution CT als wertvolle Hilfe

Energy Technology Data Exchange (ETDEWEB)

Heckmann, M.; Kramann, B.; Heinrich, M. [Klinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany); Uder, M. [Inst. fuer Diagnostische Radiologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany)

2006-07-01

Bronchiectasis is defined as localized irreversible dilatation of the bronchial tree. Brochiectasis has been associated with a wide variety of causes, but it is mostly caused by acute, chronic or recurrent infections. This paper should give a review about the manifestation of bronchiectasis and bronchioloectasis in HR-CT and discuss the causing entities. However, integration of bronchiectasis and other HR-CT findings may enable a narrower differential diagnosis, in some cases it is possible to give the correct diagnose directly. (orig.)

Development of a nomogram combining clinical staging with 18F-FDG PET/CT image features in non-small-cell lung cancer stage I-III

International Nuclear Information System (INIS)

Desseroit, Marie-Charlotte; Visvikis, Dimitris; Majdoub, Mohamed; Hatt, Mathieu; Tixier, Florent; Perdrisot, Remy; Cheze Le Rest, Catherine; Guillevin, Remy

2016-01-01

Our goal was to develop a nomogram by exploiting intratumour heterogeneity on CT and PET images from routine 18 F-FDG PET/CT acquisitions to identify patients with the poorest prognosis. This retrospective study included 116 patients with NSCLC stage I, II or III and with staging 18 F-FDG PET/CT imaging. Primary tumour volumes were delineated using the FLAB algorithm and 3D Slicer trademark on PET and CT images, respectively. PET and CT heterogeneities were quantified using texture analysis. The reproducibility of the CT features was assessed on a separate test-retest dataset. The stratification power of the PET/CT features was evaluated using the Kaplan-Meier method and the log-rank test. The best standard metric (functional volume) was combined with the least redundant and most prognostic PET/CT heterogeneity features to build the nomogram. PET entropy and CT zone percentage had the highest complementary values with clinical stage and functional volume. The nomogram improved stratification amongst patients with stage II and III disease, allowing identification of patients with the poorest prognosis (clinical stage III, large tumour volume, high PET heterogeneity and low CT heterogeneity). Intratumour heterogeneity quantified using textural features on both CT and PET images from routine staging 18 F-FDG PET/CT acquisitions can be used to create a nomogram with higher stratification power than staging alone. (orig.)

Automated measurement of CT noise in patient images with a novel structure coherence feature

International Nuclear Information System (INIS)

Chun, Minsoo; Kim, Jong Hyo; Choi, Young Hun

2015-01-01

While the assessment of CT noise constitutes an important task for the optimization of scan protocols in clinical routine, the majority of noise measurements in practice still rely on manual operation, hence limiting their efficiency and reliability. This study presents an algorithm for the automated measurement of CT noise in patient images with a novel structure coherence feature. The proposed algorithm consists of a four-step procedure including subcutaneous fat tissue selection, the calculation of structure coherence feature, the determination of homogeneous ROIs, and the estimation of the average noise level. In an evaluation with 94 CT scans (16 517 images) of pediatric and adult patients along with the participation of two radiologists, ROIs were placed on a homogeneous fat region at 99.46% accuracy, and the agreement of the automated noise measurements with the radiologists’ reference noise measurements (PCC  =  0.86) was substantially higher than the within and between-rater agreements of noise measurements (PCC within   =  0.75, PCC between   =  0.70). In addition, the absolute noise level measurements matched closely the theoretical noise levels generated by a reduced-dose simulation technique. Our proposed algorithm has the potential to be used for examining the appropriateness of radiation dose and the image quality of CT protocols for research purposes as well as clinical routine. (paper)

MR, CT, and myelographic features of epidural lipomatosis

International Nuclear Information System (INIS)

Quint, D.J.; Boulos, R.S.; Patel, S.C.; Sanders, W.P.; Tiel, R.L.; Washington, J.M.

1987-01-01

Central deposition of fat is a well-known clinical feature of chronically elevated corticosteroid levels. Rarely described is increased extradural fat causing compression of the spinal cord and neurologic deficits. Twelve previously reported and five new cases of epidural lipomatosis are presented. Representative examples of the common myelographic and CT findings in this disorder are shown. In addition, previously undescribed examples of epidural lipomatosis demonstrating (1) the MR findings, (2) no associated myelographic block, (3) lipomatosis in both the thoracic and lumbar regions, and (4) a case in a nonobese patient without known steroid use are presented. The importance of considering this entity in the appropriate clinical setting (chronic exogenous steroid use) even with a normal myelogram is stressed

Computer-aided analysis of CT images for the differentiation of cerebral tumors

International Nuclear Information System (INIS)

Michalik, M.; Michalik, S.; Bornholdt, F.

1988-01-01

For the integration of CT imaging into the differential diagnostics of intracranial space occupations, the selection and description of characteristics facilitating a good discrimination of serveral classes of tumors becomes a very important task. From images of 93 patients with the most frequent brain tumors the optimal set of characteristics was determined. The four most significant characteristics for the differentiation of brain tumors are 'uptake of contrast medium by the tumor', 'deliniation of the tumor contours', 'progression of the tumor' and the 'average tumor density after administration of contrast media'. Very good results were obtained for the differentiation of menigneomas with and without anaplasia and for the differentiation of meningeomas from all other tumors examined. The differentiation of the degree of malignancy for various gliomatous tumors was difficult. An accurate reclassification with the computer program was obtained for 83.4% of all tumors. (author)

Focal Amyloidosis of the Orbit Presenting as a Mass: MRI and CT Features

International Nuclear Information System (INIS)

Yerli, Hasan; Aydin, Erdinc; Avci, Suat; Haberal, Nihan; Oto, Sibel

2011-01-01

Focal orbital amyloidosis is a rare entity and little is known about its magnetic resonance imaging (MRI) features. In this case report, imaging features of a case of focal orbital amyloidosis presenting as a mass have been documented together with its histopathological findings. On MRI, a well-defined mass was seen as isointense with rectus muscle on T1-weighted images and heterogeneously hypointense on T2-weighted images. Punctuate calcifications were observed on the computerized tomography (CT) examination

Pseudomembranous aspergillus bronchitis in a double-lung transplanted patient: unusual radiographic and CT features

International Nuclear Information System (INIS)

Ducreux, D.; Chevallier, P.; Raffaelli, C.; Padovani, B.; Perrin, C.; Jourdan, J.; Hofman, P.

2000-01-01

Pseudomembranous aspergillus bronchitis is considered as an early form of invasive pulmonary aspergillosis, a well-known airway infection in immunocompromised patients. Radiologic features concerning invasive aspergillosis of the airways have been reported. However, we describe here an unusual feature of invasive aspergillus bronchitis, never reported to date, observed in a double-lung transplanted patient. Chest radiograph and CT revealed significant peribronchial thickening without any parenchymal involvement. (orig.)

Computed tomography of liver tumors, 2. Differential diagnosis between hepatocellular carcinoma and metastatic hepatic tumor by dynamic CT scanning

Energy Technology Data Exchange (ETDEWEB)

Naito, Akira; Fukuoka, Haruhito; Kashiwado, Kouzou; Ichiki, Toshio; Makidono, Yoko [Hiroshima Red Cross Hospital (Japan)

1984-02-01

Differential diagnosis between hepatocellular carcinoma and metastatic hepatic tumor was attempted using dynamic CT scanning. Homogeneous and patchy types were peculiar to hepatocellular carcinoma, and ring-like type to metastatic hepatic tumor. However, with no enhancement, hepatocellular carcinoma could not be denied. Hepatocellular carcinoma was characterized by the enhancement shown on the early stage of dynamic CT. Ring enhancement was not visualized on dynamic CT but visualized on conventional contrast enhanced CT in hepatocellular carcinomas; it was visualized on conventional contrast enhanced CT and on dynamic CT in metastatic hepatic tumors.

X-ray and CT diagnosis of intraosseous ganglion

International Nuclear Information System (INIS)

Gong Xiangyang; Zhang Weimin; Yan Shigui

2002-01-01

Objective: To investigate the pathogenesis, clinical manifestations, imaging features, and differential diagnosis of intraosseous ganglion. Methods: Clinical and imaging features of 15 cases (5 men, 10 women; mean age 39.7 years) with intraosseous ganglia were retrospectively analyzed. There were 17 lesions, including 6 acetabular, 4 lunate, 3 proximal ends of tibia, 1 major tuberculum of humeral, 1 femoral head, 1 scaphoid, and 1 phalange. Results: ( 1 ) Common radiological features included a unilocular or multilocular cyst surrounded by a full and thin rim of sclerotic: bone in the subchondral epiphysis without any signs of degenerative joint disease. (2) Lesions were displayed as well-defined round radiolucent defect or multi-cystic changes with surrounding bony sclerosis or cystic and expansile change with irregular shape on CT scans. (3) CT showed an intraosseous ganglion communicating with adjacent joint in 1 patient. (4) CT values of the lesions were between 15 - 80 HU. (5) Gas in the cyst could be seen in 3 cases. Conclusion: Combined with patient's age, lesion distribution, clinical manifestations, and imaging features, it is possible to make a correct diagnosis of intraosseous ganglion

CT imaging features of anaplastic thyroid carcinoma

International Nuclear Information System (INIS)

Shi Zhenshan; You Ruixiong; Cao Dairong; Li Yueming; Zhuang Qian

2013-01-01

Objective: To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease. Methods: The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed. The patients included 7 females and 3 males. Their age ranged from 25.0 to 78 years with median of 61 years. Multi-slices plain and post contrast CT scans were performed in all patients. Results: Unilateral thyroid was involved in 6 patients. Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size. Bilateral thyroid were involved in 2 patients. The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm. All lesions demonstrated unclear margins and envelope invasion. The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images. Seven lesions showed varied calcifications, and coarse granular calcifications were found in 5 lesions among them. All lesions showed remarkable heterogenous enhancement on post-contrast CT. The CT value of solid portion of the tumor increased 40 HU after contrast media administration. The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18) and 1.25-1.41 (1.33 ± 0.28) on pre and post CT, respectively. Enlarged cervical lymph nodes were found in 6 cases (60.0%). It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case. Conclusions: Relative larger single thyroid masses with coarse granular calcifications, necrosis,envelope invasion, remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma. (authors)

Focal pancreatic enlargement: differentiation between pancreatic adenocarcinoma and focal pancreatitis on CT and ERCP

International Nuclear Information System (INIS)

Kim, Eun Kyung; Kim, Ki Whang; Lee, Jong Tae; Kim, Hee Soo; Yoo, Hyung Sik; Yu, Jeong Sik; Yoon, Sang Wook

1995-01-01

To differentiate the pancreatic adenocarcinoma from focal pancreatitis on CT and ERCP in cases of focal pancreatic enlargement. We analysed CT findings of 66 patients of pancreatic adenocarcinoma (n = 45) or focal pancreatitis (n = 21) with respect to size, density, calcification, pancreatic or biliary duct dilatation, fat plane obliteration around the vessels, direction of retroperitoneal extension, lymphadenopathy, pseudocyst formation and atrophy of pancreas. ERCP available in 48 patients were analysed in respect to morphologic appearance of CBD and pancreatic duct, and distance between the two ducts. The patients in focal pancreatitis were younger with more common history of alcohol drinking. There was no statistical difference in calcifications of the mass (18% in the adenocarcinoma, 33% in the focal pancreatitis), but a tendency of denser, larger number of calcifications was noted in focal pancreatitis. The finding of fat plane obliteration around the vessels were more common in pancreatic adenocarcinoma, and fascial thickenings were more prominent in focal pancreatitis, although not statistically significant. On ERCP, there were no differential points of CBD, pancreatic duct morphology, but distance between the two ducts at the lesion center was more wider in focal pancreatitis. Differentiating focal pancreatitis from pancreatic adenocarcinoma is difficult. However, we should consider the possibility of focal pancreatitis in cases of patients with young age, having alcoholic history in association with CT findings of large numbers of and dense calcifications, and ERCP findings of prominent separation of two duct at the lesion center

Additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms of the pancreas with mural nodules

International Nuclear Information System (INIS)

Takanami, Kentaro; Hiraide, Tomomichi; Tsuda, Masashi; Nakamura, Yausuhiro; Kaneta, Tomohiro; Takase, Kei; Takahashi, Shoki; Fukuda, Hiroshi

2011-01-01

This study aimed at determining the additional value of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas with mural nodules. This retrospective review of medical records was approved by our institutional review board. The preoperative PET/CT images of 16 non-diabetic patients with surgically proven IPMN, where mural nodules of 3 mm or larger were shown by preoperative contrast-enhanced CT, were retrospectively evaluated. The 16 patients were divided into two groups: 7 patients with benign IPMN [adenoma (n=1) and borderline tumor (n=6)] and 9 patients with malignant IPMN [carcinoma in situ (CIS) (n=8) and invasive carcinoma (n=1)]. Nuclear medicine physician blinded to the pathologic assessment of malignancy of IPMN set a spherical volume of interest (VOI) over the mural nodules on PET/CT images and recorded the peak standardized uptake value (SUV max ) in the VOI, referring the contrast-enhanced CT images. Statistical differences in the size of mural nodule, the diameter of main pancreatic duct (MPD), and SUV max of the tumors between benign IPMNs and malignant IPMNs were compared using the Mann-Whitney U test. Statistical significance was set at p max of the malignant IPMNs with mural nodules of 3 mm or larger was higher than that of benign IPMNs (2.7±0.6 vs. 1.9±0.3, p<0.01). Meanwhile, there was no significant difference in mural nodule diameter and MPD diameter between the two groups. FDG PET/CT showed an excellent diagnostic accuracy for the differentiation between malignant and benign IPMNs with mural nodules: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in malignant IPMN with mural nodule of FDG PET/CT were 77.8, 100, 100, 77.8, and 87.5 for the cutoff value of 2.3; and 100, 57.1, 75.0, 100, and 81.3 for the cutoff value of 2

Application of 11C-choline PET/CT imaging for differentiating malignant from benign prostate lesions

International Nuclear Information System (INIS)

Li Xin; Wang Muwen; Liu Qingwei; Zhu Renjuan; Liu Lihui; Yuan Xianshun; Yao Shuzhan; Liu Songtao

2006-01-01

Objective: To investigate the potential of 11 C-choline PET/CT imaging for differentiating prostate cancer from benign prostate hyperplasia. Methods: A total of 45 patients with prostate lesions under- went 11 C-choline PET/CT imaging before transrectal needle biopsy. PET/CT imaging was performed 5 min after injection of 7.4 MBq/kg 11 C-choline in supine position over lower abdomen (3 min per bed with 2 beds), including the pelvis, and the whole body with 6 beds when necessary. After attenuation correction and iterative reconstruction, PET data were analyzed semi-quantitatively by measuring maximum standardized uptake values (SUV max ) in prostate lesions (P, target) and the muscles (M, non-target) and then P/M ratios were calculated. Also visual analysis was performed in different transverse, sagittal views and slices as well as three-dimensional images. Results: Eighteen prostate cancer and 27 benign prostate hyperplasia [and(or) chronic prostatitis] were all confirmed by pathology. The mean P/M ratio of prostate cancer was 4.02± 1.88, while in benign lesions was 1.87±1.21. The statistical differences of P/M ratios between them were significant (t=2.07, P 11 C-choline PET/CT imaging were 88.89%, 88.89% and 92.31% respectively. Conclusions: 11 C-choline PET/CT imaging is a valuable non-invasive technology in the diagnosis of pros- tate cancer. The P/M ratio can differentiate prostate cancer from benign lesions better than SUV. (authors)

CT-guided interventions in children

International Nuclear Information System (INIS)

Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A.

2007-01-01

In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone

Energy Technology Data Exchange (ETDEWEB)

D' Archambeau, O.; Parizel, P.M.; Schepper, A.M. De (Antwerp University Hospital (Belgium). Department of Radiology); Koekelkoren, E.; Van De Heyning, P. (Antwerp University Hospital (Belgium). Department of E.N.T.)

The purpose of this study was to assess the diagnostic and differential diagnostic value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient). Paget's disease (one patient) and osteoporosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth. (author). 14 refs.; 13 figs; 2 tabs.

CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone

International Nuclear Information System (INIS)

D'Archambeau, O.; Parizel, P.M.; Schepper, A.M. De; Koekelkoren, E.; Van De Heyning, P.

1990-01-01

The purpose of this study was to assess the diagnostic and differential diagnostic value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient). Paget's disease (one patient) and osteoporosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth. (author). 14 refs.; 13 figs; 2 tabs

Abdominal tuberculosis: Imaging features

International Nuclear Information System (INIS)

Pereira, Jose M.; Madureira, Antonio J.; Vieira, Alberto; Ramos, Isabel

2005-01-01

Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis

Malignant Mesothelioma Versus Metastatic Carcinoma of the Pleura: A CT Challenge

International Nuclear Information System (INIS)

Bakhshayesh Karam, Mehrdad; Karimi, Shirin; Mosadegh, Leila; Chaibakhsh, Samira

2016-01-01

Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm of the pleura that typically affects individuals occupationally exposed to asbestos through a variety of industries. MPM presents with several CT features similar to more common pleural diseases such as metastatic pleural malignancy. The aim of this study is to differentiate malignant pleural mesothelioma from metastatic carcinoma of the pleura by pathological and radiological assessment in order to investigate accuracy of CT scan in this regard and to compare CT features of these two malignancies. Chest CT scans of 55 pleural malignancy patients including MPM and metastatic pleural malignancy were evaluated in this retrospective study. The pathologist made the definite diagnosis based on immunohistochemistry. A chest radiologist unaware of the pathology diagnosis observed all CT scans. Several parameters including pleural thickening, pleural effusion, thickening of inter lobar fissure, contralateral extension, contraction of involved hemithorax, parenchymal involvement (infiltration, nodules, fibrosis), pleural mediastinal involvement, lymphadenopathy, extrapleural invasion (hepatic, chest wall, diaphragm, intraperitoneal), and pericardial involvement were checked. Data analysis was carried out using SPSS version 16, and the ability of CT scan to differentiate malignant pleural mesothelioma and metastatic pleural diseases was investigated. Totally 29 males and 26 females were assessed in this study. Based on pathology, 17 MPM and 38 metastatic pleural malignancies were diagnosed. According to CT study, about 82% of the patients with MPM and about 79% of the patients with metastatic pleural diseases were correctly diagnosed by a radiologist. The most common findings suggestive of MPM were pleural thickening (88.2%), loculated effusion (58.8%), and thickening of the interlobar fissure (47.1%). Whereas free pleural effusion (71.7%), parenchymal infiltration (65.8%) and pleural thickening (63.2%) were

FDG-PET/CT assessment of differential chemotherapy effects upon skeletal muscle metabolism in patients with melanoma

International Nuclear Information System (INIS)

Goncalves, M.D.; Alavi, A.; Torigian, D.A.

2014-01-01

To quantify the differential effects of chemotherapy on the metabolic activity of skeletal muscle in vivo using molecular imaging with [18F]-fluorodeoxy-glucose (FDG)-positron emission tomography/computed tomography (PET/CT). In this retrospective study, 21 subjects with stage IV melanoma who underwent pre- and post-chemotherapy whole-body FDG-PET/CT imaging were included. The mean standardized uptake value (SUV mean ) of 8 different skeletal muscles was measured per subject. Pre- and post-treatment measurements were then averaged across all subjects for each muscle and compared for statistically significant differences between the muscles and following different chemotherapy regimens including dacarbazine (DTIC) and temozolomide (TMZ). Analysis of FDG-PET/CT images reliably detected changes in skeletal muscle metabolic activity based on muscle location. The percent change in metabolic activity of each skeletal muscle in each subject following chemotherapy was observed to be related to the type of chemotherapy received. Subjects receiving DTIC generally had a decrease in metabolic activity of all muscle groups, whereas subjects receiving TMZ generally had an increase in muscle activity of all muscle groups. FDG-PET/CT can reveal baseline metabolic differences between different muscles of the body. Different chemotherapies are associated with differential changes in the metabolic activity of skeletal muscle, which can be detected and quantified with FDG-PET/CT. (author)

Nodule detection methods using autocorrelation features on 3D chest CT scans

International Nuclear Information System (INIS)

Hara, T.; Zhou, X.; Okura, S.; Fujita, H.; Kiryu, T.; Hoshi, H.

2007-01-01

Lung cancer screening using low dose X-ray CT scan has been an acceptable examination to detect cancers at early stage. We have been developing an automated detection scheme for lung nodules on CT scan by using second-order autocorrelation features and the initial performance for small nodules (< 10 mm) shows a high true-positive rate with less than four false-positive marks per case. In this study, an open database of lung images, LIDC (Lung Image Database Consortium), was employed to evaluate our detection scheme as an consistency test. The detection performance for solid and solitary nodules in LIDC, included in the first data set opened by the consortium, was 83% (10/12) true-positive rate with 3.3 false-positive marks per case. (orig.)

Biplane CT in sellar and parasellar tumors, (2)

International Nuclear Information System (INIS)

Sadamoto, Kazuhiko; Sakaki, Saburo; Matsuoka, Kenzo; Goishi, Junji; Sokabe, Takashi.

1980-01-01

Biplane CT images of 30 cases of sellar and parasellar tumors were studied. All 3 cases of meningioma were discovered by biplane CT (the diagnostic rate, 100%). As biplane CT could exclude partial volume effects, biplane CT images could demonstrate a fine structure and the position of parasellar or skull-base meningioma. As features of craniopharyngioma visualized on biplane CT images were variable, 7 of 9 cases of craniopharyngioma were detected by biplane CT (the diagnostic rate, 80%). When contrast enhancement on biplane CT images was marked, sometimes differencial diagnosis of craniopharyngioma and other suprasellar tumors was difficult. In all 18 cases of chromophobe adenoma, biplane CT images successfully demonstrated the location and extension of the tumors including cystic tumor (the diagnostic rate, 100%). In addition, 2 cases of giant aneurysm were presented in this study as examples of the differential diagnosis of pituitary and supraseller tumors. Biplane CT images showed mainly the location and the size of aneurysm as a mass lesion: therefore, cerebral angiography including vertebral arteriography was necessary for making an exact diagnosis of aneurysm. (Tsunoda, M)

Clinical features and CT scan findings of supratentorial ependymomas and ependymoblastomas

International Nuclear Information System (INIS)

Hanakita, Junya; Handa, Hajime

1984-01-01

The clinical courses and CT scan findings of 12 cases of supratentorial ependymoma and ependymoblastoma were reviewed. The age of the patient of ependymoma ranged from 3 years to 34 years, with an average age of 16 years. The follow-up time ranged from 2 months to 9 years and 10 months. All of the six patients are still alive. The age of the patients of ependymoblastoma ranged from 7 months to 34 years, with an average age of 17 years. During the follow-up period from 2 weeks to 6 years and 4 months, four patients died. Supratentorial ependymomas and ependymoblastomas show the following characteristic features of CT scans: 1. Calcification: The incidence of calcification was 50% in ependymoma-group, and 100% in ependymoblastoma-group. 2. Cyst formation, ring-enhancement: The cyst formation was noticed in both groups. In ependymoma-group a smooth ring-enhancement pattern and the strongly enhanced mural nodule-like contour were found, but in ependymoblastoma-group, the cyst wall was enhanced in irregular shape. 3. Perifocal edema and mass effect: Considerable mass effect was noticed in both groups. Perifocal edema was slight in many cases of ependymoma-group, but mostly prominent in ependymoblastoma-group. 4. CT scan findings of recurrent tumor: In ependymoma-group, recurrent tumor showed the same characteristics of CT scan as the initial ones. In ependymoblastoma-group, cystic portion decreased in size and irregular shaped solid portion increased in recurrence. (author)

Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

Energy Technology Data Exchange (ETDEWEB)

Jang, Suk Ki [Bundang Jesaeng General Hospital, Departments of Radiology, Daejin Medical Center, Seognam-si, Gyeonggi-do (Korea, Republic of); Kim, Jung Hoon; Joo, Ijin; Jeon, Ju Hyun; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Chongno-gu, Seoul (Korea, Republic of); Shin, Kyung Sook [Chungnam National University School of Medicine, Department of Radiology, 266 Munhwa-ro, Jung-gu, Daejeon (Korea, Republic of)

2015-10-15

To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

Hybrid imaging (SPECT/CT, PET/CT) in differentiated thyroid cancer; Imagerie hybride (TEMP/TDM, TEP/TDM) et cancer differencie de la thyroide

Energy Technology Data Exchange (ETDEWEB)

Bardet, S.; Ciappuccini, R.; Aide, N. [Unite de concertation pluridisciplinaire thyroide, service de medecine nucleaire, centre Francois-Baclesse, 14 - Caen (France); Barraux, V. [Unite de radiophysique, centre Francois-Baclesse, 14 - Caen (France); Rame, J.P. [Chirurgie ORL, centre Francois-Baclesse, 14 - Caen (France)

2010-08-15

Differentiated thyroid cancer (DTC) is generally associated with a good prognosis. Local recurrences, mainly lymph-node involvement, account for 15-20% of cases and are surgically treated. Distant metastases, mostly in lungs and more rarely in bones, are present in 5% of patients. When iodine uptake is sufficient (in approximately 60% of patients), distant metastases can be destroyed by iterative activities of iodine 131. Serum thyroglobulin (Tg), which can be assessed either on hormonal treatment or on TSH stimulation is considered as the tumour marker in DTC. Functional (iodine 131 scintigraphy, FDG PET, bone scintigraphy) or anatomical (neck ultrasound, thoracic CT, bone MRI) imaging methods can be performed when Tg increases in order to show residual/recurrent disease. In recent years, new hybrid equipments integrating both a gamma camera and CT scan (SPECT/CT) have been commercialized while positron emission tomography cameras associated with CT (PET/CT) have been installed on the whole French territory. These equipments, which allow us to directly correlate functional and anatomical images, greatly improve the interpretation of planar scintigraphy or that of PET alone. Hybrid imaging enables us to precisely localize scintigraphic foci and most often, to immediately verify whether they correspond to tumour lesions. The aim of this article is to review the role of SPECT/CT and PET/CT in the management of patients with DTC in 2010. (authors)

CT features of peritoneal and mesenteric involvement in pediatric malignancies. Experience from thirteen cases

International Nuclear Information System (INIS)

Grenier, N.; Filiatrault, D.; Garel, L.; Dube, J.; Paille, P.; Grenier, N.

1986-01-01

A retrospective study of all patients presenting with abdominal malignancies since November 1982 was undertaken in order to assess the CT features of peritoneal and mesenteric involvement in childhood. Thirteen cases, including 4 cases of malignant lymphomas, 1 case of Hodgkin's disease, 5 cases of adrenal tumors and 3 cases of ovarian tumors, were selected. Providing a good technique, CT appears as the best imaging modality of the mesentery. CT is also reliable in showing peritoneal implants, even without ascites. A high quality vascular opacification is needed in order to recognize the involvement of the lesser omentum (6/13 cases in our series). Precise knowledge of the intra-abdominal extension of the primary neoplasm has a definite impact upon the surgical indications and therefore upon the prognosis [fr

Improved pulmonary nodule classification utilizing quantitative lung parenchyma features.

Science.gov (United States)

Dilger, Samantha K N; Uthoff, Johanna; Judisch, Alexandra; Hammond, Emily; Mott, Sarah L; Smith, Brian J; Newell, John D; Hoffman, Eric A; Sieren, Jessica C

2015-10-01

Current computer-aided diagnosis (CAD) models for determining pulmonary nodule malignancy characterize nodule shape, density, and border in computed tomography (CT) data. Analyzing the lung parenchyma surrounding the nodule has been minimally explored. We hypothesize that improved nodule classification is achievable by including features quantified from the surrounding lung tissue. To explore this hypothesis, we have developed expanded quantitative CT feature extraction techniques, including volumetric Laws texture energy measures for the parenchyma and nodule, border descriptors using ray-casting and rubber-band straightening, histogram features characterizing densities, and global lung measurements. Using stepwise forward selection and leave-one-case-out cross-validation, a neural network was used for classification. When applied to 50 nodules (22 malignant and 28 benign) from high-resolution CT scans, 52 features (8 nodule, 39 parenchymal, and 5 global) were statistically significant. Nodule-only features yielded an area under the ROC curve of 0.918 (including nodule size) and 0.872 (excluding nodule size). Performance was improved through inclusion of parenchymal (0.938) and global features (0.932). These results show a trend toward increased performance when the parenchyma is included, coupled with the large number of significant parenchymal features that support our hypothesis: the pulmonary parenchyma is influenced differentially by malignant versus benign nodules, assisting CAD-based nodule characterizations.

Asbestosis and other pulmonary fibrosis in asbestos-exposed workers: high-resolution CT features with pathological correlations

Energy Technology Data Exchange (ETDEWEB)

Arakawa, Hiroaki [Dokkyo Medical University, Department of Radiology, Mibu, Tochigi (Japan); Kishimoto, Takumi [Okayama Rosai Hospital, Asbestos Research Center, Okayama (Japan); Ashizawa, Kazuto [Nagasaki University Graduate School of Biomedical Sciences, Department of Clinical Oncology, Nagasaki (Japan); Kato, Katsuya [Kawasaki Medical School, Department of Diagnostic Radiology 2, Okayama (Japan); Okamoto, Kenzo [Hokkaido Chuo Hospital, Department of Pathology, Iwamizawa, Hokkaido (Japan); Honma, Koichi [Dokkyo Medical University, Department of Pathology, Mibu, Tochigi (Japan); Hayashi, Seiji [National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka (Japan); Akira, Masanori [National Hospital Organization Kinki-Chuo Chest Medical Center, Department of Radiology, Osaka (Japan)

2016-05-15

The purpose was to identify distinguishing CT features of pathologically diagnosed asbestosis, and correlate diagnostic confidence with asbestos body burden. Thirty-three workers (mean age at CT: 73 years) with clinical diagnoses of asbestosis, who were autopsied (n = 30) or underwent lobectomy (n = 3), were collected. Two radiologists independently scored high-resolution CT images for various CT findings and the likelihood of asbestosis was scored. Two pathologists reviewed the pathology specimens and scored the confidence of their diagnoses. Asbestos body count was correlated with CT and pathology scores. Pathologically, 15 cases were diagnosed as asbestosis and 18 cases with various lung fibroses other than asbestosis. On CT, only the score of the subpleural curvilinear lines was significantly higher in asbestosis (p = 0.03). Accuracy of CT diagnosis of asbestosis with a high confidence ranged from 0.73 to 0.79. Asbestos body count positively correlated with CT likelihood of asbestosis (r = 0.503, p = 0.003), and with the confidence level of pathological diagnosis (r = 0.637, p < 0.001). Subpleural curvilinear lines were the only clue for the diagnosis of asbestosis. However, this was complicated by other lung fibrosis, especially at low asbestos body burden. (orig.)

CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A multi-institutional review

Energy Technology Data Exchange (ETDEWEB)

Cornelis, F.; Grenier, N. [Pellegrin Hospital, Department of Radiology, Bordeaux (France); Ambrosetti, D. [Pasteur Hospital, Department of Pathology, Nice (France); Rocher, L. [Kremlin-Bicetre Hospital, Department of Radiology, Paris (France); Derchi, L.E. [University of Genoa, IRCCS AOU Ospedale, San Martino IST, Department of Health Sciences (DISSAL), Genoa (Italy); Renard, B.; Puech, P. [Claude Huriez Hospital, Department of Radiology, Lille (France); Claudon, M. [Brabois Hospital, Department of Radiology, Vandoeuvre-les-Nancy (France); Rouviere, O. [E. Herriot Hospital, Department of Radiology, Lyon (France); Ferlicot, S. [Kremlin-Bicetre Hospital, Department of Pathology, Paris (France); Roy, C. [Civil Hospital, Department of Radiology, Strasbourg (France); Yacoub, M. [Pellegrin Hospital, Department of Pathology, Bordeaux (France); Bernhard, J.C. [Pellegrin Hospital, Department of Urologic Surgery, Bordeaux (France)

2017-03-15

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a recently identified renal malignancy. Diagnosis of this rare subtype of renal tumour can be challenging for pathologists, and as such, any additional data would be helpful to improve diagnostic reliability. As imaging features of this new and rare sub-type have not yet been clearly described, the purpose of this study was to describe the main radiologic features on computed tomography (CT) and magnetic resonance imaging (MRI), based jointly on the literature and findings from a multi-institutional retrospective review of pathology and imaging databases. Using a combination of CT/MRI features, diagnosis of MTSCC could be suggested in many cases. A combination of slow enhancement with plateau on dynamic contrast-enhanced CT/MRI, intermediate to high T2 signal intensity contrasting with low apparent diffusion coefficient values on MRI appeared evocative of this diagnosis. (orig.)

TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

Energy Technology Data Exchange (ETDEWEB)

Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R [University of Wisconsin, Madison, Wisconsin (United States); Meyer, E [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

2014-06-15

Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

International Nuclear Information System (INIS)

Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R; Meyer, E

2014-01-01

Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

Differentiation of Adrenal Adenoma and Nonadenoma in Unenhanced CT: New Optimal Threshold Value and the Usefulness of Size Criteria for Differentiation

International Nuclear Information System (INIS)

Park, Sung Hee; Kim, Myeong Jin; Kim, Joo Hee; Lim, Joon Seok; Kim, Ki Whang

2007-01-01

To determine the optimal threshold for the attenuation values in unenhanced computed tomography (CT) and assess the value of the size criteria for differentiating between an adrenal adenoma and a nonadenoma. The unenhanced CT images of 45 patients at our institution, who underwent a surgical resection of an adrenal masses between January 2001 and July 2005, were retrospectively reviewed. Forty-five adrenal masses included 25 cortical adenomas, 12 pheochromocytomas, three lymphomas, and five metastases confirmed by pathology were examined. The CT images were obtained at a slice thickness of 2 mm to 3 mm. The mAs were varied from 100 to 160 and 200 to 280, while the 120 KVp was maintained in all cases. The mean attenuation values of an adrenal adenoma and nonadenoma were compared using an unpaired t test. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy at thresholds of 10 HU, 20 HU, and 25 HU were compared. The diagnostic accuracy according to the size criteria from 2 cm to 6 cm was also compared. The twenty-five adenomas showed significantly lower (p 90% but a specificity < 70%. Size criteria of 2 or 3 cm had a high specificity of 100% and 80% but a low sensitivity of 20% and 60%. The threshold attenuation values of 20 or 25 HU in the unenhanced CT appear optimal for discriminating an adrenal adenoma from a nonadenoma. The size criteria are of little value in differentiating adrenal masses because of their low specificity or low sensitivity

Molecular biological features of male germ cell differentiation

Science.gov (United States)

HIROSE, MIKA; TOKUHIRO, KEIZO; TAINAKA, HITOSHI; MIYAGAWA, YASUSHI; TSUJIMURA, AKIRA; OKUYAMA, AKIHIKO; NISHIMUNE, YOSHITAKE

2007-01-01

Somatic cell differentiation is required throughout the life of a multicellular organism to maintain homeostasis. In contrast, germ cells have only one specific function; to preserve the species by conveying the parental genes to the next generation. Recent studies of the development and molecular biology of the male germ cell have identified many genes, or isoforms, that are specifically expressed in the male germ cell. In the present review, we consider the unique features of male germ cell differentiation. (Reprod Med Biol 2007; 6: 1–9) PMID:29699260

Abdominal tuberculosis: Imaging features

Energy Technology Data Exchange (ETDEWEB)

Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

2005-08-01

Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.

CT and MR imaging findings of sphenoidal masses

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Shoki; Higano, Shuichi (Tohoku Univ., Sendai (Japan). School of Medicine); Ishii, Kiyoshi (and others)

1994-07-01

CT and MR imaging findings of 57 sphenoidal masses were retrospectively reviewed to assess the possibility of differential diagnosis between them. Various kinds of masses such as pituitary adenoma, epipharyngeal cancer, mucocele, chordoma, chondroma, chondrosarcoma, distant metastasis, multiple myeloma, fibrous dysplasia, craniopharyngioma, hemangiopericytoma, giant cell tumor, primary sphenoidal cancer, malignant melanoma, leukemia, histiocytosis X, and giant cell tumor were included in this series. CT scanning was performed in all cases using a spin-echo pulse sequence. The relative density of the masses, bony changes and calcification were evaluated on CT, and on MR images, signal intensity of the masses relative to the normal gray matter, contrast enhancement and extension/contour were evaluated. Although no single feature appeared to be specific to the masses, detection of calcification on CT, identification of the normal pituitary gland as deformed or displaced on T1-weighted images, signal intensity on T2-weighted images, and extension of the masses seemed to be useful and should be examined in terms of their ability to assist in differential diagnosis. Finally, accommodative classification of sphenoidal masses primarily based on presumed origin or mode of extension was attempted. (author).

CT features of neutropenic enterocolitis in adult patients with hematological diseases undergoing chemotherapy

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Vogel, M.N.; Brodoefel, H.; Claussen, C.D.; Horger, M. [Tuebingen Univ. (Germany). Dept. of Diagnostic and Interventional Radiology; Goeppert, B. [Heidelberg Univ. (Germany). Inst. of Pathology; Maksimovic, O.; Faul, C. [Tuebingen Univ. (Germany). Dept. of Internal Medicine-Oncology

2010-12-15

Purpose: This study investigates the features of neutropenic enterocolitis (NE) in adults. Materials and Methods: Chart and radiology report reviews were used to identify neutropenic patients with hematological diseases undergoing chemotherapy, who had CT scans for the clarification of abdominal symptoms between October 2003 and October 2009. Patients with any cause for enteritis other than NE were excluded. The scans were analyzed with respect to imaging features and location. Morphological findings were correlated with clinical data. Results: Thirty-one patients with NE (median age 46 years; range 20 - 75) could be identified. Wall thickening and hyperemia could be found in all bowel segments from jejunum to rectum. The right hemicolon was the most frequent location in 19 patients (61 %). Involvement was generalized in 6 patients (19 %) and segmental in 25 cases (81 %). The longer the duration of neutropenia, the more likely generalized involvement of the bowel was. In 8 patients who underwent CT follow-up, the appearance of bowel segments had completely (n = 5) or partially (n = 3) returned to normal at the latest 14 days after the initial diagnosis. Eight patients (26 %) died 1 - 78 days after NE, 7 of who had previously recovered from NE. Conclusion: CT findings are useful for the diagnosis of NE and should be considered even in the presence of isolated small bowel involvement. The terms NE and typhlitis should thus no longer be used synonymously. (orig.)

Comparative Study of the CT Findings and Clinical Features in Pediatric and Adult Sialadenitis

International Nuclear Information System (INIS)

Han, Jong Kyu; Jo, Seong Shik; Kim, Sang Won; Kim, Young Tong; Shin, Hyeong Cheol; Kim, Il Young; Lee, Yong Man

2010-01-01

We wanted to compare the CT findings and clinical features of parotitis and submandibular sialadenitis in children and adults and to evaluate the statistical significance of these in different age groups and the usefulness of a CT scan. Ninety-seven adults and 36 pediatric patients with sialadenitis were included in this retrospective study. Regardless of the site of involvement, we evaluated the CT findings and clinical manifestations between the pediatric and adult groups, and between the pediatric and adult parotitis and submandibular sialadenitis groups. At last, all the patients were classified into seven age groups. Abscess formations were more prominent in the parotitis groups, and sialiths were more common in the submandibular sialadenitis group with the lowest incidence in the young children group (≤ 10 years). Cellulitis seen on a CT scan showed a higher incidence in the adult parotitis group, and this finding was closely connected with pain. A number of patients showed cervical lymphadenitis on a CT scan and this coincided with lymph node palpation. Tonsillitis associated sialadenitis was common in the pediatric group. The therapeutic durations were longer in the pediatric parotitis patient group and the adult submandibular sialadenitis group. CT scans were very helpful to evaluate for abscess, stone, lymphadenitis and estimating the associated clinical manifestations such as swelling, palpable lymph nodes, pain with operation and the therapeutic plan

CT differentiation of solid ovarian tumor and uterine subserosal leiomyoma

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Kim, Kyung Rae; Cho, Kyoung Sik [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Sohn, Chul Ho [Dongsan Medical Center, Keimyung Univ. College of Medicine, Taegu (Korea, Republic of); Ji, Eun Kyung [Bombit Hospital, Seoul (Korea, Republic of)

1999-06-01

On the basis of CT findings, to differentiate between solid ovarian tumor and uterine subserosal myoma. In eight surgically proven cases of solid ovarian tumor and in ten uterine subserosal myoma patients, contrast-enhanced CT images were obtained. Two genitourinary radiologists reviewed the findings with regard to degree of enhancement of the mass as compared with enhancement of uterine myometrium, thickening of round ligaments, visualization of normal ovaries, contour of the mass, and the presence of ascites in the pelvic cavity. Six of eight ovarian tumors but only two of ten uterine myomas were less enhanced than normal uterine myometrium (p<0.05). Pelvic ascites were seen in six of eight ovarian tumors, but in only one of ten uterine myomas (P<0.05). Three of 16 ovaries in ovarian tumor patients, but 12 of 20 ovaries in uterine myoma patients, were normal (p<0.05). Six of 16 round ligaments of the uterus in ovarian tumor patients, were thichened but 11 of 20 round ligaments in uterine myoma patients, were thickened (p>0.05). The contour of the mass was lobulated in two of eight ovarian tumor patients, but in five of ten uterine myoma patients (p>0.05). CT findings suggestive of solid ovarian tumor were less contrast enhancement of the mass than of normal uterine myometrium, pelvic ascites, and nonvisualization of normal ovary.

CT-criteria of orbital hemangiomas and their importance in differential diagnosis of intraconal tumors

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Unsoeld, R; Hoyt, W F [California Univ., San Francisco (USA). Dept. of Neurosurgery; California Univ., San Francisco (USA). Dept. of Neurology and Opthalmology; California Univ., San Francisco (USA). Dept. of Neuroradiology)

1979-12-01

CT-Scans of 29 histologically proven cavernous hemangiomas were evaluated with respect to their location, shape, delineation from surrounding tissue, contrast-enhancement, and secondary changes of the bony orbit. Whenever a round or oval tumor, located in the outer upper muscle cone, sharply delineated from surrounding tissue, unattached to optic nerve and ocular muscles, spares a small triangular space in the orbital apex, it is in all probability a cavernous hemangioma. Evaluation of the tumors shape and its separation from surrounding tissues requires imaging in multiple sections in two planes oriented, if possible, at right angles. Changes in position of the optic nerve and eye muscles in different directions of gaze demonstrated by CT rule out significant tumor-attachments. The portion of the intraconal space least affected by optic nerve shifts and muscle contractions during eye movements, as demonstrated by CT, is the upper outer quadrant, the site preferred by the mobile tumor. Tumors which cannot be differentiated from cavernous hemangiomas by CT-criteria are rare usually benign. Reports of rare examples of well delineated or encapsulated malignant intraconal lesions indicate the possibility - however remote - of mistaking a malignant tumor for a cavernous hemangioma by CT.

Magnetic resonance imaging features of extremity sarcomas of uncertain differentiation

International Nuclear Information System (INIS)

Stacy, G.S.; Nair, L.

2007-01-01

The purpose of this review is to illustrate the pertinent clinical and imaging features of extremity sarcomas of uncertain differentiation, including synovial sarcoma, epithelioid sarcoma, clear-cell sarcoma, and alveolar soft part sarcoma. These tumours should be considered in the differential diagnosis when a soft-tissue mass is encountered in the extremity of an adolescent or young adult

CT features of cardio-pericardial masses

International Nuclear Information System (INIS)

Vasile, N.; Nicoleau, F.; Mathieu, D.

1986-01-01

The results of dynamic computed tomography (CT) in 13 patients with intracardiac filling defects and one with a pericardial lipoma are presented. The intracardiac filling defects were due to thrombus in five cases, myxoma in three, hydatid cysts in three, haemangiopericytoma in one and sarcoma in one. These kinds of lesions are well identified by CT which seems to be superior to echocardiography in the characterisation of the components and in the evaluation of the malignant spreading masses. (orig.)

CT diagnosis and differential diagnosis of the masses in lateral district of neck

International Nuclear Information System (INIS)

Cai Wenchong; Wei Zengcai; Li Huajie

2006-01-01

Objective: To analyze the CT findings and the corresponding anatomic basis of the masses arising in the lateral district of neck, and improve the diagnosis. Methods: CT findings in 52 patients with tumours in lateral district of neck, pathologically proved, were retrospectively studied on the size of the masses, morphology, density, margin, contrast enhanced characteristics, location and relationship with adjacent vessels and spaces. Results: Among the 52 cases, masses were located in the prestyloid space in 8 cases, in the parotid in 8, within the masticator space in 2, and in the carotid space in 31. In most of the cases, CT revealed the pathologic nature of the masses and adjacent anatomic structure. According to the displacement of the adjacent spaces muscles and vessels caused by the masses, the origin of the masses could be predicted. The origin of the masses was spatially related to the internal carotid artery and the jugular vein. Conclusion: CT is an effective modality for the positional diagnosis of the masses arising lateral district of neck. Considering the anatomical position and contrast enhanced characteristics and the involvement of the adjacent structure, the qualitative and differential diagnosis can be improved. (authors)

[Feature extraction for breast cancer data based on geometric algebra theory and feature selection using differential evolution].

Science.gov (United States)

Li, Jing; Hong, Wenxue

2014-12-01

The feature extraction and feature selection are the important issues in pattern recognition. Based on the geometric algebra representation of vector, a new feature extraction method using blade coefficient of geometric algebra was proposed in this study. At the same time, an improved differential evolution (DE) feature selection method was proposed to solve the elevated high dimension issue. The simple linear discriminant analysis was used as the classifier. The result of the 10-fold cross-validation (10 CV) classification of public breast cancer biomedical dataset was more than 96% and proved superior to that of the original features and traditional feature extraction method.

Estimation of lung tumor position from multiple anatomical features on 4D-CT using multiple regression analysis.

Science.gov (United States)

Ono, Tomohiro; Nakamura, Mitsuhiro; Hirose, Yoshinori; Kitsuda, Kenji; Ono, Yuka; Ishigaki, Takashi; Hiraoka, Masahiro

2017-09-01

To estimate the lung tumor position from multiple anatomical features on four-dimensional computed tomography (4D-CT) data sets using single regression analysis (SRA) and multiple regression analysis (MRA) approach and evaluate an impact of the approach on internal target volume (ITV) for stereotactic body radiotherapy (SBRT) of the lung. Eleven consecutive lung cancer patients (12 cases) underwent 4D-CT scanning. The three-dimensional (3D) lung tumor motion exceeded 5 mm. The 3D tumor position and anatomical features, including lung volume, diaphragm, abdominal wall, and chest wall positions, were measured on 4D-CT images. The tumor position was estimated by SRA using each anatomical feature and MRA using all anatomical features. The difference between the actual and estimated tumor positions was defined as the root-mean-square error (RMSE). A standard partial regression coefficient for the MRA was evaluated. The 3D lung tumor position showed a high correlation with the lung volume (R = 0.92 ± 0.10). Additionally, ITVs derived from SRA and MRA approaches were compared with ITV derived from contouring gross tumor volumes on all 10 phases of the 4D-CT (conventional ITV). The RMSE of the SRA was within 3.7 mm in all directions. Also, the RMSE of the MRA was within 1.6 mm in all directions. The standard partial regression coefficient for the lung volume was the largest and had the most influence on the estimated tumor position. Compared with conventional ITV, average percentage decrease of ITV were 31.9% and 38.3% using SRA and MRA approaches, respectively. The estimation accuracy of lung tumor position was improved by the MRA approach, which provided smaller ITV than conventional ITV. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

CT and MR imaging features in patients with intracranial dolichoectasia

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Tien, Kuang Lung; Yu, In Kyu; Yoon, Sook Ja; Yoon, Yong Kyu [Eulji College of Medicine, Eulji Hospital, Seoul (Korea, Republic of)

2000-02-01

To describe the CT and MR imaging features in patients with intracranial dolichoectasia. The CT (n=3D21), MR (n=3D20) and MRA (n=3D11) imaging features seen in 28 patients (M:F=3D12:16 aged between 65 and 82 (mean, 65) years) with intracranial dolichoectasia were retrospectively reviewed with regard to involved sites, arterial changes (maximum diameter, wall calcification, high signal intensity in the involved artery, as seen on T1-weighted MR images), infarction, hemorrhagic lesion, compression of brain parenchyma or cranial nerves, hydrocephalus and brain atrophy. Involved sites were classified as either type 1 (involvement of only the posterior circulation), type 2 (only the anterior circulation), or type 3 (both). In order of frequency, involved sites were type 1 (43%), type 3 (36%) and type 2 (22%). Dolichoectasia was more frequently seen in the posterior circulation (79%) than in the anterior (57%). Arterial changes as seen on T1-weighted MR images, included dolichoectasia (mean maximum diameter 7.4 mm in the distal internal carotid artery, and 6.7 mm in the basilar artery), wall calcification (100% in involved arteries) and high signal intensity in involved. Cerebral infarction in the territory of the involved artery was found in all patients, and a moderate degree of infarct was 87%. Hemorrhagic lesions were found in 19 patients (68%); these were either lobar (53%), petechial (37%), or subarachnoid (16%), and three patients showed intracranial aneurysms, including one case of dissecting aneurysm. In 19 patients (68%), lesions were compressed lesions by the dolichoectatic arteries, and were found-in order of descending frequency-in the medulla, pons, thalamus, and cerebellopontine angle cistern. Obstructive hydrocephalus was found in two patients (7%), and 23 (82%) showed a moderate degree of brain atrophy. In patients with intracranial dolichoectasia, moderate degrees of cerebral infarction and brain atrophy in the territory of involved arteries, as well as

WE-G-207-05: Relationship Between CT Image Quality, Segmentation Performance, and Quantitative Image Feature Analysis

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Lee, J; Nishikawa, R [University of Pittsburgh, Pittsburgh, PA (United States); Reiser, I [The University of Chicago, Chicago, IL (United States); Boone, J [UC Davis Medical Center, Sacramento, CA (United States)

2015-06-15

Purpose: Segmentation quality can affect quantitative image feature analysis. The objective of this study is to examine the relationship between computed tomography (CT) image quality, segmentation performance, and quantitative image feature analysis. Methods: A total of 90 pathology proven breast lesions in 87 dedicated breast CT images were considered. An iterative image reconstruction (IIR) algorithm was used to obtain CT images with different quality. With different combinations of 4 variables in the algorithm, this study obtained a total of 28 different qualities of CT images. Two imaging tasks/objectives were considered: 1) segmentation and 2) classification of the lesion as benign or malignant. Twenty-three image features were extracted after segmentation using a semi-automated algorithm and 5 of them were selected via a feature selection technique. Logistic regression was trained and tested using leave-one-out-cross-validation and its area under the ROC curve (AUC) was recorded. The standard deviation of a homogeneous portion and the gradient of a parenchymal portion of an example breast were used as an estimate of image noise and sharpness. The DICE coefficient was computed using a radiologist’s drawing on the lesion. Mean DICE and AUC were used as performance metrics for each of the 28 reconstructions. The relationship between segmentation and classification performance under different reconstructions were compared. Distributions (median, 95% confidence interval) of DICE and AUC for each reconstruction were also compared. Results: Moderate correlation (Pearson’s rho = 0.43, p-value = 0.02) between DICE and AUC values was found. However, the variation between DICE and AUC values for each reconstruction increased as the image sharpness increased. There was a combination of IIR parameters that resulted in the best segmentation with the worst classification performance. Conclusion: There are certain images that yield better segmentation or classification

Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

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Payabvash, Seyedmehdi [Zeenat Qureshi Stroke Institute, Minneapolis, MN (United States); University of Minnesota, Department of Radiology, Minneapolis, MN (United States); Qureshi, Mushtaq H.; Khan, Shayaan M.; Khan, Mahnoor; Majidi, Shahram; Pawar, Swaroop; Qureshi, Adnan I. [Zeenat Qureshi Stroke Institute, Minneapolis, MN (United States)

2014-09-15

This study aimed to identify the imaging characteristics that can help differentiate intraparenchymal hemorrhage from benign contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients after endovascular treatment. We reviewed the clinical and imaging records of all acute ischemic stroke patients who underwent endovascular treatment in two hospitals over a 3.5-year period. The immediate post-procedural CT scan was evaluated for the presence of hyperdense lesion(s). The average attenuation of the lesion(s) was measured. Intraparenchymal hemorrhage was defined as a persistent hyperdensity visualized on follow-up CT scan, 24 h or greater after the procedure. Of the 135 patients studied, 74 (55 %) patients had hyperdense lesion(s) on immediate post-procedural CT scan. Follow-up scans confirmed the diagnosis of intraparenchymal hemorrhage in 20 of these 74 patients. A receiver operating characteristic analysis showed that the average attenuation of the most hyperdense lesion can differentiate intraparenchymal hemorrhage from contrast extravasation with an area under the curve of 0.78 (p = 0.001). An average attenuation of <50 Hounsfield units (HU) in the most visually hyperattenuating hyperdense lesion had 100 % specificity and 56 % sensitivity for identification of contrast extravasations. Petechial hyperdensity was seen in 46/54 (85 %) patients with contrast extravasation versus 9/20 (45 %) patients with intraparenchymal hemorrhage on the immediate post-procedural CT scan (p < 0.001). An average attenuation <50 HU of the most hyperattenuating hyperdense parenchymal lesion on immediate post-procedural CT scan was very specific for differentiating contrast extravasation from intraparenchymal hemorrhage in acute ischemic stroke patients after endovascular treatment. (orig.)

Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment

International Nuclear Information System (INIS)

Payabvash, Seyedmehdi; Qureshi, Mushtaq H.; Khan, Shayaan M.; Khan, Mahnoor; Majidi, Shahram; Pawar, Swaroop; Qureshi, Adnan I.

2014-01-01

This study aimed to identify the imaging characteristics that can help differentiate intraparenchymal hemorrhage from benign contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients after endovascular treatment. We reviewed the clinical and imaging records of all acute ischemic stroke patients who underwent endovascular treatment in two hospitals over a 3.5-year period. The immediate post-procedural CT scan was evaluated for the presence of hyperdense lesion(s). The average attenuation of the lesion(s) was measured. Intraparenchymal hemorrhage was defined as a persistent hyperdensity visualized on follow-up CT scan, 24 h or greater after the procedure. Of the 135 patients studied, 74 (55 %) patients had hyperdense lesion(s) on immediate post-procedural CT scan. Follow-up scans confirmed the diagnosis of intraparenchymal hemorrhage in 20 of these 74 patients. A receiver operating characteristic analysis showed that the average attenuation of the most hyperdense lesion can differentiate intraparenchymal hemorrhage from contrast extravasation with an area under the curve of 0.78 (p = 0.001). An average attenuation of <50 Hounsfield units (HU) in the most visually hyperattenuating hyperdense lesion had 100 % specificity and 56 % sensitivity for identification of contrast extravasations. Petechial hyperdensity was seen in 46/54 (85 %) patients with contrast extravasation versus 9/20 (45 %) patients with intraparenchymal hemorrhage on the immediate post-procedural CT scan (p < 0.001). An average attenuation <50 HU of the most hyperattenuating hyperdense parenchymal lesion on immediate post-procedural CT scan was very specific for differentiating contrast extravasation from intraparenchymal hemorrhage in acute ischemic stroke patients after endovascular treatment. (orig.)

Giant Serous Cystadenoma of the Pancreas (⩾10 cm: The Clinical Features and CT Findings

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Qing-Yu Liu

2016-01-01

Full Text Available Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm. Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm–16.5 cm (median value, 13.0 cm. CT imaging revealed that all 6 cases showed microcystic appearances (n=5 or mixed microcystic and macrocystic appearances (n=1. Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL. After 6–49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image.

Differences in CT features of peritoneal carcinomatosis, sarcomatosis, and lymphomatosis: Retrospective analysis of 122 cases at a tertiary cancer institution

International Nuclear Information System (INIS)

O'Neill, A.C.; Shinagare, A.B.; Rosenthal, M.H.; Tirumani, S.H.; Jagannathan, J.P.; Ramaiya, N.H.

2014-01-01

, and lymphomatosis have distinctive patterns on imaging, which can help the radiologists to differentiate between them. - Highlights: • Assessed imaging features of peritoneal carcinomatosis, sarcomatosis, lymphomatosis. • Consensus review of CT examinations of 122 patients with peritoneal tumor spread. • Peritoneal carcinomatosis had ascites, peritoneal thickening and omental cake. • Peritoneal sarcomatosis had well-defined nodules with a smooth outline. • Peritoneal lymphomatosis involved the omentum and mesentery and had lymphadenopathy

Differential diagnosis of pulmonary emphysema using the CT index: LL%w

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Kitahara, Yoshinari; Takamoto, Masahiro; Maruyama, Masao; Tanaka, Yasushi; Ishibashi, Tuneo; Shinoda, Atsushi [Ohmuta National Hospital, Fukuoka (Japan)

1989-06-01

We measured the computed tomography (CT) index, LL%w, in 81 patients of chronic obstructive pulmonary disease (COPD) and asthma. In this study we defined LL%w as the mean value of the proportion of the low density area under -950 Hounsfield units in the six lung fields: upper, middle and lower lung fields bilaterally, at deep expiration. To examine the usefulness of LL%w in differentiating pulmomary emphysema (PE) from bronchial asthma (BA) and chronic bronchitis (CB), we excluded the overlapped cases of each disease. Mean value (+- standard deviation) of LL%w in PE was 24.6+-20.2% (n=40), whereas it was 0.5+-0.8% (n=27) in BA and 0.2+-0.3% (n=14) in CB respectively. There were clear statistically differences in the values of LL%w between clinically diagnosed emphysema and others. We considered that the value of LL%w within 1% would be observed nonspecifically, because the frequent existence of low density areas originated in bronchial tangents and/or motion artifacts mainly in the left lower lung field. Thus we judged that cases with over 1% of LL%w had abnormal CT findings. The relationship between clinically diagnosed emphysema and CT abnormality (LL%w > 1%) was significant in the analysis of the four-fold table. The CT sensitivity for diagnosing PE was 100%, the CT specificity was 87.8%, and CT accuracy was 93.8%. When cases of LL%w > 1% were shown in BA or CB, it would be better to consider the existence of complicated emphysema or the presence of air trapping or air spaces of any origin. We compared three groups (A', E', C') selected from groups BA, PE and CB, respectively. The groups consisted of patients showing almost the same mean values of FEV{sub 1.0}/VC(%). The value of the LL%w of E', selected from PE, also showed a significantly higher value than those from BA or CB. (J.P.N).

Differential diagnosis of pulmonary emphysema using the CT index: LL%w

International Nuclear Information System (INIS)

Kitahara, Yoshinari; Takamoto, Masahiro; Maruyama, Masao; Tanaka, Yasushi; Ishibashi, Tuneo; Shinoda, Atsushi

1989-01-01

We measured the computed tomography (CT) index, LL%w, in 81 patients of chronic obstructive pulmonary disease (COPD) and asthma. In this study we defined LL%w as the mean value of the proportion of the low density area under -950 Hounsfield units in the six lung fields: upper, middle and lower lung fields bilaterally, at deep expiration. To examine the usefulness of LL%w in differentiating pulmomary emphysema (PE) from bronchial asthma (BA) and chronic bronchitis (CB), we excluded the overlapped cases of each disease. Mean value (± standard deviation) of LL%w in PE was 24.6±20.2% (n=40), whereas it was 0.5±0.8% (n=27) in BA and 0.2±0.3% (n=14) in CB respectively. There were clear statistically differences in the values of LL%w between clinically diagnosed emphysema and others. We considered that the value of LL%w within 1% would be observed nonspecifically, because the frequent existence of low density areas originated in bronchial tangents and/or motion artifacts mainly in the left lower lung field. Thus we judged that cases with over 1% of LL%w had abnormal CT findings. The relationship between clinically diagnosed emphysema and CT abnormality (LL%w > 1%) was significant in the analysis of the four-fold table. The CT sensitivity for diagnosing PE was 100%, the CT specificity was 87.8%, and CT accuracy was 93.8%. When cases of LL%w > 1% were shown in BA or CB, it would be better to consider the existence of complicated emphysema or the presence of air trapping or air spaces of any origin. We compared three groups (A', E', C') selected from groups BA, PE and CB, respectively. The groups consisted of patients showing almost the same mean values of FEV 1.0 /VC(%). The value of the LL%w of E', selected from PE, also showed a significantly higher value than those from BA or CB. (J.P.N)

Interstitial Features at Chest CT Enhance the Deleterious Effects of Emphysema in the COPDGene Cohort.

Science.gov (United States)

Ash, Samuel Y; Harmouche, Rola; Ross, James C; Diaz, Alejandro A; Rahaghi, Farbod N; Sanchez-Ferrero, Gonzalo Vegas; Putman, Rachel K; Hunninghake, Gary M; Onieva, Jorge Onieva; Martinez, Fernando J; Choi, Augustine M; Bowler, Russell P; Lynch, David A; Hatabu, Hiroto; Bhatt, Surya P; Dransfield, Mark T; Wells, J Michael; Rosas, Ivan O; San Jose Estepar, Raul; Washko, George R

2018-06-05

Purpose To determine if interstitial features at chest CT enhance the effect of emphysema on clinical disease severity in smokers without clinical pulmonary fibrosis. Materials and Methods In this retrospective cohort study, an objective CT analysis tool was used to measure interstitial features (reticular changes, honeycombing, centrilobular nodules, linear scar, nodular changes, subpleural lines, and ground-glass opacities) and emphysema in 8266 participants in a study of chronic obstructive pulmonary disease (COPD) called COPDGene (recruited between October 2006 and January 2011). Additive differences in patients with emphysema with interstitial features and in those without interstitial features were analyzed by using t tests, multivariable linear regression, and Kaplan-Meier analysis. Multivariable linear and Cox regression were used to determine if interstitial features modified the effect of continuously measured emphysema on clinical measures of disease severity and mortality. Results Compared with individuals with emphysema alone, those with emphysema and interstitial features had a higher percentage predicted forced expiratory volume in 1 second (absolute difference, 6.4%; P < .001), a lower percentage predicted diffusing capacity of lung for carbon monoxide (DLCO) (absolute difference, 7.4%; P = .034), a 0.019 higher right ventricular-to-left ventricular (RVLV) volume ratio (P = .029), a 43.2-m shorter 6-minute walk distance (6MWD) (P < .001), a 5.9-point higher St George's Respiratory Questionnaire (SGRQ) score (P < .001), and 82% higher mortality (P < .001). In addition, interstitial features modified the effect of emphysema on percentage predicted DLCO, RVLV volume ratio, 6WMD, SGRQ score, and mortality (P for interaction < .05 for all). Conclusion In smokers, the combined presence of interstitial features and emphysema was associated with worse clinical disease severity and higher mortality than was emphysema alone. In addition, interstitial features

Evaluation of usefulness of thallium-201-SPECT and CT images in differential diagnosis between organizing pneumonia and primary lung cancer

International Nuclear Information System (INIS)

Nakamura, Kazuhiko; Fujiwara, Yoshio; Ogawa, Hirofumi; Nakano, Kenji; Ogawa, Toshihide

2007-01-01

We tried differential diagnosis between organizing pneumonia and primary lung cancer using CT and 201 Tl single photon emission computed tomography (SPECT) images. CT images were estimated margin, air space consolidation, air bronchogram, ground-glass attenuation, spicula and indentation of the lesions. 201 Tl SPECT images were evaluated early and delayed lesion-to-normal contralateral lung uptake ratio (ER and DR) and retention index (RI). Clearness of margin and ground-glass attenuation of CT images of organizing pneumonia were significant different from those of primary lung cancer. On the other hand, DR and RI of organizing pneumonia were significant lower than those of primary lung cancer. We emphasized that 201 Tl SPECT was useful to evaluate differential diagnosis between organizing pneumonia and primary lung cancer. (author)

SU-D-BRA-06: Dual-Energy Chest CT: The Effects of Virtual Monochromatic Reconstructions On Texture Analysis Features

International Nuclear Information System (INIS)

Sorensen, J; Duran, C; Stingo, F; Wei, W; Rao, A; Zhang, L; Court, L; Erasmus, J; Godoy, M

2015-01-01

able to reliably differentiate between most tissues types regardless of energy level. Dr Godoy has received a dual-energy CT research grant from Siemens Healthcare. That grant did not directly fund this research

SU-D-BRA-06: Dual-Energy Chest CT: The Effects of Virtual Monochromatic Reconstructions On Texture Analysis Features

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Sorensen, J; Duran, C; Stingo, F; Wei, W; Rao, A; Zhang, L; Court, L; Erasmus, J; Godoy, M [UT MD Anderson Cancer Center, Houston, TX (United States)

2015-06-15

able to reliably differentiate between most tissues types regardless of energy level. Dr Godoy has received a dual-energy CT research grant from Siemens Healthcare. That grant did not directly fund this research.

CT, Magnetic Resonance, and 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Imaging Features of Mucosa-Associated Lymphoid Tissue Lymphoma Involving Medial Rectus Muscle: A Case Report

International Nuclear Information System (INIS)

Lee, Sang Kwon; Choe, Mi Sun

2013-01-01

We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma involving the medial rectus muscle in a 47-year-old man along with CT, MRI, 18 F-fluorodeoxy-glucose positron emission tomography/CT ( 18 F-FDG PET/CT), and pathologic features. The lesion was manifested as a fusiform enlargement isolated to the right medial rectus muscle with involvement of its tendinous insertion. The lesion was isoattenuating to the brain on non-enhanced CT images, showing as isointense to gray matter on fast spin echo T1- and T2-weighted images with fat saturation, and showed homogeneous enhancement on contrast-enhanced CT and MR images. The maximum stan- dardized uptake value on 18 F-FDG PET/CT was 4.9 g/mL. The results of histological and immunohistochemical examinations of the specimen obtained by biopsy of the right medial rectus muscle were consistent with MALT lymphoma. It should be noted that the extraocular muscle (EOM) is a rare location for the involvement of MALT lympho- ma, and MALT lymphoma of the EOM may mimic thyroid orbitopathy.

Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT

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Furuhashi, Naohiro; Suzuki, Kojiro; Sakurai, Yusuke; Naganawa, Shinji [Nagoya University Graduate School of Medicine, Department of Radiology, Nagoya (Japan); Ikeda, Mitsuru [Nagoya University Graduate School of Medicine, Department of Radiological Technology, Nagoya (Japan); Kawai, Yuichi [Japanese Red Cross Nagoya Daiichi Hospital, Department of Diagnostic Radiology, Nagoya (Japan)

2015-05-01

To evaluate the utility of multiphase contrast-enhanced computed tomography (CT) findings alone and in combination for differentiating focal-type autoimmune pancreatitis (f-AIP) from pancreatic carcinoma (PC). The study group comprised 22 f-AIP lesions and 61 PC lesions. Two radiologists independently evaluated CT findings. Frequencies of findings were compared between f-AIP and PC. Statistical, univariate and multivariate analyses were performed. Homogeneous enhancement during the portal phase (AIP, 59 % vs. PC, 3 %; P < 0.001), dotted enhancement during the pancreatic phase (50 % vs. 7 %; P < 0.001), duct-penetrating sign (46 % vs. 2 %; P < 0.001), enhanced duct sign (36 % vs. 2 %; P < 0.001) and capsule-like rim (46 % vs. 3 %; P < 0.001) were more frequently observed in AIP. Ring-like enhancement during the delayed phase (5 % vs. 46 %; P < 0.001) and peripancreatic strands with a length of at least 10 mm (5 % vs. 39 %; P = 0.001) were more frequently observed in PC. AIP was identified with 82 % sensitivity and 98 % specificity using four of these seven findings. Multivariate analysis revealed significant differences in dotted enhancement (P = 0.004), duct-penetrating sign (P < 0.001) and capsule-like rim (P = 0.007). The combination of CT findings may allow improvements in differentiating f-AIP from PC. (orig.)

A clinical study on the usefulness of CT and MRI imaging in evaluating differential diagnosis and the degree of dementia in vascular dementia

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Hagiwara, Mariko [Nippon Medical School, Tokyo (Japan)

1990-06-01

In a retrospective review of 117 computed tomography (CT) scans and 56 magnetic resonance imaging (MRI) scans sequentially performed for dementia patients, CT and MRI were compared for assessment of the usefulness in the differential diagnosis and determination of the functional prognosis of vascular dementia. The correlation between CT findings and the degree of mental function was also examined. Since MRI had a higher sensitivity than CT in detecting small infarcts or lacunaes in the perforating area or white matter, it should differentiate vascular dementia from dementia of Alzheimer type. When both dementia of Alzheimer type was clinically diagnosed and infarct areas were detected on either CT or MRI, activity of daily living tended to be poor. Even when mixed type of dementia or vascular dementia was clinically diagnosed in spite of negative findings on either CT or MRI, troublesome behavior was frequently observed, posing the likelihood of dementia of Alzheimer type. The ability of CT and MRI to detect lesions was not correlated with the degree of dementia or aging, even if MRI was capable of detecting smaller lesions. CT was thus considered to be more specific modality for evaluating mental function. The size of lesions on CT was found to be more significant than the number and localization of lesions in determining the degree of dementia in the chronic stage of cerebrovascular disease. The ability of MRI to detect smaller lesions, as well as clinically determined ischemic scores, may assist in the diagnostic differentiation. Lesion size on CT may be an important factor for determining the degree of dementia and functional prognosis. (N.K.).

A clinical study on the usefulness of CT and MRI imaging in evaluating differential diagnosis and the degree of dementia in vascular dementia

International Nuclear Information System (INIS)

Hagiwara, Mariko

1990-01-01

In a retrospective review of 117 computed tomography (CT) scans and 56 magnetic resonance imaging (MRI) scans sequentially performed for dementia patients, CT and MRI were compared for assessment of the usefulness in the differential diagnosis and determination of the functional prognosis of vascular dementia. The correlation between CT findings and the degree of mental function was also examined. Since MRI had a higher sensitivity than CT in detecting small infarcts or lacunaes in the perforating area or white matter, it should differentiate vascular dementia from dementia of Alzheimer type. When both dementia of Alzheimer type was clinically diagnosed and infarct areas were detected on either CT or MRI, activity of daily living tended to be poor. Even when mixed type of dementia or vascular dementia was clinically diagnosed in spite of negative findings on either CT or MRI, troublesome behavior was frequently observed, posing the likelihood of dementia of Alzheimer type. The ability of CT and MRI to detect lesions was not correlated with the degree of dementia or aging, even if MRI was capable of detecting smaller lesions. CT was thus considered to be more specific modality for evaluating mental function. The size of lesions on CT was found to be more significant than the number and localization of lesions in determining the degree of dementia in the chronic stage of cerebrovascular disease. The ability of MRI to detect smaller lesions, as well as clinically determined ischemic scores, may assist in the diagnostic differentiation. Lesion size on CT may be an important factor for determining the degree of dementia and functional prognosis. (N.K.)

Diagnostic Criteria on 18F-FDG PET/CT for Differentiating Benign from Malignant Focal Hypermetabolic Lesions of Parotid Gland

International Nuclear Information System (INIS)

Park, Soo Bin; Choi, Joon Young; Lee, Eun Jeong; Yoo, Jang; Cheon, Miju; Cho, Suk Kyong; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae

2012-01-01

We investigated PET/CT diagnostic criteria for differentiating benign from malignant parotid lesions with focal 18 F-FDG uptake. The subjects of the study were 272 patients who exhibited focal 18 F-FDG uptake of the parotid gland. Sixty-eight pathologically confirmed parotid lesions from 67 patients were included. The maximum SUV (SUVmax), uptake patterns (homogeneous vs. heterogeneous), size measured by CT, maximum Housfield units (HUmax) and margins on CT (well vs. ill defined) of each parotid lesion on PET/CT images were compared with final diagnoses. Thirty- two parotid lesions were histologically proven to be malignant. There were significant differences in uptake patterns (cancer incidence, heterogeneous:homogeneous=79.2%:29.5%, p<0.0001) and margins on CT (cancer incidence, ill:well defined=84.4%:13.3%, p<0.0001) between benign and malignant lesions. The cancer risks of parotid lesions were 89.5% with heterogeneous uptake and ill-defined margins, 70.6% with heterogeneous uptake or ill-defined margins (no overlap in subjects) and 9.3% with homogeneous uptake and well-defined margins (p<0.0001). When any lesion with heterogeneous uptake or ill-defined margins was regarded as malignant, the sensitivity, positive predictive value, negative predictive value and accuracy were 90.6% (29/32) and 85.6% (58/68), respectively. For predicting malignancy, combined PET/CT criteria showed better sensitivity, NPV and accuracy than PET-only criteria, and had a tendency to have more accurate results than CT-only criteria, and had a tendency to have more accurate results than CT-only criteria. There were no significant differences in SUVmax, size or HUmax between benign and malignant lesions. Uptake patterns and margins on CT are useful PET/CT diagnostic criteria for differentiating benign from malignant lesions

Subprosthetic Pannus after Aortic Valve Replacement Surgery: Cardiac CT Findings and Clinical Features.

Science.gov (United States)

Han, Kichang; Yang, Dong Hyun; Shin, So Youn; Kim, Namkug; Kang, Joon-Won; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won; Lim, Tae-Hwan

2015-09-01

). Cardiac CT revealed subprosthetic pannus to be a cause of the hemodynamic changes in patients who had undergone aortic valve replacement. By helping quantify the encroachment ratio by pannus, cardiac CT may help differentiate which subprosthetic panni might lead to substantial flow limitation over the prosthetic aortic valve.

CT findings of peritoneal carcinomatosis

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Kim, Eun Sook; Park, Mi Sook; Cho, On Koo; Koh, Byung Hee; Kim, Soon Yong

1989-01-01

CT findings in 137 patients with peritoneal cacinomatosis were reviewed to determine the CT signs of peritoneal malignancy. CT of the 20 liver cirrhosis and 17 tuberculous peritonitis were also reviewed to define the differential point between benign and malignant peritoneal change. The results were as follows. 1. The most common primary malignancy encountered in peritoneal carcinomatosis was stomach Ca.(50.4%), followed by pancreas Ca, hepatoma, colon Ca. and ovarian Ca. 2. Ascites was the most common CT feature of peritoneal malignancy, present in 99 cases (72.3%). The amount of ascites was voluminous, grade III in 70% of cases and showed high density ascites with average 23 Hounsfield units. 3. Greater omentum involvement was noted in 88 patients, peritoneum in 71 patients and mesentery in 65% patients. There was no correlation of the primary malignancy type with the incidence or pattern of the above mentioned site. 4. Bowel wall thickenings were observed in 51 patients, among which transverse colon was most frequently involved. 5. Mean attenuation value of ascites in liver cirrhosis was 10.7 HU, which was much lower than that of peritoneal carcinomatosis. 6. Even though intraperitoneal findings in Tbc. Peritonitis showed tendency of relatively small amount of ascites with more predominant mesenteric change, but, the findings of high density ascites, change of peritoneum and omentum etc. were very similar to those of peritoneal carcinomatosis. Therefore, based on only intraperitoneal change, differential diagnosis between them was difficult. 7. False negatives in CT diagnosis of peritoneal carcinomatosis occurred in 7 cases. There were tiny nodular changes in intraperitoneal cavity without ascites on operative findings

Correlation between spiral CT features of pericolic infiltration and tumor angiogenesis in colorectal carcinoma

International Nuclear Information System (INIS)

Zhang Ruiping; Li Jianding

2007-01-01

Objective: To investigate the correlation of spiral CT (SCT) features with pathology, microvessel density (MVD), expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2( MMP-2) in colorectal carcinoma. Methods: Forty patients with colorectal carcinoma confirmed by operation were examined by SCT. The resected tumor specimens were immunohistochemically stained for the expression of VEGF, MMP-2 and the calculation of MVD. Results: The accuracy of SCT in depicting the pericolic and wall infiltration was 92.5%. The metastasis rates of colorectal cancer with pericolic infiltration and wall infiltration were 75.0% and 33.3%, respectively, the differences were statistically significant between the two groups (P<0.05). The differences of CT enhancement value, MVD, expressions of VEGF and MMP-2 between the two groups were statistically significant (P<0.05). The enhancement degree of CT had a positive correlation with MVD (P<0.05). Conclusion: SCT is accurate for depicting pericolic and wall infiltration, pericolic infiltration in colorectal carcinoma indicates the tendency of metastasis. The enhancement degree of CT might be used to quantitatively evaluate the tumor angiogenesis, expressions of VEGF and MMP-2 and MVD are closely correlated with the infiltration of colorectal cancer. (authors)

Clear cell sarcoma of the abdominal wall with peritoneal sarcomatosis: CT features

International Nuclear Information System (INIS)

Sabate, J.M.; Fernandez, A.; Torrubia, S.; Villanueva, A.; Monill, J.M.

1999-01-01

Clear cell sarcoma, also called malignant melanoma of soft parts, is an uncommon neoplasm that involves tendons or aponeuroses of the lower extremity. The CT features of a clear cell sarcoma arising from the abdominal wall with later peritoneal dissemination are described. Peritoneal sarcomatosis from soft tissue sarcomas is a very rare condition previously unreported in the radiologic literature. Metastases to peritoneal surfaces must therefore be considered a possible site for systemic dissemination of soft tissue sarcomas. (orig.)

The CT features of recurrent laryngeal nerve paralysis

International Nuclear Information System (INIS)

Wu Bin; Peng Weijun; Gu Yajia; Yang Tianxi; Wang Hongshi

2006-01-01

Objective: To describe the CT appearance of recurrent laryngeal nerve paralysis, discuss the anatomic and pathologic basis of this paralysis, and evaluate CT diagnosis. Methods: 32 cases of recurrent laryngeal nerve paralysis clinical confirmed were analyzed retrospectively. All of these patients had the CT scans from the level of hyoid bone to the upper thorax, the slice and interval are 5 mm. Results: CT findings of recurrent laryngeal nerve paralysis included: oblique of aryepiglottic fold, dislocation of arytenoid cartilage and cricoarytenoid joint, dilation and relaxation of piriform sinus for 27 cases (84.4%); wide and asymmetrical ventricle of larynx for 16 cases (50.0%); asymmetrical and fix of vocal fold for 11 cases (34.4%) et al. Conclusion: The recurrent laryngeal nerve innervate all the intrinsic muscles of the larynx except cricothyroid muscle, paralysis of the nerve leads to atrophy of related muscles. CT scan demonstrate the larynx morphologic changes of recurrent nerve paralysis and is helpful to identify the etiology. (authors)

Diagnostic accuracy of the clinical and CT findings for differentiating Kikuchi's disease and tuberculous lymphadenitis presenting with cervical lymphadenopathy.

Science.gov (United States)

Baek, Hye Jin; Lee, Jeong Hyun; Lim, Hyun Kyung; Lee, Ha Young; Baek, Jung Hwan

2014-11-01

To determine the optimal clinical and CT findings for differentiating Kikuchi's disease (KD) and tuberculous lymphadenitis (TB) in patients presenting with cervical lymphadenopathy. From 2006 to 2010, 87 consecutive patients who were finally diagnosed with KD or TB were enrolled. Two radiologists performed independent analysis of contrast-enhanced neck CT images with regard to the involvement pattern, nodal or perinodal changes, and evidence of the previous infection. Significant clinical and CT findings of KD were determined by statistical analyses. Of the 87 patients, 27 (31%) were classified as having KD and 60 (69%) as having TB. Statistically significant findings of KD patients were younger age, presence of fever, involvement of ≥5 nodal levels or the bilateral neck, no or minimal nodal necrosis, marked perinodal infiltration, and no evidence of upper lung lesion or mediastinal lymphadenopathy. The presence of four or more statistically significant clinical and CT findings of KD had the largest area under the receiver-operating characteristic curve (A z = 0.861; 95% confidence intervals 0.801, 0.909), with a sensitivity of 89% and specificity of 83%. CT can be a helpful tool for differentiating KD from TB, especially when it is combined with the clinical findings.

CT characteristics of primary retroperitoneal neoplasms in children

International Nuclear Information System (INIS)

Xu Yufeng; Wang Jichen; Peng Yun; Zeng Jinjin

2010-01-01

Primary retroperitoneal neoplasms are uncommon in children. Retroperitoneal neoplasms are either mesodermal, neurogenic, germ cell ectodermal or lymphatic in origin. In general, primary retroperitoneal neoplasms in children have different spectrum and prevalence compared to those in adults. Neuroblastoma, rhabdomyosarcoma, benign teratoma and lymphoma are the common retroperitoneal neoplasms. In this review, the clinical and CT futures of common retroperitoneal neoplasms in children are described. Coarse, amorphous, and mottled calcification are very common in neuroblastoma. Paraganglioma tends to show marked and early enhancement and may present with clinical symptoms associated with the excess catecholamine. Sarcomas are often very large and have heterogeneous appearance. Imaging cannot be reliably used to identify the type of retroperitoneal sarcomas due to overlapped radiographic features. In children, lipoblastoma is the most common lipomatous tumor in the retroperitoneum. The percentage of visible fat in tumor varies depending on the cellular composition of the lesion. The CT characteristics of teratoma are quite variable, which may be cystic, solid, on a combination of both. Typically teratoma appears as a large complex mass containing fluid, fat, fat-fluid level, and calcifications. Lymphoma is often homogeneous on both enhanced and unenhanced CT scans. Necrosis and calcification are rare on CT. In conclusion, making a final histological diagnosis of retroperitoneal tumor base on CT features is not often possible; however, CT can help to develop a differential diagnosis and determine the size and extent of the retroperitoneal neoplasms.

A reconstruction method for cone-beam differential x-ray phase-contrast computed tomography.

Science.gov (United States)

Fu, Jian; Velroyen, Astrid; Tan, Renbo; Zhang, Junwei; Chen, Liyuan; Tapfer, Arne; Bech, Martin; Pfeiffer, Franz

2012-09-10

Most existing differential phase-contrast computed tomography (DPC-CT) approaches are based on three kinds of scanning geometries, described by parallel-beam, fan-beam and cone-beam. Due to the potential of compact imaging systems with magnified spatial resolution, cone-beam DPC-CT has attracted significant interest. In this paper, we report a reconstruction method based on a back-projection filtration (BPF) algorithm for cone-beam DPC-CT. Due to the differential nature of phase contrast projections, the algorithm restrains from differentiation of the projection data prior to back-projection, unlike BPF algorithms commonly used for absorption-based CT data. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured with a three-grating interferometer and a micro-focus x-ray tube source. Moreover, the numerical simulation and experimental results demonstrate that the proposed method can deal with several classes of truncated cone-beam datasets. We believe that this feature is of particular interest for future medical cone-beam phase-contrast CT imaging applications.

Evaluation of CT in hepatocellular carcinoma

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Nakao, Norio; Miura, Yukio; Ohnishi, Mitsunori; Kamikon-ya, Norihiko; Sakamoto, Yoshisato; Miura, Takashi; Sakamoto, Kiyoshi; Takayasu, Yoshio

1985-06-01

In order to evaluate the diagnostic ability of CT in hepatocellular carcinoma, four kinds of CT images were comparatively studied by the accuracy and ROC (receiver operating characteristic) curve analysis. As a result, it was clarified that CT images were evaluated more objectively by ROC curve analysis than by accuracy. The diagnostic ability of existence and differentiation of tumor in the liver were higher in order of plain CT, contrast enhanced CT (CECT), bolus CT and CT arteriography (CTA). Therefore, in an usual CT examination intended to make differential diagnosis in space occupying liver disease, bolus CT seems to be indispensable, and also CTA is essential where diagnosis is difficult even by bolus CT.

Leiomyoma of the sinonasal cavity: CT and MRI findings

International Nuclear Information System (INIS)

Yang, B.T.; Wang, Z.C.; Xian, J.F.; Hao, D.P.; Chen, Q.H.

2009-01-01

Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10 -3 mm 2 /s and 1.78 x 10 -3 mm 2 /s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

Leiomyoma of the sinonasal cavity: CT and MRI findings

Energy Technology Data Exchange (ETDEWEB)

Yang, B.T., E-mail: cjr.yangbentao@vip.163.co [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China); Wang, Z.C.; Xian, J.F.; Hao, D.P.; Chen, Q.H. [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China)

2009-12-15

Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10{sup -3} mm{sup 2}/s and 1.78 x 10{sup -3} mm{sup 2}/s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

Comparison of the Use of FDG PET/CT and Ultrasonography for the Diagnosis of Recurrent or Metastatic Disease after Treatment for Differentiated Thyroid Carcinoma

International Nuclear Information System (INIS)

Kim, Jae Hwan; Lee, Tae Hyun; Kim, Kie Hwan; Park, Dong Hee; Choe, Du Hwan

2009-01-01

This study was designed to compare the accuracy of the use of PET/CT and ultrasonography (US) for the detection of recurrence or a metastasis after surgical treatment in patients with differentiated thyroid carcinoma. A total of 128 patients with differentiated thyroid carcinoma, who had previously undergone a neck operation, were evaluated with the use of PET/CT and US. The two studies were performed within three months of each other. The presence of a metastasis or recurrence was based on histological results. Statistical values for FDG PET/CT and US findings were calculated statistically. Recurrence or a metastasis occurred in 40 of 128 patients. Thirty-one patients had lesions that were detected with the use of both PET/CT and US. Eight patients had lesions that were detected only with US. A lesion in one patient that had a high SUV on PET/CT was not detected by the use of US. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for PET/CT were 80%, 82%, 82%, 68% and 90%, respectively. The corresponding values for US were 97%, 85%, 89%, 75% and 99%, respectively. The sensitivity and specificity for US were higher as compared to PET/CT, with no statistically significant difference. To detect recurrent or metastatic disease after surgical treatment in patients with differentiated thyroid carcinoma, US of the neck is a better screening modality as compared to the use of PET/CT

CT, Magnetic Resonance, and {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/CT Imaging Features of Mucosa-Associated Lymphoid Tissue Lymphoma Involving Medial Rectus Muscle: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Sang Kwon; Choe, Mi Sun [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

2013-06-15

We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma involving the medial rectus muscle in a 47-year-old man along with CT, MRI, 18 F-fluorodeoxy-glucose positron emission tomography/CT ( 18 F-FDG PET/CT), and pathologic features. The lesion was manifested as a fusiform enlargement isolated to the right medial rectus muscle with involvement of its tendinous insertion. The lesion was isoattenuating to the brain on non-enhanced CT images, showing as isointense to gray matter on fast spin echo T1- and T2-weighted images with fat saturation, and showed homogeneous enhancement on contrast-enhanced CT and MR images. The maximum stan- dardized uptake value on 18 F-FDG PET/CT was 4.9 g/mL. The results of histological and immunohistochemical examinations of the specimen obtained by biopsy of the right medial rectus muscle were consistent with MALT lymphoma. It should be noted that the extraocular muscle (EOM) is a rare location for the involvement of MALT lympho- ma, and MALT lymphoma of the EOM may mimic thyroid orbitopathy.

ADDITIONAL VALUE OF POST-THERAPY 131 I SPECT/CT IN PATIENTS WITH DIFFERENTIATED THYROID CANCER

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Satyawati Deswal

2017-03-01

Full Text Available BACKGROUND Generally, it is seen that SPECT/CT images are more useful than the planar images. We compared post-therapy 131 I imaging findings on planar and SPECT/CT scans to assess the clinical utility of SPECT/CT in management of patients with differentiated thyroid cancer. MATERIALS AND METHODS Post-therapy imaging was performed at 4-7 (when 5mR/hrs. exposure rate were observed by the survey meter days after 131 I administration and all patients underwent whole-body scintigraphy and SPECT/CT scanning on the same day. A generalised McNemar 1 was used to determine to establish the agreement between planar whole-body imaging and SPECT/CT for the assignment of benign, equivocal and malignant findings. RESULTS In 44 patients, 32 of the 44 patients underwent postsurgical 131 I ablation of residual thyroid tissue and 12 of 44 patients, 2 patients were treated twice. Hence, a total of 46 scans were analysed. SPECT/CT helped to localise focal iodine uptake and characterise it as either normal or abnormal thereby reducing the need for additional imaging studies. In post-thyroidectomy patients, SPECT/CT findings affected the ATA risk classification with implications for management by changing the interval for clinical followup and the need for additional imaging and laboratory tests. Our study found an 11% change in nodal status in the postsurgical group. Change in patient management was observed in 18%. CONCLUSION SPECT/CT enabled more accurate characterisation of focal iodine accumulation in patients.

Role of 18F-F.D.G. PET/CT in management of patients with differentiated thyroid cancer

International Nuclear Information System (INIS)

Sibille, L.; Guillemard, S.; Eberle-Pouzeratte, M.C.; Espitalier-Riviere, C.; Faurous, P.; Artus, J.C.; Thezenas, S.; Lamy, P.J.; Rossi, M.

2010-01-01

18 F-F.D.G. PET/CT by combining both metabolic and anatomical information has proven to be an effective modality for detecting many types of cancer. Some differentiated forms of cancer like differentiated thyroid carcinoma (D.T.C.) are less F.D.G. avid and thus less easily detectable. Nevertheless 18 F-F.D.G. PET/CT has been proved useful in D.T.C. especially in case of suspected recurrent disease with negative whole-body radioiodine scintigraphy ( 131 I W.B.S.) and elevated thyroglobulin (Tg) or thyroglobulin autoantibodies (AbTg) levels. Impact on clinical management after 18 F-F.D.G. PET/CT examinations has been analyzed in patients with suspected recurrent D.T.C. in this retrospective study. Methodology. Fifty-five 18 F-F.D.G. PET/CT were performed in 45 patients with suspected recurrent or residual disease either because of elevated Tg/AbTg levels (n 45) or uncertain conventional imaging (n = 10) including 131 I W.B.S., cervical echography and CT scan if necessary. 18 F-F.D.G. PET/CT results were compared with histopathology and/or clinical follow-up with evaluation of impact on clinical management. Results. Twenty-nine exams were positive (53 %). There were 20 true-positive (T.P.) (14 locoregional relapses and six with distant metastases) and nine false-positive (F.P.) (all cervical). SUV max median values of hyper-metabolic foci were significantly higher in T.P. (5.1) than in F.P. (2.8). Overall, 20 (36 %) 18 F-F.D.G. PET/CT directly affected clinical management resulting in 13 (65 %) new surgical operations. Sensitivity, specificity, predictive positive value, predictive negative value and accuracy of 18 F-F.D.G. PET/CT were estimated for the whole group (respectively 83 %, 71 %, 69 %, 85 % and 76 %) and for two subgroups depending on Tg level (less or more than 1.2 ng/ml). Discussion and conclusion. 18 F-F.D.G. PET/CT is a powerful and useful tool in patients with suspected D.T.C. recurrence or residual disease and should be systematically performed when

Machine Learning Algorithms Utilizing Quantitative CT Features May Predict Eventual Onset of Bronchiolitis Obliterans Syndrome After Lung Transplantation.

Science.gov (United States)

Barbosa, Eduardo J Mortani; Lanclus, Maarten; Vos, Wim; Van Holsbeke, Cedric; De Backer, William; De Backer, Jan; Lee, James

2018-02-19

Long-term survival after lung transplantation (LTx) is limited by bronchiolitis obliterans syndrome (BOS), defined as a sustained decline in forced expiratory volume in the first second (FEV 1 ) not explained by other causes. We assessed whether machine learning (ML) utilizing quantitative computed tomography (qCT) metrics can predict eventual development of BOS. Paired inspiratory-expiratory CT scans of 71 patients who underwent LTx were analyzed retrospectively (BOS [n = 41] versus non-BOS [n = 30]), using at least two different time points. The BOS cohort experienced a reduction in FEV 1 of >10% compared to baseline FEV 1 post LTx. Multifactor analysis correlated declining FEV 1 with qCT features linked to acute inflammation or BOS onset. Student t test and ML were applied on baseline qCT features to identify lung transplant patients at baseline that eventually developed BOS. The FEV 1 decline in the BOS cohort correlated with an increase in the lung volume (P = .027) and in the central airway volume at functional residual capacity (P = .018), not observed in non-BOS patients, whereas the non-BOS cohort experienced a decrease in the central airway volume at total lung capacity with declining FEV 1 (P = .039). Twenty-three baseline qCT parameters could significantly distinguish between non-BOS patients and eventual BOS developers (P machine), we could identify BOS developers at baseline with an accuracy of 85%, using only three qCT parameters. ML utilizing qCT could discern distinct mechanisms driving FEV 1 decline in BOS and non-BOS LTx patients and predict eventual onset of BOS. This approach may become useful to optimize management of LTx patients. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

CT features of second branchial cleft cysts: emphasis on the locations of lesions

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Han, Deok Sub; Kim, Byong Geun; Park, Byung Ran; Kim, Se Jong; Ko, Kang Seok; Oh, Jong Sub [Kwangju Christian Hospital, Gwangju (Korea, Republic of); Seo, Jeong Jin [Chonnam Univ. Medical School, Gwangju (Korea, Republic of)

1994-11-15

The purpose of this study was to evaluate the CT features of second branchial cleft cysts. We retrospectively analyzed the computed tomographic images in nine cases of second branchial cleft cyst which was confirmed pathologically. Emphasis was on localization of the masses to fascial spaces as defined by the deep cervical fasica. In all nine cases, the lesions were located in the submandibular and carotid spaces. Among these cases, six(67%) had simultaneous involvement of the other contiguous spaces, such as anterior and posterior cervical spaces. All cases had round or oval, unilocular, cystic masses with partial or complete rim enhancement. In eight cases(89%), smooth and thin walls were observed. In one case, thick wall and septations were noted. No definite calcifications were noted in all cases. The internal contents of cystic masses showed relatively homogeneous appearance, and CT number ranged from 20 to 35.2 Hounsfield unit(HU)(mean, 28.4HU). CT diagnosis of second branchial cleft cyst would be easily obtained from recognition of frequent simultaneous involvement of the other contiguous spaces, along with a typical location and characteristic morphology.

CT features of second branchial cleft cysts: emphasis on the locations of lesions

International Nuclear Information System (INIS)

Han, Deok Sub; Kim, Byong Geun; Park, Byung Ran; Kim, Se Jong; Ko, Kang Seok; Oh, Jong Sub; Seo, Jeong Jin

1994-01-01

The purpose of this study was to evaluate the CT features of second branchial cleft cysts. We retrospectively analyzed the computed tomographic images in nine cases of second branchial cleft cyst which was confirmed pathologically. Emphasis was on localization of the masses to fascial spaces as defined by the deep cervical fasica. In all nine cases, the lesions were located in the submandibular and carotid spaces. Among these cases, six(67%) had simultaneous involvement of the other contiguous spaces, such as anterior and posterior cervical spaces. All cases had round or oval, unilocular, cystic masses with partial or complete rim enhancement. In eight cases(89%), smooth and thin walls were observed. In one case, thick wall and septations were noted. No definite calcifications were noted in all cases. The internal contents of cystic masses showed relatively homogeneous appearance, and CT number ranged from 20 to 35.2 Hounsfield unit(HU)(mean, 28.4HU). CT diagnosis of second branchial cleft cyst would be easily obtained from recognition of frequent simultaneous involvement of the other contiguous spaces, along with a typical location and characteristic morphology

Characterizing, measuring, and utilizing the resolution of CT imagery for improved quantification of fine-scale features

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Ketcham, Richard A., E-mail: ketcham@jsg.utexas.edu; Hildebrandt, Jordan

2014-04-01

Quantitative results extracted from computed tomographic (CT) data sets should be the same across resolutions and between different instruments and laboratory groups. Despite the proliferation of scanners and data processing methods and tools, and scientific studies utilizing them, relatively little emphasis has been given to ensuring that these results are comparable or reproducible. This issue is particularly pertinent when the features being imaged and measured are of the same order size as data voxels, as is often the case with fracture apertures, pore throats, and cell walls. We have created a tool that facilitates quantification of the spatial resolution of CT data via its point-spread function (PSF), in which the user draws a traverse across a sharp interface between two materials and a Gaussian PSF is fitted to the blurring across that interface. Geometric corrections account for voxel shape and the angle of the traverse to the interface, which does not need to be orthogonal. We use the tool to investigate a series of grid phantoms scanned at varying conditions and observe how the PSF varies within and between slices. The PSF increases with increasing radial distance within slices, and can increase tangentially with increasing radial distance in CT data sets acquired with relatively few projections. The PSF between CT slices is similar to that within slices when a 2-D detector is used, but is much sharper when the data are acquired one slice at a time with a collimated linear detector array. The capability described here can be used not only to calibrate processing algorithms that use deconvolution operations, but it can also help evaluate scans on a routine basis within and between CT research groups, and with respect to the features within the imagery that are being measured.

Investigating the use of texture features for analysis of breast lesions on contrast-enhanced cone beam CT

Science.gov (United States)

Wang, Xixi; Nagarajan, Mahesh B.; Conover, David; Ning, Ruola; O'Connell, Avice; Wismueller, Axel

2014-04-01

Cone beam computed tomography (CBCT) has found use in mammography for imaging the entire breast with sufficient spatial resolution at a radiation dose within the range of that of conventional mammography. Recently, enhancement of lesion tissue through the use of contrast agents has been proposed for cone beam CT. This study investigates whether the use of such contrast agents improves the ability of texture features to differentiate lesion texture from healthy tissue on CBCT in an automated manner. For this purpose, 9 lesions were annotated by an experienced radiologist on both regular and contrast-enhanced CBCT images using two-dimensional (2D) square ROIs. These lesions were then segmented, and each pixel within the lesion ROI was assigned a label - lesion or non-lesion, based on the segmentation mask. On both sets of CBCT images, four three-dimensional (3D) Minkowski Functionals were used to characterize the local topology at each pixel. The resulting feature vectors were then used in a machine learning task involving support vector regression with a linear kernel (SVRlin) to classify each pixel as belonging to the lesion or non-lesion region of the ROI. Classification performance was assessed using the area under the receiver-operating characteristic (ROC) curve (AUC). Minkowski Functionals derived from contrastenhanced CBCT images were found to exhibit significantly better performance at distinguishing between lesion and non-lesion areas within the ROI when compared to those extracted from CBCT images without contrast enhancement (p < 0.05). Thus, contrast enhancement in CBCT can improve the ability of texture features to distinguish lesions from surrounding healthy tissue.

Intraperitoneal fluid collection: CT characteristics in determining the causes

International Nuclear Information System (INIS)

Kim, Mi Young; Suh, Chang Hae; Chung, Won Kyun; Kim, Chong Soo; Choi, Ki Chul

1995-01-01

Abdominal CT scans in patients with intraperitoneal fluid were retrospectively studied to identify characteristic features useful for differential diagnosis of various causes. One hundred and seventy patients with intraperitoneal fluid collection were classified as categories of hepatic disease, carcinomatosis, and infectious disease. We analyzed sites of fluid collection, the presence of peritoneal thickening, omental and mesenteric fat infiltration, and lymph node enlargement. Intraperitoneal fluid was present in subhepatic space, subphrenic space, paracolic gutter, mesentery, and fossa of the gallbladder in decreasing order of frequency. Fluid in the gallbladder fossa was the most frequent in hepatic disease. The fluid collection in subhepatic and subphrenic space was less frequent in infectious disease. Peritoneal thickening was noted in infectious diseases, and carcinomatosis. Omental fat infiltration and enlarged lymph nodes were the most frequent in carcinomatosis (58% and 44%, respectively), whereas, mesenteric fat infiltration and enlarged lymph nodes were the most common in infectious diseases (61%, and 26%, respectively). The location of peritoneal fluid collection showed some lesion specific characteristics, and CT features of fat infiltration and enlarged lymph nodes of peritoneum, omentum, and mesentery were helpful for differential diagnosis between carcinomatosis and infectious diseases

SU-D-207B-01: Radiomics Feature Reproducibility From Repeat CT Scans of Patients with Rectal Cancer

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Hu, P; Wang, J; Zhong, H; Zhou, Z; Shen, L; Hu, W; Zhang, Z [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

2016-06-15

Purpose: To evaluate the reproducibility of radiomics features by repeating computed tomographic (CT) scans in rectal cancer. To choose stable radiomics features for rectal cancer. Methods: 40 rectal cancer patients were enrolled in this study, each of whom underwent two CT scans within average 8.7 days (5 days to 17 days), before any treatment was delivered. The rectal gross tumor volume (GTV) was distinguished and segmented by an experienced oncologist in both CTs. Totally, more than 2000 radiomics features were defined in this study, which were divided into four groups (I: GLCM, II: GLRLM III: Wavelet GLCM and IV: Wavelet GLRLM). For each group, five types of features were extracted (Max slice: features from the largest slice of target images, Max value: features from all slices of target images and choose the maximum value, Min value: minimum value of features for all slices, Average value: average value of features for all slices, Matrix sum: all slices of target images translate into GLCM and GLRLM matrices and superpose all matrices, then extract features from the superposed matrix). Meanwhile a LOG (Laplace of Gauss) filter with different parameters was applied to these images. Concordance correlation coefficients (CCC) and inter-class correlation coefficients (ICC) were calculated to assess the reproducibility. Results: 403 radiomics features were extracted from each type of patients’ medical images. Features of average type are the most reproducible. Different filters have little effect for radiomics features. For the average type features, 253 out of 403 features (62.8%) showed high reproducibility (ICC≥0.8), 133 out of 403 features (33.0%) showed medium reproducibility (0.8≥ICC≥0.5) and 17 out of 403 features (4.2%) showed low reproducibility (ICC≥0.5). Conclusion: The average type radiomics features are the most stable features in rectal cancer. Further analysis of these features of rectal cancer can be warranted for treatment monitoring and

Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients

International Nuclear Information System (INIS)

Lee, Hong Je; Song, Bong Il; Kang, Sung Min; Jeong, Shin Young; Seo, Ji Hyoung; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae

2009-01-01

We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8±10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT

Differentiation of urinary calculi with dual energy CT: effect of spectral shaping by high energy tin filtration.

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Thomas, Christoph; Krauss, Bernhard; Ketelsen, Dominik; Tsiflikas, Ilias; Reimann, Anja; Werner, Matthias; Schilling, David; Hennenlotter, Jörg; Claussen, Claus D; Schlemmer, Heinz-Peter; Heuschmid, Martin

2010-07-01

In dual energy (DE) computed tomography (CT), spectral shaping by additional filtration of the high energy spectrum can theoretically improve dual energy contrast. The aim of this in vitro study was to examine the influence of an additional tin filter for the differentiation of human urinary calculi by dual energy CT. A total of 36 pure human urinary calculi (uric acid, cystine, calciumoxalate monohydrate, calciumoxalate dihydrate, carbonatapatite, brushite, average diameter 10.5 mm) were placed in a phantom and imaged with 2 dual source CT scanners. One scanner was equipped with an additional tin (Sn) filter. Different combinations of tube voltages (140/80 kV, 140/100 kV, Sn140/100 kV, Sn140/80 kV, with Sn140 referring to 140 kV with the tin filter) were applied. Tube currents were adapted to yield comparable dose indices. Low- and high energy images were reconstructed. The calculi were segmented semiautomatically in the datasets and DE ratios (attenuation@low_kV/attenuation@high_kV) and were calculated for each calculus. DE contrasts (DE-ratio_material1/DE-ratio_material2) were computed for uric acid, cystine and calcified calculi and compared between the combinations of tube voltages. Using exclusively DE ratios, all uric acid, cystine and calcified calculi (as a group) could be differentiated in all protocols; the calcified calculi could not be differentiated among each other in any examination protocol. The highest DE ratios and DE contrasts were measured for the Sn140/80 protocol (53%-62% higher DE contrast than in the 140/80 kV protocol without additional filtration). The DE ratios and DE contrasts of the 80/140 kV and 100/Sn140 kV protocols were comparable. Uric acid, cystine and calcified calculi could be reliably differentiated by any of the protocols. A dose-neutral gain of DE contrast was found in the Sn-filter protocols, which might improve the differentiation of smaller calculi (Sn140/80 kV) and improve image quality and calculi differentiation in

Pericardial sinuses and recesses effusion of 16-slice helical CT imaging and anatomic correlation

International Nuclear Information System (INIS)

Lu Chunyan; Yang Zhigang; Zhou Xiangping; Yu Jianqun; Zhu Jie; Yang Kaiqing

2007-01-01

Objective: To evaluate the CT features and implications of the pericardial sinuses and recesses effusion by combining the sectional cadavers and 16 multi-slice CT (MSCT) reformation. Methods: The anatomy and communication of the pericardial sinuses and recesses on the axial, coronal and saggital sectional cadavers (respectively 1 case), and the morphologic features on MSCT reformatted images in 104 patients were observed. The detection rate of effusion was analyzed. Results: The sectional cadavers and CT images showed that the pericardial sinuses and recesses were formed by the reflections of the pericardium on the root of the great vessels. The detection rate of the sinuses and recesses was lower in small effusion than in moderate and large effusion (P<0.05). The superior aortic recess was the most common recess for pericardial effusion. Conclusion: The MSCT reformatted images can show the morphologic features of pericardial sinuses and recesses effusion and communications with the pericardial cavity, help differentiate pericardial effusion from other mediastinal or pericardial lesions. (authors)

Application of 18F-FDG PET/CT combined with carbohydrate antigen 19-9 for differentiating pancreatic carcinoma from chronic mass-forming pancreatitis in Chinese elderly

Directory of Open Access Journals (Sweden)

Gu X

2016-09-01

Full Text Available Xinjin Gu,1 Rong Liu2 1Department of Hepatobiliary Surgery, Chinese People’s Liberation Army General Hospital and Hainan Branch, Sanya, 2Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China Objective: The current study was designed to analyze the value of 18F-FDG positron emission tomography/computed tomography (PET/CT combined with carbohydrate antigen 19-9 (CA19-9 in differentiating pancreatic carcinoma (PC from chronic mass-forming pancreatitis (CMFP in Chinese elderly. Methods: As it is impossible to differentially diagnose PC from CMFP, 60 participants older than 65 years with focal pancreatic lesions were scanned by 18F-FDG PET/CT and their CA19-9 levels were tested. Diagnoses of all participants were confirmed by comprehensive methods including aspiration biopsy, surgical pathology, and clinical follow-up of 12 months. Twenty participants with CMFP were included in CMFP group and 40 participants with PC in PC group.Results: In CMFP and PC groups, 46 participants showed increased 18F-FDG uptake, 43 had elevated CA19-9 levels, and 38 participants had both increased 18F-FDG uptake and elevated CA19-9 levels. Standardized uptake value maximum of PC group (5.98±2.27 was significantly different from CMFP group (2.58±1.81, P<0.05. Sensitivity, specificity, and accuracy of 18F-FDG PET/CT in differentiating PC from CMFP were 95%, 60%, and 83.3%, respectively. CA19-9 levels of PC group (917.44±1,088.24 were significantly different from CMFP group (19.09±19.54, P<0.05. Sensitivity, specificity, and accuracy of CA19-9 levels in differentiating PC from CMFP were 87.5%, 60%, and 78.3%, respectively. Sensitivity, specificity, and accuracy of 18F-FDG PET/CT combined with CA19-9 levels in differentiating PC from CMFP were 90%, 90%, and 90%, respectively.Conclusion: 18F-FDG PET/CT had reliable sensitivity, specificity, and accuracy in differentiating

WE-E-17A-05: Complementary Prognostic Value of CT and 18F-FDG PET Non-Small Cell Lung Cancer Tumor Heterogeneity Features Quantified Through Texture Analysis

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Desseroit, M; Cheze Le Rest, C; Tixier, F [CHU Poitiers Poitiers (France); INSERM LaTIM UMR 1101, Brest (France); Majdoub, M; Visvikis, D; Hatt, M [INSERM LaTIM UMR 1101, Brest (France); Guillevin, R; Perdrisot, R [CHU Poitiers Poitiers (France)

2014-06-15

Purpose: Previous studies have shown that CT or 18F-FDG PET intratumor heterogeneity features computed using texture analysis may have prognostic value in Non-Small Cell Lung Cancer (NSCLC), but have been mostly investigated separately. The purpose of this study was to evaluate the potential added value with respect to prognosis regarding the combination of non-enhanced CT and 18F-FDG PET heterogeneity textural features on primary NSCLC tumors. Methods: One hundred patients with non-metastatic NSCLC (stage I–III), treated with surgery and/or (chemo)radiotherapy, that underwent staging 18F-FDG PET/CT images, were retrospectively included. Morphological tumor volumes were semi-automatically delineated on non-enhanced CT using 3D SlicerTM. Metabolically active tumor volumes (MATV) were automatically delineated on PET using the Fuzzy Locally Adaptive Bayesian (FLAB) method. Intratumoral tissue density and FDG uptake heterogeneities were quantified using texture parameters calculated from co-occurrence, difference, and run-length matrices. In addition to these textural features, first order histogram-derived metrics were computed on the whole morphological CT tumor volume, as well as on sub-volumes corresponding to fine, medium or coarse textures determined through various levels of LoG-filtering. Association with survival regarding all extracted features was assessed using Cox regression for both univariate and multivariate analysis. Results: Several PET and CT heterogeneity features were prognostic factors of overall survival in the univariate analysis. CT histogram-derived kurtosis and uniformity, as well as Low Grey-level High Run Emphasis (LGHRE), and PET local entropy were independent prognostic factors. Combined with stage and MATV, they led to a powerful prognostic model (p<0.0001), with median survival of 49 vs. 12.6 months and a hazard ratio of 3.5. Conclusion: Intratumoral heterogeneity quantified through textural features extracted from both CT and FDG PET

[18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

International Nuclear Information System (INIS)

Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars; Burg, Matthias Christian; Allkemper, Thomas; Schaefers, Michael

2016-01-01

To evaluate the diagnostic potential of PET/MRI with [ 18 F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [ 18 F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [ 18 F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [ 18 F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [ 18 F]FDG PET/MRI was inferior to low-dose [ 18 F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [ 18 F]FDG PET/MRI was equal to contrast-enhanced neck [ 18 F]FDG PET/CT. Therefore, [ 18 F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated. (orig.)

A feature alignment score for online cone-beam CT-based image-guided radiotherapy for prostate cancer.

Science.gov (United States)

Hargrave, Catriona; Deegan, Timothy; Poulsen, Michael; Bednarz, Tomasz; Harden, Fiona; Mengersen, Kerrie

2018-05-17

To develop a method for scoring online cone-beam CT (CBCT)-to-planning CT image feature alignment to inform prostate image-guided radiotherapy (IGRT) decision-making. The feasibility of incorporating volume variation metric thresholds predictive of delivering planned dose into weighted functions, was investigated. Radiation therapists and radiation oncologists participated in workshops where they reviewed prostate CBCT-IGRT case examples and completed a paper-based survey of image feature matching practices. For 36 prostate cancer patients, one daily CBCT was retrospectively contoured then registered with their plan to simulate delivered dose if (a) no online setup corrections and (b) online image alignment and setup corrections, were performed. Survey results were used to select variables for inclusion in classification and regression tree (CART) and boosted regression trees (BRT) modeling of volume variation metric thresholds predictive of delivering planned dose to the prostate, proximal seminal vesicles (PSV), bladder, and rectum. Weighted functions incorporating the CART and BRT results were used to calculate a score of individual tumor and organ at risk image feature alignment (FAS TV _ OAR ). Scaled and weighted FAS TV _ OAR were then used to calculate a score of overall treatment compliance (FAS global ) for a given CBCT-planning CT registration. The FAS TV _ OAR were assessed for sensitivity, specificity, and predictive power. FAS global thresholds indicative of high, medium, or low overall treatment plan compliance were determined using coefficients from multiple linear regression analysis. Thirty-two participants completed the prostate CBCT-IGRT survey. While responses demonstrated consensus of practice for preferential ranking of planning CT and CBCT match features in the presence of deformation and rotation, variation existed in the specified thresholds for observed volume differences requiring patient repositioning or repeat bladder and bowel

The CT appearances of sclerosing mesenteritis and associated diseases

International Nuclear Information System (INIS)

Wat, S.Y.J.; Harish, S.; Winterbottom, A.; Choudhary, A.K.; Freeman, A.H.

2006-01-01

Sclerosing mesenteritis is characterized by non-specific inflammation of the mesenteric fat associated with variable amount of fibrosis. The aetiology is unclear; the pathogenesis is obscure, and even its nomenclature remains variable. It is a rare condition with imaging features that can be mistaken either for a mesenteric neoplasm or for a wide variety of non-neoplastic inflammatory conditions. Knowledge of the imaging features of this condition may prevent unwarranted aggressive therapy. This review discusses the pathogenesis, clinical manifestations of this condition, as well as illustrating the characteristic computed tomography (CT) features of sclerosing mesenteritis. A rational approach to the differential diagnosis is discussed

Evaluation of using 99Tcm-MDP SPECT/CT for differentiating malignancy from benignancy in femoral diseases

International Nuclear Information System (INIS)

Ou Xiaohong; Huang Rui; Su Minggang; Zhou Li'na; Fan Qiuping

2010-01-01

Objective: To evaluate the value of SPECT/CT in assessment of femoral foci of abnormal bone metabolism classified as intermediated on bone scanning using 99Tcm-methylene diphosphonate (MDP). Methods: There were 94 patients with solitary femoral abnormal uptake in bone scanning included. SPECT was accompanied by inline CT over the femoral region. All of the images were blindly interpreted independently by two experienced board-certified radiologists. The reference standard was follow-up over half a year of MRI, CT, SPECT, or pathology. Diagnosis which consist with reference were counted as accurate. Diagnosis which either not consist with reference or undetermined were counted as false. Results: Of the 94 patients, 78 patients (male 42 , female 36, mean age 62 yrs) have the definite diagnosis of their femoral foci. 19 were proved to be metastasis and the other 59 were benign diseases. The diagnostic accuracy by bone SPECT, bone CT and fusion imaging were 58.9%, 87.2%, 96.2% respectively. Conclusions: Most of the solitary femoral foci caused by benign diseases. SPECT/CT using 99 Tc m -MDP has additional valuable in differentiating malignancy from benignancy in femoral foci . (authors)

Autoimmune Thyroiditis: Clinical Course Features and Principles of Differential Therapy

Directory of Open Access Journals (Sweden)

L.Ye. Bobyryova

2014-02-01

Full Text Available Constant increase in the incidence of autoimmune thyroiditis (AIT in different regions of Ukraine puts this problem in actual number that determines the need to identify features of the clinical course of AIT, the principles of differentiated treatment depending on the nature of the metabolic changes and taking into account regional differences in thyroid pathology, particularly AIT. The paper presents data on the study of features of clinical course and complex treatment of AIT.

Social Graph Community Differentiated by Node Features with Partly Missing Information

Directory of Open Access Journals (Sweden)

V. O. Chesnokov

2015-01-01

Full Text Available This paper proposes a new algorithm for community differentiation in social graphs, which uses information both on the graph structure and on the vertices. We consider user's ego-network i.e. his friends, with no himself, where each vertex has a set of features such as details on a workplace, institution, etc. The task is to determine missing or unspecified features of the vertices, based on their neighbors' features, and use these features to differentiate the communities in the social graph. Two vertices are believed to belong to the same community if they have a common feature. A hypothesis has been put forward that if most neighbors of a vertex have a common feature, there is a good probability that the vertex has this feature as well. The proposed algorithm is iterative and updates features of vertices, based on its neighbors, according to the hypothesis. Share of neighbors that form a majority is specified by the algorithm parameter. Complexity of single iteration depends linearly on the number of edges in the graph.To assess the quality of clustering three normalized metrics were used, namely: expected density, silhouette index, and Hubert's Gamma Statistic. The paper describes a method for test sampling of 2.000 graphs of the user's social network \\VKontakte". The API requests addressed \\VKontakte" and parsing HTML-pages of user's profiles and search results provided crawling. Information on user's group membership, secondary and higher education, and workplace was used as features. To store data the PostgreSQL DBMS was used, and the gexf format was used for data processing. For the test sample, metrics for several values of algorithm parameter were estimated: the value of index silhouettes was low (0.14-0.20, but within the normal range; the value of expected density was high, i.e. 1.17-1.52; the value of Hubert's gamma statistic was 0.94-0.95 that is close to the maximum. The number of vertices with no features was calculated before

CT and sonographic characteristics of lymphangioma of the retoperitoneum

International Nuclear Information System (INIS)

Davidson, A.J.; Hartman, D.S.

1989-01-01

This paper reports on CT (N = 14) used to localize lymphangioma as perirenal (N = 6), pararenal (N = 7), or pelvic (N = 1). Two arose in viscera, the adrenal, and bladder. Eight were unicameral, and six were multiloculated. Septa and walls were thick in 12. Attenuation varied from chyle to soft tissue. Sonography (N = 18) was used to characterize lymphangioma as unicameral (N = 7) or multilocular (N = 11). Septa were thick in 10 of 11 multiloculated lesions. Fluid was uncomplicated, contained dependent debris, or formed elements. Six extended across several boundaries. The authors' results show distinctive CT and sonographic features that helped to differentiate lymphangioma from other retroperitoneal masses

CT analysis of pulmonary Wegener's granulomatosis

International Nuclear Information System (INIS)

Liao Hualing; Chen Jianbo; Zhong Wenchen; Chen Jingdi

2010-01-01

Objective: To study the CT features and to improve the diagnostic accuracy of pulmonary Wegener's granulomatosis. Methods: 11 patients with histopathologically and clinically proven Wegener's granulomatosis were included in the study. Chest radiography was performed in all 11 patients and 8 patients underwent chest CT. Results: Lung abnormalities were noted in 10/11 patients including patchy lung opacities (n=3), multiple nodules (less than 3 cm in diameter, n=4), masses (more than 3cm in diameter, n=3), and cavitations (n=8). Multiple findings were observed in 4 patients. Conclusion: Imaging manifestations of pulmonary Wegener's granulomatosis were variable. Patchy lung opacities, nodules and cavitation were most common. Thin-walled cavity and ring-shaped cavity were characteristic. Pneumonia, abscess, tuberculosis and carcinoma should be included in the differential diagnosis. (authors)

Differentiating pheochromocytoma from lipid-poor adrenocortical adenoma by CT texture analysis: feasibility study.

Science.gov (United States)

Zhang, Gu-Mu-Yang; Shi, Bing; Sun, Hao; Jin, Zheng-Yu; Xue, Hua-Dan

2017-09-01

To investigate the feasibility of using CT texture analysis (CTTA) to differentiate pheochromocytoma from lipid-poor adrenocortical adenoma (lp-ACA). Ninety-eight pheochromocytomas and 66 lp-ACAs were included in this retrospective study. CTTA was performed on unenhanced and enhanced images. Receiver operating characteristic (ROC) analysis was performed, and the area under the ROC curve (AUC) was calculated for texture parameters that were significantly different for the objective. Diagnostic accuracies were evaluated using the cutoff values of texture parameters with the highest AUCs. Compared to lp-ACAs, pheochromocytomas had significantly higher mean gray-level intensity (Mean), entropy, and mean of positive pixels (MPP), but lower skewness and kurtosis on unenhanced images (P feasible to use CTTA to differentiate pheochromocytoma from lp-ACA.

Hypervascular solid-appearing serous cystic neoplasms of the pancreas: Differential diagnosis with neuroendocrine tumours

Energy Technology Data Exchange (ETDEWEB)

Park, Hye Sun; Kim, So Yeon; Park, Seong Ho; Lee, Seung Soo; Byun, Jae Ho; Kim, Jin Hee; Kim, Hyoung Jung; Lee, Moon-Gyu [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Hong, Seung-Mo [University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, Seoul (Korea, Republic of)

2016-05-15

To describe imaging findings of arterial hypervascular solid-appearing serous cystic neoplasms (SCNs) of the pancreas on CT and MR and determine imaging features differentiating them from neuroendocrine tumours (NETs). We retrospectively identified 15 arterial hypervascular solid-appearing SCNs and randomly chose 30 size-matched pancreatic NETs. On CT, two radiologists in consensus assessed the size, morphology, and CT attenuation. On MR, predominant signal intensity and the amount of the cystic component on T2-weighted images and ADC maps were evaluated and compared using Fisher's exact and Student's t-test. The mean SCN size was 2.6 cm (range, 0.8-8.3). The CT findings were similar between the two tumours: location, shape, margin, and enhancement pattern. SCNs were significantly more hypodense on non-enhanced CT images than NETs (P =.03). They differed significantly on MR: bright signal intensity (P =.01) and more than a 10 % cystic component on T2-weighted images (P =.01) were more common in SCNs than in NETs. All SCNs showed a non-restrictive pattern on the ADC map, while NETs showed diffusion restriction (P <.01). Arterial hypervascular solid-appearing SCNs and NETs share similar imaging features. Non-enhanced CT and MR images with T2-weighted images and ADC maps can facilitate the differentiation. (orig.)

CT findings in rhinocerebral mucormycosis and aspergillosis

International Nuclear Information System (INIS)

Kim, Dong Ik; Suh, Jung Ho; Lee, Jong Doo; Lee, Kyu Chang

1986-01-01

Invasive aspergillosis or mucormycosis of the paranasal sinuses involving the cranial cavity is termed rhinocerebral mycosis, which is often difficult to differentiate from malignancy. Prognosis of rhinocerebral mycosis is disastrous and usually fatal. The authors herein report 6 cases of rhinocerebral mycosis; two of them were mucormycosis and four were aspergillosis histopathologically. Main CT features are nodular mucosal thickening in the multiple sites of the paranasal sinuses that extend to orbital apex or cavernous sinus through focal destruction of bony wall. In spite of their invasiveness beyond bony boundary, destruction is not so remarkable and it is always accompanied by bony sclerosis. Awareness of these disease and CT patterns discussed in this report should be helpful in leading to early biopsy and treatment.

Classification decision tree in CT imaging: application to the differential diagnosis of solitary pulmonary nodules

International Nuclear Information System (INIS)

Ma Hongxia; Guo Yulin; Wang Qiuping; Qiang Yongqian; Liu Min; Guo Xiaojuan; Guo Youmin; Chen Qihang

2008-01-01

Objective: To establish classification and regression tree (CART) for differentiating benign from malignant solitary pulmonary nudules (SPN). Methods: One hundred and sixteen consecutive cases with 116 solitary pulmonary nodules, which finally were pathologically proven 54 malignant nodules and 62 benign nodules, were prospectively registered in this research. Twelve clinical presentations and 22 CT findings were collected as predictors. A classification tree was established to distinguish benign SPNs from malignant ones. In the observer test, two groups (one made of junior radiologists and one of senior radiologists) were independently presented with clinical information and CT images without knowing the pathologic and machine-learning results. Performance of observers and CART were compared by receiver operating characteristic analysis. Results: Receiver operating characteristic analysis showed areas under the curve of CART, senior radiologists and junior radiologists respectively were 0.910±0.029, 0.827±0.038, 0.612±0.052. Difference between areas(DBF) between CART and junior radiologists was 0.297(P<0.01). DBF between CART and senior radiologists was 0.083 (P<0.05). DBF between senior and junior radiologists was 0.214 (P<0.01). CART showed a best diagnostic efficiency, followed by junior radiologists, and then senior radiologists. Conclusion: Our data mining techniques using CART prove a high accuracy in differentiating benign from malignant pulmonary nodules based on clinical variables and CT findings. It will be a potentially useful tool in further application of artificial intelligence in the imaging diagnosis. (authors)

MO-DE-207B-04: Impact of Reconstruction Field of View On Radiomics Features in Computed Tomography (CT) Using a Texture Phantom

Energy Technology Data Exchange (ETDEWEB)

Shafiq ul Hassan, M; Zhang, G; Oliver, J; Moros, E [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Department of Physics, University of South Florida (United States); Latifi, K; Hunt, D; Guzman, R; Balagurunathan, Y; Gillies, R [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Mackin, D; Court, L [UT MD Anderson Cancer Center, Houston, TX (United States)

2016-06-15

Purpose: To investigate the impact of reconstruction Field of View on Radiomics features in computed tomography (CT) using a texture phantom. Methods: A rectangular Credence Cartridge Radiomics (CCR) phantom, composed of 10 different cartridges, was scanned on four different CT scanners from two manufacturers. A pre-defined scanning protocol was adopted for consistency. The slice thickness and reconstruction interval of 1.5 mm was used on all scanners. The reconstruction FOV was varied to result a voxel size ranging from 0.38 to 0.98 mm. A spherical region of interest (ROI) was contoured on the shredded rubber cartridge from CCR phantom CT scans. Ninety three Radiomics features were extracted from ROI using an in-house program. These include 10 shape, 22 intensity, 26 GLCM, 11 GLZSM, 11 RLM, 5 NGTDM and 8 fractal dimensional features. To evaluate the Interscanner variability across three scanners, a coefficient of variation (COV) was calculated for each feature group. Each group was further classified according to the COV by calculating the percentage of features in each of the following categories: COV≤ 5%, between 5 and 10% and ≥ 10%. Results: Shape features were the most robust, as expected, because of the spherical contouring of ROI. Intensity features were the second most robust with 54.5 to 64% of features with COV < 5%. GLCM features ranged from 31 to 35% for the same category. RLM features were sensitive to specific scanner and 5% variability was 9 to 54%. Almost all GLZM and NGTDM features showed COV ≥10% among the scanners. The dependence of fractal dimensions features on FOV was not consistent across different scanners. Conclusion: We concluded that reconstruction FOV greatly influence Radiomics features. The GLZSM and NGTDM are highly sensitive to FOV. funded in part by Grant NIH/NCI R01CA190105-01.

The spiral CT manifestations of the blood supply of primary hepatocellular carcinoma: correlation with pathological findings

International Nuclear Information System (INIS)

Huang Juan; Zhou Xiangping; Liu Rongbo; Chen Xian; Xu Chongyong; Yan Zhihan; Xu Jianying

2000-01-01

Objective: To study the correlation between the CT features of tumor blood supplies and the pathological changes in primary hepatocellular carcinoma (PHCC). Methods: Fifty cases with surgically and pathologically proved PHCC underwent spiral CT scanning (plain + dual-phase). One research group blindly evaluated the CT films obtained. According to tumor contrast enhancement and signals showed on CT, the patterns of PHCC was divided into 4 types: arterial blood supplying, portal blood supplying, arterial combining with portal blood supplying, and poorly blood supplying. Microscopically, PHCC was respectively classified into grade I to IV with Edmonson's standard, and into 4 types (trabecular, pseudo-glandular, compact, scirrhous) with WHO histological grading standard. At last, the CT features of tumor blood supplies were correlated with pathologic changes. Results: 36(72%) cases were supplied by hepatic arterial blood, 6(12%) by arterial combining with portal blood supplying, 4(8%) by portal, and 4(8%) were poorly blood supplying. The patterns of tumor blood supplies in PHCC correlated with tumor cells differentiation (P<0.05). PHCC with better tumor cells differentiation was more associated with portal blood supplies. The patterns of tumor blood supplying in PHCC correlated with the histological type of the tumor cell (P < 0.05). All of the scirrhous PHCC were lack of blood supplies, the entire compact and most of the trabecular PHCC were supplied by a arterial blood. Conclusion: The most of PHCC were supplied by hepatic arterial blood and others were supplied by portal blood, arterial combining with portal blood or lack of blood supplies. Evaluation of tumor blood supplies in PHCC is considered to be useful in differential diagnosis and treatment of PHCC

TU-C-12A-09: Modeling Pathologic Response of Locally Advanced Esophageal Cancer to Chemo-Radiotherapy Using Quantitative PET/CT Features, Clinical Parameters and Demographics

International Nuclear Information System (INIS)

Zhang, H; Chen, W; Kligerman, S; D’Souza, W; Suntharalingam, M; Lu, W; Tan, S; Kim, G

2014-01-01

Purpose: To develop predictive models using quantitative PET/CT features for the evaluation of tumor response to neoadjuvant chemo-radiotherapy (CRT) in patients with locally advanced esophageal cancer. Methods: This study included 20 patients who underwent tri-modality therapy (CRT + surgery) and had 18 F-FDG PET/CT scans before initiation of CRT and 4-6 weeks after completion of CRT but prior to surgery. Four groups of tumor features were examined: (1) conventional PET/CT response measures (SUVmax, tumor diameter, etc.); (2) clinical parameters (TNM stage, histology, etc.) and demographics; (3) spatial-temporal PET features, which characterize tumor SUV intensity distribution, spatial patterns, geometry, and associated changes resulting from CRT; and (4) all features combined. An optimal feature set was identified with recursive feature selection and cross-validations. Support vector machine (SVM) and logistic regression (LR) models were constructed for prediction of pathologic tumor response to CRT, using cross-validations to avoid model over-fitting. Prediction accuracy was assessed via area under the receiver operating characteristic curve (AUC), and precision was evaluated via confidence intervals (CIs) of AUC. Results: When applied to the 4 groups of tumor features, the LR model achieved AUCs (95% CI) of 0.57 (0.10), 0.73 (0.07), 0.90 (0.06), and 0.90 (0.06). The SVM model achieved AUCs (95% CI) of 0.56 (0.07), 0.60 (0.06), 0.94 (0.02), and 1.00 (no misclassifications). Using spatial-temporal PET features combined with conventional PET/CT measures and clinical parameters, the SVM model achieved very high accuracy (AUC 1.00) and precision (no misclassifications), significantly better than using conventional PET/CT measures or clinical parameters and demographics alone. For groups with a large number of tumor features (groups 3 and 4), the SVM model achieved significantly higher accuracy than the LR model. Conclusion: The SVM model using all features including

CT features of renal infarction

International Nuclear Information System (INIS)

Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F.

2002-01-01

Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction

Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus?

International Nuclear Information System (INIS)

Macari, M.; Spieler, B.; Babb, J.; Pachter, H.L.

2011-01-01

Aim: To determine whether the location of the computed tomography (CT) whirl sign can be used to help differentiate caecal from sigmoid volvulus. Materials and methods: Thirty-one patients (mean age 64.6 years) underwent multidetector CT and had confirmed colonic volvulus. There were 15 patients with caecal volvulus and 16 with sigmoid volvulus. Axial and coronal images were retrospectively evaluated on the picture archiving and communication system (PACS) by two reviewers in consensus without knowledge of the final diagnosis to determine whether a CT whirl sign was present and, if so, was the location to the right of midline or in the midline/left. The location of the twisting at imaging was correlated with whether the patient had caecal or sigmoid volvulus. Fisher's exact test was used to determine whether there was an association between the location of the twist (right versus mid-left) and the location of the colonic volvulus (caecal versus sigmoid). The non contrast CT (NCCT) examinations of 30 additional patients without colonic volvulus were evaluated for the presence or absence of a CT whirl sign. Results: All 31 patients with colonic volvulus had a CT whirl sign. No patient who underwent NCCT for kidney stones demonstrated a CT whirl sign. According to Fisher's exact test, there was a highly significant association (p < 0.0001) between the location of the twist (right versus mid-left) and the location of the colonic volvulus (caecal versus sigmoid). Using the location of the twist as a predictor of whether the volvulus was caecal or sigmoid provided a correct diagnosis for 93.3% (14/15) of the patients with caecal volvulus and 100% (16/16) of those with sigmoid volvulus, yielding an overall diagnostic accuracy of 96.8% (30/31). Conclusion: The location of the mesenteric twist (CT whirl sign) is a highly accurate finding in discriminating caecal from sigmoid volvulus.

SU-F-R-07: Radiomics of CT Features and Associations and Correlation with Outcomes Following Lung SBRT

Energy Technology Data Exchange (ETDEWEB)

Schreibmann, E; Iwinski Sutter, A; Whitaker, D; Switchenko, J; Elder, E; Higgins, K; Patel, P [Department of Radiation Oncology and Winship Cancer Institute of Emory University Atlanta, GA (United States)

2016-06-15

Objective: To investigate the prognostic significance of image gradients and in predicting clinical outcomes in a patients with non-small cell lung cancer treated with stereotactic body radiotherapy (SBRT) on 71 patients with 83 treated lesions. Methods: The records of patients treated with lung SBRT were retrospectively reviewed. When applicable, SBRT target volumes were modified to exclude any overlap with pleura, chestwall, or mediastinum. The ITK software package was utilized to generate quantitative measures of image intensity, inhomogeneity, shape morphology and first and second-order CT textures. Multivariate and univariate models containing CT features were generated to assess associations with clinicopathologic factors. Results: On univariate analysis, tumor size (HR 0.54, p=0.045) sumHU (HR 0.31, p=0.044) and short run grey level emphasis STD (HR 0.22, p=0.019) were associated with regional failure-free survival; meanHU (HR 0.30, p=0.035), long run emphasis (HR 0.21, p=0.011) and long run low grey level emphasis (HR 0.14, p=0.005) was associated with distant failure-free survival (DFFS). No features were significant on multivariate modeling however long run low grey level emphasis had a hazard ratio of 0.12 (p=0.061) for DFFS. Adenocarcinoma and squamous cell carcinoma differed with respect to long run emphasis STD (p=0.024), short run low grey level emphasis STD (p<0.001), and long run low grey level emphasis STD (p=0.024). Multivariate modeling of texture features associated with tumor histology was used to estimate histologies of 18 lesions treated without histologic confirmation. Of these, MVA suggested the same histology as a prior metachronous lung malignancy in 3/7 patients. Conclusion: Extracting radiomics features on clinical datasets was feasible with the ITK package with minimal effort to identify pre-treatment quantitative CT features with prognostic factors for distant control after lung SBRT.

Textural features and SUV-based variables assessed by dual time point 18F-FDG PET/CT in locally advanced breast cancer.

Science.gov (United States)

Garcia-Vicente, Ana María; Molina, David; Pérez-Beteta, Julián; Amo-Salas, Mariano; Martínez-González, Alicia; Bueno, Gloria; Tello-Galán, María Jesús; Soriano-Castrejón, Ángel

2017-12-01

To study the influence of dual time point 18F-FDG PET/CT in textural features and SUV-based variables and their relation among them. Fifty-six patients with locally advanced breast cancer (LABC) were prospectively included. All of them underwent a standard 18F-FDG PET/CT (PET-1) and a delayed acquisition (PET-2). After segmentation, SUV variables (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained. Eighteen three-dimensional (3D) textural measures were computed including: run-length matrices (RLM) features, co-occurrence matrices (CM) features, and energies. Differences between all PET-derived variables obtained in PET-1 and PET-2 were studied. Significant differences were found between the SUV-based parameters and MTV obtained in the dual time point PET/CT, with higher values of SUV-based variables and lower MTV in the PET-2 with respect to the PET-1. In relation with the textural parameters obtained in dual time point acquisition, significant differences were found for the short run emphasis, low gray-level run emphasis, short run high gray-level emphasis, run percentage, long run emphasis, gray-level non-uniformity, homogeneity, and dissimilarity. Textural variables showed relations with MTV and TLG. Significant differences of textural features were found in dual time point 18F-FDG PET/CT. Thus, a dynamic behavior of metabolic characteristics should be expected, with higher heterogeneity in delayed PET acquisition compared with the standard PET. A greater heterogeneity was found in bigger tumors.

Comparison of CT and chemical-shift MRI for differentiating thymoma from non-thymomatous conditions in myasthenia gravis: value of qualitative and quantitative assessment

International Nuclear Information System (INIS)

Priola, A.M.; Priola, S.M.; Gned, D.; Giraudo, M.T.; Fornari, A.; Veltri, A.

2016-01-01

Aim: To evaluate the usefulness of computed tomography (CT) and chemical-shift magnetic resonance imaging (MRI) in patients with myasthenia gravis (MG) for differentiating thymoma (THY) from thymic lymphoid hyperplasia (TLH) and normal thymus (NT), and to determine which technique is more accurate. Materials and methods: Eighty-three patients with generalised MG who underwent surgery were divided into the TLH/NT group (A; 65 patients) and THY group (B; 24 patients). Differences in qualitative characteristics and quantitative data (CT: radiodensity in Hounsfield units; MRI: signal intensity index [SII]) between groups were tested using Fisher's exact test and Student's t-test. Logistic regression models were estimated for both qualitative and quantitative analyses. At quantitative analysis, discrimination abilities were determined according to the area under the receiver operating characteristic (ROC) curve (AUROC) with computation of optimal cut-off points. The diagnostic accuracies of CT and MRI were compared using McNemar's test. Results: At qualitative assessment, MRI had higher accuracy than CT (96.4%, 80/83 and 86.7%, 72/83, respectively). At quantitative analysis, both the radiodensity and SII were significantly different between groups (p<0.0001). For CT, at quantitative assessment, the AUROC of the radiodensity in discriminating between groups was 0.904 (optimal cut-off point, 20 HU) with an accuracy of 77.1% (64/83). For MRI, the AUROC of the SII was 0.989 (optimal cut-off point, 7.766%) with an accuracy of 96.4% (80/83), which was significantly higher than CT (p<0.0001). By using optimal cut-off points for cases with an erroneous diagnosis at qualitative assessment, accuracy improved both for CT (89.2%, 74/83) and MRI (97.6%, 81/83). Conclusion: Quantitative analysis is useful in evaluating patients with MG and improves the diagnostic accuracy of CT and MRI based on qualitative assessment. Chemical-shift MRI is more reliable than CT in differentiating

Role of post-therapy 131Iodine SPECT-CT in risk stratification and management of patients with differentiated thyroid cancer

International Nuclear Information System (INIS)

Agarwal, K.; Bhattacharya, A.; Harishankar, C.N.B.; Manohar, K.; Mittal, B.R.

2010-01-01

Full text: To determine whether post therapy 131 I SPECT/CT changed the American Thyroid Association risk of recurrence classification and further management of the patients with differentiated thyroid carcinoma. Materials and Methods: In this prospective study, 33 consecutive patients with thyroid carcinoma (28 papillary, 4 follicular, 1 Hurthle cell) were included. Planar imaging and SPECT/CT were performed 4-7 days after the therapeutic administration of 1,221-5,180 MBq (33-140 mCi) of 131 I. SPECT/CT of the neck and upper chest were obtained for all subjects. Additional SPECT/CT scans of the abdomen or pelvis were acquired if planar imaging showed any abnormal focus of uptake. Planar and SPECT/CT images were interpreted independently, and sites of uptake were categorized as residual thyroid uptake, level VI cervical lymph node uptake, level II-V cervical lymph nodal uptake or distant metastasis. An experienced nuclear medicine physician determined if the imaging findings changed the patient's risk category and further management. Results: In 4 of 33 post surgical patients, SPECT/CT findings changed the initial ATA risk of recurrence classification. In 3 of these 4 patients, WB planar imaging showed distant metastases (1 in lung, 1 in spleen, 1 in left humerus), SPECT/CT confirming these to physiological uptake in breast and intestine and skin contamination respectively. This altered the risk of recurrence from high to intermediate category. In 1 of these 4 patients, WB planar imaging was suggestive of cervical lymph nodal metastasis, but SPECT/CT localized the abnormal focus of uptake to residual thyroid tissue, altering the risk of recurrence from intermediate to low. SPECT/CT changed the further post ablation management in 13 out of 33 patients. In 4/13 patients SPECT/CT detected cervical lymph nodes metastases, in 1/13 patient supraclavicular lymph node metastasis was detected, in 7/13 patients distant metastases was confirmed as physiological uptake or

Radiographic and computed tomographic features of caval foramen hernias of the liver in 7 dogs: mimicking lung nodules.

Science.gov (United States)

Kim, Jaehwan; Kim, Soyoung; Jo, Jieun; Lee, Seungjun; Eom, Kidong

2016-12-01

This study describes the imaging features and characteristics of caval foramen hernias in 7 dogs diagnosed by computed tomography (CT). On lateral radiographs, 6 of 7 dogs showed dome-shaped, broad-based, caudal mediastinal lesions. CT findings included caudal vena cava (CVC) compression (n=7), right lateral (n=6) or medial (n=1) liver lobe involvement, hepatic vein dilation (n=5) and biliary tract involvement (n=1) with partial (n=6) or entire (n=1) liver lobe hernias. A caval foramen hernia should be part of the differential diagnosis when the aforementioned imaging features are detected. CT is considered as a useful tool for diagnosis and evaluation in dogs with a caval foramen hernia.

Assessment of triple-phase CT findings for the differentiation of fat-deficient hepatic angiomyolipoma from hepatocellular carcinoma in non-cirrhotic liver

International Nuclear Information System (INIS)

Jeon, Tae Yeon; Kim, Seong Hyun; Lim, Hyo K.; Lee, Won Jae

2010-01-01

Background: To evaluate the triple-phase CT findings for the differentiation of fat-deficient angiomyolipoma from hepatocellular carcinoma in non-cirrhotic liver. Methods: We retrospectively reviewed contrast-enhanced triple-phase CT images of 10 patients with fat-deficient hepatic angiomyolipoma and 28 patients with 29 hepatocellular carcinomas in non-cirrhotic liver proved on histologic examination. The CT findings for the two types of tumors were compared using Fisher's exact test. Results: Early draining vein depicted on arterial or portal phases was seen in eight (80%) angiomyolipomas and two hepatocellular carcinomas (7%) (p < 0.001), in which the early draining vein was connected with tumoral vessels. The tumoral vessels in the angiomyolipoma were more prominent and ectatic, were distributed both centrally and peripherally, and were seen in smaller tumors than in the hepatocellular carcinoma. Tumor capsule enhancement was absent in all angiomyolipomas as compared with two (7%) hepatocellular carcinomas with no tumor capsule (p < 0.001). The other CT findings were not significantly different for the two different types of tumors. Conclusions: The presence of early draining vein connecting with prominent tumoral vessels and absent tumor capsule were useful CT findings for the differentiation of fat-deficient angiomyolipoma from hepatocellular carcinoma in non-cirrhotic liver.

TH-E-17A-01: Internal Respiratory Surrogate for 4D CT Using Fourier Transform and Anatomical Features

Energy Technology Data Exchange (ETDEWEB)

Hui, C; Suh, Y; Robertson, D; Pan, T; Das, P; Crane, C; Beddar, S [MD Anderson Cancer Center, Houston, TX (United States)

2014-06-15

Purpose: To develop a novel algorithm to generate internal respiratory signals for sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm extracted multiple time resolved features as potential respiratory signals. These features were taken from the 4D CT images and its Fourier transformed space. Several low-frequency locations in the Fourier space and selected anatomical features from the images were used as potential respiratory signals. A clustering algorithm was then used to search for the group of appropriate potential respiratory signals. The chosen signals were then normalized and averaged to form the final internal respiratory signal. Performance of the algorithm was tested in 50 4D CT data sets and results were compared with external signals from the real-time position management (RPM) system. Results: In almost all cases, the proposed algorithm generated internal respiratory signals that visibly matched the external respiratory signals from the RPM system. On average, the end inspiration times calculated by the proposed algorithm were within 0.1 s of those given by the RPM system. Less than 3% of the calculated end inspiration times were more than one time frame away from those given by the RPM system. In 3 out of the 50 cases, the proposed algorithm generated internal respiratory signals that were significantly smoother than the RPM signals. In these cases, images sorted using the internal respiratory signals showed fewer artifacts in locations corresponding to the discrepancy in the internal and external respiratory signals. Conclusion: We developed a robust algorithm that generates internal respiratory signals from 4D CT images. In some cases, it even showed the potential to outperform the RPM system. The proposed algorithm is completely automatic and generally takes less than 2 min to process. It can be easily implemented into the clinic and can potentially replace the use of external surrogates.

TH-E-17A-01: Internal Respiratory Surrogate for 4D CT Using Fourier Transform and Anatomical Features

International Nuclear Information System (INIS)

Hui, C; Suh, Y; Robertson, D; Pan, T; Das, P; Crane, C; Beddar, S

2014-01-01

Purpose: To develop a novel algorithm to generate internal respiratory signals for sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm extracted multiple time resolved features as potential respiratory signals. These features were taken from the 4D CT images and its Fourier transformed space. Several low-frequency locations in the Fourier space and selected anatomical features from the images were used as potential respiratory signals. A clustering algorithm was then used to search for the group of appropriate potential respiratory signals. The chosen signals were then normalized and averaged to form the final internal respiratory signal. Performance of the algorithm was tested in 50 4D CT data sets and results were compared with external signals from the real-time position management (RPM) system. Results: In almost all cases, the proposed algorithm generated internal respiratory signals that visibly matched the external respiratory signals from the RPM system. On average, the end inspiration times calculated by the proposed algorithm were within 0.1 s of those given by the RPM system. Less than 3% of the calculated end inspiration times were more than one time frame away from those given by the RPM system. In 3 out of the 50 cases, the proposed algorithm generated internal respiratory signals that were significantly smoother than the RPM signals. In these cases, images sorted using the internal respiratory signals showed fewer artifacts in locations corresponding to the discrepancy in the internal and external respiratory signals. Conclusion: We developed a robust algorithm that generates internal respiratory signals from 4D CT images. In some cases, it even showed the potential to outperform the RPM system. The proposed algorithm is completely automatic and generally takes less than 2 min to process. It can be easily implemented into the clinic and can potentially replace the use of external surrogates

Basic pattern in CT of the lung and differential diagnosis

International Nuclear Information System (INIS)

Jacobi, V.; Thalhammer, A.

2006-01-01

Infectious, physical, chemical or other noxae elicit a limited number of reactions in lung tissue. As in the case of other organs and tissues, lung tissue has specific reactions that are often more indicative of the particular organ than the harmful agent. The resulting radiological features are usually ambiguous and therefore prevent definitive diagnosis. This complicates etiological categorization of the disease. Pathognomonic findings are rare. The same noxa can yield different radiographic features and clinical pictures for different patients. A diagnosis is generally not comprised of a single radiographic feature, but rather of a combination of a plurality of features. Although the number of possible diagnoses can be limited via radiological means, a final diagnosis is determined in conjunction with the medical history, the clinical picture, as well as lab and histopathological values. This article defines the most common pulmonary changes and also discusses differential diagnostic criteria. (orig.)

Clinical study on the efficacy of contrast enhanced CT scan for the diagnosis of pancreatic cancer. With special reference to the evaluation of new CT findings useful for differentiation from tumor-forming pancreatitis

International Nuclear Information System (INIS)

Matsuura, Naotaka; Saisho, Hiromitsu; Yamaguchi, Taketo; Ohto, Masao

1995-01-01

Differential diagnosis of pancreatic cancer (PCA) and tumor-forming pancreatitis (TFP) is made based on early-phase staining pattern in contrast enhanced X-ray CT (CE-CT). In the present study, I evaluated also late-phase findings and findings by tumor diameter and identified new CE-CT findings useful for differential diagnosis. CE-CT findings useful for the diagnosis of small pancreatic cancer were also evaluated. Included in the present study were 68 PCA cases and 39 TFP cases examined in this and affiliated facilities over the last 11 years. In the early phase, density in tumorous areas was useful for differentiating PCA and TFP, because 94 % of tumorous areas showed hypodensity in PCA, while 85 % showed isodensity in TFP. However, differentiation was difficult due to hypodensity, similar to PCA, in the remaining 15% of TFP. The following five findings were found to be PCA-specific with specificity rates of 95% and over: non-staining area (early phase), hyperdensity spot and line (early phase), hyperdensity zone (early and late phase) and hyperdensity (late phase). The diagnosis of PCA could be made more accurately using these findings. The incidence of non-staining area or hyperdensity spot and line, early-phase findings, was also useful for diagnosis, as it increased with the tumor size, from 13 % when the tumor size was 20 mm or smaller to 80% when it was 21 mm or larger. The incidence of late-phase hyperdensity or hyperdensity zone was higher for smaller tumors: 71% for tumors of 20mm or smaller. Therefore, hyperdensity in tumorous areas in the late phase is thought to be useful in the diagnosis of small pancreatic cancer. (author)

Preliminary study of spectral CT imaging in the differential diagnosis of metastatic lymphadenopathy due to various tumors

International Nuclear Information System (INIS)

Liu Jingang; Liu Ya; Li Lixin

2011-01-01

Objective: To investigate the feasibility of differentiating lymph node metastases of four types of primary tumors (lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma) using gemstone spectral imaging (GSI). Methods: Three cases with lymphoma (28 lymph node), five cases with lung adenocarcinoma (30 lymph node), four cases with lung squamous cell carcinoma (24 lymph node) and two cases with cholangiocarcinoma (10 lymph node) were evaluated by germstona spectra imaging CT scans. Imaging protocol included unenhanced conventional CT scan (120 kVp), enhanced GSI (80/140 kVp) on arterial phase and conventional CT scan (120 kVp) on portal phase. CT attenuation values of lymph nodes in the monochromatic images at Il sets of keV levels (40- 140 keV, 10 keV step) and the iodine and water contents of these lymph nodes were measured. All results were analyzed with ANOVA and t test. Results: The optimal monochromatic level was 70 keV for the optimal contrast-noise ratio (CNR) of metastatic lymphadenopathy. The CT attenuation values of metastatic lymphadenopathy were (81.36±9.81), (58.33±21.55), (56.47±10.62) and (73.57±4.43) HU, respectively, at 70 keV (F=17.29, P 0.05). The iodine contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were (1.93±0.04), (1.16±0.15), (1.25±0.21) and (1.44±0.04) g/L, respectively. The water contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were (1029.40±20.85), (1024.98±11.19), (1022.12±12.94) and (1030.87±10.10) g/L, respectively. Except between lung squamous cell carcinoma and lung adenocarcinoma, the differences in the iodine contents of metastatic lymphadenopathy were significant among tumors (P 0.05 ). Conclusions: Although CT spectral imaging fails to differentiate metastatic lymphadenopathy of lung adenocarcinoma and lung squamous cell carcinoma, it is also a promising method of distinguishing metastatic

Spect-CT and PET: CT in the management of differentiated thyroid cancer

International Nuclear Information System (INIS)

Khan, Shoukat H.

2007-01-01

Full text: With the advancement and evolution in medical technology notably imaging there has been a sea change in the overall management strategy of most of the cancers of human body. The present day functional, imaging with PET and MRI enables us to pick up a tumour at its cellular stage. Molecular imaging and nanotechnology have further added to this expanding armamentarium of cancer imaging and treatment. Thyroid cancer is one such cancer where the cutting edge biotechnology has dramatically changed the management profile of a disease. Thyroid cancer can safely be classified as one of the cancers which if optimally managed is curable. Hybrid and fusion imaging like SPECT-CT and PET-CT with their superior sensitivity and specificity have greatly improved the accuracy of disease detection and reduced drastically the false positive disease sites. Disease not detected by conventional planar imaging can now be detected and also anatomically localized using hybrid imaging modalities of SPECT-CT and PET-CT. An accurate detection and precise localization improves image interpretation and a treatment optimization in the curable cancer of thyroid

2D and 3D CT Radiomics Features Prognostic Performance Comparison in Non-Small Cell Lung Cancer

Directory of Open Access Journals (Sweden)

Chen Shen

2017-12-01

Full Text Available OBJECTIVE: To compare 2D and 3D radiomics features prognostic performance differences in CT images of non-small cell lung cancer (NSCLC. METHOD: We enrolled 588 NSCLC patients from three independent cohorts. Two sets of 463 patients from two different institutes were used as the training cohort. The remaining cohort with 125 patients was set as the validation cohort. A total of 1014 radiomics features (507 2D features and 507 3D features correspondingly were assessed. Based on the dichotomized survival data, 2D and 3D radiomics indicators were calculated for each patient by trained classifiers. We used the area under the receiver operating characteristic curve (AUC to assess the prediction performance of trained classifiers (the support vector machine and logistic regression. Kaplan–Meier and Cox hazard survival analyses were also employed. Harrell's concordance index (C-Index and Akaike's information criteria (AIC were applied to assess the trained models. RESULTS: Radiomics indicators were built and compared by AUCs. In the training cohort, 2D_AUC = 0.653, 3D_AUC = 0.671. In the validation cohort, 2D_AUC = 0.755, 3D_AUC = 0.663. Both 2D and 3D trained indicators achieved significant results (P < .05 in the Kaplan-Meier analysis and Cox regression. In the validation cohort, 2D Cox model had a C-Index = 0.683 and AIC = 789.047; 3D Cox model obtained a C-Index = 0.632 and AIC = 799.409. CONCLUSION: Both 2D and 3D CT radiomics features have a certain prognostic ability in NSCLC, but 2D features showed better performance in our tests. Considering the cost of the radiomics features calculation, 2D features are more recommended for use in the current study.

SU-E-J-272: Auto-Segmentation of Regions with Differentiating CT Numbers for Treatment Response Assessment

International Nuclear Information System (INIS)

Yang, C; Noid, G; Dalah, E; Paulson, E; Li, X; Gilat-Schmidt, T

2015-01-01

Purpose: It has been reported recently that the change of CT number (CTN) during and after radiation therapy (RT) may be used to assess RT response. The purpose of this work is to develop a tool to automatically segment the regions with differentiating CTN and/or with change of CTN in a series of CTs. Methods: A software tool was developed to identify regions with differentiating CTN using K-mean Cluster of CT numbers and to automatically delineate these regions using convex hull enclosing method. Pre- and Post-RT CT, PET, or MRI images acquired for sample lung and pancreatic cancer cases were used to test the software tool. K-mean cluster of CT numbers within the gross tumor volumes (GTVs) delineated based on PET SUV (standard uptake value of fludeoxyglucose) and/or MRI ADC (apparent diffusion coefficient) map was analyzed. The cluster centers with higher value were considered as active tumor volumes (ATV). The convex hull contours enclosing preset clusters were used to delineate these ATVs with color washed displays. The CTN defined ATVs were compared with the SUV- or ADC-defined ATVs. Results: CTN stability of the CT scanner used to acquire the CTs in this work is less than 1.5 Hounsfield Unit (HU) variation annually. K-mean cluster centers in the GTV have difference of ∼20 HU, much larger than variation due to CTN stability, for the lung cancer cases studied. The dice coefficient between the ATVs delineated based on convex hull enclosure of high CTN centers and the PET defined GTVs based on SUV cutoff value of 2.5 was 90(±5)%. Conclusion: A software tool was developed using K-mean cluster and convex hull contour to automatically segment high CTN regions which may not be identifiable using a simple threshold method. These CTN regions were reasonably overlapped with the PET or MRI defined GTVs

The comparison of CT findings between peripheral pulmonary squamous cell carcinoma and pulmonary adenocarcinoma

International Nuclear Information System (INIS)

Tan Guosheng; Yang Xufeng; Zhou Xuhui; Li Ziping; Fan Miao; Chen Jindi

2007-01-01

Objective: To compare the principal HRCT features of peripheral pulmonary squamous cell carcinoma and pulmonary adenocarcinoma and to explore their pathological mechanism, in order to improve the recognition of the CT signs of peripheral pulmonary carcinoma. Methods: The principal HRCT signs of thirty-five cases with pathologically proved peripheral pulmonary squamous cell carcinoma and forty cases with pathologically proved peripheral pulmonary adenocarcinoma were analyzed retrospectively to explore the relationship between CT features and pathological findings. Results: The main features of peripheral pulmonary squamous cell carcinoma included larger masses, clear boundary, superficial sublobes and intra-tumor necrosis. While peripheral pulmonary adenocarcinoma mostly demonstrated as smaller nodules, deep sublobes, spiculations, spiculate protuberance, pleural indentation, vessel converging signs, and vacuole signs. The different of these above findings of peripheral pulmonary squamous cell carcinoma and adenocarcinoma were significant (P<0.05). Peripheral pulmonary squamous cell carcinoma may depict bronchial casts and polygonal nodules; and peripheral pulmonary adenocarcinoma may demonstrate ground glass-like nodules. Conclusion: The difference of the CT findings between peripheral pulmonary squamous cell carcinoma and peripheral adenocarcinoma is based on their different histological features and biological behaviors. It is possible to differentiate them before operation in combination with clinical information. (authors)

Radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst: with emphasis on CT

International Nuclear Information System (INIS)

Soh, Byung Chun; Heo, Min Suk; An, Chang Hyeon; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won; Choi, Mi

2002-01-01

To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (L/S) ratio of the lesion, and expansion angle of the cortex. Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1%), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The L/S ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8 .deg. C) and OKC (31.5 .deg. C). The numeric morphology (L/S ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

Radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst: with emphasis on CT

Energy Technology Data Exchange (ETDEWEB)

Soh, Byung Chun; Heo, Min Suk; An, Chang Hyeon; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won [College of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mi [College of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

2002-09-15

To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (L/S) ratio of the lesion, and expansion angle of the cortex. Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1%), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The L/S ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8 .deg. C) and OKC (31.5 .deg. C). The numeric morphology (L/S ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

Additional effects of FDG-PET to thin-section CT for the differential diagnosis of lung nodules. A Japanese multicenter clinical study

International Nuclear Information System (INIS)

Kubota, Kazuo; Murakami, Koji; Inoue, Tomio; Saga, Tsuneo; Shiomi, Susumu

2011-01-01

This study was a controlled multicenter clinical study on patients with peripheral lung nodules to verify the improvement in the diagnostic ability of fluorodeoxyglucose-positron emission tomography (FDG-PET) when used in combination with thin-section CT (TS-CT). Patients with peripheral lung nodules (long maximal diameter: 10-30 mm) detected using CT were examined using TS-CT and FDG-PET for the differential diagnosis of benign or malignant lesions. The primary endpoint was the specificity of the results using a combination of TS-CT and FDG-PET, compared with the results for TS-CT alone. Images were interpreted by investigators at each institution. Blind readings were also performed by an independent image interpretation committee. The gold standard was a pathological diagnosis determined using a surgical or biopsy specimen obtained after PET; and the patients in whom a pathological diagnosis could not be obtained were diagnosed based on a follow-up TS-CT performed more than 6 months later. Adverse reactions to FDG were also evaluated. The blind reading results for 82 lesions in 81 subjects eligible for analysis among the 90 subjects included in the study showed a specificity of 91.2% (31/34) (95% confidence interval (CI): 76.3-98.1) for TS-CT + PET, compared with a specificity of 67.6% (23/34) (95% CI: 49.5-82.6) for TS-CT alone. The specificity was significantly improved by the addition of the PET findings (p<0.05). The sensitivity improved from 89.6% (43/48) for TS-CT to 91.7% (44/48) for TS-CT + PET; the addition of PET increased the level of confidence in the diagnosis, but the difference was not significant. The results reported by the institutional investigators were not significantly different. No serious adverse reactions occurred, although two of the 90 subjects exhibited mild adverse reactions. The addition of FDG-PET to TS-CT for the differential diagnosis of benign or malignant peripheral lung nodules resulted in a significant improvement in

SU-E-J-256: Predicting Metastasis-Free Survival of Rectal Cancer Patients Treated with Neoadjuvant Chemo-Radiotherapy by Data-Mining of CT Texture Features of Primary Lesions

International Nuclear Information System (INIS)

Zhong, H; Wang, J; Shen, L; Hu, W; Wan, J; Zhou, Z; Zhang, Z

2015-01-01

Purpose: The purpose of this study is to investigate the relationship between computed tomographic (CT) texture features of primary lesions and metastasis-free survival for rectal cancer patients; and to develop a datamining prediction model using texture features. Methods: A total of 220 rectal cancer patients treated with neoadjuvant chemo-radiotherapy (CRT) were enrolled in this study. All patients underwent CT scans before CRT. The primary lesions on the CT images were delineated by two experienced oncologists. The CT images were filtered by Laplacian of Gaussian (LoG) filters with different filter values (1.0–2.5: from fine to coarse). Both filtered and unfiltered images were analyzed using Gray-level Co-occurrence Matrix (GLCM) texture analysis with different directions (transversal, sagittal, and coronal). Totally, 270 texture features with different species, directions and filter values were extracted. Texture features were examined with Student’s t-test for selecting predictive features. Principal Component Analysis (PCA) was performed upon the selected features to reduce the feature collinearity. Artificial neural network (ANN) and logistic regression were applied to establish metastasis prediction models. Results: Forty-six of 220 patients developed metastasis with a follow-up time of more than 2 years. Sixtyseven texture features were significantly different in t-test (p<0.05) between patients with and without metastasis, and 12 of them were extremely significant (p<0.001). The Area-under-the-curve (AUC) of ANN was 0.72, and the concordance index (CI) of logistic regression was 0.71. The predictability of ANN was slightly better than logistic regression. Conclusion: CT texture features of primary lesions are related to metastasisfree survival of rectal cancer patients. Both ANN and logistic regression based models can be developed for prediction

Differentiation of adrenal adenomas from nonadenomas using CT histogram analysis method: A prospective study

International Nuclear Information System (INIS)

Halefoglu, Ahmet Mesrur; Bas, Nagihan; Yasar, Ahmet; Basak, Muzaffer

2010-01-01

Objective: The objective of our study was to prospectively evaluate the effectiveness of computed tomography (CT) histogram analysis method in the differentiation of benign and malignant adrenal masses. Materials and Methods: Between March 2007 and June 2008, 94 patients (46 males, 48 females, age range: 30-79 years, mean age: 57.7 years) with 113 adrenal masses (mean diameter: 3.03 cm, range: 1.07-8.02 cm) were prospectively evaluated. These included 66 adenomas, 45 metastases and 2 pheochromocytomas. Histogram analysis method was performed using a circular region of interest (ROI) and mean attenuation, total number of pixels, number of negative pixels and subsequent percentage of negative pixels were detected on both unenhanced and delayed contrast-enhanced CT images for each adrenal mass. A mean attenuation threshold of 10 Hounsfield unit (HU) for unenhanced CT and 5% and 10% negative pixel thresholds for both unenhanced and delayed contrast-enhanced CT were calculated by a consensus of at least two reviewers and the correlation between mean attenuation and percentage of negative pixels was determined. Final diagnoses were based on imaging follow-up of minimum 6 months, biopsy, surgery and adrenal washout study. Results: 51 of 66 adenomas (77.3%) showed attenuation values of ≤10 HU and 15 (22.7%) adenomas showed more than 10 HU on unenhanced CT. All of these adenomas contained negative pixels on unenhanced CT. Eight of 66 (12.1%) adenomas showed a mean attenuation value of ≤10 HU on delayed contrast-enhanced scans and 45 adenomas (68.2%) persisted on containing negative pixels. All metastases had an attenuation value of greater than 10 HU on unenhanced CT images. 21 of 45 (46.6%) metastases contained negative pixels on unenhanced images but only seven metastases (15.5%) had negative pixels on delayed contrast-enhanced images. Two pheochromocytomas had negative pixels on both unenhanced and delayed contrast-enhanced CT images. Increase in the percentage of

Intramural hypoattenuated nodules in thickened wall of the gallbladder; CT features according to their primary causes

International Nuclear Information System (INIS)

Lee, Jun Hyung; Ha, Hyun Kwon; Lee, Jeong Hyun; Lee, Jean Hwa; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu; Kim, Myung-Jin

2001-01-01

According to published reports, a common feature of xanthogranulomatous cholecystitis is the presence of intramural hypoattenuated nodules in thickened gallbladder wall. These nodules can, however, also be seen in pathological conditions such as acute cholecystitis, hyperplastic cholecystoses (cholesterolosis and adenomyomatosis), gallbladder cancer, and other inflammatory diseases such as tuberculosis. Retrospective review of the abdominal CT findings in 622 patients who for various reasons underwent cholecystectomy during a one-year period showed that intramural nodules were present in 60. In this pictorial essay we illustrate the imaging features of the many different pathological conditions which give rise to intramural hypoattenuated nodules in thickened wall of the gallbladder, correlating these features with the histopathological findings

Precision and accuracy in CT attenuation measurement of vascular wall using region-of-interest supported by differentiation curve

International Nuclear Information System (INIS)

Suzuki, Shigeru; Kidouchi, Takashi; Kuwahara, Sadatoshi; Vembar, Mani; Takei, Ryoji; Yamamoto, Asako

2012-01-01

Objectives: To evaluate the precision and accuracy in CT attenuation measurement of vascular wall using region-of-interest (ROI) supported by differentiation curves. Study design: We used vascular models (actual attenuation value of the wall: 87 HU) with wall thicknesses of 1.5, 1.0, or 0.5 mm, filled with contrast material of 250, 348, or 436 HU. The nine vascular models were scanned with a 64-detector CT. The wall attenuation values were measured using three sizes (diameter: 0.5, 1.0, and 1.5 mm) of ROIs without differentiation curves. Sixteen measurements were repeated for each vascular model by each of two operators. Measurements supported by differentiation curves were also performed. We used analyses of variance with repeated measures for the measured attenuations for each size of the ROI. Results: Without differentiation curves, there were significant differences in the attenuation values of the wall among the three densities of contrast material, and the attenuation values tended to be overestimated more as the contrast material density increased. Operator dependencies were also found in measurements for 0.5- and 1.5-mm thickness models. With differentiation curves, measurements were not possible for 0.5- and 1.0-mm thickness models. Using differentiation curves for 1.5-mm thickness models with a ROI of 1.0- or 1.5-mm diameter, the wall attenuations were not affected by the contrast material densities and were operator independent, measuring between 75 and 103 HU. Conclusions: The use of differentiation curves can improve the precision and accuracy in wall attenuation measurement using a ROI technique, while measurements for walls of ≤1.0 mm thickness are difficult.

Development of a guideline on reading CT images of malignant pleural mesothelioma and selection of the reference CT films

International Nuclear Information System (INIS)

Zhou, Huashi; Tamura, Taro; Kusaka, Yukinori; Suganuma, Narufumi; Subhannachart, Ponglada; Vijitsanguan, Chomphunut; Noisiri, Weeraya; Hering, Kurt G.; Akira, Masanori; Itoh, Harumi

2012-01-01

Purpose: International experts developed a guideline on reading CT images of malignant pleural mesothelioma for radiologists and physicians. It is intended that it act as a supplement to the current International Classification of HRCT for Occupational and Environmental Respiratory Diseases. Methods: The research literatures on mesothelioma CT features were systematically reviewed. Ten mesothelioma CT features were adopted into the guideline prepared according to experts’ opinion. The terminology of mesothelioma CT features and mesothelioma probability were agreed by consensus of experts. The CT reference films for each mesothelioma feature were selected based on agreement by experts from 22 definite mesothelioma cases confirmed pathologically and immunohistochemically. To support the validity of the mesothelioma probability, 4 experts’ readings of CT films from 57 cases with or without mesothelioma were analyzed by kappa statistics between the experts; sensitivity and specificity for mesothelioma were also assessed. Results: The mesothelioma CT Guideline was developed, providing the terminology of CT features and the mesothelioma probability, the judgement of severity, the distribution of mesothelioma, and the revised CT reading sheet including mesothelioma items. The CT reference films with ten mesothelioma typical features were selected. The average linearly and quadratically weighted kappa of the agreement on the 4-point scale mesothelioma probability were 0.58 and 0.71, respectively. The average sensitivity and specificity for mesothelioma were 93.2% and 65.6%, respectively. Conclusion: The evidence-based mesothelioma CT Guideline developed may serve as a good educational tool to facilitate physicians in recognising mesothelioma and improve their proficiency in diagnosis of mesothelioma.

Development of a guideline on reading CT images of malignant pleural mesothelioma and selection of the reference CT films

Energy Technology Data Exchange (ETDEWEB)

Zhou, Huashi, E-mail: zhouhua@u-fukui.ac.jp [Department of Environmental Health, School of Medicine, University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193 (Japan); Tamura, Taro, E-mail: tarou@u-fukui.ac.jp [Department of Environmental Health, School of Medicine, University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193 (Japan); Kusaka, Yukinori, E-mail: kusakayk@gmail.com [Department of Environmental Health, School of Medicine, University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193 (Japan); Suganuma, Narufumi, E-mail: nsuganuma@kochi-u.ac.jp [Department of Environmental Medicine, Kochi University School of Medicine (Japan); Subhannachart, Ponglada, E-mail: pongladas@gmail.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi 11000 (Thailand); Vijitsanguan, Chomphunut, E-mail: Chompoo_vj@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi 11000 (Thailand); Noisiri, Weeraya, E-mail: weeraya_tat@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi 11000 (Thailand); Hering, Kurt G., E-mail: k.g.hering@t-online.de [Department of Diagnostic Radiology, Radiooncology and Nuclear Medicine, Radiological Clinic, Miner' s Hospital, Radiologische Klinik, Lansppaschaftskranhaus Dortmund, Wieckesweg 27 44309, Dortmund (Germany); Akira, Masanori, E-mail: akira@kch.hosp.go.jp [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai, Osaka 591-8555 (Japan); Itoh, Harumi, E-mail: hitoh@fmsrsa.fukui-med.ac.jp [Department of Environmental Health, School of Medicine, University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193 (Japan); Department of Radiology, School of Medicine, University of Fukui, 23-3 Shimoaitsuki Matsuoka, Eiheizi-cho, Fukui Prefecture 910-1193 (Japan); and others

2012-12-15

Purpose: International experts developed a guideline on reading CT images of malignant pleural mesothelioma for radiologists and physicians. It is intended that it act as a supplement to the current International Classification of HRCT for Occupational and Environmental Respiratory Diseases. Methods: The research literatures on mesothelioma CT features were systematically reviewed. Ten mesothelioma CT features were adopted into the guideline prepared according to experts’ opinion. The terminology of mesothelioma CT features and mesothelioma probability were agreed by consensus of experts. The CT reference films for each mesothelioma feature were selected based on agreement by experts from 22 definite mesothelioma cases confirmed pathologically and immunohistochemically. To support the validity of the mesothelioma probability, 4 experts’ readings of CT films from 57 cases with or without mesothelioma were analyzed by kappa statistics between the experts; sensitivity and specificity for mesothelioma were also assessed. Results: The mesothelioma CT Guideline was developed, providing the terminology of CT features and the mesothelioma probability, the judgement of severity, the distribution of mesothelioma, and the revised CT reading sheet including mesothelioma items. The CT reference films with ten mesothelioma typical features were selected. The average linearly and quadratically weighted kappa of the agreement on the 4-point scale mesothelioma probability were 0.58 and 0.71, respectively. The average sensitivity and specificity for mesothelioma were 93.2% and 65.6%, respectively. Conclusion: The evidence-based mesothelioma CT Guideline developed may serve as a good educational tool to facilitate physicians in recognising mesothelioma and improve their proficiency in diagnosis of mesothelioma.

Imaging with 124I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?

International Nuclear Information System (INIS)

Binse, I.; Poeppel, T.D.; Ruhlmann, M.; Gomez, B.; Bockisch, A.; Rosenbaum-Krumme, S.J.; Umutlu, L.

2016-01-01

The aim of this study was to compare integrated PET/CT and PET/MRI for their usefulness in detecting and categorizing cervical iodine-positive lesions in patients with differentiated thyroid cancer using 124 I as tracer. The study group comprised 65 patients at high risk of iodine-positive metastasis who underwent PET/CT (low-dose CT scan, PET acquisition time 2 min; PET/CT 2 ) followed by PET/MRI of the neck 24 h after 124 I administration. PET images from both modalities were analysed for the numbers of tracer-positive lesions. Two different acquisition times were used for the comparisons, one matching the PET/CT 2 acquisition time (2 min, PET/MRI 2 ) and the other covering the whole MRI scan time (30 min, PET/MRI 30 ). Iodine-positive lesions were categorized as metastasis, thyroid remnant or inconclusive according to their location on the PET/CT images. Morphological information provided by MRI was considered for evaluation of lesions on PET/MRI and for volume information. PET/MRI 2 detected significantly more iodine-positive metastases and thyroid remnants than PET/CT 2 (72 vs. 60, p = 0.002, and 100 vs. 80, p = 0.001, respectively), but the numbers of patients with at least one tumour lesion identified were not significantly different (21/65 vs. 17/65 patients). PET/MRI 30 tended to detect more PET-positive metastases than PET/MRI 2 (88 vs. 72), but the difference was not significant (p = 0.07). Of 21 lesions classified as inconclusive on PET/CT, 5 were assigned to metastasis or thyroid remnant when evaluated by PET/MRI. Volume information was available in 34 % of iodine-positive metastases and 2 % of thyroid remnants on PET/MRI. PET/MRI of the neck was found to be superior to PET/CT in detecting iodine-positive lesions. This was attributed to the higher sensitivity of the PET component, Although helpful in some cases, we found no substantial advantage of PET/MRI over PET/CT in categorizing iodine-positive lesions as either metastasis or thyroid remnant

Small cell lung cancer: CT evaluation and comparison with nonhodgkin's lymphoma

International Nuclear Information System (INIS)

Whang, Sun Hee; Lee, Kyung Soo; Lee, Byoung Ho

1991-01-01

We analyzed plain radiographic and computed tomographic (CT) features of 26 biopsy proven small cell lung cancer (SCLC). Eleven cases of non Hodgkin's lymphoma involving the thorax were also reviewed and compared with the small cell lung cancer for differential diagnostic clues. Centrally manifesting lymphadenopathy was the main findings of SCLC in both plain radiographs and CT. The most frequently involved lymph nodes were subcarinal, right lower paratracheal, left lower paratracheal, and right tracheobronchial node. The most difficult site to identify the lymphadenopathy with simple radiograph was subcarinal, paraesophageal, pulmonary ligamental, anterior mediastinal (group 6), and left upper paratracheal nodes CT scan revealed lymphadenopathy clearly in all of these Groups. Right lower paratracheal and subcarinal nodes were involved frequently in both SCLC's and lymphomas. Bilateral tracheobronchial and bilateral intrapulmonary nodes were involved more frequently in SCLC's while anterior mediastinal, upper paratracheal, and aorticopulmonary (AP) window nodes were involved predominantly in lymphomas. Cystic low attenuation, presumed necrosis lymphadenopathy, was noted in two cases of lymphomas but not found in SCLC's at all. In conclusion, the CT could detect involved lymphadenopathy in SCLC more accurately than plain radiograph and the sites of involved lymphadenopathy may give a differential diagnostic clue between SCLC and lymphoma

The Serum CA-125 Concentration Data Assists in Evaluating CT Imaging Information When Used to Differentiate Borderline Ovarian Tumor from Malignant Epithelial Ovarian Tumors

International Nuclear Information System (INIS)

Shin, Ji Eun; Choi, Hyuck Jae; Kim, Mi Hyun; Cho, Kyoung Sik

2011-01-01

We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis. An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009). The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs.

Quantitative CT analysis of small pulmonary vessels in lymphangioleiomyomatosis

International Nuclear Information System (INIS)

Ando, Katsutoshi; Tobino, Kazunori; Kurihara, Masatoshi; Kataoka, Hideyuki; Doi, Tokuhide; Hoshika, Yoshito; Takahashi, Kazuhisa; Seyama, Kuniaki

2012-01-01

Backgrounds: Lymphangioleiomyomatosis (LAM) is a destructive lung disease that share clinical, physiologic, and radiologic features with chronic obstructive pulmonary disease (COPD). This study aims to identify those features that are unique to LAM by using quantitative CT analysis. Methods: We measured total cross-sectional areas of small pulmonary vessels (CSA) less than 5 mm 2 and 5–10 mm 2 and calculated percentages of those lung areas (%CSA), respectively, in 50 LAM and 42 COPD patients. The extent of cystic destruction (LAA%) and mean parenchymal CT value were also calculated and correlated with pulmonary function. Results: The diffusing capacity for carbon monoxide/alveolar volume (DL CO /VA %predicted) was similar for both groups (LAM, 44.4 ± 19.8% vs. COPD, 45.7 ± 16.0%, p = 0.763), but less tissue damage occurred in LAM than COPD (LAA% 21.7 ± 16.3% vs. 29.3 ± 17.0; p CO /VA %predicted, %CSA and mean parenchymal CT value were still greater for LAM than COPD (p < 0.05). Conclusions: Quantitative CT analysis revealing a correlation between cystic destruction and CSA in COPD but not LAM indicates that this approach successfully reflects different mechanisms governing the two pathologic courses. Such determinations of small pulmonary vessel density may serve to differentiate LAM from COPD even in patients with severe lung destruction.

Auditing SNOMED CT hierarchical relations based on lexical features of concepts in non-lattice subgraphs.

Science.gov (United States)

Cui, Licong; Bodenreider, Olivier; Shi, Jay; Zhang, Guo-Qiang

2018-02-01

We introduce a structural-lexical approach for auditing SNOMED CT using a combination of non-lattice subgraphs of the underlying hierarchical relations and enriched lexical attributes of fully specified concept names. Our goal is to develop a scalable and effective approach that automatically identifies missing hierarchical IS-A relations. Our approach involves 3 stages. In stage 1, all non-lattice subgraphs of SNOMED CT's IS-A hierarchical relations are extracted. In stage 2, lexical attributes of fully-specified concept names in such non-lattice subgraphs are extracted. For each concept in a non-lattice subgraph, we enrich its set of attributes with attributes from its ancestor concepts within the non-lattice subgraph. In stage 3, subset inclusion relations between the lexical attribute sets of each pair of concepts in each non-lattice subgraph are compared to existing IS-A relations in SNOMED CT. For concept pairs within each non-lattice subgraph, if a subset relation is identified but an IS-A relation is not present in SNOMED CT IS-A transitive closure, then a missing IS-A relation is reported. The September 2017 release of SNOMED CT (US edition) was used in this investigation. A total of 14,380 non-lattice subgraphs were extracted, from which we suggested a total of 41,357 missing IS-A relations. For evaluation purposes, 200 non-lattice subgraphs were randomly selected from 996 smaller subgraphs (of size 4, 5, or 6) within the "Clinical Finding" and "Procedure" sub-hierarchies. Two domain experts confirmed 185 (among 223) suggested missing IS-A relations, a precision of 82.96%. Our results demonstrate that analyzing the lexical features of concepts in non-lattice subgraphs is an effective approach for auditing SNOMED CT. Copyright © 2017 Elsevier Inc. All rights reserved.

Discrimination method of large log-likelihood study in differential diagnosis of pulmonary diffuse mild micro-nodule

International Nuclear Information System (INIS)

Chen Budong; Ma Daqing; He Wen; Tang Hongqu; Qian Linxue; Zhou Ronglin

2001-01-01

Objective: To analyze HRCT and thin-slice CT scan findings in 150 patients with pulmonary diffuse mild micro-nodule, and to find the features with the purpose of identifying random micro-nodule, peri-lymphatic micro-nodule, and centrilobular micro-nodule. Methods: The useful features i 150 patients with pulmonary diffuse mild micro-nodule were translated into scores by means of discrimination method of large log-likelihood to identify the micro-nodular category. Results: The accuracy of diagnosis was 94.0% for random micro-nodule, 76.0% for peri-lymphatic micro-nodule, and 90.0% for centrilobular micro-nodule. Conclusion: HRCT and thin-slice CT scans were helpful in differential diagnosis of pulmonary diffuse mild micro-nodule. The discrimination method of large log-likelihood was propitious to diagnosis and differential diagnosis

CT-guided interventions in children; Computertomografisch gesteuerte Interventionen bei Kindern

Energy Technology Data Exchange (ETDEWEB)

Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

2007-06-15

In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

Crura sign: differentiation between traumatic rupture of the diaphragm and nontraumatic diaphragmatic elevation on CT

International Nuclear Information System (INIS)

Kim, Sung Jin; Han, Hae Ja; Kim, Wang Jung; Youk, Yong Soo; Han, Gi Seok; Cha, Sang Hoon; Park, Kil Sun; Kim, Dae Young

1997-01-01

To evaluate whether in patients with diffuse evaluation of a hemidiaphragm on chest radiographs, the apparence of the crura on CT might be helpful in differentiating between traumatic rupture of the diaphragm (TRD) and nontraumatic causes such as diaphragmatic palsy or diffuse diaphragmatic eventration. Among patients with diffuse elevations of a hemidiaphragm on chest radiograph, 27 who had patients undergone CT scans were retrospectively reviewed. Twelve patients had surgically proven TRD, and 15 had nontraumatic elevation of a hemidiaphragm such as diaphragmatic palsy or diffuse diaphragmatic eventration. Under the hypothesis that the affected crus is markedly thinner than the normal side in nontraumatic elevation but is normal in TRD ('crura sign', we optically assessed without measurement the thickness of both crura. In all patients with TRD, the thickness of the affected crus was similar to that of the contralateral side. In all patients with nontraumatic causes, however, the crus of the elevated hemidiaphragm was markedly thinner than that of the normal side. The 'crura sign' may be useful additional CT finding of traumatic rupture the diaphragm

Max-AUC feature selection in computer-aided detection of polyps in CT colonography.

Science.gov (United States)

Xu, Jian-Wu; Suzuki, Kenji

2014-03-01

We propose a feature selection method based on a sequential forward floating selection (SFFS) procedure to improve the performance of a classifier in computerized detection of polyps in CT colonography (CTC). The feature selection method is coupled with a nonlinear support vector machine (SVM) classifier. Unlike the conventional linear method based on Wilks' lambda, the proposed method selected the most relevant features that would maximize the area under the receiver operating characteristic curve (AUC), which directly maximizes classification performance, evaluated based on AUC value, in the computer-aided detection (CADe) scheme. We presented two variants of the proposed method with different stopping criteria used in the SFFS procedure. The first variant searched all feature combinations allowed in the SFFS procedure and selected the subsets that maximize the AUC values. The second variant performed a statistical test at each step during the SFFS procedure, and it was terminated if the increase in the AUC value was not statistically significant. The advantage of the second variant is its lower computational cost. To test the performance of the proposed method, we compared it against the popular stepwise feature selection method based on Wilks' lambda for a colonic-polyp database (25 polyps and 2624 nonpolyps). We extracted 75 morphologic, gray-level-based, and texture features from the segmented lesion candidate regions. The two variants of the proposed feature selection method chose 29 and 7 features, respectively. Two SVM classifiers trained with these selected features yielded a 96% by-polyp sensitivity at false-positive (FP) rates of 4.1 and 6.5 per patient, respectively. Experiments showed a significant improvement in the performance of the classifier with the proposed feature selection method over that with the popular stepwise feature selection based on Wilks' lambda that yielded 18.0 FPs per patient at the same sensitivity level.

SU-F-R-30: Interscanner Variability of Radiomics Features in Computed Tomography (CT) Using a Standard ACR Phantom

Energy Technology Data Exchange (ETDEWEB)

Shafiq ul Hassan, M; Zhang, G; Moros, E [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Department of Physics, University of South Florida, Tampa, FL (United States); Budzevich, M; Latifi, K; Hunt, D; Gillies, R [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

2016-06-15

Purpose: A simple approach to investigate Interscanner variability of Radiomics features in computed tomography (CT) using a standard ACR phantom. Methods: The standard ACR phantom was scanned on CT scanners from three different manufacturers. Scanning parameters of 120 KVp, 200 mA were used while slice thickness of 3.0 mm on two scanners and 3.27 mm on third scanner was used. Three spherical regions of interest (ROI) from water, medium density and high density inserts were contoured. Ninety four Radiomics features were extracted using an in-house program. These features include shape (11), intensity (22), GLCM (26), GLZSM (11), RLM (11), and NGTDM (5) and 8 fractal dimensions features. To evaluate the Interscanner variability across three scanners, a coefficient of variation (COV) is calculated for each feature group. Each group is further classified according to the COV- by calculating the percentage of features in each of the following categories: COV less than 2%, between 2 and 10% and greater than 10%. Results: For all feature groups, similar trend was observed for three different inserts. Shape features were the most robust for all scanners as expected. 70% of the shape features had COV <2%. For intensity feature group, 2% COV varied from 9 to 32% for three scanners. All features in four groups GLCM, GLZSM, RLM and NGTDM were found to have Interscanner variability ≥2%. The fractal dimensions dependence for medium and high density inserts were similar while it was different for water inserts. Conclusion: We concluded that even for similar scanning conditions, Interscanner variability across different scanners was significant. The texture features based on GLCM, GLZSM, RLM and NGTDM are highly scanner dependent. Since the inserts of the ACR Phantom are not heterogeneous in HU values suggests that matrix based 2nd order features are highly affected by variation in noise. Research partly funded by NIH/NCI R01CA190105-01.

SU-E-J-251: Incorporation of Pre-Therapy 18F-FDG Uptake with CT Texture Features in a Predictive Model for Radiation Pneumonitis Development

International Nuclear Information System (INIS)

Anthony, G; Cunliffe, A; Armato, S; Al-Hallaq, H; Castillo, R; Pham, N; Guerrero, T

2015-01-01

Purpose: To determine whether the addition of standardized uptake value (SUV) statistical variables to CT lung texture features can improve a predictive model of radiation pneumonitis (RP) development in patients undergoing radiation therapy. Methods: Anonymized data from 96 esophageal cancer patients (18 RP-positive cases of Grade ≥ 2) were retrospectively collected including pre-therapy PET/CT scans, pre-/posttherapy diagnostic CT scans and RP status. Twenty texture features (firstorder, fractal, Laws’ filter and gray-level co-occurrence matrix) were calculated from diagnostic CT scans and compared in anatomically matched regions of the lung. The mean, maximum, standard deviation, and 50th–95th percentiles of the SUV values for all lung voxels in the corresponding PET scans were acquired. For each texture feature, a logistic regression-based classifier consisting of (1) the average change in that texture feature value between the pre- and post-therapy CT scans and (2) the pre-therapy SUV standard deviation (SUV SD ) was created. The RP-classification performance of each logistic regression model was compared to the performance of its texture feature alone by computing areas under the receiver operating characteristic curves (AUCs). T-tests were performed to determine whether the mean AUC across texture features changed significantly when SUV SD was added to the classifier. Results: The AUC for single-texturefeature classifiers ranged from 0.58–0.81 in high-dose (≥ 30 Gy) regions of the lungs and from 0.53–0.71 in low-dose (< 10 Gy) regions. Adding SUVSD in a logistic regression model using a 50/50 data partition for training and testing significantly increased the mean AUC by 0.08, 0.06 and 0.04 in the low-, medium- and high-dose regions, respectively. Conclusion: Addition of SUVSD from a pre-therapy PET scan to a single CT-based texture feature improves RP-classification performance on average. These findings demonstrate the potential for more

SU-E-J-251: Incorporation of Pre-Therapy 18F-FDG Uptake with CT Texture Features in a Predictive Model for Radiation Pneumonitis Development

Energy Technology Data Exchange (ETDEWEB)

Anthony, G; Cunliffe, A; Armato, S; Al-Hallaq, H [The University of Chicago, Chicago, IL (United States); Castillo, R [Univ Texas Medical Branch of Galveston, Pearland, TX (United States); Pham, N [Baylor College of Medicine, Houston, TX (United States); Guerrero, T [Beaumont Health System, Royal Oak, MI (United States)

2015-06-15

Purpose: To determine whether the addition of standardized uptake value (SUV) statistical variables to CT lung texture features can improve a predictive model of radiation pneumonitis (RP) development in patients undergoing radiation therapy. Methods: Anonymized data from 96 esophageal cancer patients (18 RP-positive cases of Grade ≥ 2) were retrospectively collected including pre-therapy PET/CT scans, pre-/posttherapy diagnostic CT scans and RP status. Twenty texture features (firstorder, fractal, Laws’ filter and gray-level co-occurrence matrix) were calculated from diagnostic CT scans and compared in anatomically matched regions of the lung. The mean, maximum, standard deviation, and 50th–95th percentiles of the SUV values for all lung voxels in the corresponding PET scans were acquired. For each texture feature, a logistic regression-based classifier consisting of (1) the average change in that texture feature value between the pre- and post-therapy CT scans and (2) the pre-therapy SUV standard deviation (SUV{sub SD}) was created. The RP-classification performance of each logistic regression model was compared to the performance of its texture feature alone by computing areas under the receiver operating characteristic curves (AUCs). T-tests were performed to determine whether the mean AUC across texture features changed significantly when SUV{sub SD} was added to the classifier. Results: The AUC for single-texturefeature classifiers ranged from 0.58–0.81 in high-dose (≥ 30 Gy) regions of the lungs and from 0.53–0.71 in low-dose (< 10 Gy) regions. Adding SUVSD in a logistic regression model using a 50/50 data partition for training and testing significantly increased the mean AUC by 0.08, 0.06 and 0.04 in the low-, medium- and high-dose regions, respectively. Conclusion: Addition of SUVSD from a pre-therapy PET scan to a single CT-based texture feature improves RP-classification performance on average. These findings demonstrate the potential for

Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus?

Energy Technology Data Exchange (ETDEWEB)

Macari, M., E-mail: michael.macari@med.nyu.ed [Department of Radiology, NYU School of Medicine, New York, NY (United States); Spieler, B.; Babb, J. [Department of Radiology, NYU School of Medicine, New York, NY (United States); Pachter, H.L. [Department of Surgery, NYU School of Medicine, New York, NY (United States)

2011-02-15

Aim: To determine whether the location of the computed tomography (CT) whirl sign can be used to help differentiate caecal from sigmoid volvulus. Materials and methods: Thirty-one patients (mean age 64.6 years) underwent multidetector CT and had confirmed colonic volvulus. There were 15 patients with caecal volvulus and 16 with sigmoid volvulus. Axial and coronal images were retrospectively evaluated on the picture archiving and communication system (PACS) by two reviewers in consensus without knowledge of the final diagnosis to determine whether a CT whirl sign was present and, if so, was the location to the right of midline or in the midline/left. The location of the twisting at imaging was correlated with whether the patient had caecal or sigmoid volvulus. Fisher's exact test was used to determine whether there was an association between the location of the twist (right versus mid-left) and the location of the colonic volvulus (caecal versus sigmoid). The non contrast CT (NCCT) examinations of 30 additional patients without colonic volvulus were evaluated for the presence or absence of a CT whirl sign. Results: All 31 patients with colonic volvulus had a CT whirl sign. No patient who underwent NCCT for kidney stones demonstrated a CT whirl sign. According to Fisher's exact test, there was a highly significant association (p < 0.0001) between the location of the twist (right versus mid-left) and the location of the colonic volvulus (caecal versus sigmoid). Using the location of the twist as a predictor of whether the volvulus was caecal or sigmoid provided a correct diagnosis for 93.3% (14/15) of the patients with caecal volvulus and 100% (16/16) of those with sigmoid volvulus, yielding an overall diagnostic accuracy of 96.8% (30/31). Conclusion: The location of the mesenteric twist (CT whirl sign) is a highly accurate finding in discriminating caecal from sigmoid volvulus.

Differentiation of tuboovarian abscess from endometriosis: CT indicators

Energy Technology Data Exchange (ETDEWEB)

Eo, Hong; Choi, Hyuck Jae; Kim, Sun Ho; Jung, Seong Il; Park, Byung Kwan; Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2005-10-15

To assess and compare CT findings of surgically confirmed cases of tuboovarian abscesses (TOA) and endometriosis in order to identify indicators which may be helpful in making correct preoperative diagnoses. Of the 35 consecutive patients with surgically confirmed TOA, CT images were available for 11 of those patients. As a comparative group, 36 patients with surgically confirmed endometriosis with CT images were selected. CT images of TOA were compared with those of endometriosis. A retrospective analysis of the CT images of both groups was performed without knowledge of the pathologic diagnosis. The analysis compared the thickness and enhancement pattern of the cyst wall, attenuation of the cyst content, size and shape of the cyst, and paraaortic lymphadenopathy. Mean thickness of the cyst wall was 6.2 {+-} 2.0 mm in TOA and 4.5 {+-} 2.4 mm in endometriosis. Multilayered appearance in both diseases was seen on enhanced CT in 91% (10/11) of TOA cases and in 25% (9/36) of endometriosis cases. Hounsefield units of the cyst contents were 20.0 {+-} 5.5 HU and 24.7 {+-} 10.0 HU for TOA and endometriosis, respectively. Mean diameter of the cysts was 7.5 {+-} 1.7 cm in TOA and 7.9 {+-} 3.1 in endometriosis. Shape of the cyst was multilocular in 82% (9/11) of TOA cases and in 75% (27/36) of endometriosis cases. Paraaortic lymphadenopathy was present in 73% (8/11) and 44% (16/36) for TOA and endometriosis, respectively. TOA should be suspected on CT when a multilocular cystic ovarian mass is observed, especially if the lesion has a thick wall and has a multilayered appearance, and is accompanied by paraaortic lymphadenopathy.

MO-DE-207B-11: Reliability of PET/CT Radiomics Features in Functional and Morphological Components of NSCLC Lesions: A Repeatability Analysis in a Prospective Multicenter Cohort

Energy Technology Data Exchange (ETDEWEB)

Desseroit, M [INSERM, LaTIM UMR 1101, Brest (France); EE DACTIM, CHU de Poitiers, Poitiers (France); Tixier, F; Cheze Le Rest, C [EE DACTIM, CHU de Poitiers, Poitiers (France); Majdoub, M; Visvikis, D; Hatt, M [INSERM, LaTIM UMR 1101, Brest (France); Weber, W [Memorial Sloan Kettering Cancer Center, New-york, NY (United States); Siegel, B [Washington University School of Medicine, St Louis, MO (United States)

2016-06-15

Purpose: The goal of this study was to evaluate the repeatability of radiomics features (intensity, shape and heterogeneity) in both PET and low-dose CT components of test-retest FDG-PET/CT images in a prospective multicenter cohort of 74 NSCLC patients from ACRIN 6678 and a similar Merck trial. Methods: Seventy-four patients with stage III-IV NCSLC were prospectively included. The primary tumor and up to 3 additional lesions per patient were analyzed. The Fuzzy Locally Adaptive Bayesian algorithm was used to automatically delineate metabolically active volume (MAV) in PET. The 3D SlicerTM software was exploited to delineate anatomical volumes (AV) in CT. Ten intensity first-order features, as well as 26 textural features and four 3D shape descriptors were calculated from tumour volumes in both modalities. The repeatability of each metric was assessed by Bland-Altman analysis. Results: One hundred and five lesions (primary tumors and nodal or distant metastases) were delineated and characterized. The MAV and AV determination had a repeatability of −1.4±11.0% and −1.2±18.7% respectively. Several shape and heterogeneity features were found to be highly or moderately repeatable (e.g., sphericity, co-occurrence entropy or intensity size-zone matrix zone percentage), whereas others were confirmed as unreliable with much higher variability (more than twice that of the corresponding volume determination). Conclusion: Our results in this large multicenter cohort with more than 100 measurements confirm the PET findings in previous studies (with <30 lesions). In addition, our study is the first to explore the repeatability of radiomics features in the low-dose CT component of PET/CT acquisitions (previous studies considered dosimetry CT, CE-CT or CBCT). Several features were identified as reliable in both PET and CT components and could be used to build prognostic models. This work has received a French government support granted to the CominLabs excellence laboratory

Predicting Response to Neoadjuvant Chemoradiotherapy in Esophageal Cancer with Textural Features Derived from Pretreatment 18F-FDG PET/CT Imaging.

Science.gov (United States)

Beukinga, Roelof J; Hulshoff, Jan B; van Dijk, Lisanne V; Muijs, Christina T; Burgerhof, Johannes G M; Kats-Ugurlu, Gursah; Slart, Riemer H J A; Slump, Cornelis H; Mul, Véronique E M; Plukker, John Th M

2017-05-01

Adequate prediction of tumor response to neoadjuvant chemoradiotherapy (nCRT) in esophageal cancer (EC) patients is important in a more personalized treatment. The current best clinical method to predict pathologic complete response is SUV max in 18 F-FDG PET/CT imaging. To improve the prediction of response, we constructed a model to predict complete response to nCRT in EC based on pretreatment clinical parameters and 18 F-FDG PET/CT-derived textural features. Methods: From a prospectively maintained single-institution database, we reviewed 97 consecutive patients with locally advanced EC and a pretreatment 18 F-FDG PET/CT scan between 2009 and 2015. All patients were treated with nCRT (carboplatin/paclitaxel/41.4 Gy) followed by esophagectomy. We analyzed clinical, geometric, and pretreatment textural features extracted from both 18 F-FDG PET and CT. The current most accurate prediction model with SUV max as a predictor variable was compared with 6 different response prediction models constructed using least absolute shrinkage and selection operator regularized logistic regression. Internal validation was performed to estimate the model's performances. Pathologic response was defined as complete versus incomplete response (Mandard tumor regression grade system 1 vs. 2-5). Results: Pathologic examination revealed 19 (19.6%) complete and 78 (80.4%) incomplete responders. Least absolute shrinkage and selection operator regularization selected the clinical parameters: histologic type and clinical T stage, the 18 F-FDG PET-derived textural feature long run low gray level emphasis, and the CT-derived textural feature run percentage. Introducing these variables to a logistic regression analysis showed areas under the receiver-operating-characteristic curve (AUCs) of 0.78 compared with 0.58 in the SUV max model. The discrimination slopes were 0.17 compared with 0.01, respectively. After internal validation, the AUCs decreased to 0.74 and 0.54, respectively. Conclusion

Diagnostic accuracy of 18F-FDG-PET and PET/CT in the differential diagnosis between malignant and benign pleural lesions: a systematic review and meta-analysis.

Science.gov (United States)

Treglia, Giorgio; Sadeghi, Ramin; Annunziata, Salvatore; Lococo, Filippo; Cafarotti, Stefano; Bertagna, Francesco; Prior, John O; Ceriani, Luca; Giovanella, Luca

2014-01-01

To systematically review and meta-analyze published data about the diagnostic accuracy of fluorine-18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in the differential diagnosis between malignant and benign pleural lesions. A comprehensive literature search of studies published through June 2013 regarding the diagnostic performance of (18)F-FDG-PET and PET/CT in the differential diagnosis of pleural lesions was carried out. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) of (18)F-FDG-PET or PET/CT in the differential diagnosis of pleural lesions on a per-patient-based analysis were calculated. The area under the summary receiver operating characteristic curve (AUC) was calculated to measure the accuracy of these methods. Subanalyses considering device used (PET or PET/CT) were performed. Sixteen studies including 745 patients were included in the systematic review. The meta-analysis of 11 selected studies provided the following results: sensitivity 95% (95% confidence interval [95%CI]: 92-97%), specificity 82% (95%CI: 76-88%), LR+ 5.3 (95%CI: 2.4-11.8), LR- 0.09 (95%CI: 0.05-0.14), DOR 74 (95%CI: 34-161). The AUC was 0.95. No significant improvement of the diagnostic accuracy considering PET/CT studies only was found. (18)F-FDG-PET and PET/CT demonstrated to be accurate diagnostic imaging methods in the differential diagnosis between malignant and benign pleural lesions; nevertheless, possible sources of false-negative and false-positive results should be kept in mind. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Differentiation of primary chordoma, giant cell tumor and schwannoma of the sacrum by CT and MRI

Energy Technology Data Exchange (ETDEWEB)

Si, Ming-Jue, E-mail: smjsh@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Wang, Cheng-Sheng [Department of Radiology, Union Hospital, Fujian Medical University, Fuzhou 350001 (China); Ding, Xiao-Yi, E-mail: dingxiaoyi1965@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Yuan, Fei, E-mail: yuanfeirj@hotmail.com [Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Du, Lian-Jun; Lu, Yong [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Zhang, Wei-Bin [Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China)

2013-12-01

Objective: To evaluate criteria to differentiate sacral chordoma (SC), sacral giant cell tumor (SGCT) and giant sacral schwannoma (GSS) with CT and MRI. Materials and methods: CT and MR images of 22 SCs, 19 SGCTs and 8 GSSs were reviewed. The clinical and imaging features of each tumor were analyzed. Results: The mean ages of SC, SGCT and GSS were 55.1 ± 10.7, 34.3 ± 10.7 and 42.4 ± 15.7 years old. SCs (77.3%) were predominantly located in the midline of lower sacrum, while most SGCTs (73.7%) and GSSs (87.5%) were eccentrically located in upper sacrum. There were significant differences in age, location, eccentricity, morphology of bone residues, intratumoral bleeding and septations. Multiple small cysts were mainly observed in SGCTs (73.7%) with large central cysts in GSSs (87.5%). SGCTs expanded mainly inside sacrum while SCs and GSSs often extended into pelvic cavity (P = 0.0022). Involvement of sacroiliac joints and muscles were also different. Ascending extension within sacral canal was only displayed in SCs. The preservation of intervertebral discs showed difference between large and small tumors (P = 0.0002), regardless of tumor type (P = 0.095). No significant difference was displayed in gender (P = 0.234) or tumor size (P = 0.0832) among three groups. Conclusion: Age, epicenter of the lesion (midline vs. eccentric and upper vs. lower sacral vertebra), bone residues, cysts, bleeding, septation, expanding pattern, muscles and sacroiliac joint involvement can be criteria for diagnosis. Fluid–fluid level is specific for SGCTs and ascending extension within the sacral canal for SCs. The preservation of intervertebral discs is related to tumor size rather than tumor type.

Differential clinical features and stool findings in shigellosis and amoebic dysentery

NARCIS (Netherlands)

Speelman, P.; McGlaughlin, R.; Kabir, I.; Butler, T.

1987-01-01

To obtain information that could assist the clinician to differentiate between shigellosis and amoebic dysentery, we compared clinical features and stool findings in 58 adult male patients in Bangladesh. Mean values indicated that patients with invasive amoebiasis were older and had a longer

CT diagnosis of cystic ovarian lesions

International Nuclear Information System (INIS)

Iio, Kazuto; Shinmura, Ryoji; Arima, Naomi; Yamada, Eiichiro; Ohkubo, Koichi; Nagata, Yukihiro

1985-01-01

CT was undertaken and CT numbers were measured in 47 patients with cystic ovarian lesions. CT features particularly for chocolate cyst revealed the uniform thickness of the whole cystic wall, findings suggesting adhesion to the surrounding organs, circular or oval shape, and higher CT numbers within the cyst than those in the other cystic ovarian lesions. However, because these features are not always observed in cases of chocolate cyst, one should not rely solely on CT findings in the diagnosis of chocolate cyst. (Namekawa, K.)

Well-differentiated liposarcoma of the retroperitoneum with a fat-fluid level: US, CT, and MR appearance

International Nuclear Information System (INIS)

Kurosaki, Y.; Tanaka, Y.O.; Itai, Y.

1998-01-01

We report a case of retroperitoneal liposarcoma with a fat-fluid level that has not been previously described. A 36-year-old man presented with abdominal distension. Ultrasonography, CT, and MR imaging showed a tumor with a fat-fluid level; nondependent fluid was characteristic of fat. Liposarcoma should be included in the differential diagnosis of tumors exhibiting a fat-fluid level. (orig.)

Stability of deep features across CT scanners and field of view using a physical phantom

Science.gov (United States)

Paul, Rahul; Shafiq-ul-Hassan, Muhammad; Moros, Eduardo G.; Gillies, Robert J.; Hall, Lawrence O.; Goldgof, Dmitry B.

2018-02-01

Radiomics is the process of analyzing radiological images by extracting quantitative features for monitoring and diagnosis of various cancers. Analyzing images acquired from different medical centers is confounded by many choices in acquisition, reconstruction parameters and differences among device manufacturers. Consequently, scanning the same patient or phantom using various acquisition/reconstruction parameters as well as different scanners may result in different feature values. To further evaluate this issue, in this study, CT images from a physical radiomic phantom were used. Recent studies showed that some quantitative features were dependent on voxel size and that this dependency could be reduced or removed by the appropriate normalization factor. Deep features extracted from a convolutional neural network, may also provide additional features for image analysis. Using a transfer learning approach, we obtained deep features from three convolutional neural networks pre-trained on color camera images. An we examination of the dependency of deep features on image pixel size was done. We found that some deep features were pixel size dependent, and to remove this dependency we proposed two effective normalization approaches. For analyzing the effects of normalization, a threshold has been used based on the calculated standard deviation and average distance from a best fit horizontal line among the features' underlying pixel size before and after normalization. The inter and intra scanner dependency of deep features has also been evaluated.

Differentiation of tuboovarian abscess from endometriosis: CT indicators

International Nuclear Information System (INIS)

Eo, Hong; Choi, Hyuck Jae; Kim, Sun Ho; Jung, Seong Il; Park, Byung Kwan; Kim, Seung Hyup

2005-01-01

To assess and compare CT findings of surgically confirmed cases of tuboovarian abscesses (TOA) and endometriosis in order to identify indicators which may be helpful in making correct preoperative diagnoses. Of the 35 consecutive patients with surgically confirmed TOA, CT images were available for 11 of those patients. As a comparative group, 36 patients with surgically confirmed endometriosis with CT images were selected. CT images of TOA were compared with those of endometriosis. A retrospective analysis of the CT images of both groups was performed without knowledge of the pathologic diagnosis. The analysis compared the thickness and enhancement pattern of the cyst wall, attenuation of the cyst content, size and shape of the cyst, and paraaortic lymphadenopathy. Mean thickness of the cyst wall was 6.2 ± 2.0 mm in TOA and 4.5 ± 2.4 mm in endometriosis. Multilayered appearance in both diseases was seen on enhanced CT in 91% (10/11) of TOA cases and in 25% (9/36) of endometriosis cases. Hounsefield units of the cyst contents were 20.0 ± 5.5 HU and 24.7 ± 10.0 HU for TOA and endometriosis, respectively. Mean diameter of the cysts was 7.5 ± 1.7 cm in TOA and 7.9 ± 3.1 in endometriosis. Shape of the cyst was multilocular in 82% (9/11) of TOA cases and in 75% (27/36) of endometriosis cases. Paraaortic lymphadenopathy was present in 73% (8/11) and 44% (16/36) for TOA and endometriosis, respectively. TOA should be suspected on CT when a multilocular cystic ovarian mass is observed, especially if the lesion has a thick wall and has a multilayered appearance, and is accompanied by paraaortic lymphadenopathy

Opportunities for new CT contrast agents to maximize the diagnostic potential of emerging spectral CT technologies.

Science.gov (United States)

Yeh, Benjamin M; FitzGerald, Paul F; Edic, Peter M; Lambert, Jack W; Colborn, Robert E; Marino, Michael E; Evans, Paul M; Roberts, Jeannette C; Wang, Zhen J; Wong, Margaret J; Bonitatibus, Peter J

2017-04-01

The introduction of spectral CT imaging in the form of fast clinical dual-energy CT enabled contrast material to be differentiated from other radiodense materials, improved lesion detection in contrast-enhanced scans, and changed the way that existing iodine and barium contrast materials are used in clinical practice. More profoundly, spectral CT can differentiate between individual contrast materials that have different reporter elements such that high-resolution CT imaging of multiple contrast agents can be obtained in a single pass of the CT scanner. These spectral CT capabilities would be even more impactful with the development of contrast materials designed to complement the existing clinical iodine- and barium-based agents. New biocompatible high-atomic number contrast materials with different biodistribution and X-ray attenuation properties than existing agents will expand the diagnostic power of spectral CT imaging without penalties in radiation dose or scan time. Copyright © 2016 Elsevier B.V. All rights reserved.

Gilbert’s syndrome: clinical features, diagnostics, differential diagnosis and treatment (part 2

Directory of Open Access Journals (Sweden)

T.V. Sorokman

2017-02-01

discoloration of the skin (“teinte bilieuse”, especially on the face, hands, and feet without a distinct scleral icterus. Sometimes the development of repeatedly intermittent episodes of jaundice with high bilirubinemia (indirect bilirubin without the evidence of hemolysis (differential diagnostic feature is observed. 2. A tendency to development of pigmented and vascular nevi and xanthelasma of the eyelids, and hyperpigmentation around the eyes; to bradycardia, hypothermia, migraine, postural, intermittent albuminuria or to alimentary glycosuria. 3. An increased tendency to pigmentation under the influence of light, heat, and also chemical and mechanical stimuli. 4. A neuromuscular hyperexcitability. 5. Increased sensitivity to cold. 6. Dyspeptic complaints (pain, nausea, abdominal bloa­ting, diarrhea or constipation. 7. No signs of increased hemolysis (differential diagnostic feature with increasing content in, bilirubin (differential diagnostic feature. 8. The majority of patients have normal liver function tests (differential diagnostic feature also normal bromsulphalein test is also normal (differential diagnostic feature. 9. The biochemical abnormality is not detected by histological methods (differential diagnostic feature .10. Frequently, a family disease of the liver is observed. The differential diagnosis of GS is conducted with all types of hyperbilirubinemias, hemolytic anemias, congenital hepatic cirrhosis, hepatitis, cholecystopathy, atresia of biliary ducts or the small intestine. Medications are used only in severe hyperbilirubinemias and as concomitant therapy in the presence of symptoms of vitamin deficiencies, violations of a motor-evacuation function of the upper digestive tract in the clinical picture and to prevent complications (cholelithiasis.

Differentiation of Glioblastoma and Lymphoma Using Feature Extraction and Support Vector Machine.

Science.gov (United States)

Yang, Zhangjing; Feng, Piaopiao; Wen, Tian; Wan, Minghua; Hong, Xunning

2017-01-01

Differentiation of glioblastoma multiformes (GBMs) and lymphomas using multi-sequence magnetic resonance imaging (MRI) is an important task that is valuable for treatment planning. However, this task is a challenge because GBMs and lymphomas may have a similar appearance in MRI images. This similarity may lead to misclassification and could affect the treatment results. In this paper, we propose a semi-automatic method based on multi-sequence MRI to differentiate these two types of brain tumors. Our method consists of three steps: 1) the key slice is selected from 3D MRIs and region of interests (ROIs) are drawn around the tumor region; 2) different features are extracted based on prior clinical knowledge and validated using a t-test; and 3) features that are helpful for classification are used to build an original feature vector and a support vector machine is applied to perform classification. In total, 58 GBM cases and 37 lymphoma cases are used to validate our method. A leave-one-out crossvalidation strategy is adopted in our experiments. The global accuracy of our method was determined as 96.84%, which indicates that our method is effective for the differentiation of GBM and lymphoma and can be applied in clinical diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Perigastric appendagitis: CT and clinical features in eight patients

International Nuclear Information System (INIS)

Justaniah, A.I.; Scholz, F.J.; Katz, D.S.; Scheirey, C.D.

2014-01-01

Aim: To describe perigastric appendagitis (PA) on CT as a new and distinct clinical entity to enable recognition and prevent additional unnecessary investigation or intervention. Materials and methods: Institutional review board approval was obtained and informed consent was waived. Retrospective review of the clinical data and CT findings in eight patients with PA encountered over 10 years at one institution was performed. The English literature was reviewed and summarized. Two experienced abdominal radiologists reviewed the CT images by consensus. Results: Seven of eight patients had moderate to severe epigastric pain for 1–7 days. All eight patients (four men, four women; mean age 44 years, range 33–81 years) had no fever or leukocytosis. All underwent abdominal CT which showed ovoid fat inflammation along the course of the perigastric ligaments (gastrohepatic, gastrosplenic, and falciform). Two had gastric wall thickening. Although the inflammation was correctly described, the specific diagnosis was not made on initial interpretation in five patients. Subsequently, they underwent further diagnostic testing [an upper gastrointestinal examination and hepatobiliary iminodiacetic acid (HIDA) cholescintigraphy, an upper endoscopy and MRI examination, HIDA cholescintigraphy, another CT, and an MRI examination, respectively]. The HIDA cholescintigraphy, upper GI examination, and upper endoscopy examinations were normal. No repeated examination was performed on the other three patients. Pain resolved spontaneously in all within two days. Conclusion: Perigastric appendagitis can present with an acute abdomen, which is safely managed conservatively if diagnosed correctly. Radiologists should be aware of the entity to avoid unnecessary intervention, and recognize the CT findings of ovoid fat inflammation in the distribution of the perigastric ligaments. - Highlights: • Normal perigastric ligaments can have fatty appendages. • Torsion of these appendages causes

Prospective evaluation of 68Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative 131I-whole body scan: comparison with 18F-FDG PET-CT

International Nuclear Information System (INIS)

Kundu, Parveen; Lata, Sneh; Sharma, Punit; Singh, Harmandeep; Malhotra, Arun; Bal, Chandrasekhar

2014-01-01

The purpose of the study was to evaluate the role of 68 Ga-DOTANOC PET-CT in differentiated thyroid cancer (DTC) patients with negative 131 I-whole body scan (WBS) along with serially increasing serum thyroglobulin (Tg), and compare the same with 18 F-FDG PET-CT. Sixty two DTC patients with serially rising Tg levels and negative 131 I-WBS were prospectively enrolled. All patients underwent 68 Ga-DOTANOC PET-CT and 18 F-FDG PET-CT within an interval of two weeks. PET-CT analysis was done on a per-patient basis, location wise and lesion wise. All PET-CT lesions were divided into four categories-local, nodal, pulmonary and skeletal. Histopathology and/or serial serum Tg level, clinical and imaging follow up (minimum-1 year) were used as a reference standard. Ga-DOTANOC PET-CT demonstrated disease in 40/62 (65 %) patients and 18 F-FDG PET-CT in 45/62 (72 %) patients, with no significant difference on McNemar analysis (p = 0.226). Per-patient sensitivity and specificity of 68 Ga-DOTANOC PET-CT was 78.4 %, 100 %, and for 18 F-FDG PET-CT was 86.3 %, 90.9 %, respectively. Out of 186 lesions detected by both PET-CTs, 121/186 (65 %) lesions were seen on 68 Ga-DOTANOC PET-CT and 168/186 (90.3 %) lesions on 18 F-FDG PET-CT (p 68 Ga-DOTANOC PET-CT and 18 F-FDG PET-CT for detection of local disease (k = 0.92), while moderate agreement was noted for nodal and pulmonary disease (k = 0.67). 68 Ga-DOTANOC PET-CT changed management in 21/62 (34 %) patients and 18 F-FDG PET-CT in 17/62 (27 %) patients. Ga-DOTANOC PET-CT is inferior to 18 F-FDG PET-CT on lesion based but not on patient based analysis for detection of recurrent/residual disease in DTC patients with negative WBS scan and elevated serum Tg levels. It can also help in selection of potential candidates for peptide receptor radionuclide therapy. (orig.)

A Case of Meigs' Syndrome: The {sup 18F} FDG PET/CT Findings

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Seong; Kim, Tae Sung; Yoo, Chong Woo; Seo, Sang Soo; Kim, Seok ki [Research Institute and Hospital, National Cancer Center, Gyeonggi do (Korea, Republic of)

2011-09-15

The findings of an ovarian mass with marked ascites and pleural effusion are highly suggestive of malignancy, especially in a postmenopausal female with an elevated level of CA 125. However, benign conditions such as Meigs' syndrome should be considered in the differential diagnosis if the primary mass shows benign features. {sup 18F} FDG is known to be useful to differentiate between malignant and benign diseases, and this utility is also promising in the case of ovarian tumor. We present here a case of Meigs' syndrome that was evaluated by {sup 18F} FDG PET/CT, and this helped the preoperative diagnosis be made. {sup 18F} FDG PET/CT is a promising modality to diagnose the pathological character of an ovarian tumor preoperatively, which can lead to a proper therapeutic plan.

Deep Learning with Convolutional Neural Network for Differentiation of Liver Masses at Dynamic Contrast-enhanced CT: A Preliminary Study.

Science.gov (United States)

Yasaka, Koichiro; Akai, Hiroyuki; Abe, Osamu; Kiryu, Shigeru

2018-03-01

Purpose To investigate diagnostic performance by using a deep learning method with a convolutional neural network (CNN) for the differentiation of liver masses at dynamic contrast agent-enhanced computed tomography (CT). Materials and Methods This clinical retrospective study used CT image sets of liver masses over three phases (noncontrast-agent enhanced, arterial, and delayed). Masses were diagnosed according to five categories (category A, classic hepatocellular carcinomas [HCCs]; category B, malignant liver tumors other than classic and early HCCs; category C, indeterminate masses or mass-like lesions [including early HCCs and dysplastic nodules] and rare benign liver masses other than hemangiomas and cysts; category D, hemangiomas; and category E, cysts). Supervised training was performed by using 55 536 image sets obtained in 2013 (from 460 patients, 1068 sets were obtained and they were augmented by a factor of 52 [rotated, parallel-shifted, strongly enlarged, and noise-added images were generated from the original images]). The CNN was composed of six convolutional, three maximum pooling, and three fully connected layers. The CNN was tested with 100 liver mass image sets obtained in 2016 (74 men and 26 women; mean age, 66.4 years ± 10.6 [standard deviation]; mean mass size, 26.9 mm ± 25.9; 21, nine, 35, 20, and 15 liver masses for categories A, B, C, D, and E, respectively). Training and testing were performed five times. Accuracy for categorizing liver masses with CNN model and the area under receiver operating characteristic curve for differentiating categories A-B versus categories C-E were calculated. Results Median accuracy of differential diagnosis of liver masses for test data were 0.84. Median area under the receiver operating characteristic curve for differentiating categories A-B from C-E was 0.92. Conclusion Deep learning with CNN showed high diagnostic performance in differentiation of liver masses at dynamic CT. © RSNA, 2017 Online

Histological grade of differentiation of hepatocellular carcinoma: comparison of the efficacy of diffusion-weighted MRI with T2-weighted imaging and angiography-assisted CT

International Nuclear Information System (INIS)

Saito, Kazuhiro; Nishio, Ryota; Saguchi, Toru; Akata, Soichi; Tokuuye, Koichi; Moriyasu, Fuminori; Sugimoto, Katsutoshi

2012-01-01

The purpose of this study is to determine the usefulness of diffusion-weighted imaging (DWI) for evaluating the histological grade of differentiation of hepatocellular carcinoma (HCC) compared with T2-weighted imaging (T2WI) and tumour haemodynamics. We retrospectively evaluated 32 patients with 42 pathologically confirmed HCC nodules. These patients underwent MRI, CT during arterial portography and CT hepatic arteriography. We evaluated the relationship between the histological grade of differentiation and the apparent diffusion coefficient (ADC) values, conspicuity of tumour on DWI, DWI and T2WI contrast-to-noise (C/N) ratios and tumour haemodynamics. There was no correlation between the histological grade of differentiation and the ADC values. The DWI C/N ratio was significantly different among all histological grades, but the T2WI C/N ratio was not. Tumour conspicuity on DWI correlated well with the histological grade of differentiation, but tumour haemodynamics only partially correlated with the histological grade of differentiation. DWI was useful for evaluating the histological grade of differentiation of HCC.

Well-differentiated liposarcoma of the retroperitoneum with a fat-fluid level: US, CT, and MR appearance

Energy Technology Data Exchange (ETDEWEB)

Kurosaki, Y.; Tanaka, Y.O.; Itai, Y. [Department of Radiology, University of Tsukuba, Tsukuba-shi (Japan)

1998-03-27

We report a case of retroperitoneal liposarcoma with a fat-fluid level that has not been previously described. A 36-year-old man presented with abdominal distension. Ultrasonography, CT, and MR imaging showed a tumor with a fat-fluid level; nondependent fluid was characteristic of fat. Liposarcoma should be included in the differential diagnosis of tumors exhibiting a fat-fluid level. (orig.) With 1 fig., 11 refs.

Impact of Reconstruction Algorithms on CT Radiomic Features of Pulmonary Tumors: Analysis of Intra- and Inter-Reader Variability and Inter-Reconstruction Algorithm Variability.

Science.gov (United States)

Kim, Hyungjin; Park, Chang Min; Lee, Myunghee; Park, Sang Joon; Song, Yong Sub; Lee, Jong Hyuk; Hwang, Eui Jin; Goo, Jin Mo

2016-01-01

To identify the impact of reconstruction algorithms on CT radiomic features of pulmonary tumors and to reveal and compare the intra- and inter-reader and inter-reconstruction algorithm variability of each feature. Forty-two patients (M:F = 19:23; mean age, 60.43±10.56 years) with 42 pulmonary tumors (22.56±8.51mm) underwent contrast-enhanced CT scans, which were reconstructed with filtered back projection and commercial iterative reconstruction algorithm (level 3 and 5). Two readers independently segmented the whole tumor volume. Fifteen radiomic features were extracted and compared among reconstruction algorithms. Intra- and inter-reader variability and inter-reconstruction algorithm variability were calculated using coefficients of variation (CVs) and then compared. Among the 15 features, 5 first-order tumor intensity features and 4 gray level co-occurrence matrix (GLCM)-based features showed significant differences (palgorithms. As for the variability, effective diameter, sphericity, entropy, and GLCM entropy were the most robust features (CV≤5%). Inter-reader variability was larger than intra-reader or inter-reconstruction algorithm variability in 9 features. However, for entropy, homogeneity, and 4 GLCM-based features, inter-reconstruction algorithm variability was significantly greater than inter-reader variability (palgorithms. Inter-reconstruction algorithm variability was greater than inter-reader variability for entropy, homogeneity, and GLCM-based features.

Imaging with {sup 124}I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT?

Energy Technology Data Exchange (ETDEWEB)

Binse, I.; Poeppel, T.D.; Ruhlmann, M.; Gomez, B.; Bockisch, A.; Rosenbaum-Krumme, S.J. [University of Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Umutlu, L. [University of Duisburg-Essen, Medical Faculty, Department of Radiology, Essen (Germany)

2016-06-15

The aim of this study was to compare integrated PET/CT and PET/MRI for their usefulness in detecting and categorizing cervical iodine-positive lesions in patients with differentiated thyroid cancer using {sup 124}I as tracer. The study group comprised 65 patients at high risk of iodine-positive metastasis who underwent PET/CT (low-dose CT scan, PET acquisition time 2 min; PET/CT{sub 2}) followed by PET/MRI of the neck 24 h after {sup 124}I administration. PET images from both modalities were analysed for the numbers of tracer-positive lesions. Two different acquisition times were used for the comparisons, one matching the PET/CT{sub 2} acquisition time (2 min, PET/MRI{sub 2}) and the other covering the whole MRI scan time (30 min, PET/MRI{sub 30}). Iodine-positive lesions were categorized as metastasis, thyroid remnant or inconclusive according to their location on the PET/CT images. Morphological information provided by MRI was considered for evaluation of lesions on PET/MRI and for volume information. PET/MRI{sub 2} detected significantly more iodine-positive metastases and thyroid remnants than PET/CT{sub 2} (72 vs. 60, p = 0.002, and 100 vs. 80, p = 0.001, respectively), but the numbers of patients with at least one tumour lesion identified were not significantly different (21/65 vs. 17/65 patients). PET/MRI{sub 30} tended to detect more PET-positive metastases than PET/MRI{sub 2} (88 vs. 72), but the difference was not significant (p = 0.07). Of 21 lesions classified as inconclusive on PET/CT, 5 were assigned to metastasis or thyroid remnant when evaluated by PET/MRI. Volume information was available in 34 % of iodine-positive metastases and 2 % of thyroid remnants on PET/MRI. PET/MRI of the neck was found to be superior to PET/CT in detecting iodine-positive lesions. This was attributed to the higher sensitivity of the PET component, Although helpful in some cases, we found no substantial advantage of PET/MRI over PET/CT in categorizing iodine

Thoracic endometriosis syndrome: CT and MRI features

International Nuclear Information System (INIS)

Rousset, P.; Rousset-Jablonski, C.; Alifano, M.; Mansuet-Lupo, A.; Buy, J.-N.; Revel, M.-P.

2014-01-01

Thoracic endometriosis is considered to be rare, but is the most frequent form of extra-abdominopelvic endometriosis. Thoracic endometriosis syndrome affects women of reproductive age. Diagnosis is mainly based on clinical findings, which can include catamenial pneumothorax and haemothorax, non-catamenial endometriosis-related pneumothorax, catamenial haemoptysis, lung nodules, and isolated catamenial chest pain. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this often under-diagnosed syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions