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Sample records for lesion detection performance

  1. Lesion detection and quantification performance of the Tachyon-I time-of-flight PET scanner: phantom and human studies

    Science.gov (United States)

    Zhang, Xuezhu; Peng, Qiyu; Zhou, Jian; Huber, Jennifer S.; Moses, William W.; Qi, Jinyi

    2018-03-01

    The first generation Tachyon PET (Tachyon-I) is a demonstration single-ring PET scanner that reaches a coincidence timing resolution of 314 ps using LSO scintillator crystals coupled to conventional photomultiplier tubes. The objective of this study was to quantify the improvement in both lesion detection and quantification performance resulting from the improved time-of-flight (TOF) capability of the Tachyon-I scanner. We developed a quantitative TOF image reconstruction method for the Tachyon-I and evaluated its TOF gain for lesion detection and quantification. Scans of either a standard NEMA torso phantom or healthy volunteers were used as the normal background data. Separately scanned point source and sphere data were superimposed onto the phantom or human data after accounting for the object attenuation. We used the bootstrap method to generate multiple independent noisy datasets with and without a lesion present. The signal-to-noise ratio (SNR) of a channelized hotelling observer (CHO) was calculated for each lesion size and location combination to evaluate the lesion detection performance. The bias versus standard deviation trade-off of each lesion uptake was also calculated to evaluate the quantification performance. The resulting CHO-SNR measurements showed improved performance in lesion detection with better timing resolution. The detection performance was also dependent on the lesion size and location, in addition to the background object size and shape. The results of bias versus noise trade-off showed that the noise (standard deviation) reduction ratio was about 1.1–1.3 over the TOF 500 ps and 1.5–1.9 over the non-TOF modes, similar to the SNR gains for lesion detection. In conclusion, this Tachyon-I PET study demonstrated the benefit of improved time-of-flight capability on lesion detection and ROI quantification for both phantom and human subjects.

  2. Radiologists' Performance for Detecting Lesions and the Interobserver Variability of Automated Whole Breast Ultrasound

    International Nuclear Information System (INIS)

    Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Choi, Jae Jung; Lee, Ji Hye; Song, Byung Joo; Choe, Byung Joo; Park, Sarah; Kim, Hyunbin

    2013-01-01

    To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement

  3. Radiologists' Performance for Detecting Lesions and the Interobserver Variability of Automated Whole Breast Ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Choi, Jae Jung; Lee, Ji Hye [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Song, Byung Joo; Choe, Byung Joo [Department of General Surgery, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Park, Sarah [Department of Internal Medicine, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Kim, Hyunbin [CMC Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of)

    2013-07-01

    To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement.

  4. Lesion detection and quantitation of positron emission mammography

    International Nuclear Information System (INIS)

    Qi, Jinyi; Huesman, Ronald H.

    2001-01-01

    A Positron Emission Mammography (PEM) scanner dedicated to breast imaging is being developed at our laboratory. We have developed a list mode likelihood reconstruction algorithm for this scanner. Here we theoretically study the lesion detection and quantitation. The lesion detectability is studied theoretically using computer observers. We found that for the zero-order quadratic prior, the region of interest observer can achieve the performance of the prewhitening observer with a properly selected smoothing parameter. We also study the lesion quantitation using the test statistic of the region of interest observer. The theoretical expressions for the bias, variance, and ensemble mean squared error of the quantitation are derived. Computer simulations show that the theoretical predictions are in good agreement with the Monte Carlo results for both lesion detection and quantitation

  5. Detection activity assessment and diagnosis of dental caries lesions

    DEFF Research Database (Denmark)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-01-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment...... and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process...

  6. Automated detection of fundus photographic red lesions in diabetic retinopathy.

    Science.gov (United States)

    Larsen, Michael; Godt, Jannik; Larsen, Nicolai; Lund-Andersen, Henrik; Sjølie, Anne Katrin; Agardh, Elisabet; Kalm, Helle; Grunkin, Michael; Owens, David R

    2003-02-01

    To compare a fundus image-analysis algorithm for automated detection of hemorrhages and microaneurysms with visual detection of retinopathy in patients with diabetes. Four hundred fundus photographs (35-mm color transparencies) were obtained in 200 eyes of 100 patients with diabetes who were randomly selected from the Welsh Community Diabetic Retinopathy Study. A gold standard reference was defined by classifying each patient as having or not having diabetic retinopathy based on overall visual grading of the digitized transparencies. A single-lesion visual grading was made independently, comprising meticulous outlining of all single lesions in all photographs and used to develop the automated red lesion detection system. A comparison of visual and automated single-lesion detection in replicating the overall visual grading was then performed. Automated red lesion detection demonstrated a specificity of 71.4% and a resulting sensitivity of 96.7% in detecting diabetic retinopathy when applied at a tentative threshold setting for use in diabetic retinopathy screening. The accuracy of 79% could be raised to 85% by adjustment of a single user-supplied parameter determining the balance between the screening priorities, for which a considerable range of options was demonstrated by the receiver-operating characteristic (area under the curve 90.3%). The agreement of automated lesion detection with overall visual grading (0.659) was comparable to the mean agreement of six ophthalmologists (0.648). Detection of diabetic retinopathy by automated detection of single fundus lesions can be achieved with a performance comparable to that of experienced ophthalmologists. The results warrant further investigation of automated fundus image analysis as a tool for diabetic retinopathy screening.

  7. Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

    International Nuclear Information System (INIS)

    Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin; Kogler, Michael; Schmaranzer, Ehrenfried; Forstner, Thomas; Reichkendler, Markus

    2015-01-01

    To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

  8. Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

    Energy Technology Data Exchange (ETDEWEB)

    Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin [Medical University Innsbruck, Department of Radiology, Innsbruck (Austria); Kogler, Michael; Schmaranzer, Ehrenfried [District Hospital St. Johann in Tyrol, Department of Radiology, St. Johann in Tyrol (Austria); Forstner, Thomas [Johannes Keppler University, Department for Applied Systems Research and Statistics, Linz (Austria); Reichkendler, Markus [District Hospital St. Johann in Tyrol, Department of Orthopedic Surgery, St. Johann in Tyrol (Austria)

    2015-06-01

    To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

  9. Automated Breast Ultrasound Lesions Detection using Convolutional Neural Networks.

    Science.gov (United States)

    Yap, Moi Hoon; Pons, Gerard; Marti, Joan; Ganau, Sergi; Sentis, Melcior; Zwiggelaar, Reyer; Davison, Adrian K; Marti, Robert

    2017-08-07

    Breast lesion detection using ultrasound imaging is considered an important step of Computer-Aided Diagnosis systems. Over the past decade, researchers have demonstrated the possibilities to automate the initial lesion detection. However, the lack of a common dataset impedes research when comparing the performance of such algorithms. This paper proposes the use of deep learning approaches for breast ultrasound lesion detection and investigates three different methods: a Patch-based LeNet, a U-Net, and a transfer learning approach with a pretrained FCN-AlexNet. Their performance is compared against four state-of-the-art lesion detection algorithms (i.e. Radial Gradient Index, Multifractal Filtering, Rule-based Region Ranking and Deformable Part Models). In addition, this paper compares and contrasts two conventional ultrasound image datasets acquired from two different ultrasound systems. Dataset A comprises 306 (60 malignant and 246 benign) images and Dataset B comprises 163 (53 malignant and 110 benign) images. To overcome the lack of public datasets in this domain, Dataset B will be made available for research purposes. The results demonstrate an overall improvement by the deep learning approaches when assessed on both datasets in terms of True Positive Fraction, False Positives per image, and F-measure.

  10. Lesion Detection in CT Images Using Deep Learning Semantic Segmentation Technique

    Science.gov (United States)

    Kalinovsky, A.; Liauchuk, V.; Tarasau, A.

    2017-05-01

    In this paper, the problem of automatic detection of tuberculosis lesion on 3D lung CT images is considered as a benchmark for testing out algorithms based on a modern concept of Deep Learning. For training and testing of the algorithms a domestic dataset of 338 3D CT scans of tuberculosis patients with manually labelled lesions was used. The algorithms which are based on using Deep Convolutional Networks were implemented and applied in three different ways including slice-wise lesion detection in 2D images using semantic segmentation, slice-wise lesion detection in 2D images using sliding window technique as well as straightforward detection of lesions via semantic segmentation in whole 3D CT scans. The algorithms demonstrate superior performance compared to algorithms based on conventional image analysis methods.

  11. The impact of noisy and misaligned attenuation maps on human-observer performance at lesion detection in SPECT

    Science.gov (United States)

    Wells, R. G.; Gifford, H. C.; Pretorius, P. H.; Famcombe, T. H.; Narayanan, M. V.; King, M. A.

    2002-06-01

    We have demonstrated an improvement due to attenuation correction (AC) at the task of lesion detection in thoracic SPECT images. However, increased noise in the transmission data due to aging sources or very large patients, and misregistration of the emission and transmission maps, can reduce the accuracy of the AC and may result in a loss of lesion detectability. We investigated the impact of noise in and misregistration of transmission data, on the detection of simulated Ga-67 thoracic lesions. Human-observer localization-receiver-operating-characteristic (LROC) methodology was used to assess performance. Both emission and transmission data were simulated using the MCAT computer phantom. Emission data were reconstructed using OSEM incorporating AC and detector resolution compensation. Clinical noise levels were used in the emission data. The transmission-data noise levels ranged from zero (noise-free) to 32 times the measured clinical levels. Transaxial misregistrations of 0.32, 0.63, and 1.27 cm between emission and transmission data were also examined. Three different algorithms were considered for creating the attenuation maps: filtered backprojection (FBP), unbounded maximum-likelihood (ML), and block-iterative transmission AB (BITAB). Results indicate that a 16-fold increase in the noise was required to eliminate the benefit afforded by AC, when using FBP or ML to reconstruct the attenuation maps. When using BITAB, no significant loss in performance was observed for a 32-fold increase in noise. Misregistration errors are also a concern as even small errors here reduce the performance gains of AC.

  12. Off-site evaluation of liver lesion detection by Gd-BOPTA-enhanced MR imaging

    International Nuclear Information System (INIS)

    Gehl, H.B.; Bourne, M.; Grazioli, L.; Moeller, A.; Lodemann, K.P.

    2001-01-01

    The aim of this study was to determine the efficacy of Gd-BOPTA-enhanced MRI in liver lesion detection in comparison with unenhanced MRI and dynamic CT. The image sets of 148 of 151 patients enrolled in a multicenter German phase-III trial were evaluated by two independent radiologists unaffiliated with the investigating centers. Patients underwent a routine MRI protocol comprising T2- and T1-weighted spin-echo and T1-weighted gradient-echo (GE) sequences pre and 1 h post 0.1 mmol/kg Gd-BOPTA (Bracco-Byk Gulden, Konstanz, Germany). Additionally, a serial T1-weighted GE scan was performed after administration of the first half of the dose. All patients underwent dynamic contrast-enhanced CT. The evaluation was performed with regard to the number and size of lesions detected per patient by each modality or sequence. Furthermore, all pre CM and pre + post CM image sets were analyzed for number of lesions per patient. Both readers detected significantly more lesions in the contrast-enhanced image set compared with the unenhanced image set (32 and 39 %, respectively; p < 0.0001). While contrast-enhanced CT detected a similar number of lesions to unenhanced MRI, it was clearly inferior to contrast-enhanced MRI (reader 1: p = 0.0117; reader 2: p = 0.0225). Of the T1-weighted scans performed, the dynamic and late T1-weighted GE exams contributed most to the increased lesion detection rate (reader 1: p = 0.0007; reader 2: p = 0.0037). The size of the smallest lesion detected by means of MRI was significantly larger in the pre-CM image sets than in the pre + post CM image sets (reader 1: p = 0.001; reader 2: p < 0.0001). Gd-BOPTA-enhanced MRI detected significantly smaller lesions than contrast-enhanced CT (reader 1: p = 0.0117; reader 2: p = 0.0925). Gd-BOPTA-enhanced MR imaging improves liver lesion detection significantly over unenhanced MRI and dynamic CT. (orig.)

  13. Off-site evaluation of liver lesion detection by Gd-BOPTA-enhanced MR imaging

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    Gehl, H.B. [Inst. of Diagnostic Radiology, Medical Univ. of Luebeck (Germany); Bourne, M. [Dept. of Radiology, Univ. Hospital of Wales, Cardiff (United Kingdom); Grazioli, L. [Dept. of Radiology, Univ. of Brescia (Italy); Moeller, A. [MEDIDATA GmbH, Konstanz (Germany); Lodemann, K.P. [BRACCO-BYK GULDEN GmbH, Konstanz (Germany)

    2001-02-01

    The aim of this study was to determine the efficacy of Gd-BOPTA-enhanced MRI in liver lesion detection in comparison with unenhanced MRI and dynamic CT. The image sets of 148 of 151 patients enrolled in a multicenter German phase-III trial were evaluated by two independent radiologists unaffiliated with the investigating centers. Patients underwent a routine MRI protocol comprising T2- and T1-weighted spin-echo and T1-weighted gradient-echo (GE) sequences pre and 1 h post 0.1 mmol/kg Gd-BOPTA (Bracco-Byk Gulden, Konstanz, Germany). Additionally, a serial T1-weighted GE scan was performed after administration of the first half of the dose. All patients underwent dynamic contrast-enhanced CT. The evaluation was performed with regard to the number and size of lesions detected per patient by each modality or sequence. Furthermore, all pre CM and pre + post CM image sets were analyzed for number of lesions per patient. Both readers detected significantly more lesions in the contrast-enhanced image set compared with the unenhanced image set (32 and 39 %, respectively; p < 0.0001). While contrast-enhanced CT detected a similar number of lesions to unenhanced MRI, it was clearly inferior to contrast-enhanced MRI (reader 1: p = 0.0117; reader 2: p = 0.0225). Of the T1-weighted scans performed, the dynamic and late T1-weighted GE exams contributed most to the increased lesion detection rate (reader 1: p = 0.0007; reader 2: p = 0.0037). The size of the smallest lesion detected by means of MRI was significantly larger in the pre-CM image sets than in the pre + post CM image sets (reader 1: p = 0.001; reader 2: p < 0.0001). Gd-BOPTA-enhanced MRI detected significantly smaller lesions than contrast-enhanced CT (reader 1: p = 0.0117; reader 2: p = 0.0925). Gd-BOPTA-enhanced MR imaging improves liver lesion detection significantly over unenhanced MRI and dynamic CT. (orig.)

  14. Lesion detection performance: comparative analysis of low-dose CT data of the chest on two hybrid imaging systems.

    Science.gov (United States)

    Jessop, Maryam; Thompson, John D; Coward, Joanne; Sanderud, Audun; Jorge, José; de Groot, Martijn; Lança, Luís; Hogg, Peter

    2015-03-01

    Incidental findings on low-dose CT images obtained during hybrid imaging are an increasing phenomenon as CT technology advances. Understanding the diagnostic value of incidental findings along with the technical limitations is important when reporting image results and recommending follow-up, which may result in an additional radiation dose from further diagnostic imaging and an increase in patient anxiety. This study assessed lesions incidentally detected on CT images acquired for attenuation correction on two SPECT/CT systems. An anthropomorphic chest phantom containing simulated lesions of varying size and density was imaged on an Infinia Hawkeye 4 and a Symbia T6 using the low-dose CT settings applied for attenuation correction acquisitions in myocardial perfusion imaging. Twenty-two interpreters assessed 46 images from each SPECT/CT system (15 normal images and 31 abnormal images; 41 lesions). Data were evaluated using a jackknife alternative free-response receiver-operating-characteristic analysis (JAFROC). JAFROC analysis showed a significant difference (P detection, with the figures of merit being 0.599 (95% confidence interval, 0.568, 0.631) and 0.810 (95% confidence interval, 0.781, 0.839) for the Infinia Hawkeye 4 and Symbia T6, respectively. Lesion detection on the Infinia Hawkeye 4 was generally limited to larger, higher-density lesions. The Symbia T6 allowed improved detection rates for midsized lesions and some lower-density lesions. However, interpreters struggled to detect small (5 mm) lesions on both image sets, irrespective of density. Lesion detection is more reliable on low-dose CT images from the Symbia T6 than from the Infinia Hawkeye 4. This phantom-based study gives an indication of potential lesion detection in the clinical context as shown by two commonly used SPECT/CT systems, which may assist the clinician in determining whether further diagnostic imaging is justified. © 2015 by the Society of Nuclear Medicine and Molecular Imaging

  15. Imaging inflammatory acne: lesion detection and tracking

    Science.gov (United States)

    Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

    2010-02-01

    It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

  16. Multispectral detection of cutaneous lesions using spectroscopy and microscopy approaches

    Science.gov (United States)

    Borisova, E.; Genova-Hristova, Ts.; Troyanova, P.; Pavlova, E.; Terziev, I.; Semyachkina-Glushkovskaya, O.; Lomova, M.; Genina, E.; Stanciu, G.; Tranca, D.; Avramov, L.

    2018-02-01

    Autofluorescence, diffuse-reflectance and transmission spectral, and microscopic measurements were made on different cutaneous neoplastic lesions, namely basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and dysplastic and benign lesions related. Spectroscopic measurements were made on ex vivo tissue samples, and confocal microscopy investigations were made on thin tissue slices. Fluorescence spectra obtained reveal statistically significant differences between the different benign, dysplastic and malignant lesions by the level of emission intensity, as well by spectral shape, which are fingerprints applicable for differentiation algorithms. In reflectance mode the most significant differences are related to the influence of skin pigments - melanin and hemoglobin. Transmission spectroscopy mode gave complementary optical properties information about the tissue samples investigated to that one of reflectance and absorption spectroscopy. Using autofluorescence detection of skin lesions we obtain very good diagnostic performance for distinguishing of nonmelanoma lesions. Using diffuse reflectance and transmission spectroscopy we obtain significant tool for pigmented pathologies differentiation, but it is a tool with moderate sensitivity for non-melanoma lesions detection. One could rapidly increase the diagnostic accuracy of the received combined "optical biopsy" method when several spectral detection techniques are applied in common algorithm for lesions' differentiation. Specific spectral features observed in each type of lesion investigated on micro and macro level would be presented and discussed. Correlation between the spectral data received and the microscopic features observed would be discussed in the report.

  17. Diagnostic imaging strategy for MDCT- or MRI-detected breast lesions: use of targeted sonography

    International Nuclear Information System (INIS)

    Nakano, Satoko; Ohtsuka, Masahiko; Mibu, Akemi; Karikomi, Masato; Sakata, Hitomi; Yamamoto, Masahiro

    2012-01-01

    Leading-edge technology such as magnetic resonance imaging (MRI) or computed tomography (CT) often reveals mammographically and ultrasonographically occult lesions. MRI is a well-documented, effective tool to evaluate these lesions; however, the detection rate of targeted sonography varies for MRI detected lesions, and its significance is not well established in diagnostic strategy of MRI detected lesions. We assessed the utility of targeted sonography for multidetector-row CT (MDCT)- or MRI-detected lesions in practice. We retrospectively reviewed 695 patients with newly diagnosed breast cancer who were candidates for breast conserving surgery and underwent MDCT or MRI in our hospital between January 2004 and March 2011. Targeted sonography was performed in all MDCT- or MRI-detected lesions followed by imaging-guided biopsy. Patient background, histopathology features and the sizes of the lesions were compared among benign, malignant and follow-up groups. Of the 695 patients, 61 lesions in 56 patients were detected by MDCT or MRI. The MDCT- or MRI-detected lesions were identified by targeted sonography in 58 out of 61 lesions (95.1%). Patients with pathological diagnoses were significantly older and more likely to be postmenopausal than the follow-up patients. Pathological diagnosis proved to be benign in 20 cases and malignant in 25. The remaining 16 lesions have been followed up. Lesion size and shape were not significantly different among the benign, malignant and follow-up groups. Approximately 95% of MDCT- or MRI-detected lesions were identified by targeted sonography, and nearly half of these lesions were pathologically proven malignancies in this study. Targeted sonography is a useful modality for MDCT- or MRI-detected breast lesions

  18. Medical Imaging Lesion Detection Based on Unified Gravitational Fuzzy Clustering

    Directory of Open Access Journals (Sweden)

    Jean Marie Vianney Kinani

    2017-01-01

    Full Text Available We develop a swift, robust, and practical tool for detecting brain lesions with minimal user intervention to assist clinicians and researchers in the diagnosis process, radiosurgery planning, and assessment of the patient’s response to the therapy. We propose a unified gravitational fuzzy clustering-based segmentation algorithm, which integrates the Newtonian concept of gravity into fuzzy clustering. We first perform fuzzy rule-based image enhancement on our database which is comprised of T1/T2 weighted magnetic resonance (MR and fluid-attenuated inversion recovery (FLAIR images to facilitate a smoother segmentation. The scalar output obtained is fed into a gravitational fuzzy clustering algorithm, which separates healthy structures from the unhealthy. Finally, the lesion contour is automatically outlined through the initialization-free level set evolution method. An advantage of this lesion detection algorithm is its precision and its simultaneous use of features computed from the intensity properties of the MR scan in a cascading pattern, which makes the computation fast, robust, and self-contained. Furthermore, we validate our algorithm with large-scale experiments using clinical and synthetic brain lesion datasets. As a result, an 84%–93% overlap performance is obtained, with an emphasis on robustness with respect to different and heterogeneous types of lesion and a swift computation time.

  19. Automated lesion detection on MRI scans using combined unsupervised and supervised methods

    International Nuclear Information System (INIS)

    Guo, Dazhou; Fridriksson, Julius; Fillmore, Paul; Rorden, Christopher; Yu, Hongkai; Zheng, Kang; Wang, Song

    2015-01-01

    Accurate and precise detection of brain lesions on MR images (MRI) is paramount for accurately relating lesion location to impaired behavior. In this paper, we present a novel method to automatically detect brain lesions from a T1-weighted 3D MRI. The proposed method combines the advantages of both unsupervised and supervised methods. First, unsupervised methods perform a unified segmentation normalization to warp images from the native space into a standard space and to generate probability maps for different tissue types, e.g., gray matter, white matter and fluid. This allows us to construct an initial lesion probability map by comparing the normalized MRI to healthy control subjects. Then, we perform non-rigid and reversible atlas-based registration to refine the probability maps of gray matter, white matter, external CSF, ventricle, and lesions. These probability maps are combined with the normalized MRI to construct three types of features, with which we use supervised methods to train three support vector machine (SVM) classifiers for a combined classifier. Finally, the combined classifier is used to accomplish lesion detection. We tested this method using T1-weighted MRIs from 60 in-house stroke patients. Using leave-one-out cross validation, the proposed method can achieve an average Dice coefficient of 73.1 % when compared to lesion maps hand-delineated by trained neurologists. Furthermore, we tested the proposed method on the T1-weighted MRIs in the MICCAI BRATS 2012 dataset. The proposed method can achieve an average Dice coefficient of 66.5 % in comparison to the expert annotated tumor maps provided in MICCAI BRATS 2012 dataset. In addition, on these two test datasets, the proposed method shows competitive performance to three state-of-the-art methods, including Stamatakis et al., Seghier et al., and Sanjuan et al. In this paper, we introduced a novel automated procedure for lesion detection from T1-weighted MRIs by combining both an unsupervised and a

  20. Targeted Ultrasound for MR-Detected Lesions in Breast Cancer Patients

    International Nuclear Information System (INIS)

    Shin, Jung Hee; Han, Boo Kyung; Choe, Yeon Hyeon; Ko, Kyung Ran; Choi, Nami

    2007-01-01

    To investigate the usefulness of targeted ultrasound (US) in the identification of additional suspicious lesions found by magnetic resonance (MR) imaging in breast cancer patients and the changes in treatment based on the identification of the lesions by the use of targeted US. One-hundred forty nine patients who underwent breast MR imaging for a preoperative evaluation of breast cancer between January 2002 and July 2004 were included in the study. We searched all cases for any additional lesions that were found initially by MR imaging and investigated the performance of targeted US in identifying the lesions. We also investigated their pathological outcomes and changes in treatment as a result of lesion identification. Of the 149 patients with breast cancer, additional suspicious lesions were detected with MR imaging in 62 patients (42%). Of the 69 additional lesions found in those 62 patients, 26 (38%) were confirmed as cancers by histology. Thirty-eight lesions in 31 patients were examined with targeted US and were histologically revealed as cancers in 18 (47%), high risk lesions in two (5%), benign lesions in 15 (39%), and unidentified lesions in three (8%). The cancer rate was statistically higher in lesions with a US correlate than in lesions without a US correlate (p = 0.028). Of 31 patients, the surgical plan was altered in 27 (87%). The use of targeted US justified a change in treatment for 22 patients (81%) and misled five patients (19%) into having an unnecessary surgical excision. Targeted US can play a useful role in the evaluation of additional suspicious lesions detected by MR imaging in breast cancer patients, but is limited in lesions without a US correlate

  1. Computerized detection of mass lesions in digital mammograms

    International Nuclear Information System (INIS)

    Yin, F.F.; Giger, M.L.; Doi, K.; Metz, C.E.; Vyborny, C.J.; Schmidt, R.A.

    1989-01-01

    Early detection of breast cancer from the periodic screening of asymptomatic women could reduce breast cancer mortality by at least 40%. The authors are developing a computerized scheme for the detection of mass lesions in digital mammograms as an aid to radiologists in such high volume screening programs. Based on left-right architectural symmetry and gray-level histogram analysis, bilateral subtraction of left and right breast images is performed. False-positive detections included in bilateral-difference images are reduced with various images feature-extraction techniques. The database involves clinical film mammograms digitized by a TV camera and analyzed on a Micro-VAX workstation. Among five different bilateral subtraction techniques investigated, a nonlinear approach provided superior lesion enhancement. Feature-extraction techniques reduced substantially the remaining false-positives. Preliminary results, for 32 pairs of clinical mammograms, yielded a true-positive rate of approximately 95% with a false-positive rate of about 2 per image

  2. Detection of Fundus Lesions Using Classifier Selection

    Science.gov (United States)

    Nagayoshi, Hiroto; Hiramatsu, Yoshitaka; Sako, Hiroshi; Himaga, Mitsutoshi; Kato, Satoshi

    A system for detecting fundus lesions caused by diabetic retinopathy from fundus images is being developed. The system can screen the images in advance in order to reduce the inspection workload on doctors. One of the difficulties that must be addressed in completing this system is how to remove false positives (which tend to arise near blood vessels) without decreasing the detection rate of lesions in other areas. To overcome this difficulty, we developed classifier selection according to the position of a candidate lesion, and we introduced new features that can distinguish true lesions from false positives. A system incorporating classifier selection and these new features was tested in experiments using 55 fundus images with some lesions and 223 images without lesions. The results of the experiments confirm the effectiveness of the proposed system, namely, degrees of sensitivity and specificity of 98% and 81%, respectively.

  3. Optimization of PET system design for lesion detection

    International Nuclear Information System (INIS)

    Qi, Jinyi

    2000-01-01

    Traditionally, the figures of merit used in designing a PET scanner are spatial resolution, noise equivalent count rate, noise equivalent sensitivity, etc. These measures, however, do not directly reflect the lesion detectability using the PET scanner. Here we propose to optimize PET scanner design directly for lesion detection. The signal-to-noise ratio (SNR) of lesion detection can be easily computed using the theoretical expressions that we have previously derived. Because no time consuming Monte Carlo simulation is needed, the theoretical expressions allow evaluation of a large range of parameters. The PET system parameters can then be chosen to achieve the maximum SNR for lesion detection. The simulation study shown in this paper was focused a single ring PET scanner without depth of interaction measurement. Randoms and scatters were also ignored

  4. Automated detection of multiple sclerosis lesions in serial brain MRI

    International Nuclear Information System (INIS)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi; Valls, Laia; Vilanova, Joan C.; Ramio-Torrenta, Lluis; Rovira, Alex

    2012-01-01

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  5. Automated detection of multiple sclerosis lesions in serial brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Valls, Laia [Dr. Josep Trueta University Hospital, Department of Radiology, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2012-08-15

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  6. Automatic Detection of Lung and Liver Lesions in 3-D Positron Emission Tomography Images: A Pilot Study

    Science.gov (United States)

    Lartizien, Carole; Marache-Francisco, Simon; Prost, Rémy

    2012-02-01

    Positron emission tomography (PET) using fluorine-18 deoxyglucose (18F-FDG) has become an increasingly recommended tool in clinical whole-body oncology imaging for the detection, diagnosis, and follow-up of many cancers. One way to improve the diagnostic utility of PET oncology imaging is to assist physicians facing difficult cases of residual or low-contrast lesions. This study aimed at evaluating different schemes of computer-aided detection (CADe) systems for the guided detection and localization of small and low-contrast lesions in PET. These systems are based on two supervised classifiers, linear discriminant analysis (LDA) and the nonlinear support vector machine (SVM). The image feature sets that serve as input data consisted of the coefficients of an undecimated wavelet transform. An optimization study was conducted to select the best combination of parameters for both the SVM and the LDA. Different false-positive reduction (FPR) methods were evaluated to reduce the number of false-positive detections per image (FPI). This includes the removal of small detected clusters and the combination of the LDA and SVM detection maps. The different CAD schemes were trained and evaluated based on a simulated whole-body PET image database containing 250 abnormal cases with 1230 lesions and 250 normal cases with no lesion. The detection performance was measured on a separate series of 25 testing images with 131 lesions. The combination of the LDA and SVM score maps was shown to produce very encouraging detection performance for both the lung lesions, with 91% sensitivity and 18 FPIs, and the liver lesions, with 94% sensitivity and 10 FPIs. Comparison with human performance indicated that the different CAD schemes significantly outperformed human detection sensitivities, especially regarding the low-contrast lesions.

  7. Diagnostic performance of reduced-dose CT with a hybrid iterative reconstruction algorithm for the detection of hypervascular liver lesions: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Nakamoto, Atsushi; Tanaka, Yoshikazu; Juri, Hiroshi; Nakai, Go; Narumi, Yoshifumi [Osaka Medical College, Department of Radiology, Takatsuki, Osaka (Japan); Yoshikawa, Shushi [Osaka Medical College Hospital, Central Radiology Department, Takatsuki, Osaka (Japan)

    2017-07-15

    To investigate the diagnostic performance of reduced-dose CT with a hybrid iterative reconstruction (IR) algorithm for the detection of hypervascular liver lesions. Thirty liver phantoms with or without simulated hypervascular lesions were scanned with a 320-slice CT scanner with control-dose (40 mAs) and reduced-dose (30 and 20 mAs) settings. Control-dose images were reconstructed with filtered back projection (FBP), and reduced-dose images were reconstructed with FBP and a hybrid IR algorithm. Objective image noise and the lesion to liver contrast-to-noise ratio (CNR) were evaluated quantitatively. Images were interpreted independently by 2 blinded radiologists, and jackknife alternative free-response receiver-operating characteristic (JAFROC) analysis was performed. Hybrid IR images with reduced-dose settings (both 30 and 20 mAs) yielded significantly lower objective image noise and higher CNR than control-dose FBP images (P <.05). However, hybrid IR images with reduced-dose settings had lower JAFROC1 figure of merit than control-dose FBP images, although only the difference between 20 mAs images and control-dose FBP images was significant for both readers (P <.01). An aggressive reduction of the radiation dose would impair the detectability of hypervascular liver lesions, although objective image noise and CNR would be preserved by a hybrid IR algorithm. (orig.)

  8. Incidentally Detected Enhancing Breast Lesions on Chest Computed Tomography

    International Nuclear Information System (INIS)

    Lin, Wen Chiung; Hsu, Hsian He; Yu, Jyh Cherng; Hsu, Giu Cheng; Yu, Cheng Ping; Chang, Tsun Hou; Huang, Guo Shu; Li, Chao Shiang

    2011-01-01

    To evaluate the nature and imaging appearance of incidental enhancing breast lesions detected on a routine contrast-enhanced chest CT. Twenty-three patients with incidental enhancing breast lesions on contrast-enhanced chest CT were retrospectively reviewed. The breast lesions were reviewed by unenhanced and enhanced CT, and evaluated by observing the shapes, margins, enhancement patterns and backgrounds of breast lesions. A histopathologic diagnosis or long-term follow-up served as reference standard. Sixteen (70%) patients had malignant breast lesions and seven (30%) had benign lesions. In 10 patients, the breast lesions were exclusively detected on contrast-enhanced CT. Using unenhanced CT, breast lesions with fi broglandular backgrounds were prone to be obscured (p < 0.001). Incidental primary breast cancer showed an non-significant trend of a higher percentage irregular margin (p = 0.056). All of the four incidental breast lesions with non-mass-like enhancement were proven to be malignant. Routine contrast-enhanced chest CT can reveal sufficient details to allow for the detection of unsuspected breast lesions, in which some cases may be proven as malignant. An irregular margin of incidental enhancing breast lesion can be considered a suggestive sign of malignancy

  9. An ensemble deep learning based approach for red lesion detection in fundus images.

    Science.gov (United States)

    Orlando, José Ignacio; Prokofyeva, Elena; Del Fresno, Mariana; Blaschko, Matthew B

    2018-01-01

    Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in the world. Its earliest sign are red lesions, a general term that groups both microaneurysms (MAs) and hemorrhages (HEs). In daily clinical practice, these lesions are manually detected by physicians using fundus photographs. However, this task is tedious and time consuming, and requires an intensive effort due to the small size of the lesions and their lack of contrast. Computer-assisted diagnosis of DR based on red lesion detection is being actively explored due to its improvement effects both in clinicians consistency and accuracy. Moreover, it provides comprehensive feedback that is easy to assess by the physicians. Several methods for detecting red lesions have been proposed in the literature, most of them based on characterizing lesion candidates using hand crafted features, and classifying them into true or false positive detections. Deep learning based approaches, by contrast, are scarce in this domain due to the high expense of annotating the lesions manually. In this paper we propose a novel method for red lesion detection based on combining both deep learned and domain knowledge. Features learned by a convolutional neural network (CNN) are augmented by incorporating hand crafted features. Such ensemble vector of descriptors is used afterwards to identify true lesion candidates using a Random Forest classifier. We empirically observed that combining both sources of information significantly improve results with respect to using each approach separately. Furthermore, our method reported the highest performance on a per-lesion basis on DIARETDB1 and e-ophtha, and for screening and need for referral on MESSIDOR compared to a second human expert. Results highlight the fact that integrating manually engineered approaches with deep learned features is relevant to improve results when the networks are trained from lesion-level annotated data. An open source implementation of our

  10. Generative adversarial networks for brain lesion detection

    Science.gov (United States)

    Alex, Varghese; Safwan, K. P. Mohammed; Chennamsetty, Sai Saketh; Krishnamurthi, Ganapathy

    2017-02-01

    Manual segmentation of brain lesions from Magnetic Resonance Images (MRI) is cumbersome and introduces errors due to inter-rater variability. This paper introduces a semi-supervised technique for detection of brain lesion from MRI using Generative Adversarial Networks (GANs). GANs comprises of a Generator network and a Discriminator network which are trained simultaneously with the objective of one bettering the other. The networks were trained using non lesion patches (n=13,000) from 4 different MR sequences. The network was trained on BraTS dataset and patches were extracted from regions excluding tumor region. The Generator network generates data by modeling the underlying probability distribution of the training data, (PData). The Discriminator learns the posterior probability P (Label Data) by classifying training data and generated data as "Real" or "Fake" respectively. The Generator upon learning the joint distribution, produces images/patches such that the performance of the Discriminator on them are random, i.e. P (Label Data = GeneratedData) = 0.5. During testing, the Discriminator assigns posterior probability values close to 0.5 for patches from non lesion regions, while patches centered on lesion arise from a different distribution (PLesion) and hence are assigned lower posterior probability value by the Discriminator. On the test set (n=14), the proposed technique achieves whole tumor dice score of 0.69, sensitivity of 91% and specificity of 59%. Additionally the generator network was capable of generating non lesion patches from various MR sequences.

  11. Random forest learning of ultrasonic statistical physics and object spaces for lesion detection in 2D sonomammography

    Science.gov (United States)

    Sheet, Debdoot; Karamalis, Athanasios; Kraft, Silvan; Noël, Peter B.; Vag, Tibor; Sadhu, Anup; Katouzian, Amin; Navab, Nassir; Chatterjee, Jyotirmoy; Ray, Ajoy K.

    2013-03-01

    Breast cancer is the most common form of cancer in women. Early diagnosis can significantly improve lifeexpectancy and allow different treatment options. Clinicians favor 2D ultrasonography for breast tissue abnormality screening due to high sensitivity and specificity compared to competing technologies. However, inter- and intra-observer variability in visual assessment and reporting of lesions often handicaps its performance. Existing Computer Assisted Diagnosis (CAD) systems though being able to detect solid lesions are often restricted in performance. These restrictions are inability to (1) detect lesion of multiple sizes and shapes, and (2) differentiate between hypo-echoic lesions from their posterior acoustic shadowing. In this work we present a completely automatic system for detection and segmentation of breast lesions in 2D ultrasound images. We employ random forests for learning of tissue specific primal to discriminate breast lesions from surrounding normal tissues. This enables it to detect lesions of multiple shapes and sizes, as well as discriminate between hypo-echoic lesion from associated posterior acoustic shadowing. The primal comprises of (i) multiscale estimated ultrasonic statistical physics and (ii) scale-space characteristics. The random forest learns lesion vs. background primal from a database of 2D ultrasound images with labeled lesions. For segmentation, the posterior probabilities of lesion pixels estimated by the learnt random forest are hard thresholded to provide a random walks segmentation stage with starting seeds. Our method achieves detection with 99.19% accuracy and segmentation with mean contour-to-contour error < 3 pixels on a set of 40 images with 49 lesions.

  12. Temporal characteristics of radiologists’ and novices’ lesion detection in viewing medical images presented rapidly and sequentially

    Directory of Open Access Journals (Sweden)

    Ryoichi Nakashima

    2016-10-01

    Full Text Available Although viewing multiple stacks of medical images presented on a display is a relatively new but useful medical task, little is known about this task. Particularly, it is unclear how radiologists search for lesions in this type of image reading. When viewing cluttered and dynamic displays, continuous motion itself does not capture attention. Thus, it is effective for the target detection that observers’ attention is captured by the onset signal of a suddenly appearing target among the continuously moving distractors (i.e., a passive viewing strategy. This can be applied to stack viewing tasks, because lesions often show up as transient signals in medical images which are sequentially presented simulating a dynamic and smoothly transforming image progression of organs. However, it is unclear whether observers can detect a target when the target appears at the beginning of a sequential presentation where the global apparent motion onset signal (i.e., signal of the initiation of the apparent motion by sequential presentation occurs. We investigated the ability of radiologists to detect lesions during such tasks by comparing the performances of radiologists and novices. Results show that overall performance of radiologists is better than novices. Furthermore, the temporal locations of lesions in CT image sequences, i.e., when a lesion appears in an image sequence, does not affect the performance of radiologists, whereas it does affect the performance of novices. Results indicate that novices have greater difficulty in detecting a lesion appearing early than late in the image sequence. We suggest that radiologists have other mechanisms to detect lesions in medical images with little attention which novices do not have. This ability is critically important when viewing rapid sequential presentations of multiple CT images, such as stack viewing tasks.

  13. Detecting circumscribed lesions with the Hough transform

    Energy Technology Data Exchange (ETDEWEB)

    Groshong, B.R; Kegelmeyer, W.P., Jr

    1996-01-11

    We have designed and implemented a circumscribed lesion detection algorithm, based on the Hough Transform, which will detect zero or more approximately circular structures in a mammogram over a range of radii from a few pixels to nearly the size of the breast. We address the geometrical behavior of peaks in Hough parameter space (x,y,r) for both the true radius of a circular structure in the image (r = r{sub o}), and for the parameter r as it passes through this radius. In addition, we evaluate peaks in Hough parameter space by re-analyzing the underlying mammogram in the vicinity of the circular disk indicated by the peak. Discs suggested by the resulting peaks are accumulated in a feature image, scaled by a measure of their quality. These results are then rectified with respect to image contrast extremes and average value. The result is a feature with a continuously scaled pixel level output which suggests the likelihood that a pixel is located inside a circular structure, irrespective of the radius of the structure and overall mammogram contrast. These features are evaluated fast qualitative and quantitative performance metrics which permit circumscribed lesion detection features to be initially evaluated without a full end-to-end classification experiment.

  14. Management of breast lesions detectable only on MRI

    International Nuclear Information System (INIS)

    Siegmann-Luz, K.C.; Bahrs, S.D.; Preibsch, H.; Hattermann, V.; Claussen, C.D.

    2014-01-01

    Breast MR imaging has become established as the most sensitive imaging method for diagnosing breast cancer. As a result of the increasing examination volume and improved image quality, the number of breast lesions detected only on MRI and requiring further clarification has risen in recent years. According to the S3-guideline 'Diagnosis, Therapy, and Follow-Up of Breast Cancer' as revised in July 2012, institutions performing breast MRI should provide the option of an MRI-guided intervention for clarification. This review describes the indications, methods and results of MRI-guided interventions for the clarification of breast lesions only visible on MRI. Recent guidelines and study results are also addressed and alternative methods and pitfalls are presented. (orig.)

  15. Comparison of SPECT/CT and MRI in diagnosing symptomatic lesions in ankle and foot pain patients: diagnostic performance and relation to lesion type.

    Science.gov (United States)

    Ha, Seunggyun; Hong, Sung Hwan; Paeng, Jin Chul; Lee, Dong Yeon; Cheon, Gi Jeong; Arya, Amitabh; Chung, June-Key; Lee, Dong Soo; Kang, Keon Wook

    2015-01-01

    The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types. Fifty consecutive patients with ankle and foot pain, who underwent 99mTc-MDP SPECT/CT and MRI, were retrospectively enrolled in this study. Symptomatic lesions were determined based on clinical examination and response to treatment. On MRI and SPECT/CT, detected lesions were classified as bone, ligament/tendon, and joint lesions. Uptake on SPECT/CT was assessed using a 4-grade system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT/CT and MRI were evaluated in all detected lesions and each lesion type. Diagnostic value of uptake grade was analyzed using receiver-operating characteristics (ROC) curve analysis, and diagnostic performance was compared using Chi-square or McNemar tests. In overall lesions, the sensitivity, PPV and NPV of SPECT/CT for symptomatic lesions were 93%, 56%, 91%, and they were 98%, 48%, 95% for MRI. There was no significant difference between SPECT/CT and MRI. However, the specificity of SPECT/CT was significantly higher than that of MRI (48% versus 24%, P = 0.016). Uptake grade on SPECT/CT was significantly higher in symptomatic lesions (P diagnostic performance for symptomatic lesions in ankle and foot pain patients. SPECT/CT and MRI exhibit different diagnostic specificity in different lesion types. SPECT/CT may be used as a complementary imaging method to MRI for enhancing diagnostic specificity.

  16. Comparison of AMI-25 enhanced MRI and helical dynamic CT in the detection of hepatic lesions

    International Nuclear Information System (INIS)

    Saitou, Kazuhiro; Matsuda, Hiromichi; Fukushima, Hiroaki; Kanzaki, Hiroshi; Hirose, Takashi; Karizaki, Dai; Abe, Kimihiko; Amino, Saburou

    1994-01-01

    We performed AMI-25 enhanced MRI and helical dynamic CT in 12 cases of hepatic lesions. Nine of these were hepatocellular carcinomas. Two cases were metastatic liver tumors (the primary lesion was gastric in one and the other was gallbladder cancer). One case was suspected to be adenomatous hyperplasia. Thirty-two lesions were detected in T2-weighted SE images before AMI-25 administration, while 46 lesions were detected in AMI-25 enhanced MRI images. In particular, AMI-25 enhanced MRI was superior to plain MRI in lesions less than 10 mm in size. A total of 48 lesions were detected in helical dynamic CT. Although AMI-25 enhanced MRI almost equaled helical dynamic CT in the detection of liver tumors, helical dynamic CT was slightly superior to AMI-25 enhanced MRI in the detection of subphrenic lesions. It was possible to know the hemodynamics in each hepatic lesion by helical dynamic CT. AMI-25 enhanced MRI was useful to know the inclusion of reticuloendothelial system, and that yielded different diagnoses in adenomatous hyperplasia and well differentiated hepatocellular carcinoma. Helical dynamic CT was useful for qualitative diagnosis. Both AMI-25 enhanced MRI and helical dynamic CT contributed to the detection of liver tumor and qualitative diagnosis. (author)

  17. Contralateral lesions detected by preoperative MRI in patients with recently diagnosed breast cancer: Application of MR CAD in differentiation of benign and malignant lesions

    International Nuclear Information System (INIS)

    Cho, Nariya; Kim, Sun Mi; Park, Jeong Seon; Jang, Mijung; Kim, Soo-Yeon; Chang, Jung Min; Moon, Woo Kyung

    2012-01-01

    Objectives: To retrospectively investigate the added value of kinetic features measured by computer-aided diagnosis (CAD) for differentiating benign and malignant contralateral breast lesions detected by preoperative MRI in breast cancer patients. Methods: This study was approved by our institutional review board, and the requirement for informed consent was waived. Fifty-two breast MR images and their CAD kinetic features were obtained for 52 consecutive breast cancer patients with contralateral breast lesions detected by preoperative MRI and confirmed by excision (23 cancers and 29 benign lesions). Three experienced radiologists independently reviewed the MR images without CAD information and assessed probabilities of malignancy. Four weeks later, these probabilities were reanalyzed using stored CAD data. Diagnostic performances and detection rates of delayed washout components were compared between interpretations without and with CAD for each reader. Results: Use of MR CAD increased detection of washout component by 2.4- to 3.7-fold than visual assessment for enhancing contralateral lesions, which increased sensitivity (91% vs. 87% in reader 1; 96% vs. 74% in reader 2; 91% vs. 70% in reader 3) and decreased specificity, but statistical significance was only found for decreased specificity in one reader (52% vs. 28%, P = 0.039), and overall performance (areas under ROC curves 0.672 vs. 0.616 in reader 1; 0.624 vs. 0.603 in reader 2; 0.706 vs. 0.590 in reader 3) remained unimproved. Conclusion: Addition of MR CAD increased sensitivity and decreased specificity than radiologist's assessment alone for differentiating benign and malignant contralateral lesions in breast cancer patients and overall performance remained unimproved.

  18. Correlation between model observer and human observer performance in CT imaging when lesion location is uncertain

    Energy Technology Data Exchange (ETDEWEB)

    Leng, Shuai; Yu, Lifeng; Zhang, Yi; McCollough, Cynthia H. [Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905 (United States); Carter, Rickey [Department of Biostatistics, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905 (United States); Toledano, Alicia Y. [Biostatistics Consulting, LLC, 10606 Wheatley Street, Kensington, Maryland 20895 (United States)

    2013-08-15

    Purpose: The purpose of this study was to investigate the correlation between model observer and human observer performance in CT imaging for the task of lesion detection and localization when the lesion location is uncertain.Methods: Two cylindrical rods (3-mm and 5-mm diameters) were placed in a 35 × 26 cm torso-shaped water phantom to simulate lesions with −15 HU contrast at 120 kV. The phantom was scanned 100 times on a 128-slice CT scanner at each of four dose levels (CTDIvol = 5.7, 11.4, 17.1, and 22.8 mGy). Regions of interest (ROIs) around each lesion were extracted to generate images with signal-present, with each ROI containing 128 × 128 pixels. Corresponding ROIs of signal-absent images were generated from images without lesion mimicking rods. The location of the lesion (rod) in each ROI was randomly distributed by moving the ROIs around each lesion. Human observer studies were performed by having three trained observers identify the presence or absence of lesions, indicating the lesion location in each image and scoring confidence for the detection task on a 6-point scale. The same image data were analyzed using a channelized Hotelling model observer (CHO) with Gabor channels. Internal noise was added to the decision variables for the model observer study. Area under the curve (AUC) of ROC and localization ROC (LROC) curves were calculated using a nonparametric approach. The Spearman's rank order correlation between the average performance of the human observers and the model observer performance was calculated for the AUC of both ROC and LROC curves for both the 3- and 5-mm diameter lesions.Results: In both ROC and LROC analyses, AUC values for the model observer agreed well with the average values across the three human observers. The Spearman's rank order correlation values for both ROC and LROC analyses for both the 3- and 5-mm diameter lesions were all 1.0, indicating perfect rank ordering agreement of the figures of merit (AUC

  19. Automated detection of Lupus white matter lesions in MRI

    Directory of Open Access Journals (Sweden)

    Eloy Roura Perez

    2016-08-01

    Full Text Available Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML. In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM, gray matter (GM and cerebrospinal fluid (CSF, while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative and quantitative results in terms of precision and sensitivity of lesion detection (True Positive Rate (62% and Positive Prediction Value (80% respectively as well as segmentation accuracy (Dice Similarity Coefficient (72%. Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration.

  20. Theoretical Analysis of Penalized Maximum-Likelihood Patlak Parametric Image Reconstruction in Dynamic PET for Lesion Detection.

    Science.gov (United States)

    Yang, Li; Wang, Guobao; Qi, Jinyi

    2016-04-01

    Detecting cancerous lesions is a major clinical application of emission tomography. In a previous work, we studied penalized maximum-likelihood (PML) image reconstruction for lesion detection in static PET. Here we extend our theoretical analysis of static PET reconstruction to dynamic PET. We study both the conventional indirect reconstruction and direct reconstruction for Patlak parametric image estimation. In indirect reconstruction, Patlak parametric images are generated by first reconstructing a sequence of dynamic PET images, and then performing Patlak analysis on the time activity curves (TACs) pixel-by-pixel. In direct reconstruction, Patlak parametric images are estimated directly from raw sinogram data by incorporating the Patlak model into the image reconstruction procedure. PML reconstruction is used in both the indirect and direct reconstruction methods. We use a channelized Hotelling observer (CHO) to assess lesion detectability in Patlak parametric images. Simplified expressions for evaluating the lesion detectability have been derived and applied to the selection of the regularization parameter value to maximize detection performance. The proposed method is validated using computer-based Monte Carlo simulations. Good agreements between the theoretical predictions and the Monte Carlo results are observed. Both theoretical predictions and Monte Carlo simulation results show the benefit of the indirect and direct methods under optimized regularization parameters in dynamic PET reconstruction for lesion detection, when compared with the conventional static PET reconstruction.

  1. A subtraction pipeline for automatic detection of new appearing multiple sclerosis lesions in longitudinal studies

    Energy Technology Data Exchange (ETDEWEB)

    Ganiler, Onur; Oliver, Arnau; Diez, Yago; Freixenet, Jordi; Llado, Xavier [University of Girona, VICOROB Computer Vision and Robotics Group, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Beltran, Brigitte [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2014-05-15

    Time-series analysis of magnetic resonance images (MRI) is of great value for multiple sclerosis (MS) diagnosis and follow-up. In this paper, we present an unsupervised subtraction approach which incorporates multisequence information to deal with the detection of new MS lesions in longitudinal studies. The proposed pipeline for detecting new lesions consists of the following steps: skull stripping, bias field correction, histogram matching, registration, white matter masking, image subtraction, automated thresholding, and postprocessing. We also combine the results of PD-w and T2-w images to reduce false positive detections. Experimental tests are performed in 20 MS patients with two temporal studies separated 12 (12M) or 48 (48M) months in time. The pipeline achieves very good performance obtaining an overall sensitivity of 0.83 and 0.77 with a false discovery rate (FDR) of 0.14 and 0.18 for the 12M and 48M datasets, respectively. The most difficult situation for the pipeline is the detection of very small lesions where the obtained sensitivity is lower and the FDR higher. Our fully automated approach is robust and accurate, allowing detection of new appearing MS lesions. We believe that the pipeline can be applied to large collections of images and also be easily adapted to monitor other brain pathologies. (orig.)

  2. Fully automatic detection of deep white matter T1 hypointense lesions in multiple sclerosis

    Science.gov (United States)

    Spies, Lothar; Tewes, Anja; Suppa, Per; Opfer, Roland; Buchert, Ralph; Winkler, Gerhard; Raji, Alaleh

    2013-12-01

    A novel method is presented for fully automatic detection of candidate white matter (WM) T1 hypointense lesions in three-dimensional high-resolution T1-weighted magnetic resonance (MR) images. By definition, T1 hypointense lesions have similar intensity as gray matter (GM) and thus appear darker than surrounding normal WM in T1-weighted images. The novel method uses a standard classification algorithm to partition T1-weighted images into GM, WM and cerebrospinal fluid (CSF). As a consequence, T1 hypointense lesions are assigned an increased GM probability by the standard classification algorithm. The GM component image of a patient is then tested voxel-by-voxel against GM component images of a normative database of healthy individuals. Clusters (≥0.1 ml) of significantly increased GM density within a predefined mask of deep WM are defined as lesions. The performance of the algorithm was assessed on voxel level by a simulation study. A maximum dice similarity coefficient of 60% was found for a typical T1 lesion pattern with contrasts ranging from WM to cortical GM, indicating substantial agreement between ground truth and automatic detection. Retrospective application to 10 patients with multiple sclerosis demonstrated that 93 out of 96 T1 hypointense lesions were detected. On average 3.6 false positive T1 hypointense lesions per patient were found. The novel method is promising to support the detection of hypointense lesions in T1-weighted images which warrants further evaluation in larger patient samples.

  3. Automatic segmentation of lesions for the computer-assisted detection in fluorescence urology

    Science.gov (United States)

    Kage, Andreas; Legal, Wolfgang; Kelm, Peter; Simon, Jörg; Bergen, Tobias; Münzenmayer, Christian; Benz, Michaela

    2012-03-01

    Bladder cancer is one of the most common cancers in the western world. The diagnosis in Germany is based on the visual inspection of the bladder. This inspection performed with a cystoscope is a challenging task as some kinds of abnormal tissues do not differ much in their appearance from their surrounding healthy tissue. Fluorescence Cystoscopy has the potential to increase the detection rate. A liquid marker introduced into the bladder in advance of the inspection is concentrated in areas with high metabolism. Thus these areas appear as bright "glowing". Unfortunately, the fluorescence image contains besides the glowing of the suspicious lesions no more further visual information like for example the appearance of the blood vessels. A visual judgment of the lesion as well as a precise treatment has to be done using white light illumination. Thereby, the spatial information of the lesion provided by the fluorescence image has to be guessed by the clinical expert. This leads to a time consuming procedure due to many switches between the modalities and increases the risk of mistreatment. We introduce an automatic approach, which detects and segments any suspicious lesion in the fluorescence image automatically once the image was classified as a fluorescence image. The area of the contour of the detected lesion is transferred to the corresponding white light image and provide the clinical expert the spatial information of the lesion. The advantage of this approach is, that the clinical expert gets the spatial and the visual information of the lesion together in one image. This can save time and decrease the risk of an incomplete removal of a malign lesion.

  4. Differentiation of thyroid lesion detected by FDG PET/CT using SUV ratio

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    We investigated the usefulness of SUV ratio to discriminate focal thyroid lesion incidentally detected on 18F-FDG PET/CT (FDG PET) in patients with malignant disease. A total of 2167 subjects with malignant tumor underwent PET/CT for staging. Forty-five of 2167 subjects (2.1%) showed hypermetabolic thyroid lesions on FDG PET. Of 45, 21 lesions were confirmed by pathology (n = 16) or follow up exam (n=5). Seventeen patients had focal FDG uptakes, while 4 patients had diffuse thyroid uptakes. Standardized uptake value (SUV) was measured by drawing region of interest (ROI) on bilateral thyroid lobes and liver. From 21 patients, 12 thyroid lesions were confirmed as malignant lesions and 9 lesions as benign lesions. All of bilateral thyroid FDG uptakes were determined as benign disease such as thyroiditis. From seventeen focal thyroid incidentaloma, FDG PET had 100 % (12/12) of sensitivity and 60 % (3/5) of specificity, retrospectively. Malignant nodules had a significantly higher lesion to liver ratio than those of benign nodules (2.10.9 vs. 1.20.6, p=0.029). With ROC curve, the best cut-off value of lesion to liver was 1.0 with sensitivity of 100% and specificity of 60 % (area under the curve=0.783). The SUV ratio of lesion to contralateral lobe do not have statistical significance to determine malignancy (3.72.1 vs. 2.61.7, p=0.079). This study showed that focal thyroidal FDG uptake detected by FDG PET could be differentiated with best performance by SUV ratio of lesion to liver.

  5. Fast approach to evaluate MAP reconstruction for lesion detection and localization

    International Nuclear Information System (INIS)

    Qi, Jinyi; Huesman, Ronald H.

    2004-01-01

    Lesion detection is an important task in emission tomography. Localization ROC (LROC) studies are often used to analyze the lesion detection and localization performance. Most researchers rely on Monte Carlo reconstruction samples to obtain LROC curves, which can be very time-consuming for iterative algorithms. In this paper we develop a fast approach to obtain LROC curves that does not require Monte Carlo reconstructions. We use a channelized Hotelling observer model to search for lesions, and the results can be easily extended to other numerical observers. We theoretically analyzed the mean and covariance of the observer output. Assuming the observer outputs are multivariate Gaussian random variables, an LROC curve can be directly generated by integrating the conditional probability density functions. The high-dimensional integrals are calculated using a Monte Carlo method. The proposed approach is very fast because no iterative reconstruction is involved. Computer simulations show that the results of the proposed method match well with those obtained using the tradition LROC analysis

  6. Importance of Defect Detectability in Positron Emission Tomography Imaging of Abdominal Lesions

    International Nuclear Information System (INIS)

    Yamashita, Shozo; Yokoyama, Kunihiko; Onoguchi, Masahisa; Yamamoto, Haruki; Nakaichi, Tetsu; Tsuji, Shiro; Nakajima, Kenichi

    2015-01-01

    This study was designed to assess defect detectability in positron emission tomography (PET) imaging of abdominal lesions. A National Electrical Manufactures Association International Electrotechnical Commission phantom was used. The simulated abdominal lesion was scanned for 10 min using dynamic list-mode acquisition method. Images, acquired with scan duration of 1-10 min, were reconstructed using VUE point HD and a 4.7 mm full-width at half-maximum (FWHM) Gaussian filter. Iteration-subset combinations of 2-16 and 2-32 were used. Visual and physical analyses were performed using the acquired images. To sequentially evaluate defect detectability in clinical settings, we examined two middle-aged male subjects. One had a liver cyst (approximately 10 mm in diameter) and the other suffered from pancreatic cancer with an inner defect region (approximately 9 mm in diameter). In the phantom study, at least 6 and 3 min acquisition durations were required to visualize 10 and 13 mm defect spheres, respectively. On the other hand, spheres with diameters ≥17 mm could be detected even if the acquisition duration was only 1 min. The visual scores were significantly correlated with background (BG) variability. In clinical settings, the liver cyst could be slightly visualized with an acquisition duration of 6 min, although image quality was suboptimal. For pancreatic cancer, the acquisition duration of 3 min was insufficient to clearly describe the defect region. The improvement of BG variability is the most important factor for enhancing lesion detection. Our clinical scan duration (3 min/bed) may not be suitable for the detection of small lesions or accurate tumor delineation since an acquisition duration of at least 6 min is required to visualize 10 mm lesions, regardless of reconstruction parameters. Improvements in defect detectability are important for radiation treatment planning and accurate PET-based diagnosis

  7. Evaluation of the application of chemical shift for the detection of lipid in brain lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lim, C.J. [Department of Biomedical Imaging, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur (Malaysia); Ng, K.H., E-mail: ngkh@um.edu.m [Department of Biomedical Imaging, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur (Malaysia); Ramli, N.; Azman, R.R. [Department of Biomedical Imaging, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur (Malaysia)

    2011-02-15

    Non-invasive detection of the presence of lipids is particularly important in staging of intracranial tumours. Presence of lipid peak in aggressive intracranial tumours has been reported widely using MR spectroscopy. However this method has limitation due to long imaging time and artefacts formed by adjacent bones. Chemical shift MR imaging (with has shorter imaging time) is an alternative method that had been used to detect presence of lipid in vivo by means of signal intensity loss. The purpose of this study was to evaluate gradient echo in- and opposed-phase chemical shift pulse sequences for detection of lipid elements in brain lesion. Ten cylindered phantoms measuring 3 x 3 cm were filled with various mixtures of lipid and water: 0-90% lipid, in 10% step by weight. The gradient echo in- and opposed-phase chemical shift sequences were performed using a 1.5 T MRI (Magnetom Vision, Siemens) with a head coil. In addition, we performed MRI and chemical shift studies on 32 patients with brain lesion. We then analysed the association between out of phase intensity value and classification of the lesions. For phantom containing 50% lipid, maximum signal loss on opposed-phase images was observed. There were significant differences between in- and opposed-phase lipid-water phantom images (P = 0.0054). Most of the benign lesions fall into the positive out of phase intensity value, and malignant lesions fall into negative out of phase intensity value. We conclude that chemical shift artefact can be applied in detecting and characterising lipid elements in brain lesion.

  8. Evaluation of the application of chemical shift for the detection of lipid in brain lesion

    International Nuclear Information System (INIS)

    Lim, C.J.; Ng, K.H.; Ramli, N.; Azman, R.R.

    2011-01-01

    Non-invasive detection of the presence of lipids is particularly important in staging of intracranial tumours. Presence of lipid peak in aggressive intracranial tumours has been reported widely using MR spectroscopy. However this method has limitation due to long imaging time and artefacts formed by adjacent bones. Chemical shift MR imaging (with has shorter imaging time) is an alternative method that had been used to detect presence of lipid in vivo by means of signal intensity loss. The purpose of this study was to evaluate gradient echo in- and opposed-phase chemical shift pulse sequences for detection of lipid elements in brain lesion. Ten cylindered phantoms measuring 3 x 3 cm were filled with various mixtures of lipid and water: 0-90% lipid, in 10% step by weight. The gradient echo in- and opposed-phase chemical shift sequences were performed using a 1.5 T MRI (Magnetom Vision, Siemens) with a head coil. In addition, we performed MRI and chemical shift studies on 32 patients with brain lesion. We then analysed the association between out of phase intensity value and classification of the lesions. For phantom containing 50% lipid, maximum signal loss on opposed-phase images was observed. There were significant differences between in- and opposed-phase lipid-water phantom images (P = 0.0054). Most of the benign lesions fall into the positive out of phase intensity value, and malignant lesions fall into negative out of phase intensity value. We conclude that chemical shift artefact can be applied in detecting and characterising lipid elements in brain lesion.

  9. Detection and classification of retinal lesions for grading of diabetic retinopathy.

    Science.gov (United States)

    Usman Akram, M; Khalid, Shehzad; Tariq, Anam; Khan, Shoab A; Azam, Farooque

    2014-02-01

    Diabetic Retinopathy (DR) is an eye abnormality in which the human retina is affected due to an increasing amount of insulin in blood. The early detection and diagnosis of DR is vital to save the vision of diabetes patients. The early signs of DR which appear on the surface of the retina are microaneurysms, haemorrhages, and exudates. In this paper, we propose a system consisting of a novel hybrid classifier for the detection of retinal lesions. The proposed system consists of preprocessing, extraction of candidate lesions, feature set formulation, and classification. In preprocessing, the system eliminates background pixels and extracts the blood vessels and optic disc from the digital retinal image. The candidate lesion detection phase extracts, using filter banks, all regions which may possibly have any type of lesion. A feature set based on different descriptors, such as shape, intensity, and statistics, is formulated for each possible candidate region: this further helps in classifying that region. This paper presents an extension of the m-Mediods based modeling approach, and combines it with a Gaussian Mixture Model in an ensemble to form a hybrid classifier to improve the accuracy of the classification. The proposed system is assessed using standard fundus image databases with the help of performance parameters, such as, sensitivity, specificity, accuracy, and the Receiver Operating Characteristics curves for statistical analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Assessment of the breath motion correction on the detectability of lesions in PET oncology

    International Nuclear Information System (INIS)

    Marache-Francisco, S.

    2012-02-01

    Positron emission tomography (PET) is a nuclear medicine imaging technique that produces a three-dimensional image of functional processes in the body. The system detects pairs of gamma rays emitted by a tracer, which is introduced into the body. Three-dimensional images of tracer concentration within the body are then constructed by computer analysis. Respiratory motion in emission tomography leads to image blurring especially in the lower thorax and the upper abdomen, influencing this way the quantitative accuracy of PET measurements as well as leading to a loss of sensitivity in lesion detection. Although PET exams are getting shorter thanks to the improvement of scanner sensitivity, the current 2-3 minutes acquisitions per bed position are not yet compatible with patient breath-holding. Performing accurate respiratory motion correction without impairing the standard clinical protocol, i.e. without increasing the acquisition time, thus remains challenging. Different types of respiratory motion correction approaches have been proposed, mostly based on the use of non-rigid deformation fields either applied to the gated PET images or integrated during an iterative reconstruction algorithm. Evaluation of theses methods has been mainly focusing on the quantification and localization accuracy of small lesions, but their impact on the clinician detection performance during the diagnostic task has not been fully investigated yet. The purpose of this study is to address this question based on a computer assisted detection study. We evaluate the influence of two motion correction methods on the detection of small lesions in human oncology FDG PET images. This study is based on a series of realistic simulated whole-body FDG images based on the XCAT model. Detection performance is evaluated with a computer-aided detection system that we are developing for whole-body PET/CT images. Detection performances achieved with these two correction methods are compared with those

  11. Red lesion detection using background estimation and lesions characteristics in diabetic retinal image

    Science.gov (United States)

    Zhang, Dongbo; Peng, Yinghui; Yi, Yao; Shang, Xingyu

    2013-10-01

    Detection of red lesions [hemorrhages (HRs) and microaneurysms (MAs)] is crucial for the diagnosis of early diabetic retinopathy. A method based on background estimation and adapted to specific characteristics of HRs and MAs is proposed. Candidate red lesions are located by background estimation and Mahalanobis distance measure and then some adaptive postprocessing techniques, which include vessel detection, nonvessel exclusion based on shape analysis, and noise points exclusion by double-ring filter (only used for MAs detection), are conducted to remove nonlesion pixels. The method is evaluated on our collected image dataset, and experimental results show that it is better than or approximate to other previous approaches. It is effective to reduce the false-positive and false-negative results that arise from incomplete and inaccurate vessel structure.

  12. Role of multidetector computed tomography in evaluating incidentally detected breast lesions.

    Science.gov (United States)

    Moschetta, Marco; Scardapane, Arnaldo; Lorusso, Valentina; Rella, Leonarda; Telegrafo, Michele; Serio, Gabriella; Angelelli, Giuseppe; Ianora, Amato Antonio Stabile

    2015-01-01

    Computed tomography (CT) does not represent the primary method for the evaluation of breast lesions; however, it can detect breast abnormalities, even when performed for other reasons related to thoracic structures. The aim of this study is to evaluate the potential benefits of 320-row multidetector CT (MDCT) in evaluating and differentiating incidentally detected breast lesions by using vessel probe and 3D analysis software with net enhancement value. Sixty-two breast lesions in 46 patients who underwent 320-row chest CT examination were retrospectively evaluated. CT scans were assessed searching for the presence, location, number, morphological features, and density of breast nodules. Net enhancement was calculated by subtracting precontrast density from the density obtained by postcontrast values. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT were calculated for morphological features and net enhancement. Thirty of 62 lesions were found to be malignant at histological examination and 32 were found to be benign. When morphological features were considered, the sensitivity, specificity, accuracy, PPV, and NPV of CT were 87%, 100%, 88%, 100%, and 50%, respectively. Based on net enhancement, CT reached a sensitivity, specificity, accuracy, PPV, and NPV of 100%, 94%, 97%, 94%, and 100%, respectively. MDCT allows to recognize and characterize breast lesions based on morphological features. Net enhancement can be proposed as an additional accurate feature of CT.

  13. Accuracy of the detection of infratentorial stroke lesions using perfusion CT: an experimenter-blinded study

    International Nuclear Information System (INIS)

    Lee, In Hyouk; Kim, Myung Soon; Kim, Young Ju; Lee, Myeong Sub; You, Joshua H.; Lee, Ji Yong; Whang, Kum

    2010-01-01

    Although perfusion CT (PCT) for the detection of supratentorial stroke is well established, there is a dearth of evidence of its effectiveness in the detection of infratentorial stroke. Hence, this study compared sensitivity, specificity, and accuracy of PCT maps between infratentorial and supratentorial stroke lesions. One hundred patients with acute stroke who had successfully undergone near whole-brain PCT with the toggling table technique and follow-up MRI were included. Wilcoxon Mann-Whitney test was performed at P 0.01 in all PCT maps) between supratentorial and infratentorial stroke. Also, there was no remarkable difference in both sensitivity and specificity of PCT maps. This was the first study to investigate the accuracy of PCT with the toggling table technique in detection of infratentorial stroke lesions. Clinically, PCT is highly reliable and accurate in detecting infratentorial stroke lesions. (orig.)

  14. Optimal reconstructed section thickness for the detection of liver lesions with multidetector CT

    International Nuclear Information System (INIS)

    Soo, G.; Lau, K.K.; Yik, T.; Kutschera, P.

    2010-01-01

    Aim: To evaluate the impact of different reconstructed section thicknesses on liver lesion detection using multidetector computed tomography (CT). Methods: Fifty-three patients were examined using a 16-section CT machine with axial reconstructions provided at 2.5, 5, 7.5, and 10 mm section thicknesses. Images of different reconstructed section thicknesses from different patients were presented in random order to three independent, blinded radiologists for review at multiple sessions. All images were then reviewed by three radiologists in a common session. Consensus was reached following review of the previous interpretation results and results of follow-up imaging regarding the number of true liver lesions (n = 101) for comparison. Results: Mean detection rates were as follows: 93/101 lesions detected with the 2.5 mm section thickness, 98/101 lesions detected at the 5 mm section thickness, 78/101 lesions detected at the 7.5 mm section thickness, and 54/101 lesions detected at the 10 mm section thickness. Lesions missed at the 2.5 mm section thickness were due to masking by image noise. There was particular difficulty detecting subcapsular lesions and lesions adjacent to fissures or the gall bladder at the 7.5 mm and 10 mm section thicknesses. Conclusion: The optimal reconstructed section thickness for lesion detection in the liver was 5 mm.

  15. Evaluation of the Significance of Incidental Breast Lesions Detected by Chest CT

    International Nuclear Information System (INIS)

    Kim, Jae Hyun; Chang, Yun Woo; Hwang, Jung Hwa; Kim, Hyung Hwan; Lee, Eun Hye; Yang, Seung Boo

    2013-01-01

    To evaluate the significance of incidentally detected breast lesions on a chest CT scan. Thirty-six incidental breast lesions in 26 patients were detected on a chest CT scan and were correlated with breast sonography, retrospectively. Among them, twenty-four breast lesions in 20 patients that were correlated with chest CT and sonography were available to pathology or follow up sonography. The CT findings were compared with sonographic findings according to the pathologic results. Incidentally detected breast lesions on a chest CT scan were correlated with sonography in 86% (31/36). Among 24 lesions that were available to pathology or follow up sonography, seven (29.2%) lesions were malignant and 17 (70.8%) lesions were benign. CT revealed a significant difference between benign and malignant lesions in terms of shape and margin (p = 0.007; p = 0.008, respectively). The CT findings were well correlated with sonographic findings in shape and margin (p = 0.001, respectively). Incidentally detected breast lesions on chest CT can be correlated with sonography. An irregular shape or a non-circumscribed margin of breast lesions on a CT scan can be considered as a suggestive sign of malignancy.

  16. Small white matter lesion detection in cerebral small vessel disease

    Science.gov (United States)

    Ghafoorian, Mohsen; Karssemeijer, Nico; van Uden, Inge; de Leeuw, Frank E.; Heskes, Tom; Marchiori, Elena; Platel, Bram

    2015-03-01

    Cerebral small vessel disease (SVD) is a common finding on magnetic resonance images of elderly people. White matter lesions (WML) are important markers for not only the small vessel disease, but also neuro-degenerative diseases including multiple sclerosis, Alzheimer's disease and vascular dementia. Volumetric measurements such as the "total lesion load", have been studied and related to these diseases. With respect to SVD we conjecture that small lesions are important, as they have been observed to grow over time and they form the majority of lesions in number. To study these small lesions they need to be annotated, which is a complex and time-consuming task. Existing (semi) automatic methods have been aimed at volumetric measurements and large lesions, and are not suitable for the detection of small lesions. In this research we established a supervised voxel classification CAD system, optimized and trained to exclusively detect small WMLs. To achieve this, several preprocessing steps were taken, which included a robust standardization of subject intensities to reduce inter-subject intensity variability as much as possible. A number of features that were found to be well identifying small lesions were calculated including multimodal intensities, tissue probabilities, several features for accurate location description, a number of second order derivative features as well as multi-scale annular filter for blobness detection. Only small lesions were used to learn the target concept via Adaboost using random forests as its basic classifiers. Finally the results were evaluated using Free-response receiver operating characteristic.

  17. Seven-Tesla Magnetization Transfer Imaging to Detect Multiple Sclerosis White Matter Lesions.

    Science.gov (United States)

    Chou, I-Jun; Lim, Su-Yin; Tanasescu, Radu; Al-Radaideh, Ali; Mougin, Olivier E; Tench, Christopher R; Whitehouse, William P; Gowland, Penny A; Constantinescu, Cris S

    2018-03-01

    Fluid-attenuated inversion recovery (FLAIR) imaging at 3 Tesla (T) field strength is the most sensitive modality for detecting white matter lesions in multiple sclerosis. While 7T FLAIR is effective in detecting cortical lesions, it has not been fully optimized for visualization of white matter lesions and thus has not been used for delineating lesions in quantitative magnetic resonance imaging (MRI) studies of the normal appearing white matter in multiple sclerosis. Therefore, we aimed to evaluate the sensitivity of 7T magnetization-transfer-weighted (MT w ) images in the detection of white matter lesions compared with 3T-FLAIR. Fifteen patients with clinically isolated syndrome, 6 with multiple sclerosis, and 10 healthy participants were scanned with 7T 3-dimensional (D) MT w and 3T-2D-FLAIR sequences on the same day. White matter lesions visible on either sequence were delineated. Of 662 lesions identified on 3T-2D-FLAIR images, 652 were detected on 7T-3D-MT w images (sensitivity, 98%; 95% confidence interval, 97% to 99%). The Spearman correlation coefficient between lesion loads estimated by the two sequences was .910. The intrarater and interrater reliability for 7T-3D-MT w images was good with an intraclass correlation coefficient (ICC) of 98.4% and 81.8%, which is similar to that for 3T-2D-FLAIR images (ICC 96.1% and 96.7%). Seven-Tesla MT w sequences detected most of the white matter lesions identified by FLAIR at 3T. This suggests that 7T-MT w imaging is a robust alternative for detecting demyelinating lesions in addition to 3T-FLAIR. Future studies need to compare the roles of optimized 7T-FLAIR and of 7T-MT w imaging. © 2017 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  18. Impact of compressed breast thickness and dose on lesion detectability in digital mammography: FROC study with simulated lesions in real mammograms

    Energy Technology Data Exchange (ETDEWEB)

    Salvagnini, Elena, E-mail: elena.salvagnini@gmail.com [Department of Imaging and Pathology, Radiology, KUL, Herestraat 49, Leuven B-3000 (Belgium); SCK-CEN, Boeretang 200, Mol 2400 (Belgium); Bosmans, Hilde; Marshall, Nicholas W. [Department of Imaging and Pathology, Radiology, KUL, Herestraat 49, Leuven B-3000 (Belgium); Department of Radiology, Radiology, UZ Gasthuisberg, Herestraat 49, Leuven B-3000 (Belgium); Van Ongeval, Chantal; Van Steen, Andreas; Cockmartin, Lesley [Department of Radiology, Radiology, UZ Gasthuisberg, Herestraat 49, Leuven B-3000 (Belgium); Michielsen, Koen [Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KUL, Herestraat 49, Leuven B-3000 (Belgium); Struelens, Lara [SCK-CEN, Boeretang 200, Mol 2400 (Belgium)

    2016-09-15

    Purpose: The aim of this work was twofold: (1) to examine whether, with standard automatic exposure control (AEC) settings that maintain pixel values in the detector constant, lesion detectability in clinical images decreases as a function of breast thickness and (2) to verify whether a new AEC setup can increase lesion detectability at larger breast thicknesses. Methods: Screening patient images, acquired on two identical digital mammography systems, were collected over a period of 2 yr. Mammograms were acquired under standard AEC conditions (part 1) and subsequently with a new AEC setup (part 2), programmed to use the standard AEC settings for compressed breast thicknesses ≤49 mm, while a relative dose increase was applied above this thickness. The images were divided into four thickness groups: T1 ≤ 29 mm, T2 = 30–49 mm, T3 = 50–69 mm, and T4 ≥ 70 mm, with each thickness group containing 130 randomly selected craniocaudal lesion-free images. Two measures of density were obtained for every image: a BI-RADS score and a map of volumetric breast density created with a software application (VolparaDensity, Matakina, NZ). This information was used to select subsets of four images, containing one image from each thickness group, matched to a (global) BI-RADS score and containing a region with the same (local) VOLPARA volumetric density value. One selected lesion (a microcalcification cluster or a mass) was simulated into each of the four images. This process was repeated so that, for a given thickness group, half the images contained a single lesion and half were lesion-free. The lesion templates created and inserted in groups T3 and T4 for the first part of the study were then inserted into the images of thickness groups T3 and T4 acquired with higher dose settings. Finally, all images were visualized using the ViewDEX software and scored by four radiologists performing a free search study. A statistical jackknife-alternative free-response receiver operating

  19. Effect of dose reduction on the detection of mammographic lesions: A mathematical observer model analysis

    International Nuclear Information System (INIS)

    Chawla, Amarpreet S.; Samei, Ehsan; Saunders, Robert; Abbey, Craig; Delong, David

    2007-01-01

    The effect of reduction in dose levels normally used in mammographic screening procedures on the detection of breast lesions were analyzed. Four types of breast lesions were simulated and inserted into clinically-acquired digital mammograms. Dose reduction by 50% and 75% of the original clinically-relevant exposure levels were simulated by adding corresponding simulated noise into the original mammograms. The mammograms were converted into luminance values corresponding to those displayed on a clinical soft-copy display station and subsequently analyzed by Laguerre-Gauss and Gabor channelized Hotelling observer models for differences in detectability performance with reduction in radiation dose. Performance was measured under a signal known exactly but variable detection task paradigm in terms of receiver operating characteristics (ROC) curves and area under the ROC curves. The results suggested that luminance mapping of digital mammograms affects performance of model observers. Reduction in dose levels by 50% lowered the detectability of masses with borderline statistical significance. Dose reduction did not have a statistically significant effect on detection of microcalcifications. The model results indicate that there is room for optimization of dose level in mammographic screening procedures

  20. [Accuracy of computer aided measurement for detecting dental proximal caries lesions in images of cone-beam computed tomography].

    Science.gov (United States)

    Zhang, Z L; Li, J P; Li, G; Ma, X C

    2017-02-09

    Objective: To establish and validate a computer program used to aid the detection of dental proximal caries in the images cone beam computed tomography (CBCT) images. Methods: According to the characteristics of caries lesions in X-ray images, a computer aided detection program for proximal caries was established with Matlab and Visual C++. The whole process for caries lesion detection included image import and preprocessing, measuring average gray value of air area, choosing region of interest and calculating gray value, defining the caries areas. The program was used to examine 90 proximal surfaces from 45 extracted human teeth collected from Peking University School and Hospital of Stomatology. The teeth were then scanned with a CBCT scanner (Promax 3D). The proximal surfaces of the teeth were respectively detected by caries detection program and scored by human observer for the extent of lesions with 6-level-scale. With histologic examination serving as the reference standard, the caries detection program and the human observer performances were assessed with receiver operating characteristic (ROC) curves. Student t -test was used to analyze the areas under the ROC curves (AUC) for the differences between caries detection program and human observer. Spearman correlation coefficient was used to analyze the detection accuracy of caries depth. Results: For the diagnosis of proximal caries in CBCT images, the AUC values of human observers and caries detection program were 0.632 and 0.703, respectively. There was a statistically significant difference between the AUC values ( P= 0.023). The correlation between program performance and gold standard (correlation coefficient r (s)=0.525) was higher than that of observer performance and gold standard ( r (s)=0.457) and there was a statistically significant difference between the correlation coefficients ( P= 0.000). Conclusions: The program that automatically detects dental proximal caries lesions could improve the

  1. Impact of time-of-flight PET on whole-body oncologic studies: a human observer lesion detection and localization study.

    Science.gov (United States)

    Surti, Suleman; Scheuermann, Joshua; El Fakhri, Georges; Daube-Witherspoon, Margaret E; Lim, Ruth; Abi-Hatem, Nathalie; Moussallem, Elie; Benard, Francois; Mankoff, David; Karp, Joel S

    2011-05-01

    Phantom studies have shown improved lesion detection performance with time-of-flight (TOF) PET. In this study, we evaluate the benefit of fully 3-dimensional, TOF PET in clinical whole-body oncology using human observers to localize and detect lesions in realistic patient anatomic backgrounds. Our hypothesis is that with TOF imaging we achieve improved lesion detection and localization for clinically challenging tasks, with a bigger impact in large patients. One hundred patient studies with normal (18)F-FDG uptake were chosen. Spheres (diameter, 10 mm) were imaged in air at variable locations in the scanner field of view corresponding to lung and liver locations within each patient. Sphere data were corrected for attenuation and merged with patient data to produce fused list-mode data files with lesions added to normal-uptake scans. All list files were reconstructed with full corrections and with or without the TOF kernel using a list-mode iterative algorithm. The images were presented to readers to localize and report the presence or absence of a lesion and their confidence level. The interpretation results were then analyzed to calculate the probability of correct localization and detection, and the area under the localized receiver operating characteristic (LROC) curve. The results were analyzed as a function of scan time per bed position, patient body mass index (BMI patient sizes. With TOF imaging, there was a bigger increase in the area under the LROC curve for larger patients (BMI ≥ 26). Finally, we saw smaller differences in the area under the LROC curve for large and small patients when longer scan times were combined with TOF imaging. A combination of longer scan time (3 min in this study) and TOF imaging provides the best performance for imaging large patients or a low-uptake lesion in small or large patients. This imaging protocol also provides similar performance for all patient sizes for lesions in the same organ type with similar relative uptake

  2. Intestinal lesions in pediatric Crohn disease: comparative detectability among pulse sequences at MR enterography

    International Nuclear Information System (INIS)

    Sohn, Beomseok; Kim, Myung-Joon; Lee, Mi-Jung; Koh, Hong; Han, Kyung Hwa

    2014-01-01

    Variable sequences can be used in MR enterography, and no consensus exists for the best protocol in children with Crohn disease. To compare the lesion detectability of various MR enterography sequences and to correlate the findings of these sequences with the Pediatric Crohn's Disease Activity Index (PCDAI) in children with Crohn disease. Children with clinically or pathologically confirmed Crohn disease underwent MR enterography, including a single-shot fast spin-echo (SSFSE) sequence, motility imaging (coronal 2-D balanced fast field echo), diffusion-weighted imaging (DWI), and dynamic contrast enhancement imaging (including arterial, portal and delayed phases). The lesion detectability of each sequence was graded 0-2 for each involved bowel segment. The lesion detectability and PCDAI result on different sequences were compared using the weighted least squares method and Student's t-test, respectively. Fifteen children (11 boys, 4 girls, mean age 13.7 ± 1.4 years) with a total of 41 lesions were included in this study. All lesions detected in more than two sequences were visible on the single-shot fast spin-echo (SSFSE) sequence. The relative lesion detection rate was 78.1% on motility imaging, 90.2% on DWI, and 92.7% on arterial, 95.1% on portal and 95.1% on delayed phase imaging. Compared to the SSFSE sequence, motility imaging (P < 0.001) and DWI (P = 0.039) demonstrated lower detectability. The mean PCDAI result in the detected lesions was statistically higher only on dynamic enhancement imaging (P < 0.001). All MR enterography sequences were found to have relatively high lesion detectability in children with Crohn disease, while motility imaging showed the lowest lesion detectability. Lesions detected on dynamic enhancement imaging showed a higher PCDAI result, which suggests that this sequence is specific for active inflammation. (orig.)

  3. Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network

    Science.gov (United States)

    2018-01-01

    Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved. PMID:29439500

  4. Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network

    Directory of Open Access Journals (Sweden)

    Yuexiang Li

    2018-02-01

    Full Text Available Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1, lesion dermoscopic feature extraction (task 2 and lesion classification (task 3. A deep learning framework consisting of two fully convolutional residual networks (FCRN is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved.

  5. Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network.

    Science.gov (United States)

    Li, Yuexiang; Shen, Linlin

    2018-02-11

    Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved.

  6. Ultrasonographic detection of focal liver lesions: increased sensitivity and specificity with microbubble contrast agents

    International Nuclear Information System (INIS)

    Hohmann, J.; Albrecht, T.; Hoffmann, C.W.; Wolf, K.-J.

    2003-01-01

    Ultrasonography (US) is the first choice for screening patients with suspected liver lesions. However, due to a lack of contrast agents, US used to be less sensitive and specific compared with computed tomography (CT) and magnet resonance imaging (MRI). The advent of microbubble contrast agents increased both sensitivity and specificity dramatically. Rapid developments of the contrast agents as well as of special imaging techniques were made in recent years. Today numerous different US imaging methods exist which based either on Doppler or on harmonic imaging. They are using the particular behaviour of microbubbles in a sound field which varies depending on the energy of insonation (low/high mechanical index, MI) as well as on the properties of the agent themselves. Apart from just blood pool enhancement some agents have a hepatosplenic specific late phase. US imaging during this late phase using relatively high MI in phase inversion mode (harmonic imaging) or stimulated acoustic emission (SAE; Doppler method) markedly improves the detection of focal liver lesions and is also very helpful for lesion characterisation. With regards to detection, contrast enhanced US performs similarly to CT as shown by recent studies. Early results of studies using low MI imaging and the newer perfluor agents are also showing promising results for lesion detection. Low MI imaging with these agents has the advantage of real time imaging and is particularly helpful for characterisation of focal lesions based on their dynamic contrast behaviour. Apart from the techniques which based on the morphology of liver lesions there were some attempts for the detection of occult metastases or micrometastases by means of liver blood flow changes. Also in this field the use of US contrast agents appears to have advantages over formerly used non contrast-enhanced methods although no conclusive results are available yet

  7. Bright Retinal Lesions Detection using Colour Fundus Images Containing Reflective Features

    Energy Technology Data Exchange (ETDEWEB)

    Giancardo, Luca [ORNL; Karnowski, Thomas Paul [ORNL; Chaum, Edward [ORNL; Meriaudeau, Fabrice [ORNL; Tobin Jr, Kenneth William [ORNL; Li, Yaquin [University of Tennessee, Knoxville (UTK)

    2009-01-01

    In the last years the research community has developed many techniques to detect and diagnose diabetic retinopathy with retinal fundus images. This is a necessary step for the implementation of a large scale screening effort in rural areas where ophthalmologists are not available. In the United States of America, the incidence of diabetes is worryingly increasing among the young population. Retina fundus images of patients younger than 20 years old present a high amount of reflection due to the Nerve Fibre Layer (NFL), the younger the patient the more these reflections are visible. To our knowledge we are not aware of algorithms able to explicitly deal with this type of reflection artefact. This paper presents a technique to detect bright lesions also in patients with a high degree of reflective NFL. First, the candidate bright lesions are detected using image equalization and relatively simple histogram analysis. Then, a classifier is trained using texture descriptor (Multi-scale Local Binary Patterns) and other features in order to remove the false positives in the lesion detection. Finally, the area of the lesions is used to diagnose diabetic retinopathy. Our database consists of 33 images from a telemedicine network currently developed. When determining moderate to high diabetic retinopathy using the bright lesions detected the algorithm achieves a sensitivity of 100% at a specificity of 100% using hold-one-out testing.

  8. Automatic detection of breast lesions with MIBI-Tc99m scintimammography using a novelty filter

    International Nuclear Information System (INIS)

    Costa, M.; Moura, L.

    1996-01-01

    An automatic method for detecting breast lesion in scintimammography is described. It is reported that the proposed method not only detects lesions but also classifies them as benign or malignant. The detection method makes use of Kohonen's novelty filter and the classification method is obtained by the analysis of an identified lesion mean profile. The method was able to detect all lesions presented in the scintimammogram and to correctly classify 16 out of 17 malignant lesions and 15 out of 17 benign lesions. The sensitivity of the method was 94,12% and specificity was 88,24%

  9. The performance of multimodal hyperspectral spectroscopy in the detection of precancerous cervical lesions

    Science.gov (United States)

    Trahmono; Lusiana, N.; Indarti, J.

    2017-08-01

    The aim of this study was to compare the performance of multimodal hyperspectral spectroscopy (MHS), which combines fluorescence and reflectance spectroscopy, with that of conventional laboratory-based screening tests, such as the Papanicolaou (Pap) smear test and human papilloma virus (HPV) DNA test, for detecting precancerous lesions of the cervix. The study utilized a cross-sectional design, and the kappa test was used in the analytical assessment. MHS scans were obtained from a sample of 70 consecutive patients, followed by sample collection for Pap and HPV DNA analysis and colposcopy referral, if indicated. Of the 70 patients evaluated, the results of cervical spectroscopy were normal in 38 (54.3%) patients, and they were abnormal in 32 (45.7%) patients. Based on the cytology results, 45 (64.3%) samples were normal, and 25 (35.7%) samples were abnormal. According to the results of the HPV DNA test, 47 (67.14%) samples were normal, and 17 (24.28%) samples were abnormal. Based on the results of the kappa test, the agreement between MHS and cytology was 0.793 (p < 0.001). The agreement between MHS and the HPV DNA test was 0.195 (p = 0.086), and the agreement between MHS and colposcopy was 0.479 (p < 0.001).

  10. Detection of infarct lesions from single MRI modality using inconsistency between voxel intensity and spatial location--a 3-D automatic approach.

    Science.gov (United States)

    Shen, Shan; Szameitat, André J; Sterr, Annette

    2008-07-01

    Detection of infarct lesions using traditional segmentation methods is always problematic due to intensity similarity between lesions and normal tissues, so that multispectral MRI modalities were often employed for this purpose. However, the high costs of MRI scan and the severity of patient conditions restrict the collection of multiple images. Therefore, in this paper, a new 3-D automatic lesion detection approach was proposed, which required only a single type of anatomical MRI scan. It was developed on a theory that, when lesions were present, the voxel-intensity-based segmentation and the spatial-location-based tissue distribution should be inconsistent in the regions of lesions. The degree of this inconsistency was calculated, which indicated the likelihood of tissue abnormality. Lesions were identified when the inconsistency exceeded a defined threshold. In this approach, the intensity-based segmentation was implemented by the conventional fuzzy c-mean (FCM) algorithm, while the spatial location of tissues was provided by prior tissue probability maps. The use of simulated MRI lesions allowed us to quantitatively evaluate the performance of the proposed method, as the size and location of lesions were prespecified. The results showed that our method effectively detected lesions with 40-80% signal reduction compared to normal tissues (similarity index > 0.7). The capability of the proposed method in practice was also demonstrated on real infarct lesions from 15 stroke patients, where the lesions detected were in broad agreement with true lesions. Furthermore, a comparison to a statistical segmentation approach presented in the literature suggested that our 3-D lesion detection approach was more reliable. Future work will focus on adapting the current method to multiple sclerosis lesion detection.

  11. Real-time virtual sonography (RVS)-guided vacuum-assisted breast biopsy for lesions initially detected with breast MRI.

    Science.gov (United States)

    Uematsu, Takayoshi

    2013-12-01

    To report on our initial experiences with a new method of real-time virtual sonography (RVS)-guided 11-gauge vacuum-assisted breast biopsy for lesions that were initially detected with breast MRI. RVS-guided 11-gauge vacuum-assisted biopsy is performed when a lesion with suspicious characteristics is initially detected with breast MRI and is occult on mammography, sonography, and physical examination. Live sonographic images were co-registered to the previously loaded second-look spine contrast-enhanced breast MRI volume data to correlate the sonography and MR images. Six lesions were examined in six consecutive patients scheduled to undergo RVS-guided 11-gauge vacuum-assisted biopsy. One patient was removed from the study because of non-visualization of the lesion in the second-look spine contrast-enhanced breast MRI. Five patients with non-mass enhancement lesions were biopsied. The lesions ranged in size from 9 to 13 mm (mean 11 mm). The average procedural time, including the sonography and MR image co-registration time, was 25 min. All biopsies resulted in tissue retrieval. One was fibroadenomatous nodules, and those of four were fibrocystic changes. There were no complications during or after the procedures. RVS-guided 11-gauge vacuum-assisted breast biopsies provide a safe and effective method for the examination of suspicious lesions initially detected with MRI.

  12. Proliferative changes in nonpalpable breast lesions detected by mammography

    International Nuclear Information System (INIS)

    Vega, A.; Delgado, A.; Ortega, E.; Garijo, F.; Mosquera, J.; Sogo, C.; Alvarez, A.

    2000-01-01

    To analyze retrospectively the radiological findings in nonpalpable breast lesions detected by mammography that lead to the performance of surgical biopsy, resulting in a histological diagnosis of proliferative breast disease with and without atypia. From two Spanish hospitals, 421 women with 429 biopsies indicative of the presence of proliferative breast disease with and without atypia were selected out of a total of 1252 surgical biopsies in nonpalpable lesions that proved to be benign. Age, personal and familial history of breast cancer, reason for requesting the mammography and radiological findings that had indicated the need for surgical biopsy were recorded for each patient. The diagnosis was proliferative breast disease (epithelial hyperplasia) in 347 women with 354 biopsies and atypical hyperplasia in the remaining 74 women with 75 biopsies, representing 28% and 6%, respectively, of the 1252 biopsies of lesions found to be benign. In 221 of the 354 cases of epithelial hyperplasia (62%) and 45 of the 75 cases of atypical hyperplasia (60%), the presence of calcifications was the most common radiological findings leading to biopsy (p<0.05). Parenchymal distortion, with or without calcifications, was the second most common radiological sign. The histological study revealed a close relationship between these proliferative events and radial scars. Calcifications are the radiological finding that most frequently indicate the need for surgical biopsy in nonpalpable lesions that results in a diagnosis of proliferative breast disease with and without atypia. (Author) 12 refs

  13. Accuracy of the detection of infratentorial stroke lesions using perfusion CT: an experimenter-blinded study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Hyouk; Kim, Myung Soon; Kim, Young Ju; Lee, Myeong Sub [Yonsei University, Department of Radiology, Wonju College of Medicine, Wonju (Korea, Republic of); You, Joshua H. [Center for Health, Wellness, Fitness, Prevention, and Healing Across the Life Span, Department of Physical Therapy, Graduate School of Rehabilitation Science, Yonsei University, Center for Movement Impairment Solutions, Wonju City (Korea, Republic of); Lee, Ji Yong [Yonsei University, Department of Neurology, Wonju College of Medicine, Wonju (Korea, Republic of); Whang, Kum [Yonsei University, Department of Neurosurgery, Wonju College of Medicine, Wonju (Korea, Republic of)

    2010-12-15

    Although perfusion CT (PCT) for the detection of supratentorial stroke is well established, there is a dearth of evidence of its effectiveness in the detection of infratentorial stroke. Hence, this study compared sensitivity, specificity, and accuracy of PCT maps between infratentorial and supratentorial stroke lesions. One hundred patients with acute stroke who had successfully undergone near whole-brain PCT with the toggling table technique and follow-up MRI were included. Wilcoxon Mann-Whitney test was performed at P < 0.01. There was no significant statistical difference in the accuracy (91.79% vs. 93.23% in regional cerebral blood volume; 92.26% vs. 95.31% in regional cerebral blood flow; 89.17% vs. 92.71% in mean transit time; 89.76% vs. 92.19% in time to peak; P > 0.01 in all PCT maps) between supratentorial and infratentorial stroke. Also, there was no remarkable difference in both sensitivity and specificity of PCT maps. This was the first study to investigate the accuracy of PCT with the toggling table technique in detection of infratentorial stroke lesions. Clinically, PCT is highly reliable and accurate in detecting infratentorial stroke lesions. (orig.)

  14. The role of second-look ultrasound of BIRADS-3 mammary lesions detected by breast MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fiaschetti, V., E-mail: fiaschettivaleria@tin.it [Department of Imaging Diagnostic, Molecular Imaging, Interventional Radiology and Radiation Therapy University Hospital ' Tor Vergata' , 81 Oxford street, 00133 Rome (Italy); Salimbeni, C.; Gaspari, E.; Dembele, G. Kabunda; Bolacchi, F.; Cossu, E.; Pistolese, C.A.; Perretta, T.; Simonetti, G. [Department of Imaging Diagnostic, Molecular Imaging, Interventional Radiology and Radiation Therapy University Hospital ' Tor Vergata' , 81 Oxford street, 00133 Rome (Italy)

    2012-11-15

    Objective: To asses the value of second-look ultrasound (US) for identifying BIRADS 3 (Breast Imaging Reporting Data System) mammary lesions detected by breast Magnetic Resonance imaging (MRI). Materials and methods: From April 2008 to May 2009 330 breast MRI were performed of which 60 patients are classified as BIRADS 3. 84 lesions underwent second-look US and percutaneous vacuum biopsy Vacora system US-guided. Statistical analysis: lesions were stratified into two groups: visible on US (Group 1) and not visible on US (Group 2). The clinical impact of second-look US was studied in terms of negative predictive value (NPV). Results: The positive predictive value (PPV) of category 3 BIRADS MRI was found to be 89%. Second look-US results detected lesions in 51% of the MRI enhancing lesions. The second look-US showed a NPV of 97%. The NPV of second look-US was significantly greater than the NPV of MRI BIRADS 3 (97% vs 89%, p < 0.05). The logistic regression analysis showed a higher number of malignant lesions in group 1 than in group 2 (7vs 2, OR 3.7, p < 0.05). Conclusions: The second-look US permitted the correct management of subcentimetric MRI BIRADS 3 lesions not visible with conventional imaging tecniques.

  15. The role of second-look ultrasound of BIRADS-3 mammary lesions detected by breast MR imaging

    International Nuclear Information System (INIS)

    Fiaschetti, V.; Salimbeni, C.; Gaspari, E.; Dembele, G. Kabunda; Bolacchi, F.; Cossu, E.; Pistolese, C.A.; Perretta, T.; Simonetti, G.

    2012-01-01

    Objective: To asses the value of second-look ultrasound (US) for identifying BIRADS 3 (Breast Imaging Reporting Data System) mammary lesions detected by breast Magnetic Resonance imaging (MRI). Materials and methods: From April 2008 to May 2009 330 breast MRI were performed of which 60 patients are classified as BIRADS 3. 84 lesions underwent second-look US and percutaneous vacuum biopsy Vacora system US-guided. Statistical analysis: lesions were stratified into two groups: visible on US (Group 1) and not visible on US (Group 2). The clinical impact of second-look US was studied in terms of negative predictive value (NPV). Results: The positive predictive value (PPV) of category 3 BIRADS MRI was found to be 89%. Second look-US results detected lesions in 51% of the MRI enhancing lesions. The second look-US showed a NPV of 97%. The NPV of second look-US was significantly greater than the NPV of MRI BIRADS 3 (97% vs 89%, p < 0.05). The logistic regression analysis showed a higher number of malignant lesions in group 1 than in group 2 (7vs 2, OR 3.7, p < 0.05). Conclusions: The second-look US permitted the correct management of subcentimetric MRI BIRADS 3 lesions not visible with conventional imaging tecniques.

  16. Fecal-tagging CT colonography with structure-analysis electronic cleansing for detection of colorectal flat lesions

    International Nuclear Information System (INIS)

    Xu, Yonghua; Cai, Wenli; Nappi, Janne; Yoshida, Hiro

    2012-01-01

    Purpose: To evaluate the feasibility and sensitivity of the 3D-reading of fecal-tagging CT colonography (CTC) with a novel structure-analysis electronic cleansing (SAEC) in detecting colorectal flat lesions in comparison with a cleansed 3D reading with Viatronix V3D Colon system (V3D) and primary uncleansed 2D reading (2D). Materials and methods: Forty CTC cases with flat lesions were retrospectively observed. The Subjects from a multicenter clinical trial underwent cathartic bowel preparation with orally administrated barium-based fecal-tagging. Sixty-nine flat lesions were confirmed using colonoscopy and histopathology as a reference standard. The results from SAEC reading were compared with those of prospective V3D and 2D readings. Results: Overall detection sensitivity with SAEC was 52% (36/69), which was statistically higher than that of 32% (22/69) and 29% (20/69) with V3D and 2D readings, respectively (p < 0.05). The sensitivities in detecting not-on-fold flat lesions were 63% (24/38), 45% (17/38), and 42% (16/38) with SAEC, V3D, and 2D readings, respectively; whereas those of on-fold flat lesions were 39% (12/31), 16% (5/31), and 13% (4/31), respectively. None of the eight flat lesions (2-9 mm) at cecum was detected by any of the three reading methods. Excluding the flat lesions at cecum, the sensitivity with SAEC for detecting flat lesion ≥4 mm increased to 84% (31/37). Conclusions: The fecal-tagging CTC with structure-analysis electronic cleansing could yield a high sensitivity for detecting flat lesions ≥4 mm. The not-on-fold flat lesions were detected with higher sensitivity than on-fold flat lesions.

  17. Theoretical evaluation of the detectability of random lesions in bayesian emission reconstruction

    International Nuclear Information System (INIS)

    Qi, Jinyi

    2003-01-01

    Detecting cancerous lesion is an important task in positron emission tomography (PET). Bayesian methods based on the maximum a posteriori principle (also called penalized maximum likelihood methods) have been developed to deal with the low signal to noise ratio in the emission data. Similar to the filter cut-off frequency in the filtered backprojection method, the prior parameters in Bayesian reconstruction control the resolution and noise trade-off and hence affect detectability of lesions in reconstructed images. Bayesian reconstructions are difficult to analyze because the resolution and noise properties are nonlinear and object-dependent. Most research has been based on Monte Carlo simulations, which are very time consuming. Building on the recent progress on the theoretical analysis of image properties of statistical reconstructions and the development of numerical observers, here we develop a theoretical approach for fast computation of lesion detectability in Bayesian reconstruction. The results can be used to choose the optimum hyperparameter for the maximum lesion detectability. New in this work is the use of theoretical expressions that explicitly model the statistical variation of the lesion and background without assuming that the object variation is (locally) stationary. The theoretical results are validated using Monte Carlo simulations. The comparisons show good agreement between the theoretical predications and the Monte Carlo results

  18. Hierarchical detection of red lesions in retinal images by multiscale correlation filtering

    Science.gov (United States)

    Zhang, Bob; Wu, Xiangqian; You, Jane; Li, Qin; Karray, Fakhri

    2009-02-01

    This paper presents an approach to the computer aided diagnosis (CAD) of diabetic retinopathy (DR) -- a common and severe complication of long-term diabetes which damages the retina and cause blindness. Since red lesions are regarded as the first signs of DR, there has been extensive research on effective detection and localization of these abnormalities in retinal images. In contrast to existing algorithms, a new approach based on Multiscale Correlation Filtering (MSCF) and dynamic thresholding is developed. This consists of two levels, Red Lesion Candidate Detection (coarse level) and True Red Lesion Detection (fine level). The approach was evaluated using data from Retinopathy On-line Challenge (ROC) competition website and we conclude our method to be effective and efficient.

  19. Performance of computer-aided detection applied to full-field digital mammography in detection of breast cancers

    International Nuclear Information System (INIS)

    Sadaf, Arifa; Crystal, Pavel; Scaranelo, Anabel; Helbich, Thomas

    2011-01-01

    Objective: The aim of this retrospective study was to evaluate performance of computer-aided detection (CAD) with full-field digital mammography (FFDM) in detection of breast cancers. Materials and Methods: CAD was retrospectively applied to standard mammographic views of 127 cases with biopsy proven breast cancers detected with FFDM (Senographe 2000, GE Medical Systems). CAD sensitivity was assessed in total group of 127 cases and for subgroups based on breast density, mammographic lesion type, mammographic lesion size, histopathology and mode of presentation. Results: Overall CAD sensitivity was 91% (115 of 127 cases). There were no statistical differences (p > 0.1) in CAD detection of cancers in dense breasts 90% (53/59) versus non-dense breasts 91% (62/68). There was statistical difference (p 20 mm 97% (22/23). Conclusion: CAD applied to FFDM showed 100% sensitivity in identifying cancers manifesting as microcalcifications only and high sensitivity 86% (71/83) for other mammographic appearances of cancer. Sensitivity is influenced by lesion size. CAD in FFDM is an adjunct helping radiologist in early detection of breast cancers.

  20. Early detection of breast cancer mass lesions by mammogram segmentation images based on texture features

    International Nuclear Information System (INIS)

    Mahmood, F.H.

    2012-01-01

    Mammography is at present one of the available method for early detection of masses or abnormalities which is related to breast cancer.The calcifications. The challenge lies in early and accurate detection to overcome the development of breast cancer that affects more and more women throughout the world. Breast cancer is diagnosed at advanced stages with the help of the digital mammogram images. Masses appear in a mammogram as fine, granular clusters, which are often difficult to identify in a raw mammogram. The incidence of breast cancer in women has increased significantly in recent years. This paper proposes a computer aided diagnostic system for the extraction of features like mass lesions in mammograms for early detection of breast cancer. The proposed technique is based on a four-step procedure: (a) the preprocessing of the image is done, (b) regions of interest (ROI) specification, (c) supervised segmentation method includes two to stages performed using the minimum distance (M D) criterion, and (d) feature extraction based on Gray level Co-occurrence matrices GLC M for the identification of mass lesions. The method suggested for the detection of mass lesions from mammogram image segmentation and analysis was tested over several images taken from A L-llwiya Hospital in Baghdad, Iraq.The proposed technique shows better results.

  1. Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Takashi; Urata, Joji [Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Mitsuzaki, Katsuhiko; Matsuda, Katsuhiko; Kawakami, Megumi [Medical Examination Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Utsunomiya, Daisuke; Yamamura, Sadahiro; Yamashita, Yasuyuki [Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)], e-mail: utsunomi@kumamoto-u.ac.jp

    2012-09-15

    Background: Although the screening of small, flat polyps is clinically important, the role of CT colonography (CTC) screening in their detection has not been thoroughly investigated. Purpose: To evaluate the detection capability and usefulness of CTC in the screening of flat and polypoid lesions by comparing CTC with optic colonoscopy findings as the gold standard. Material and Methods: We evaluated the CTC detection capability for flat colorectal polyps with a flat surface and a height not exceeding 3 mm (n = 42) by comparing to conventional polypoid lesions (n = 418) according to the polyp diameter. Four types of reconstruction images including multiplanar reconstruction, volume rendering, virtual gross pathology, and virtual endoscopic images were used for visual analysis. We compared the abilities of the four reconstructions for polyp visualization. Results: Detection sensitivity for flat polyps was 31.3 %, 44.4 %, and 87.5 % for lesions measuring 2-3 mm, 4-5 mm, and {>=}6 mm, respectively; the corresponding sensitivity for polypoid lesions was 47.6 %, 79.0 %, and 91.7 %. The overall sensitivity for flat lesions (47.6%) was significantly lower than polypoid lesions (64.1%). Virtual endoscopic imaging showed best visualization among the four reconstructions. Colon cancers were detected in eight patients by optic colonoscopy, and CTC detected colon cancers in all eight patients. Conclusion: CTC using 64-row multidetector CT is useful for colon cancer screening to detect colorectal polyps while the detection of small, flat lesions is still challenging.

  2. The evaluation of the effect of attenuation correction on lesion detectability in whole-body FDG-PET

    International Nuclear Information System (INIS)

    Tomemori, Takashi; Uno, Kimiichi; Oka, Takashi; Suzuki, Takayuki; Tomiyoshi, Katsumi; Jin Wu

    2004-01-01

    The aim of this study was to compare the attenuation corrected and non-corrected FDG-PET images in patients with malignant lesions and to evaluate the effect of attenuation correction on lesion detectability. A total of 71 persons with 112 malignant lesions was examined. All subjects fasted for at least 4 hours before PET study and whole-body PET imaging was performed 45 min after the intravenous administration of FDG (mean dose: 273.8 MBq). Emission scans of 6 min and post-injection transmission scans of 6 min per bed position were used. The intensity of lesion uptake in FDG-PET image was visually classified into 3 grades; grade 2=the lesion was clearly identified in the maximum intensity projection (MIP) image of FDG-PET, grade 1=the lesion was not identified in MIP image but it can be identified in coronal image, grade 0=there was no contrast between lesion and background in both MIP and coronal image. Ninety-eight lesions (87.5%) were classified into same grade in both attenuation corrected and non-corrected image, but in 11 lesions (9.8%) attenuation corrected image was better lesion visualization than non-corrected image. All lesions divided between the primary lesions and the metastatic lesions. In 50 primary lesions, 43 lesions were depicted in both attenuation corrected and non-corrected image and other 7 lesions were not in both image. In 62 metastatic lesions, 50 lesions (80.7%) were classified into same grade in both attenuation corrected and non-corrected image, but in 10 lesions (16.1%) attenuation corrected image were better lesion visualization than non-corrected image. In the most cases, the lesions were depicted in both attenuation corrected and non-corrected image. In the primary lesions, the lesion detectability between attenuation corrected and non-corrected image was similar. But in some cases with the metastatic lesions, attenuation corrected image were better lesion visualization than non-corrected image. For asymptomatic patients, non

  3. Performance evaluation of the Aptima HSV-1 and 2 assay for the detection of HSV in cutaneous and mucocutaneous lesion specimens.

    Science.gov (United States)

    Sam, Soya S; Caliendo, Angela M; Ingersoll, Jessica; Abdul-Ali, Deborah; Kraft, Colleen S

    Timely and precise laboratory diagnosis of Herpes simplex viruses (HSV) is required to guide clinical management. The study evaluated limit of detection (LOD) and performance characteristics of the Aptima HSV 1 & 2 assay in comparison to four assays. The multi-center study compared qualitative detection of HSV-1 and 2 by the Aptima HSV-1 and 2 assay (Hologic) to ELVIS culture, Lyra Direct (Quidel), AmpliVue (Quidel) and a laboratory developed test (LDT). LOD was performed using VTM and STM diluted viral concentrations and clinical performance was evaluated using 505 swab specimens. The Aptima LOD studies performed showed a lower detection limit for STM specimens as 1450 copies/mL and 430 copies/mL for HSV1 and HSV-2 respectively; the LOD for VTM specimens was 9370 copies/mL and 8045 copies/mL for HSV-1 and HSV-2 respectively. When the assays were analyzed based on the positive consensus result established the Aptima had 95% of percent positive agreement (PPA) and 100% negative percent agreement (NPA) for the HSV-1. For the HSV-2, the PPA and NPA for Aptima were 96% and 100% respectively. AmpliVue had 1.8% invalid rate, while Lyra had no invalid results but an inhibition rate of 0.8%. Aptima and LDT did not have any invalid or inhibited results. The results indicate that the Aptima HSV-1 & 2 assay is sensitive and the performance characteristics of the Aptima assay is comparable to the assays analyzed for the detection and differentiation of HSV-1 and 2 from cutaneous and mucocutaneous lesions. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Detection of lesions in multiple sclerosis by 2D FLAIR and single-slab 3D FLAIR sequences at 3.0 T: initial results

    International Nuclear Information System (INIS)

    Bink, Andrea; Gaa, Jochen; Lanfermann, Heinrich; Zanella, Friedhelm E.; Schmitt, Melanie; Mugler, John P.

    2006-01-01

    The aim of this study was to compare conventional 2D FLAIR and single-slab 3D FLAIR sequences in the detection of lesions in patients with multiple sclerosis. Eight patients with MS were examined at 3.0 T by using a 2D FLAIR sequence and a single-slab 3D FLAIR sequence. A comparison of lesion detectability was performed for the following regions: periventricular, nonperiventricular/juxtacortical and infratentorial. The contrast-to-noise ratios (CNRs) between lesions and brain tissue and CSF were calculated for each sequence. A total of 424 lesions were found using the 2D FLAIR sequence, while with the 3D FLAIR sequence 719 lesions were found. With the 2D FLAIR sequence, 41% fewer lesions were detected than with the 3D FLAIR sequence. Further, 40% fewer supratentorial and 62.5% fewer infratentorial lesions were found with the 2D FLAIR sequence. In images acquired with the 3D FLAIR sequence, the lesions had significantly higher CNRs than in images acquired with the 2D FLAIR sequence. These are the first results using a single-slab 3D FLAIR sequence at 3.0 T for detection of lesions in patients with MS. With the 3D FLAIR sequence significantly higher CNRs were achieved and significantly more lesions in patients with MS were detected. (orig.)

  5. Application of sonoelastography: Comparison of performance between mass and non-mass lesion

    International Nuclear Information System (INIS)

    Ko, Eun Sook; Choi, Hye Young; Kim, Rock Bum; Noh, Woo-Chul

    2012-01-01

    Objectives: The purpose of this study was to determine the performance of the conventional ultrasonography (US) and sonoelastography (SE) in three conditions of all lesions, confined to mass, and confined to non-mass lesion and to compare the performance of each modality between mass and non-mass lesion. Materials and methods: A total 364 patients with 375 lesions were evaluated with US and subsequently SE before performing US-guided biopsy. Two radiologists retrospectively analyzed conventional US and elasticity images by consensus. The US findings were classified as mass or non-mass lesion. With final pathology as reference, in each case of all lesions, masses, and non-mass lesions, areas under the ROC curves (Az) were calculated and compared for the two techniques. The comparison of Az values between the curves for US and SE, and between the curves for mass and non-mass lesion was performed. Results: Among 375 lesions, 104 (28%) lesions were malignant and 271 (72%) lesions were benign. 36 (9.6%) of 375 lesions were classified as non-mass lesion at US. There were statistically significant difference of performance between US and SE in cases of all lesion (p = 0.003) and mass (p = 0.023). However, there was no statistically significant difference of performance in case of non-mass lesion (p = 0.5). Comparisons of the Az values of US and SE between mass and non-mass lesions were not statistically significant (p = 0.745, p = 0.415, respectively). Conclusion: There was no statistically significant difference of performance of US and SE between mass and non-mass lesion.

  6. Performance of FLT-PET for pulmonary lesion diagnosis compared with traditional FDG-PET: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zixing; Wang, Yuyan [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China); Sui, Xin; Zhang, Wei [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Shi, Ruihong [National Institutes for Food and Drug Control, Beijing, 100000 (China); Zhang, Yingqiang; Dang, Yonghong; Qiao, Zhen [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Zhang, Biao [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China); Song, Wei, E-mail: cjr.songwei@vip.163.com [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Jiang, Jingmei, E-mail: jingmeijiang238@hotmail.com [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China)

    2015-07-15

    Highlights: • FDG PET is more sensitive compared with FLT for detecting small and early staged lung cancers. • FLT can reduce false positives of FDG for inflammation-based lesions such as tuberculosis. • FLT shows comparable accuracies for diagnoses of late stage tumors and larger pulmonary lesions. - Abstract: Purpose: Widely used {sup 18}F 2′-deoxy-2′-fluoro-D-glucose (FDG) positron emission tomography (PET) can be problematic with false positives in cancer imaging. This study aims to investigate the diagnostic accuracy of a candidate PET tracer, {sup 18}F 2′,3′-dideoxy-3′-fluoro-2-thiothymidine (FLT), in diagnosing pulmonary lesions compared with FDG. Materials and methods: After comprehensive search and study selection, a meta-analysis was performed on data from 548 patients pooled from 17 studies for evaluating FLT accuracy, in which data from 351 patients pooled from ten double-tracer studies was used for direct comparison with FDG. Weighted sensitivity and specificity were used as main indicators of test performance. Individual data was extracted and patient subgroup analyses were performed. Results: Overall, direct comparisons showed lower sensitivity (0.80 vs. 0.89) yet higher specificity (0.82 vs. 0.66) for FLT compared with FDG (both p < 0.01). Patient subgroup analysis showed FLT was less sensitive than FDG in detecting lung cancers staged as T1 or T2, and those ≤2.0 cm in diameter (0.81 vs. 0.93, and 0.53 vs. 0.78, respectively, both p < 0.05), but was comparable for cancers staged as T3 or T4, and those >2.0 cm in diameter (0.95 vs. 1.00, 0.96 vs. 0.88, both p > 0.05). For benignities, FLT performed better compared with FDG in ruling out inflammation-based lesions (0.57 vs. 0.32, p < 0.05), and demonstrated greater specificity regardless of lesion sizes. Conclusions: Although FLT cannot replace FDG in detecting small and early lung cancers, it may help to prevent patients with larger or inflammatory lesions from cancer misdiagnosis

  7. A comparison between fast and conventional spin-echo in the detection of multiple sclerosis lesions

    International Nuclear Information System (INIS)

    Thorpe, J.W.; Halpin, S.F.; MacManus, D.G.; Barker, G.J.; Kendall, B.E.; Miller, D.H.

    1994-01-01

    Long repetition time (TR) spin-echo (SE) with T 2 - or proton density weighting is the sequence of choice to detect the brain lesions of multiple sclerosis (MS). Fast spin-echo (FSE) permits the generation of T 2 -weighted images with similar contrast to SE but in a fraction of the time. We compared the sensitivity of FSE and SE in the detection of the brain lesions of MS. Six patients with clinically definite MS underwent brain imaging with both dual echo (long TR, long and short echo time (TE) SE and dual echo FSE. The SE and FSE images were first reviewed independently and then compared. A total of 404 lesions was detected on SE and 398 on FSE. Slightly more periventricular lesions were detected using SE than FSE (145 vs 127), whereas more posterior cranial fossa lesions were detected by FSE (77 vs 57). With both SE and FSE the short TE images revealed more lesions than the long echo. These results suggest that FSE could replace SE as the long TR sequence of choice in the investigation of MS. (orig.)

  8. Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with primary progressive multiple sclerosis.

    Science.gov (United States)

    Filippi, M; Campi, A; Martinelli, V; Colombo, B; Yousry, T; Canal, N; Scotti, G; Comi, G

    1995-01-01

    This study was performed to evaluate whether a triple dose of gadolinium-DTPA (Gd-DTPA) increases the sensitivity of brain MRI for detecting enhancing lesions in patients with primary progressive multiple sclerosis (PPMS). T1 weighted brain MRI was obtained for 10 patients with PPMS in two sessions. In the first session, one scan was obtained five to seven minutes after the injection of 0.1 mmol/kg Gd-DTPA (standard dose). In the second session, six to 24 hours later, one scan before and two scans five to seven minutes and one hour after the injection of 0.3 mmol/kg Gd-DTPA (triple dose) were obtained. Four enhancing lesions were detected in two patients when the standard dose of Gd-DTPA was used. The numbers of enhancing lesions increased to 13 and the numbers of patients with such lesions to five when the triple dose of Gd-DTPA was used and to 14 and six in the one hour delayed scans. The mean contrast ratio for enhancing lesions detected with the triple dose of Gd-DTPA was higher than those for lesions present in both the standard dose (P DTPA many more enhancing lesions can be detected in patients with PPMS. This is important both for planning clinical trials and for detecting the presence of inflammation in vivo in the lesions of such patients. Images PMID:8530944

  9. A Robust and Fast System for CTC Computer-Aided Detection of Colorectal Lesions

    Directory of Open Access Journals (Sweden)

    Gareth Beddoe

    2010-01-01

    Full Text Available We present a complete, end-to-end computer-aided detection (CAD system for identifying lesions in the colon, imaged with computed tomography (CT. This system includes facilities for colon segmentation, candidate generation, feature analysis, and classification. The algorithms have been designed to offer robust performance to variation in image data and patient preparation. By utilizing efficient 2D and 3D processing, software optimizations, multi-threading, feature selection, and an optimized cascade classifier, the CAD system quickly determines a set of detection marks. The colon CAD system has been validated on the largest set of data to date, and demonstrates excellent performance, in terms of its high sensitivity, low false positive rate, and computational efficiency.

  10. Detection of Helicobacter pylori in Oral Lesions

    Directory of Open Access Journals (Sweden)

    Soussan Irani

    2013-12-01

    Full Text Available Background and aims. Helicobacter pylori is a microaerophilic gram-negative spiral organism. It is recognized as the etiologic factor for peptic ulcers, gastric adenocarcinoma and gastric lymphoma. Recently, it has been isolated from dental plaque and the dorsum of the tongue. This study was designed to assess the association between H. pylori and oral lesions such as ulcerative/inflammatory lesions, squamous cell carcinoma (SCC and primary lymphoma. Materials and methods. A total of 228 biopsies diagnosed as oral ulcerative/inflammatory lesions, oral squamous cell carcinoma (OSCC and oral primary lymphoma were selected from the archives of the Pathology Department. Thirty-two samples that were diagnosed as being without any pathological changes were selected as the control group. All the paraffin blocks were cut for hematoxylin and eosin staining to confirm the diagnoses and then the samples were prepared for immunohistochemistry staining. Data were collected and analyzed. Results. Chi-squared test showed significant differences between the frequency of H. pylori positivity in normal tissue and the lesions were examined (P=0.000. In addition, there was a statistically significant difference between the lesions examined (P=0.042. Chi-squared test showed significant differences between H. pylori positivity and different tissue types except inside the muscle layer as follows: in epithelium and in lamina propria (P=0.000, inside the blood vessels (P=0.003, inside the salivary gland duct (P=0.036, and muscle layer (P=0.122. Conclusion. There might be a relation between the presence of H. pylori and oral lesions. Therefore, early detection and eradication of H. pylori in high-risk patients are suggested.

  11. Stereotaxic cytology of nonpalpable lesions detected at mammography

    International Nuclear Information System (INIS)

    Ciatto, S.; Rosselli del Turco, M.; Bravetti, P.; Catarzi, S.

    1991-01-01

    The authors report on 791 consecutive cases undergoing stereotaxic cytology for non palpable lesions detected at mammography. Histologic diagnosis (malignant = 179, benign = 107) or mammographic folow-up after at least one year (benign = 275) was available in 561 cases. The overall inadequacy rate of stereotaxic cytology was 0.21, and dependent on lesion type (benign = 0.25, malignant = 0.13 p<0.001) and on sampling operator experience (range 0.17-0.31, p<0.001). Sensitivity (dubious+positive, after exclusion of inadequates) was 0.83 and dependent on histologic type (infiltrating = 0.87, intraductal = 0.68). Specificity (negative/benign, after exclusion of inadequates) was 0.96. Stereotaxic cytology helped in reducing the number of unnecessary beningn biopsies and the biopsy ratio was 0.6 benign to 1 malignant biopsy. In cases with moderate suspicion at mammography the radiologist felt reassured by negative cytology and advised mammographic control rather than surgical biopsy. Cytology was determinant in advising surgical biopsy in 9 cancer cases whereas the absence of cytologic positivity contributed to diagnostic delay in 2 cancer cases. Overall, stereotaxic cytology allowed a relevant reduction of unnecessary benign biopsies and should be routinely employed in the diagnostic work-up of nonpalpable lesions detected at mammography

  12. Lesion detection in ultra-wide field retinal images for diabetic retinopathy diagnosis

    Science.gov (United States)

    Levenkova, Anastasia; Sowmya, Arcot; Kalloniatis, Michael; Ly, Angelica; Ho, Arthur

    2018-02-01

    Diabetic retinopathy (DR) leads to irreversible vision loss. Diagnosis and staging of DR is usually based on the presence, number, location and type of retinal lesions. Ultra-wide field (UWF) digital scanning laser technology provides an opportunity for computer-aided DR lesion detection. High-resolution UWF images (3078×2702 pixels) may allow detection of more clinically relevant retinopathy in comparison with conventional retinal images as UWF imaging covers a 200° retinal area, versus 45° by conventional cameras. Current approaches to DR diagnosis that analyze 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) retinal images provide similar results to UWF imaging. However, in 40% of cases, more retinopathy was found outside the 7- field ETDRS fields by UWF and in 10% of cases, retinopathy was reclassified as more severe. The reason is that UWF images examine both the central retina and more peripheral regions. We propose an algorithm for automatic detection and classification of DR lesions such as cotton wool spots, exudates, microaneurysms and haemorrhages in UWF images. The algorithm uses convolutional neural network (CNN) as a feature extractor and classifies the feature vectors extracted from colour-composite UWF images using a support vector machine (SVM). The main contribution includes detection of four types of DR lesions in the peripheral retina for diagnostic purposes. The evaluation dataset contains 146 UWF images. The proposed method for detection of DR lesion subtypes in UWF images using two scenarios for transfer learning achieved AUC ≈ 80%. Data was split at the patient level to validate the proposed algorithm.

  13. detecting multiple sclerosis lesions with a fully bioinspired visual attention model

    Science.gov (United States)

    Villalon-Reina, Julio; Gutierrez-Carvajal, Ricardo; Thompson, Paul M.; Romero-Castro, Eduardo

    2013-11-01

    The detection, segmentation and quantification of multiple sclerosis (MS) lesions on magnetic resonance images (MRI) has been a very active field for the last two decades because of the urge to correlate these measures with the effectiveness of pharmacological treatment. A myriad of methods has been developed and most of these are non specific for the type of lesions and segment the lesions in their acute and chronic phases together. On the other hand, radiologists are able to distinguish between several stages of the disease on different types of MRI images. The main motivation of the work presented here is to computationally emulate the visual perception of the radiologist by using modeling principles of the neuronal centers along the visual system. By using this approach we are able to detect the lesions in the majority of the images in our population sample. This type of approach also allows us to study and improve the analysis of brain networks by introducing a priori information.

  14. Diffusion-weighted imaging as part of hybrid PET/MRI protocols for whole-body cancer staging: Does it benefit lesion detection?

    Energy Technology Data Exchange (ETDEWEB)

    Buchbender, Christian, E-mail: christian.buchbender@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Hartung-Knemeyer, Verena, E-mail: verena.hartung@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Hufelandstr. 55, D-45147 Essen (Germany); Beiderwellen, Karsten, E-mail: karsten.beiderwellen@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Heusch, Philipp, E-mail: philipp.heusch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Kühl, Hilmar, E-mail: hilmar.kuehl@uni-due.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Lauenstein, Thomas C., E-mail: thomas.lauenstein@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Forsting, Michael, E-mail: michael.forsting@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Heusner, Till A., E-mail: heusner@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2013-05-15

    Purpose: Positron emission tomography/magnetic resonance imaging (PET/MRI) requires efficient scan protocols for whole-body cancer staging. The aim of this study was to evaluate if the application of diffusion-weighted MR imaging (DWI) results in a diagnostic benefit for lesion detection in oncologic patients if added to a whole-body [18F]-fluorodesoxyglucose ([18F]-FDG) PET/MRI protocol. Methods: 25 consecutive oncologic patients (16 men, 9 women; age 57 ± 12 years) prospectively underwent whole-body [18F]-FDG-PET/MRI including DWI on a hybrid PET/MRI scanner. A team of two readers assessed [18F]-FDG PET/MRI without DWI for primary tumors and metastases. In a second session, now considering DWI, readers reassessed [18F]-FDG PET/MRI accordingly. Additionally, the lesion-to-background contrast on [18F]-FDG PET and DWI was rated qualitatively (0, invisible; 1, low; 2, intermediate; 3, high). Wilcoxon's signed-rank test was performed to test for differences in the lesion-to-background contrast. Results: 49 lesions were detected in 16 patients (5 primaries, 44 metastases). All 49 lesions were concordantly detected by [18F]-FDG PET/MRI alone and [18F]-FDG PET/MRI with DWI. The lesion-to-background contrast on DWI compared to [18F]-FDG PET was rated lower in 22 (44.9%) of 49 detected lesions resulting in a significantly higher lesion-to-background contrast on [18F]-FDG PET compared to DWI (P = 0.001). Conclusions: DWI as part of whole-body [18F]-FDG PET/MRI does not benefit lesion detection. Given the necessity to optimize imaging protocols with regard to patient comfort and efficacy, DWI has to be questioned as a standard tool for whole-body staging in oncologic PET/MRI.

  15. Visual performance of pigeons following hippocampal lesions.

    Science.gov (United States)

    Bingman, V P; Hodos, W

    1992-11-15

    The effect of hippocampal lesions on performance in two psychophysical measures of spatial vision (acuity and size-difference threshold) was examined in 7 pigeons. No difference between the preoperative and postoperative thresholds of the experimental birds was found. The visual performance of pigeons in the psychophysical tasks failed to reveal a role of the hippocampal formation in vision. The results argue strongly that the behavioral deficits found in pigeons with hippocampal lesions when tested in a variety of memory-related spatial tasks is not based on a defect in spatial vision but impaired spatial cognition.

  16. Spinal focal lesion detection in multiple myeloma using multimodal image features

    Science.gov (United States)

    Fränzle, Andrea; Hillengass, Jens; Bendl, Rolf

    2015-03-01

    Multiple myeloma is a tumor disease in the bone marrow that affects the skeleton systemically, i.e. multiple lesions can occur in different sites in the skeleton. To quantify overall tumor mass for determining degree of disease and for analysis of therapy response, volumetry of all lesions is needed. Since the large amount of lesions in one patient impedes manual segmentation of all lesions, quantification of overall tumor volume is not possible until now. Therefore development of automatic lesion detection and segmentation methods is necessary. Since focal tumors in multiple myeloma show different characteristics in different modalities (changes in bone structure in CT images, hypointensity in T1 weighted MR images and hyperintensity in T2 weighted MR images), multimodal image analysis is necessary for the detection of focal tumors. In this paper a pattern recognition approach is presented that identifies focal lesions in lumbar vertebrae based on features from T1 and T2 weighted MR images. Image voxels within bone are classified using random forests based on plain intensities and intensity value derived features (maximum, minimum, mean, median) in a 5 x 5 neighborhood around a voxel from both T1 and T2 weighted MR images. A test data sample of lesions in 8 lumbar vertebrae from 4 multiple myeloma patients can be classified at an accuracy of 95% (using a leave-one-patient-out test). The approach provides a reasonable delineation of the example lesions. This is an important step towards automatic tumor volume quantification in multiple myeloma.

  17. Can breast MRI computer-aided detection (CAD) improve radiologist accuracy for lesions detected at MRI screening and recommended for biopsy in a high-risk population?

    International Nuclear Information System (INIS)

    Arazi-Kleinman, T.; Causer, P.A.; Jong, R.A.; Hill, K.; Warner, E.

    2009-01-01

    Aim: To evaluate the sensitivity and specificity of magnetic resonance imaging (MRI) computer-aided detection (CAD) for breast MRI screen-detected lesions recommended for biopsy in a high-risk population. Material and methods: Fifty-six consecutive Breast Imaging Reporting and Data System (BI-RADS) 3-5 lesions with histopathological correlation [nine invasive cancers, 13 ductal carcinoma in situ (DCIS) and 34 benign] were retrospectively evaluated using a breast MRI CAD prototype (CAD-Gaea). CAD evaluation was performed separately and in consensus by two radiologists specializing in breast imaging, blinded to the histopathology. Thresholds of 50, 80, and 100% and delayed enhancement were independently assessed with CAD. Lesions were rated as malignant or benign according to threshold and delayed enhancement only and in combination. Sensitivities, specificities, and negative predictive values (NPV) were determined for CAD assessments versus pathology. Initial MRI BI-RADS interpretation without CAD versus CAD assessments were compared using paired binary diagnostic tests. Results: Threshold levels for lesion enhancement were: 50% to include all malignant (and all benign) lesions; and 100% for all invasive cancer and high-grade DCIS. Combined use of threshold and enhancement patterns for CAD assessment was best (73% sensitivity, 56% specificity and 76% NPV for all cancer). Sensitivities and NPV were better for invasive cancer (100%/100%) than for all malignancies (54%/76%). Radiologists' MRI interpretation was more sensitive than CAD (p = 0.05), but less specific (p = 0.001) for cancer detection. Conclusion: The breast MRI CAD system used could not improve the radiologists' accuracy for distinguishing all malignant from benign lesions, due to the poor sensitivity for DCIS detection.

  18. A comparative study of the detectability of TMJ radiographic techniques for artificial mandibular condylar lesions

    International Nuclear Information System (INIS)

    Jeong, Hee Jeong; Jung, Yeon Hwa; Cho, Bong Hae

    1997-01-01

    The purpose of this study was to evaluate the detectability of various radiographic techniques for mandibular condylar lesions. Erosive lesion, osteophyte and flattening were formed on the artificial mandibular condyle, and panoramic, transcranial, transorbital radiography, lateral and frontal tomography were taken. The results were as follows; 1. The detectability for erosive lesions was superior in the order of frontal tomography (96%), lateral tomography (78%), transorbital (59%), transcranial (56%) and panoramic (48%) radiography. 2. The location of erosive lesion that showed the highest detectability was the medial third in panoramic, the lateral third in transcranial, the central portion of anteroposterior direction in transorbital, the central portion of mediolateral direction and the posterior third in lateral tomography. Frontal tomography disclosed all erosive lesions except one anterolateral lesion. 3. The detectability of osteophyte was 100% in lateral tomography, 78% in transcranial and 56% in panoramic radiography. 4. For flattening, lateral tomography showed the flattened condyle, but both panoramic and transcranial views showed only decreased bone density without the change of condylar shape.

  19. Descriptive data on cancerous lung lesions detected by auto-fluorescence bronchoscope: A five-year study

    Directory of Open Access Journals (Sweden)

    Asmitananda Thakur

    2012-01-01

    Full Text Available Background: Auto-fluorescence bronchoscopy (AFB has been used for the identification and localization of intra-epithelial pre-neoplastic and neoplastic lesions within the bronchus. Objectives: To determine the applicability of AFB for the detection and localization of precancerous and cancerous lesions, in addition to analyzing the morphologic presentation, their association to histological type and the variation between genders. Methods: A five-year study involving 4983 patients, who underwent routine bronchoscopy [B] examination in a local tertiary teaching hospital, was done. The B examination was performed under intratracheal lidocaine, and samples were obtained using suitable approach. One thousand four hundred and eighty-five pathologically confirmed lung cancer patients were included in the study. The following parameters were studied: Morphological presentation, biopsy sites, histology. Differences between the groups were analyzed using Chi square test. Result: One thousand four hundred and eighty-five patients who had hyperplasia or neoplastic lesions were further confirmed as lung cancer pathologically. Lung cancer was more commonly found in the right lung (51.58% vs. 42.82%. The lesion occurred more frequently in the upper lobe than the lower lobe (44.17% vs. 22.42%. Male patients with squamous cell carcinoma showed upper lobe involvement more commonly, while the left main bronchus was more commonly involved in female patients. Adenocarcinoma mostly involved lesion of the upper lobe. Squamous cell carcinoma and small cell carcinoma were the major proliferative types (80.15% and 76.16% respectively. Conclusion: AFB is efficient in the detection of pre-invasive and invasive lung lesions. The morphological presentation is associated to the histological type. There is variation in the presentation and histology of cancerous lung lesions between genders.

  20. Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?

    Science.gov (United States)

    Yang, Pan; Peng, Yulan; Zhao, Haina; Luo, Honghao; Jin, Ya; He, Yushuang

    2015-01-01

    Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies. To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions. One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated. The maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate. Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.

  1. Management of breast lesions detectable only on MRI; Abklaerung ausschliesslich MRT-detektierbarer Mammalaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Siegmann-Luz, K.C.; Bahrs, S.D.; Preibsch, H.; Hattermann, V.; Claussen, C.D. [Universitaetsklinikum Tuebingen (Germany). Abt. Diagnostische und Interventionelle Radiologie

    2014-01-15

    Breast MR imaging has become established as the most sensitive imaging method for diagnosing breast cancer. As a result of the increasing examination volume and improved image quality, the number of breast lesions detected only on MRI and requiring further clarification has risen in recent years. According to the S3-guideline 'Diagnosis, Therapy, and Follow-Up of Breast Cancer' as revised in July 2012, institutions performing breast MRI should provide the option of an MRI-guided intervention for clarification. This review describes the indications, methods and results of MRI-guided interventions for the clarification of breast lesions only visible on MRI. Recent guidelines and study results are also addressed and alternative methods and pitfalls are presented. (orig.)

  2. Improved Detection of Microsatellite Instability in Early Colorectal Lesions.

    Directory of Open Access Journals (Sweden)

    Jeffery W Bacher

    Full Text Available Microsatellite instability (MSI occurs in over 90% of Lynch syndrome cancers and is considered a hallmark of the disease. MSI is an early event in colon tumor development, but screening polyps for MSI remains controversial because of reduced sensitivity compared to more advanced neoplasms. To increase sensitivity, we investigated the use of a novel type of marker consisting of long mononucleotide repeat (LMR tracts. Adenomas from 160 patients, ranging in age from 29-55 years old, were screened for MSI using the new markers and compared with current marker panels and immunohistochemistry standards. Overall, 15 tumors were scored as MSI-High using the LMRs compared to 9 for the NCI panel and 8 for the MSI Analysis System (Promega. This difference represents at least a 1.7-fold increase in detection of MSI-High lesions over currently available markers. Moreover, the number of MSI-positive markers per sample and the size of allelic changes were significantly greater with the LMRs (p = 0.001, which increased confidence in MSI classification. The overall sensitivity and specificity of the LMR panel for detection of mismatch repair deficient lesions were 100% and 96%, respectively. In comparison, the sensitivity and specificity of the MSI Analysis System were 67% and 100%; and for the NCI panel, 75% and 97%. The difference in sensitivity between the LMR panel and the other panels was statistically significant (p<0.001. The increased sensitivity for detection of MSI-High phenotype in early colorectal lesions with the new LMR markers indicates that MSI screening for the early detection of Lynch syndrome might be feasible.

  3. Association between power law coefficients of the anatomical noise power spectrum and lesion detectability in breast imaging modalities

    Science.gov (United States)

    Chen, Lin; Abbey, Craig K.; Boone, John M.

    2013-03-01

    Previous research has demonstrated that a parameter extracted from a power function fit to the anatomical noise power spectrum, β, may be predictive of breast mass lesion detectability in x-ray based medical images of the breast. In this investigation, the value of β was compared with a number of other more widely used parameters, in order to determine the relationship between β and these other parameters. This study made use of breast CT data sets, acquired on two breast CT systems developed in our laboratory. A total of 185 breast data sets in 183 women were used, and only the unaffected breast was used (where no lesion was suspected). The anatomical noise power spectrum computed from two-dimensional region of interests (ROIs), was fit to a power function (NPS(f) = α f-β), and the exponent parameter (β) was determined using log/log linear regression. Breast density for each of the volume data sets was characterized in previous work. The breast CT data sets analyzed in this study were part of a previous study which evaluated the receiver operating characteristic (ROC) curve performance using simulated spherical lesions and a pre-whitened matched filter computer observer. This ROC information was used to compute the detectability index as well as the sensitivity at 95% specificity. The fractal dimension was computed from the same ROIs which were used for the assessment of β. The value of β was compared to breast density, detectability index, sensitivity, and fractal dimension, and the slope of these relationships was investigated to assess statistical significance from zero slope. A statistically significant non-zero slope was considered to be a positive association in this investigation. All comparisons between β and breast density, detectability index, sensitivity at 95% specificity, and fractal dimension demonstrated statistically significant association with p performance. Specifically, lower values of β were associated with lower breast density

  4. Representability of metastatic bone lesions in magnification radiography

    International Nuclear Information System (INIS)

    Togawa, Takashi

    1981-01-01

    Magnification radiography, bone scintigraphy, and normal roentgenography were performed on patients with malignant tumors to detect their bone metastases, and from the results obtained, these diagnostic procedures were evaluated for the detectability and representability of metastatic bone lesions. Bone scan and normal roentgenography were performed on 90 metastatic bone lesions in 37 patients, and magnification radiography was done on 14 bone lesions noted in 10 of the 37 and another with benign osseous change. Among the three, bone scintigraphy was best, and magnification radiography and normal roentgenography did not differ significantly in detectability. In magnification radiography, some metastatic bone lesions were represented more clearly than by normal roentgeography, but some were not. As regards the representability of the ribs, magnification radiography was very useful. One case of bone destruction was detected by magnification radiography, but not by normal roentgenography. (author)

  5. Comparisons of lesion detectability in ultrasound images acquired using time-shift compensation and spatial compounding.

    Science.gov (United States)

    Lacefield, James C; Pilkington, Wayne C; Waag, Robert C

    2004-12-01

    The effects of aberration, time-shift compensation, and spatial compounding on the discrimination of positive-contrast lesions in ultrasound b-scan images are investigated using a two-dimensional (2-D) array system and tissue-mimicking phantoms. Images were acquired within an 8.8 x 12-mm2 field of view centered on one of four statistically similar 4-mm diameter spherical lesions. Each lesion was imaged in four planes offset by successive 45 degree rotations about the central scan line. Images of the lesions were acquired using conventional geometric focusing through a water path, geometric focusing through a 35-mm thick distributed aberration phantom, and time-shift compensated transmit and receive focusing through the aberration phantom. The views of each lesion were averaged to form sets of water path, aberrated, and time-shift compensated 4:1 compound images and 16:1 compound images. The contrast ratio and detectability index of each image were computed to assess lesion differentiation. In the presence of aberration representative of breast or abdominal wall tissue, time-shift compensation provided statistically significant improvements of contrast ratio but did not consistently affect the detectability index, and spatial compounding significantly increased the detectability index but did not alter the contrast ratio. Time-shift compensation and spatial compounding thus provide complementary benefits to lesion detection.

  6. 111In-Octreotide and 99mTc-MDP scintigraphy in the detection of bone lesions in Langerhans cell histiocytosis

    International Nuclear Information System (INIS)

    Hervas, I.; Bello, P.; Gonzalez-Cabezas, P.; Flores, D.; Perez-Velasco, R.; Torres, I.; Castel, V.; Mateo, A.; Canete, A.

    2002-01-01

    Aim: Langerhans cell histiocytosis (LCH) is a granulomatous disease which can involve multiples sites of the body. Diagnostic imaging is of utmost importance in the management of these patients. Since now radiographic skeletal survey and bone scintigraphy (BS) have been used to assess bone involvement (both with low specificity). Magnetic resonance and CT have been used to assess visceral involvement but with the limitation that can not give information about the functional status. Recently two groups of investigators (Lastoria et al. and Calming et al.) have proposed somatostatin receptor scintigraphy (SSRS) to detect active lesions and for monitoring the response to treatment, due to the somatostatin analogue octreotide binds to the cell membrane of activated lymphocytes expressing somatostatine receptors. The aim of this study is to assess bone and somatostatine receptor scintigraphy in the detection of bone involvement in LCH in children. Visceral involvement has not been assessed due to none of the patients presented it at the moment of the SRS. Methods: 17 scintigraphies (11 SSRS and 6 BS) were performed in seven patients (3 girls and 4 boys) aged at diagnosis: 18 month- 12 years (mean age 6,2 years). The findings obtained in the scintigraphies were compared with clinical evolution and other imaging techniques. Results: All the BS detected the diagnosed lesions, that decreased the uptake after the treatment. In three cases BS detected one unknown bone lesion. Two SSRS could not detect a lesion on right rib in two patients, both at the moment of diagnosis. SSRS was true negative in one patient (clinical and other imaging remission) and true positive in the other four cases. SSRS detected three new unknown bone lesions. SRSS showed decreased uptake after treatment and increased uptake in the relapses. Conclusions: Somatostatin receptor and Bone scintigraphy can be used to detect active LCH bone lesions in children and can help in monitoring the response to

  7. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    Energy Technology Data Exchange (ETDEWEB)

    Morais, A. P. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Salgado de Oliveira University, Marechal Deodoro Street, 217 – Centro, Niterói, Rio de Janeiro (Brazil); Pino, A. V. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Souza, M. N. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Electronics Department at Polytechnic School, Federal University of Rio de Janeiro, Centro de Tecnologia Bloco H sala 217, Ilha do Fundão, Rio de Janeiro (Brazil)

    2016-08-15

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  8. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    International Nuclear Information System (INIS)

    Morais, A. P.; Pino, A. V.; Souza, M. N.

    2016-01-01

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  9. Detection and classification of focal liver lesions in patients with colorectal cancer: Retrospective comparison of diffusion-weighted MR imaging and multi-slice CT

    International Nuclear Information System (INIS)

    Eiber, Matthias; Fingerle, Alexander A.; Brügel, Melanie; Gaa, Jochen; Rummeny, Ernst J.; Holzapfel, Konstantin

    2012-01-01

    Objectives: To compare the diagnostic performance of diffusion-weighted MR imaging (DWI) with multi-slice CT (MS-CT) in the detection and classification of focal liver lesions in patients with colorectal cancer. Methods: In a retrospective study 68 patients who underwent DWI at 1.5 T (b-values of 50, 300 and 600 s/mm 2 ) and contrast-enhanced MS-CT were analysed by two radiologists blinded to the clinical results. Imaging results were correlated with intraoperative surgical and ultrasound findings (n = 24), imaging follow-up or PET (n = 44). Sensitivity of DWI and MS-CT in detection of focal liver lesions was compared on a per-lesion and a per-segment basis. Receiver operator-characteristic (ROC) curves to determine the diagnostic performance and the sensitivities of correctly identifying liver metastases on a segmental base were calculated. Results: For lesion detection, DWI was significantly superior to MS-CT both on a per-lesion (difference in sensitivities for reader 1 and 2 22.65% and 19.06%, p < 0.0001) and a per-segment basis (16.86% and 11.76%, p < 0.0001). Especially lesions smaller than 10 mm were better detected with DWI compared to MS-CT (difference 41.10% and 29.45%, p < 0.0001). ROC-analysis showed superiority for lesions classification (p < 0.0001) of DWI (AUC: 0.949 and 0.951) as compared to MS-CT (AUC: 0.879 and 0.892, p < 0.0001 and p = 0.005). DWI was able to filter out metastatic segments with a higher sensitivity (88.2 and 86.5%) compared to MS-CT (68.0 and 67.4%, p < 0.0001 and p = 0.005, respectively). Conclusion: Compared to MS-CT DWI is both more sensitive in the detection of liver lesions and more accurate in determining the extent of metastatic disease in patients with colorectal cancer and therefore might help to optimize therapeutic management in those patients.

  10. Model observer for assessing digital breast tomosynthesis for multi-lesion detection in the presence of anatomical noise

    Science.gov (United States)

    Wen, Gezheng; Markey, Mia K.; Miner Haygood, Tamara; Park, Subok

    2018-02-01

    Model observers are widely used in task-based assessments of medical image quality. The presence of multiple abnormalities in a single set of images, such as in multifocal multicentric breast cancer (MFMC), has an immense clinical impact on treatment planning and survival outcomes. Detecting multiple breast tumors is challenging as MFMC is relatively uncommon, and human observers do not know the number or locations of tumors a priori. Digital breast tomosynthesis (DBT), in which an x-ray beam sweeps over a limited angular range across the breast, has the potential to improve the detection of multiple tumors. However, prior studies of DBT image quality all focus on unifocal breast cancers. In this study, we extended our 2D multi-lesion (ML) channelized Hotelling observer (CHO) into a 3D ML-CHO that detects multiple lesions from volumetric imaging data. Then we employed the 3D ML-CHO to identify optimal DBT acquisition geometries for detection of MFMC. Digital breast phantoms with multiple embedded synthetic lesions were scanned by simulated DBT scanners of different geometries (wide/narrow angular span, different number of projections per scan) to simulate MFMC cases. With new implementations of 3D partial least squares (PLS) and modified Laguerre-Gauss (LG) channels, the 3D ML-CHO made detection decisions based upon the overall information from individual DBT slices and their correlations. Our evaluation results show that: (1) the 3D ML-CHO could achieve good detection performance with a small number of channels, and 3D PLS channels on average outperform the counterpart LG channels; (2) incorporating locally varying anatomical backgrounds and their correlations as in the 3D ML-CHO is essential for multi-lesion detection; (3) the most effective DBT geometry for detection of MFMC may vary when the task of clinical interest changes, and a given DBT geometry may not yield images that are equally informative for detecting MF, MC, and unifocal cancers.

  11. Scintigraphic detection of peptic lesions with the method of radiolabelled sucralfate

    International Nuclear Information System (INIS)

    Naumovski, J.; Kovkarova, E.; Simova, N.; Janevik-Ivanovska, E.; Georgievska- Kuzmanovska, S.

    2003-01-01

    Background. Sucralfate is an antiulcer agent that after peroral application strongly adheres to mucosal defects and in that way provides a protective barrier to further damage from acid and pepsin. If radiolabelled with a gamma isotope, it could be detected under a gamma camera pointing lesions to which it adhered. With the aim to confirm a suitable noninvasive method for investigation of caustic lesions of the upper gastrointestinal tract we evaluated in a preliminary study the validity of the radiolabelled Sucralfate scintigraphy in detection of peptic disease. Patients and methods. With that purpose, 35 patients after an endoscopic examination underwent scintigraphy with Tc-99m-DTPA sucralfate. Patients were divided in two groups: a group of 20 patients with endoscopic confirmed peptic disease and a control group of 15 persons who had not any disease of the upper gastrointestinal tract. Results. Using the test for clinical evaluation of a new method, the scan showed sensitivity of 75 %, specificity of 100 % and accuracy of 85.7 %. Conclusions. Scintigraphy with Tc-99m-DTPA Sucralfate promoting it as an additional method, complementary to routine investigations in detecting mucosal lesions. (author)

  12. Red Lesion Detection Using Dynamic Shape Features for Diabetic Retinopathy Screening.

    Science.gov (United States)

    Seoud, Lama; Hurtut, Thomas; Chelbi, Jihed; Cheriet, Farida; Langlois, J M Pierre

    2016-04-01

    The development of an automatic telemedicine system for computer-aided screening and grading of diabetic retinopathy depends on reliable detection of retinal lesions in fundus images. In this paper, a novel method for automatic detection of both microaneurysms and hemorrhages in color fundus images is described and validated. The main contribution is a new set of shape features, called Dynamic Shape Features, that do not require precise segmentation of the regions to be classified. These features represent the evolution of the shape during image flooding and allow to discriminate between lesions and vessel segments. The method is validated per-lesion and per-image using six databases, four of which are publicly available. It proves to be robust with respect to variability in image resolution, quality and acquisition system. On the Retinopathy Online Challenge's database, the method achieves a FROC score of 0.420 which ranks it fourth. On the Messidor database, when detecting images with diabetic retinopathy, the proposed method achieves an area under the ROC curve of 0.899, comparable to the score of human experts, and it outperforms state-of-the-art approaches.

  13. Computerized detection method for asymptomatic white matter lesions in brain screening MR images using a clustering technique

    International Nuclear Information System (INIS)

    Kunieda, Takuya; Uchiyama, Yoshikazu; Hara, Takeshi

    2008-01-01

    Asymptomatic white matter lesions are frequently identified by the screening system known as Brain Dock, which is intended for the detection of asymptomatic brain diseases. The detection of asymptomatic white matter lesions is important because their presence is associated with an increased risk of stroke. Therefore, we have developed a computerized method for the detection of asymptomatic white matter lesions in order to assist radiologists in image interpretation as a ''second opinion''. Our database consisted of T 1 - and T 2 -weighted images obtained from 73 patients. The locations of the white matter lesions were determined by an experienced neuroradiologist. In order to restrict the area to be searched for white matter lesions, we first segmented the cerebral region in T 1 -weighted images by applying thresholding and region-growing techniques. To identify the initial candidate lesions, k-means clustering with pixel values in T 1 - and T 2 -weighted images was applied to the segmented cerebral region. To eliminate false positives (FPs), we determined the features, such as location, size, and circularity, of each of the initial candidate lesions. Finally, a rule-based scheme and a quadratic discriminant analysis with these features were employed to distinguish between white matter lesions and FPs. The results showed that the sensitivity for the detection of white matter lesions was 93.2%, with 4.3 FPs per image, suggesting that our computerized method may be useful for the detection of asymptomatic white matter lesions in T 1 - and T 2 -weighted images. (author)

  14. Frequent Detection of Pancreatic Lesions in Asymptomatic High-Risk Individuals

    Science.gov (United States)

    Canto, Marcia Irene; Hruban, Ralph H.; Fishman, Elliot K.; Kamel, Ihab R.; Schulick, Richard; Zhang, Zhe; Topazian, Mark; Takahashi, Naoki; Fletcher, Joel; Petersen, Gloria; Klein, Alison P.; Axilbund, Jennifer; Griffin, Constance; Syngal, Sapna; Saltzman, John R.; Mortele, Koenraad J.; Lee, Jeffrey; Tamm, Eric; Vikram, Raghunandan; Bhosale, Priya; Margolis, Daniel; Farrell, James; Goggins, Michael

    2012-01-01

    BACKGROUND & AIMS The risk of pancreatic cancer is increased in patients with a strong family history of pancreatic cancer or a predisposing germline mutation. Screening can detect curable, non-invasive pancreatic neoplasms, but the optimal imaging approach is not known. We determined the baseline prevalence and characteristics of pancreatic abnormalities using 3 imaging tests to screen asymptomatic, high-risk individuals (HRI). METHODS We screened 225 asymptomatic adult HRI at 5 academic US medical centers once, using computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). We compared results in a blinded, independent fashion. RESULTS Ninety-two of 216 HRI (42%) were found to have at least 1 pancreatic mass (84 cystic, 3 solid) or a dilated pancreatic duct (n=5) by any of the imaging modalities. Fifty-one of the 84 HRI with a cyst (60.7%) had multiple lesions, typically small (mean 0.55 cm, range 2–39 mm), in multiple locations. The prevalence of pancreatic lesions increased with age; they were detected in 14% of subjects <50 years old, 34% of subjects 50–59 years old, and 53% of subjects 60–69 years old (P<.0001). CT, MRI, and EUS detected a pancreatic abnormality in 11%, 33.3%, and 42.6% of the HRI, respectively. Among these abnormalities, proven or suspected neoplasms were identified in 85 HRI (82 intraductal papillary mucinous neoplasms [IPMN] and 3 pancreatic endocrine tumors). Three of 5 HRI who underwent pancreatic resection had high-grade dysplasia in <3 cm IPMNs and in multiple intraepithelial neoplasias. CONCLUSIONS Screening of asymptomatic HRI frequently detects small pancreatic cysts, including curable, non-invasive high-grade neoplasms. EUS and MRI detect pancreatic lesions better than CT. PMID:22245846

  15. FDG PET/CT Is Superior to Enhanced CT in Detecting Recurrent Subcentimeter Lesions in the Abdominopelvic Cavity in Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai Jeon; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of); Lee, Jong Jin [Asan Medical Center, Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    This study aims to compare the performance of contrast enhanced computed tomography (CeCT) and 18 F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. We enrolled 16 patients who were clinically suspected of experiencing a recurrences (6 male, 10 female; mean age 61{+-}14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT and PET/CT confirmed nodules (5.5{+-}4.2 vs. 2.9{+-}2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT and PET/CT confirmed nodules (long axis:1.0{+-}0.3cm vs. 2.0{+-}1.1cm, p=0.001; short axis: 0.8{+-}0.3cm vs. 1.7{+-}0.9cm, p=0.001). Similarly, PET/CT only detected LNs were significantly smaller than CeCT and PET/CT identified LNs (0.7{+-}0.1cm vs. 2.3{+-}1.2cm, p<0.0001). PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

  16. Texture alteration detection in bitemporal images of lesions with psoriasis

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær

    2003-01-01

    The objective of this work is to explore the feasibility of quantifying textural change between pairs of segmented patterns without registering them. The Multi-variate Alteration Detection (M.A.D.) Transform is applied to a texture model constructed with the data of segmented psoriasis lesions im...... images. The texture model is Haralick's co-occurrence matrix, which is computed and normalized for each single band with the equalized data of a given lesion. The contribution of each single color band to the textural change is analyzed....

  17. Cylindrical SUV distribution model for detecting skin lesions in body trunk FDG-PET/CT images

    International Nuclear Information System (INIS)

    Nemoto, Mitsutaka; Nomura, Yukihiro; Masutani, Yoshitaka; Yoshikawa, Takeharu; Hayashi, Naoto; Yoshioka, Naoki; Ohtomo, Kuni; Hanaoka, Shouhei

    2010-01-01

    We have been developing a computerized detection method for skin lesions in body trunk fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT images. Spots on the skin with a high standard uptake value (SUV) are due not only to glucose metabolism in skin lesions but also to the physiological metabolism of organs near the skin. The distribution pattern of regional SUV on the skin is important information for the differential diagnosis of such high-SUV spots. In this study, we have developed a new skin lesion detection method based on a cylindrical SUV distribution model of the skin. The shape of the SUV distribution model is an approximation of the body trunk, and the SUV distribution model includes standard values for regional skin SUV. Classifier ensembles based on CT image features, SUV features, and subtraction features between the SUVs in FDG-PET images and the values in the SUV distribution model are used to extract and classify candidate regions for skin lesions. In a study of skin lesion detection using FDG-PET/CT images in 36 clinical cases, the true-positive rate was 61.7%, with 11.7 false-positive regions per case. The training results of the classifier ensemble for extracting and classifying candidate regions showed the effective features for detecting skin lesions in the study. (author)

  18. Oral precancerous lesions: Problems of early detection and oral cancer prevention

    Science.gov (United States)

    Gileva, Olga S.; Libik, Tatiana V.; Danilov, Konstantin V.

    2016-08-01

    The study presents the results of the research in the structure, local and systemic risk factors, peculiarities of the clinical manifestation, and quality of primary diagnosis of precancerous oral mucosa lesions (OMLs). In the study a wide range of OMLs and high (25.4%) proportion of oral precancerous lesions (OPLs) in their structure was indicated. The high percentage of different diagnostic errors and the lack of oncological awareness of dental practitioners, as well as the sharp necessity of inclusion of precancer/cancer early detection techniques into their daily practice were noted. The effectiveness of chemilumenescence system of early OPLs and oral cancer detection was demonstrated, the prospects of infrared thermography as a diagnostic tool were also discussed.

  19. Pigmented skin lesion detection using random forest and wavelet-based texture

    Science.gov (United States)

    Hu, Ping; Yang, Tie-jun

    2016-10-01

    The incidence of cutaneous malignant melanoma, a disease of worldwide distribution and is the deadliest form of skin cancer, has been rapidly increasing over the last few decades. Because advanced cutaneous melanoma is still incurable, early detection is an important step toward a reduction in mortality. Dermoscopy photographs are commonly used in melanoma diagnosis and can capture detailed features of a lesion. A great variability exists in the visual appearance of pigmented skin lesions. Therefore, in order to minimize the diagnostic errors that result from the difficulty and subjectivity of visual interpretation, an automatic detection approach is required. The objectives of this paper were to propose a hybrid method using random forest and Gabor wavelet transformation to accurately differentiate which part belong to lesion area and the other is not in a dermoscopy photographs and analyze segmentation accuracy. A random forest classifier consisting of a set of decision trees was used for classification. Gabor wavelets transformation are the mathematical model of visual cortical cells of mammalian brain and an image can be decomposed into multiple scales and multiple orientations by using it. The Gabor function has been recognized as a very useful tool in texture analysis, due to its optimal localization properties in both spatial and frequency domain. Texture features based on Gabor wavelets transformation are found by the Gabor filtered image. Experiment results indicate the following: (1) the proposed algorithm based on random forest outperformed the-state-of-the-art in pigmented skin lesions detection (2) and the inclusion of Gabor wavelet transformation based texture features improved segmentation accuracy significantly.

  20. Improved focal liver lesion detection by increasing flip angle during gadoxetic acid-enhancement in MRI

    International Nuclear Information System (INIS)

    Lee, Se Jy; Kim, Young Keun

    2015-01-01

    To study the differences of focal liver lesion image detection at 3 minute, 10 minute and 15 minute time points on gadoxetic acid (GA)’s enhanced MR imaging with a flip angle (FA) of 30° compared with a 11°. The subjects were 69 patients evaluated with GA enhanced MR imaging with 3.0T MR scanner. The patients are total 35(23 men and 7 women at the mean age of 60.4 years), hepatocellular carcinoma(23) and metastsis(12) except for normal, cyst and hemangioma. After GA was injected, FA 11° and 30° images were obtained at 3 minute, 10 minute and 15 minute time points respectively. After quantitative and qualitative assessment of each image was done, statistical analysis was performed by using the independent sample T-test. From both quantitative and qualitative assessment of 3 minute and 10 minute MR images after the injection of GA, FA 30° images was found to be superior than FA 11°, but there were no statistical significance. However, at 15 minute time point, Statistically significant FA 30° image(p<0.05) was better than FA 11° therefore, the FA 30° improves the focal liver lesion detection. FA 30° of MR image can detect liver lesion more sensitively than the existing FA11° image after GA contrast enhancement at 15 minute time point

  1. How Should We Perform Rotational Atherectomy to an Angulated Calcified Lesion?

    Science.gov (United States)

    Sakakura, Kenichi; Taniguchi, Yousuke; Matsumoto, Mitsunari; Wada, Hiroshi; Momomura, Shin-Ichi; Fujita, Hideo

    2016-05-25

    Rotational atherectomy to an angulated calcified lesion is always challenging. The risk of catastrophic complications such as a burr becoming stuck or vessel perforation is greater when the calcified lesion is angulated. We describe the case of an 83-year-old female suffering from unstable angina. Diagnostic coronary angiography revealed an angulated calcified lesion in the proximal segment of the right coronary artery. We performed rotational atherectomy to the lesion, but intentionally did not advance the rotational atherectomy burr beyond the top of the angulation. We controlled the rotational atherectomy burr and stopped it just before the top of the angulation to avoid complications. Following rotational atherectomy, balloon dilatation with a non-compliant balloon was performed, and drug-eluting stents were successfully deployed. In this manuscript, we provide a review of the literature on this topic, and discuss how rotational atherectomy to an angulated calcified lesion should be performed.

  2. Primary Three-Dimensional Analysis with Perspective-Filet View Versus Primary Two-Dimensional Analysis: Evaluation of Lesion Detection by Inexperienced Readers at Computed Tomographic Colonography in Symptomatic Patients

    International Nuclear Information System (INIS)

    Fisichella, V.A.; Horvath, S.; Hellstroem, M.; Jaederling, F.; Stotzer, P.O.; Kilander, A.

    2009-01-01

    Background: 'Perspective-filet view' is a novel three-dimensional (3D) viewing technique for computed tomography colonography (CTC). Studies with experienced readers have shown a sensitivity for perspective-filet view similar to that of 2D or 3D endoluminal fly-through in detection of colorectal lesions. It is not known whether perspective-filet view, compared to axial images, improves lesion detection by inexperienced readers. Purpose: To compare primary 3D analysis using perspective-filet view (3D Filet) with primary 2D analysis, as used by inexperienced CTC readers. Secondary aims were to compare lesion detection by 3D Filet when used by experienced and inexperienced readers, and to evaluate the effect of combined 3D Filet + 2D analysis. Material and Methods: Fifty symptomatic patients were prospectively enrolled. An experienced reader performed 3D Filet analysis followed by complete 2D analysis (3D Filet + 2D), before colonoscopy with segmental unblinding. Two inexperienced readers (readers 2 and 3), blinded to CTC and colonoscopy findings, retrospectively performed 3D Filet analysis and, after 5 weeks, 2D analysis. True positives =6 mm detected by the inexperienced readers with 3D Filet and/or 2D were combined to obtain 3D Filet + 2D. Results: Colonoscopy revealed 116 lesions: 16 lesions =10 mm, 19 lesions 6-9 mm, and 81 lesions =5 mm. For the experienced reader, sensitivities for lesions =6 mm with 3D Filet and 3D Filet + 2D were 77% and 83%, respectively. For the inexperienced readers, sensitivities for lesions =6 mm with 3D Filet and 2D were 51% and 57% (reader 2) and 40% and 43% (reader 3), respectively. There was no significant difference between 3D Filet and 2D regarding sensitivity and reading time. For lesions =6 mm, 3D Filet + 2D improved the sensitivity of reader 2 to 63% and of reader 3 to 51%. Conclusion: Lesion detection by inexperienced readers using perspective-filet view is comparable to that obtained by 2D. Lesion detection improves by

  3. A soft kinetic data structure for lesion border detection.

    Science.gov (United States)

    Kockara, Sinan; Mete, Mutlu; Yip, Vincent; Lee, Brendan; Aydin, Kemal

    2010-06-15

    The medical imaging and image processing techniques, ranging from microscopic to macroscopic, has become one of the main components of diagnostic procedures to assist dermatologists in their medical decision-making processes. Computer-aided segmentation and border detection on dermoscopic images is one of the core components of diagnostic procedures and therapeutic interventions for skin cancer. Automated assessment tools for dermoscopic images have become an important research field mainly because of inter- and intra-observer variations in human interpretations. In this study, a novel approach-graph spanner-for automatic border detection in dermoscopic images is proposed. In this approach, a proximity graph representation of dermoscopic images in order to detect regions and borders in skin lesion is presented. Graph spanner approach is examined on a set of 100 dermoscopic images whose manually drawn borders by a dermatologist are used as the ground truth. Error rates, false positives and false negatives along with true positives and true negatives are quantified by digitally comparing results with manually determined borders from a dermatologist. The results show that the highest precision and recall rates obtained to determine lesion boundaries are 100%. However, accuracy of assessment averages out at 97.72% and borders errors' mean is 2.28% for whole dataset.

  4. Screen film vs full-field digital mammography: image quality, detectability and characterization of lesions

    International Nuclear Information System (INIS)

    Obenauer, S.; Luftner-Nagel, S.; Heyden, D. von; Baum, F.; Grabbe, E.; Munzel, U.

    2002-01-01

    The objective of this study was to compare screen-film mammography (SFM) to full-field digital mammography (FFDM) regarding image quality as well as detectability and characterization of lesions using equivalent images of the same patient acquired with both systems. Two mammography units were used, one with a screen-film system (Senographe DMR) and the other with a digital detector (Senographe 2000D, both GEMS). Screen-film and digital mammograms were performed on 55 patients with cytologically or histologically proven tumors on the same day. Together with these, 75 digital mammograms of patients without tumor and the corresponding previous screen-film mammograms not older than 1.5 years were reviewed by three observers in a random order. Contrast, exposure, and the presence of artifacts were evaluated. Different details, such as the skin, the retromamillary region, and the parenchymal structures, were judged according to a three-point ranking scale. Finally, the detectability of microcalcifications and lesions were compared and correlated to histology. Image contrast was judged to be good in 76%, satisfactory in 20%, and unsatisfactory in 4% of screen-film mammograms. Digital mammograms were judged to be good in 99% and unsatisfactory in 1% of cases. Improper exposure of screen-film system occurred in 18% (10% overexposed and 8% underexposed). Digital mammograms were improperly exposed in 4% of all cases but were of acceptable quality after post-processing. Artifacts, most of them of no significance, were found in 78% of screen-film and in none of the digital mammograms. Different anatomical regions, such as the skin, the retromamillary region, and dense parenchymal areas, were better visualized in digital than in screen-film mammography. All malignant tumors were seen by the three radiologists; however, digital mammograms allowed a better characterization of these lesions to the Breast Imaging Reporting and Data System (BI-RADSZZZ;) categories (FFDM better than

  5. Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions

    DEFF Research Database (Denmark)

    Gimenez, Thais; Piovesan, Chaiana; Braga, Mariana M

    2015-01-01

    Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering...... the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature...... to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study...

  6. Going With the Flow: An Aid in Detecting and Differentiating Bronchopulmonary Sequestrations and Hybrid Lesions.

    Science.gov (United States)

    Oliver, Edward R; DeBari, Suzanne E; Giannone, Mariann M; Pogoriler, Jennifer E; Johnson, Ann M; Horii, Steven C; Gebb, Juliana S; Howell, Lori J; Adzick, N Scott; Coleman, Beverly G

    2018-02-01

    To assess the ability of prenatal ultrasound (US) in identifying systemic feeding arteries in bronchopulmonary sequestrations and hybrid lesions and report the ability of US in classifying bronchopulmonary sequestrations as intralobar or extralobar. Institutional Review Board-approved radiology and clinical database searches from 2008 to 2015 were performed for prenatal lung lesions with final diagnoses of bronchopulmonary sequestrations or hybrid lesions. All patients had detailed US examinations, and most patients had ultrafast magnetic resonance imaging (MRI). Lesion location, size, and identification of systemic feeding arteries and draining veins were assessed with US. The study consisted of 102 bronchopulmonary sequestrations and 86 hybrid lesions. The median maternal age was 30 years. The median gestational age was 22 weeks 5 days. Of bronchopulmonary sequestrations, 66 had surgical pathologic confirmation, and 100 had postnatal imaging. Bronchopulmonary sequestration locations were intrathoracic (n = 77), intra-abdominal (n = 19), and transdiaphragmatic (n = 6). Of hybrid lesions, 84 had surgical pathologic confirmation, and 83 had postnatal imaging. Hybrid lesion locations were intrathoracic (n = 84) and transdiaphragmatic (n = 2). Ultrasound correctly identified systemic feeding arteries in 86 of 102 bronchopulmonary sequestrations and 79 of 86 hybrid lesions. Of patients who underwent MRI, systemic feeding arteries were reported in 62 of 92 bronchopulmonary sequestrations and 56 of 81 hybrid lesions. Ultrasound identified more systemic feeding arteries than MRI in both bronchopulmonary sequestrations and hybrid lesions (P < .01). Magnetic resonance imaging identified systemic feeding arteries that US did not in only 2 cases. In cases in which both systemic feeding arteries and draining veins were identified, US could correctly predict intrathoracic lesions as intralobar or extralobar in 44 of 49 bronchopulmonary sequestrations and

  7. Detection of occlusal caries lesions using fluorescence: correlation between histology and obtained results for Diagnodent and spectroscopy

    International Nuclear Information System (INIS)

    Rocha-Cabral, Renata Maciel

    2006-01-01

    The aims of this study were to develop and test a method to detect caries lesions in vivo and in vitro, using a portable spectrometer (PS); to analyze the performance of PS as well as the commercial device Diagnodent (Dd); correlate them with the gold standard, their transversal section areas and lesions depth and between themselves. 66 occlusal pre-molars sites were examined in vivo with Dd. Sequentially, fluorescence (λexc ∼ 657 nm) was collected by an optical fiber, conducted to PS and then analyzed as spectra, which were normalized and had calculated the Ratios of their Areas Under the Curves (RAUC) of carious and sound tissues. Experiments were conducted in vitro in the same sites. Gold Standard was obtained by polarized light microscopy. Pearson correlation was used to compare the devices with transversal section area, lesions depth and between themselves. The area under ROC curve, sensitivity, specificity as well as accuracy were calculated and verified with McNemar test. Dd and RAUC showed statistically significant correlation with gold standard (p < 0.01 for Dd and p < 0.05 for RAUC) and between themselves (r = 0,83 in vivo and r = 0,87 in vitro). Although it was significant, the devices showed low correlation with depth of lesions in vivo and in vitro (r = ∼ 0.43). The transversal section area of the lesion had no influence on readings in both devices. Dd showed higher sensitivity (0.76) than PS (0.60) in vivo (p < 0.05), though this fact was not able to improve its performance. In turn, PS showed higher sensitivity (0.88) than Dd (0.79) in vitro, but this difference was not significantly. The other parameters did not show statistically significant differences (p < 0.05) between methods. PS showed positive correlation with Dd, equal correlation with lesions depth and higher ability of detecting the disease in vitro, what suggests that if accompanied with a conic and an angulated probe and a dedicated software, the PS method could be useful in clinics

  8. Detection of white matter lesion regions in MRI using SLIC0 and convolutional neural network.

    Science.gov (United States)

    Diniz, Pedro Henrique Bandeira; Valente, Thales Levi Azevedo; Diniz, João Otávio Bandeira; Silva, Aristófanes Corrêa; Gattass, Marcelo; Ventura, Nina; Muniz, Bernardo Carvalho; Gasparetto, Emerson Leandro

    2018-04-19

    White matter lesions are non-static brain lesions that have a prevalence rate up to 98% in the elderly population. Because they may be associated with several brain diseases, it is important that they are detected as soon as possible. Magnetic Resonance Imaging (MRI) provides three-dimensional data with the possibility to detect and emphasize contrast differences in soft tissues, providing rich information about the human soft tissue anatomy. However, the amount of data provided for these images is far too much for manual analysis/interpretation, representing a difficult and time-consuming task for specialists. This work presents a computational methodology capable of detecting regions of white matter lesions of the brain in MRI of FLAIR modality. The techniques highlighted in this methodology are SLIC0 clustering for candidate segmentation and convolutional neural networks for candidate classification. The methodology proposed here consists of four steps: (1) images acquisition, (2) images preprocessing, (3) candidates segmentation and (4) candidates classification. The methodology was applied on 91 magnetic resonance images provided by DASA, and achieved an accuracy of 98.73%, specificity of 98.77% and sensitivity of 78.79% with 0.005 of false positives, without any false positives reduction technique, in detection of white matter lesion regions. It is demonstrated the feasibility of the analysis of brain MRI using SLIC0 and convolutional neural network techniques to achieve success in detection of white matter lesions regions. Copyright © 2018. Published by Elsevier B.V.

  9. Proliferative changes in nonpalpable breast lesions detected by mammography; Alteraciones profiferativas de la mama en lesiones no palpables detectadas por mamografia

    Energy Technology Data Exchange (ETDEWEB)

    Vega, A.; Delgado, A.; Ortega, E.; Garijo, F. [Hospital Universitario Marques de Valdecilla. Santander (Spain); Mosquera, J.; Sogo, C.; Alvarez, A. [Complejo Hospitalario Juan Canalejo. La Coruna (Spain)

    2000-07-01

    To analyze retrospectively the radiological findings in nonpalpable breast lesions detected by mammography that lead to the performance of surgical biopsy, resulting in a histological diagnosis of proliferative breast disease with and without atypia. From two Spanish hospitals, 421 women with 429 biopsies indicative of the presence of proliferative breast disease with and without atypia were selected out of a total of 1252 surgical biopsies in nonpalpable lesions that proved to be benign. Age, personal and familial history of breast cancer, reason for requesting the mammography and radiological findings that had indicated the need for surgical biopsy were recorded for each patient. The diagnosis was proliferative breast disease (epithelial hyperplasia) in 347 women with 354 biopsies and atypical hyperplasia in the remaining 74 women with 75 biopsies, representing 28% and 6%, respectively, of the 1252 biopsies of lesions found to be benign. In 221 of the 354 cases of epithelial hyperplasia (62%) and 45 of the 75 cases of atypical hyperplasia (60%), the presence of calcifications was the most common radiological findings leading to biopsy (p<0.05). Parenchymal distortion, with or without calcifications, was the second most common radiological sign. The histological study revealed a close relationship between these proliferative events and radial scars. Calcifications are the radiological finding that most frequently indicate the need for surgical biopsy in nonpalpable lesions that results in a diagnosis of proliferative breast disease with and without atypia. (Author) 12 refs.

  10. A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

    International Nuclear Information System (INIS)

    Gong Xing; Glick, Stephen J.; Liu, Bob; Vedula, Aruna A.; Thacker, Samta

    2006-01-01

    Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (A z ) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically

  11. Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

    Science.gov (United States)

    Ertas, Gokhan; Doran, Simon; Leach, Martin O.

    2011-12-01

    In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

  12. Visual Inspection Displays Good Accuracy for Detecting Caries Lesions

    DEFF Research Database (Denmark)

    Twetman, Svante

    2015-01-01

    /QUESTION: To evaluate the overall accuracy of visual methods for detecting caries lesions. SOURCE OF FUNDING: Brazilian government (Process 2012/17888-1). TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data LEVEL OF EVIDENCE: Level 1: Good-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION......ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Visual inspection for caries detection: a systematic review and meta-analysis. Gimenez T, Piovesan C, Braga MM, Raggio DP, Deery C, Ricketts DN, Ekstrand DR, Mendes FM. J Dent Res 2015;94(7):895-904. REVIEWER: Svante Twetman, DDS, PhD, Odont Dr PURPOSE...

  13. Neural network approach to radiologic lesion detection

    International Nuclear Information System (INIS)

    Newman, F.D.; Raff, U.; Stroud, D.

    1989-01-01

    An area of artificial intelligence that has gained recent attention is the neural network approach to pattern recognition. The authors explore the use of neural networks in radiologic lesion detection with what is known in the literature as the novelty filter. This filter uses a linear model; images of normal patterns become training vectors and are stored as columns of a matrix. An image of an abnormal pattern is introduced and the abnormality or novelty is extracted. A VAX 750 was used to encode the novelty filter, and two experiments have been examined

  14. Role of Visual Inspection of Cervix with Acetic Acid (VIA in Detecting Precancerous Lesions of Cervix

    Directory of Open Access Journals (Sweden)

    Kamrun Nessa

    2014-01-01

    Full Text Available Background: Carcinoma of cervix is the most common malignancy in female and a major public health problem worldwide. It is the leading cause of death from cancer among women in low resource settings. In Bangladesh, mortality rate is high as most of the cases with cervical cancer are diagnosed in advanced stage. World Health Organization considers cervical cancer as a preventable disease as it can be identified in preinvasive stage. Considerable efforts have been given in detection and treatment of the condition all over the world. A number of cervical cancer screening tests are available. Among them, visual inspection of cervix with acetic acid is rational and can be competently performed by physicians with proper training. Objective: To find out the feasibility of the visual inspection of cervix with acetic acid for the detection of the precancerous lesions of the cervix in our country. Materials and Methods: This cross sectional, analytical study was carried out among the patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU who were VIA positive and sent for colposcopy in the colposcopy clinic in the department of Obstetrics and Gynecology in BSMMU from June to December 2004. Two hundred samples were considered for this study. Results: Out of 200 cases, colposcopically 85% had CIN and invasive lesions, 4% had inflammatory lesions while 11% had normal findings. Colposcopy directed punch biopsy revealed positive lesions in 81%, 4% had inflammatory lesions while 15% had normal findings. Conclusion: The study concluded that VIA and colposcopy are the important methods in the evaluation of cervical premalignancy. VIA may be an important tool for screening of cervical cancer in low resource settings as it is simple, easy to perform and cost-effective. After screening, VIA positive cases must be referred for colposcopic evaluation. We can screen cervical cancer by VIA all over the country and thus reduce

  15. Incremento de la detección de lesiones cervicales mediante inspección visual. Puerto Esperanza. 2008 Detection Increase of cervix lesions by means of visual examination in Puerto Esperanza, 2008

    Directory of Open Access Journals (Sweden)

    José G Sanabria Negrín

    2011-09-01

    ñales municipality in 2008. Target group: women from 15 to 64 years old who practice penetrating sexual relations. Sample: women who underwent visual examinations and altered cytology (n1= 18 cases or not (n2= 178 controls. In Cervix Pathology Office, colposcopies either by directed biopsy or conization with diathermal ansa were practiced; calculating absolute and relative percentage frequencies and the probability to detect lesions by isolated tests or in set, together with the tests of diagnostic performance. Results: VIA and VILI were positive in 92.9% and 79.6%, respectively. The joint probability of presenting lesions was 0. 7395. Those showing altered cytology (88.9% had positive VIA and 77, 9% positive VILI. Colposcopy resulted positive in 70.9% and the probability of having a lesion, proved by visual examination, simultaneously with colposcopy was 0.516. Biopsies performed to 136 women were useful (99.3%, out of them, almost 50% presented pre-malignant and malignant lesions. Yield tests were superior to VIA and VILI than to cytology. Non-invasive cancer was detected; however in situ carcinoma was. Conclusion: visual examination increased the number of diagnosis 4 times, thus its use must be generalized.

  16. Detection of intaoral lesions using a fluorescence camera

    Science.gov (United States)

    Thoms, Michael

    2006-02-01

    Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

  17. Multi-probe-based resonance-frequency electrical impedance spectroscopy for detection of suspicious breast lesions: improving performance using partial ROC optimization

    Science.gov (United States)

    Lederman, Dror; Zheng, Bin; Wang, Xingwei; Wang, Xiao Hui; Gur, David

    2011-03-01

    We have developed a multi-probe resonance-frequency electrical impedance spectroscope (REIS) system to detect breast abnormalities. Based on assessing asymmetry in REIS signals acquired between left and right breasts, we developed several machine learning classifiers to classify younger women (i.e., under 50YO) into two groups of having high and low risk for developing breast cancer. In this study, we investigated a new method to optimize performance based on the area under a selected partial receiver operating characteristic (ROC) curve when optimizing an artificial neural network (ANN), and tested whether it could improve classification performance. From an ongoing prospective study, we selected a dataset of 174 cases for whom we have both REIS signals and diagnostic status verification. The dataset includes 66 "positive" cases recommended for biopsy due to detection of highly suspicious breast lesions and 108 "negative" cases determined by imaging based examinations. A set of REIS-based feature differences, extracted from the two breasts using a mirror-matched approach, was computed and constituted an initial feature pool. Using a leave-one-case-out cross-validation method, we applied a genetic algorithm (GA) to train the ANN with an optimal subset of features. Two optimization criteria were separately used in GA optimization, namely the area under the entire ROC curve (AUC) and the partial area under the ROC curve, up to a predetermined threshold (i.e., 90% specificity). The results showed that although the ANN optimized using the entire AUC yielded higher overall performance (AUC = 0.83 versus 0.76), the ANN optimized using the partial ROC area criterion achieved substantially higher operational performance (i.e., increasing sensitivity level from 28% to 48% at 95% specificity and/ or from 48% to 58% at 90% specificity).

  18. Automated multi-lesion detection for referable diabetic retinopathy in indigenous health care.

    Science.gov (United States)

    Pires, Ramon; Carvalho, Tiago; Spurling, Geoffrey; Goldenstein, Siome; Wainer, Jacques; Luckie, Alan; Jelinek, Herbert F; Rocha, Anderson

    2015-01-01

    Diabetic Retinopathy (DR) is a complication of diabetes mellitus that affects more than one-quarter of the population with diabetes, and can lead to blindness if not discovered in time. An automated screening enables the identification of patients who need further medical attention. This study aimed to classify retinal images of Aboriginal and Torres Strait Islander peoples utilizing an automated computer-based multi-lesion eye screening program for diabetic retinopathy. The multi-lesion classifier was trained on 1,014 images from the São Paulo Eye Hospital and tested on retinal images containing no DR-related lesion, single lesions, or multiple types of lesions from the Inala Aboriginal and Torres Strait Islander health care centre. The automated multi-lesion classifier has the potential to enhance the efficiency of clinical practice delivering diabetic retinopathy screening. Our program does not necessitate image samples for training from any specific ethnic group or population being assessed and is independent of image pre- or post-processing to identify retinal lesions. In this Aboriginal and Torres Strait Islander population, the program achieved 100% sensitivity and 88.9% specificity in identifying bright lesions, while detection of red lesions achieved a sensitivity of 67% and specificity of 95%. When both bright and red lesions were present, 100% sensitivity with 88.9% specificity was obtained. All results obtained with this automated screening program meet WHO standards for diabetic retinopathy screening.

  19. Optical Assessment of Caries Lesion Structure and Activity

    Science.gov (United States)

    Lee, Robert Chulsung

    New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

  20. Management for BI-RADS category 3 lesions detected in preoperative breast MR imaging of breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Gweon, Hye Mi [Seoul National University College of Medicine, Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Cho, Nariya; Kim, Soo-Yeon [Seoul National University College of Medicine, Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Koo, Hye Ryoung [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seo, Mirinae [Kyung Hee University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Chu, Ajung [Seoul National University College of Medicine, Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Son, Eun Ju [Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2017-08-15

    To retrospectively evaluate characteristics of and determine appropriate follow-up recommendations for BI-RADS category 3 lesions detected in preoperative MRI of breast cancer patients. BI-RADS category 3 assessments were identified from the breast MRI database for 5,110 consecutive breast cancer patients who had undergone preoperative MRI and surgery. Patient and lesion characteristics, malignancy rate, and interval between lesion detection and cancer diagnosis were analysed. Histopathological results or imaging at or after 2-year follow-up were used as reference standards. Of the 626 lesions, morphological features included a single focus in 26.5% (n = 166), multiple foci in 47.1% (n = 295), mass in 21.7% (n = 136) and non-mass enhancement in 4.6% (n = 29). Cancer was found in 0.8% (5/626) at a median interval of 50 months (range, 29-66 months). Malignancy rate according to morphological feature was: 1.8% (3/166) in a single focus, 0.7% (1/136) in mass and 3.4% (1/29) in non-mass enhancement. All detected cancers were stage 0 or IA. Annual follow-up might be adequate for BI-RADS category 3 lesions detected at preoperative MRI because of the 0.8% (5/626) malignancy rate, long interval between lesion detection and cancer diagnosis, and early stage of diagnosed cancers. (orig.)

  1. Comparative analysis of MR sequences to detect structural brain lesions in tuberous sclerosis

    International Nuclear Information System (INIS)

    Pinto Gama, Hugo Pereira; Campos Meirelles, Rogerio Goncalves de; Mendonca do Rego, Jose Iram; Rocha, Antonio Jose da; Silva, Carlos Jorge da; Braga, Flavio Tulio; Martins Maia, Antonio Carlos; Lederman, Henrique Manoel

    2006-01-01

    Tuberous sclerosis (TS) is a neurocutaneous genetically inherited disease with variable penetrance characterized by dysplasias and hamartomas affecting multiple organs. MR is the imaging method of choice to demonstrate structural brain lesions in TS. To compare MR sequences and determine which is most useful for the demonstration of each type of brain lesion in TS patients. We reviewed MR scans of 18 TS patients for the presence of cortical tubers, white matter lesions (radial bands), subependymal nodules, and subependymal giant cell astrocytoma (SGCA) on the following sequences: (1) T1-weighted spin-echo (T1 SE) images before and after gadolinium (Gd) injection; (2) nonenhanced T1 SE sequence with an additional magnetization transfer contrast medium pulse on resonance (T1 SE/MTC); and (3) fluid-attenuated inversion recovery (FLAIR) sequence. Cortical tubers were found in significantly (P<0.05) larger numbers and more conspicuously in FLAIR and T1 SE/MTC sequences. The T1 SE/MTC sequence was far superior to other methods in detecting white matter lesions (P<0.01). There was no significant difference between the T1 SE/MTC and T1 SE (before and after Gd injection) sequences in the detection of subependymal nodules; FLAIR sequence showed less sensitivity than the others in identifying the nodules. T1 SE sequences after Gd injection demonstrated better the limits of the SGCA. We demonstrated the importance of appropriate MRI sequences for diagnosis of the most frequent brain lesions in TS. Our study reinforces the fact that each sequence has a particular application according to the type of TS lesion. Gd injection might be useful in detecting SGCA; however, the parameters of size and location are also important for a presumptive diagnosis of these tumors. (orig.)

  2. Reporting and management of breast lesions detected using MRI

    International Nuclear Information System (INIS)

    Dall, B.J.G.; Vinnicombe, S.; Gilbert, F.J.

    2011-01-01

    Magnetic resonance imaging (MRI) is the most accurate technique for diagnosing and delineating the extent of both invasive and in-situ breast cancer and is increasingly being used as part of the preoperative work-up to assess the local extent of disease. It is proving invaluable in providing information that allows successful single-stage surgery. An inevitable consequence of the high sensitivity of MRI is that it will identify additional lesions that may or may not represent significant extra disease. This may complicate and delay the preoperative process. This paper outlines a strategy for managing MRI-detected lesions to optimize the benefits of breast MRI as a local staging tool while minimizing the false-positive diagnoses. It discusses the importance of good technique to reduce the number of indeterminate lesions. Methods to refine the patient pathway to minimize delays are discussed. The format of MRI reporting is discussed in detail as is the usefulness of discussion of cases at multidisciplinary meetings. Illustrative cases are used to clarify the points made.

  3. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    Energy Technology Data Exchange (ETDEWEB)

    Dupuy, Sheena L.; Tauhid, Shahamat; Kim, Gloria; Chu, Renxin; Tummala, Subhash [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Hurwitz, Shelley [Departments of Medicine, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Bakshi, Rohit, E-mail: rbakshi@bwh.harvard.edu [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Departments of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States)

    2015-08-15

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  4. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    International Nuclear Information System (INIS)

    Dupuy, Sheena L.; Tauhid, Shahamat; Kim, Gloria; Chu, Renxin; Tummala, Subhash; Hurwitz, Shelley; Bakshi, Rohit

    2015-01-01

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  5. Review and management of breast lesions detected with breast tomosynthesis but not visible on mammography and ultrasonography.

    Science.gov (United States)

    Taskin, Fusun; Durum, Yasemin; Soyder, Aykut; Unsal, Alparslan

    2017-12-01

    Background Breast tomosynthesis is more sensitive than mammography and can detect lesions that are not always visible with conventional methods such as digital mammography (MG) and ultrasonography (US). No standardized approach is available for the management of lesions that are detectable with tomosynthesis but are not visible on MG or US. Purpose To review suspicious breast lesions detected with tomosynthesis but not visible on two-dimensional (2D) MG or US and to determine the management options for these lesions. Material and Methods Ethical committee approval was obtained. The radiological records, biopsy or surgery results, and follow-up findings of 107 patients who had a tomosynthesis-positive but MG- or US-negative breast lesion between 2011 and 2016 were retrospectively evaluated. Results Of 107 lesions visible only with tomosynthesis, 74% were architectural distortions and 26% were asymmetrical opacities. All patients underwent magnetic resonance imaging (MRI) for further evaluation. Among the 48 (45%) MRI-negative lesions, none had a suspicious alteration during the follow-up period. Among the MRI-positive lesions, 28% of the 50 architectural distortions and 11% of the nine asymmetrical opacities were malignant. Conclusion Given the inherent high false-positive rate of breast tomosynthesis, breast MRI prior to biopsy may reduce the number of unnecessary biopsies for suspicious breast lesions that are tomosynthesis-positive only.

  6. A new automated quantification algorithm for the detection and evaluation of focal liver lesions with contrast-enhanced ultrasound.

    Science.gov (United States)

    Gatos, Ilias; Tsantis, Stavros; Spiliopoulos, Stavros; Skouroliakou, Aikaterini; Theotokas, Ioannis; Zoumpoulis, Pavlos; Hazle, John D; Kagadis, George C

    2015-07-01

    Detect and classify focal liver lesions (FLLs) from contrast-enhanced ultrasound (CEUS) imaging by means of an automated quantification algorithm. The proposed algorithm employs a sophisticated segmentation method to detect and contour focal lesions from 52 CEUS video sequences (30 benign and 22 malignant). Lesion detection involves wavelet transform zero crossings utilization as an initialization step to the Markov random field model toward the lesion contour extraction. After FLL detection across frames, time intensity curve (TIC) is computed which provides the contrast agents' behavior at all vascular phases with respect to adjacent parenchyma for each patient. From each TIC, eight features were automatically calculated and employed into the support vector machines (SVMs) classification algorithm in the design of the image analysis model. With regard to FLLs detection accuracy, all lesions detected had an average overlap value of 0.89 ± 0.16 with manual segmentations for all CEUS frame-subsets included in the study. Highest classification accuracy from the SVM model was 90.3%, misdiagnosing three benign and two malignant FLLs with sensitivity and specificity values of 93.1% and 86.9%, respectively. The proposed quantification system that employs FLLs detection and classification algorithms may be of value to physicians as a second opinion tool for avoiding unnecessary invasive procedures.

  7. Dynamic multislice helical CT of maxillomandibular lesions. Distinction of ameloblastomas from other cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Tozaki, Mitsuhiro; Hayashi, Katsuhiko; Fukuda, Kunihiko [Jikei Univ., Tokyo (Japan). School of Medicine

    2001-10-01

    The purpose of this study was to evaluate the clinical usefulness of dynamic multislice helical CT in differentiating ameloblastoma from other cystic lesions in cases of maxillomandibular cystic lesions. The study included 32 patients with maxillomandibular cystic lesions (ameloblastoma [n=6], myxofibroma [n=1], odontogenic keratocyst [n=3], dentigerous cyst [n=11], radicular cyst [n=11], and paradental cyst [n=2]). Dynamic study was performed before and 30 sec, and 90 sec after intravenous contrast medium administration. CT density values and percentage of density increase were calculated at 30 and 90 sec. In five cases of ameloblastoma, a rapidly enhancing area was detected within the cystic lesions at 30 sec, while no apparent rapid enhancement was seen in the other cystic lesions. Three cysts showed gradual enhancement in the marginal area at 90 sec. Comparing ameloblastoma and other kinds of cysts, we found significant differences in the percentage of density increase at 30 sec (p<0.01) and 90 sec (p<0.05). Dynamic multislice helical CT is useful in the diagnosis of cystic lesions of the maxillomandibular region, especially in the detection of neovascularities in ameloblastoma. (author)

  8. Dynamic multislice helical CT of maxillomandibular lesions. Distinction of ameloblastomas from other cystic lesions

    International Nuclear Information System (INIS)

    Tozaki, Mitsuhiro; Hayashi, Katsuhiko; Fukuda, Kunihiko

    2001-01-01

    The purpose of this study was to evaluate the clinical usefulness of dynamic multislice helical CT in differentiating ameloblastoma from other cystic lesions in cases of maxillomandibular cystic lesions. The study included 32 patients with maxillomandibular cystic lesions (ameloblastoma [n=6], myxofibroma [n=1], odontogenic keratocyst [n=3], dentigerous cyst [n=11], radicular cyst [n=11], and paradental cyst [n=2]). Dynamic study was performed before and 30 sec, and 90 sec after intravenous contrast medium administration. CT density values and percentage of density increase were calculated at 30 and 90 sec. In five cases of ameloblastoma, a rapidly enhancing area was detected within the cystic lesions at 30 sec, while no apparent rapid enhancement was seen in the other cystic lesions. Three cysts showed gradual enhancement in the marginal area at 90 sec. Comparing ameloblastoma and other kinds of cysts, we found significant differences in the percentage of density increase at 30 sec (p<0.01) and 90 sec (p<0.05). Dynamic multislice helical CT is useful in the diagnosis of cystic lesions of the maxillomandibular region, especially in the detection of neovascularities in ameloblastoma. (author)

  9. Detection of oral early cancerous lesion by using polarization-sensitive optical coherence tomography: mice model

    Science.gov (United States)

    Lee, Hong-Yi; Chen, Ping-Hsien; Lee, Tzu-Han; Chang, Kuo-Wei; Kuo, Wen-Chuan

    2018-02-01

    Oral cancer is the 11th most common cancer worldwide, especially in a male adult. The median age of death in oral cancer was 55 years, 10-20 years earlier than other cancers. Presently, oral cancer is often found in late stage, because the lesion is often flat in early stage and is difficult to diagnose under traditional white light imaging. The only definitive method for determining cancer is an invasive biopsy and then using histology examination. How to detect precancerous lesions or early malignant lesions is an important issue for improving prognosis of oral cancer. Optical coherence tomography (OCT) is a new optical tool for diagnosing early malignant lesions in the skin or gastrointestinal tract recently. Here we report a new method for detecting precancerous or early malignant oral lesions by using swept source polarization-sensitive optical coherence tomography (PS-OCT) with center-wavelength 1310 nm, bandwidth 110 nm and 100 kHz swept rate. We used all single-mode fiber design to detect the change of birefringence information in the epithelium structure. This system has an advantage that enables measurement of backscattered intensity and birefringence simultaneously with only one A-scan per transverse location. In preliminary result, we computed the slope of the every A-scan signal in tissue part using a linear-curve fitting in backscattered intensity and birefringence on the enface. In this research, we used an oral cancer mice model for observing the change of structure and birefringence properties in different stages of oral cancer mice. We presented the parametric enface imaging that can detect the early oral malignant lesions.

  10. Automated multi-lesion detection for referable diabetic retinopathy in indigenous health care.

    Directory of Open Access Journals (Sweden)

    Ramon Pires

    Full Text Available Diabetic Retinopathy (DR is a complication of diabetes mellitus that affects more than one-quarter of the population with diabetes, and can lead to blindness if not discovered in time. An automated screening enables the identification of patients who need further medical attention. This study aimed to classify retinal images of Aboriginal and Torres Strait Islander peoples utilizing an automated computer-based multi-lesion eye screening program for diabetic retinopathy. The multi-lesion classifier was trained on 1,014 images from the São Paulo Eye Hospital and tested on retinal images containing no DR-related lesion, single lesions, or multiple types of lesions from the Inala Aboriginal and Torres Strait Islander health care centre. The automated multi-lesion classifier has the potential to enhance the efficiency of clinical practice delivering diabetic retinopathy screening. Our program does not necessitate image samples for training from any specific ethnic group or population being assessed and is independent of image pre- or post-processing to identify retinal lesions. In this Aboriginal and Torres Strait Islander population, the program achieved 100% sensitivity and 88.9% specificity in identifying bright lesions, while detection of red lesions achieved a sensitivity of 67% and specificity of 95%. When both bright and red lesions were present, 100% sensitivity with 88.9% specificity was obtained. All results obtained with this automated screening program meet WHO standards for diabetic retinopathy screening.

  11. MRI screening-detected breast lesions in high-risk young women: the value of targeted second-look ultrasound and imaging-guided biopsy.

    Science.gov (United States)

    Peter, P; Dhillon, R; Bose, S; Bourke, A

    2016-10-01

    To analyse the value of targeted second-look ultrasound and imaging-guided biopsy in high-risk young women eligible for screening magnetic resonance imaging (MRI) in a tertiary referral centre in Perth, Western Australia. A retrospective analysis of eligible high-risk young women who underwent screening breast MRI and targeted second-look ultrasound between June 2012 and June 2014 was performed with review of data. Over a 2-year period, 139 women underwent high-risk screening MRI. Of these, 30 women (with a total of 45 lesions) were recalled for targeted second-look ultrasound. Thirty-four MRI-detected lesions were identified on targeted ultrasound with 19 of them proceeding to ultrasound-guided biopsy, while the remaining 15 lesions were considered benign on ultrasound, were not biopsied, and were stable on follow-up imaging 12 months later. One lesion proceeded to an MRI-guided biopsy to confirm a benign result. Of the 11 lesions not seen on ultrasound, nine underwent MRI biopsy, one proceeded directly to hook wire localisation and excision, and one did not return for biopsy and was lost to follow-up. The overall biopsy rate was 14.4%. The cancer detection rate was 1.4%. The results of this study indicate that targeted second-look ultrasound and ultrasound-guided biopsy is a cost-effective and time-efficient approach for MRI-detected lesions in young women at high risk of developing breast cancer. MRI-guided biopsy should be considered for ultrasonographically occult suspicious lesions as there is a low, but definite, risk of cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Automated Whole-Body Bone Lesion Detection for Multiple Myeloma on 68Ga-Pentixafor PET/CT Imaging Using Deep Learning Methods.

    Science.gov (United States)

    Xu, Lina; Tetteh, Giles; Lipkova, Jana; Zhao, Yu; Li, Hongwei; Christ, Patrick; Piraud, Marie; Buck, Andreas; Shi, Kuangyu; Menze, Bjoern H

    2018-01-01

    The identification of bone lesions is crucial in the diagnostic assessment of multiple myeloma (MM). 68 Ga-Pentixafor PET/CT can capture the abnormal molecular expression of CXCR-4 in addition to anatomical changes. However, whole-body detection of dozens of lesions on hybrid imaging is tedious and error prone. It is even more difficult to identify lesions with a large heterogeneity. This study employed deep learning methods to automatically combine characteristics of PET and CT for whole-body MM bone lesion detection in a 3D manner. Two convolutional neural networks (CNNs), V-Net and W-Net, were adopted to segment and detect the lesions. The feasibility of deep learning for lesion detection on 68 Ga-Pentixafor PET/CT was first verified on digital phantoms generated using realistic PET simulation methods. Then the proposed methods were evaluated on real 68 Ga-Pentixafor PET/CT scans of MM patients. The preliminary results showed that deep learning method can leverage multimodal information for spatial feature representation, and W-Net obtained the best result for segmentation and lesion detection. It also outperformed traditional machine learning methods such as random forest classifier (RF), k -Nearest Neighbors ( k -NN), and support vector machine (SVM). The proof-of-concept study encourages further development of deep learning approach for MM lesion detection in population study.

  13. Automated Whole-Body Bone Lesion Detection for Multiple Myeloma on 68Ga-Pentixafor PET/CT Imaging Using Deep Learning Methods

    Directory of Open Access Journals (Sweden)

    Lina Xu

    2018-01-01

    Full Text Available The identification of bone lesions is crucial in the diagnostic assessment of multiple myeloma (MM. 68Ga-Pentixafor PET/CT can capture the abnormal molecular expression of CXCR-4 in addition to anatomical changes. However, whole-body detection of dozens of lesions on hybrid imaging is tedious and error prone. It is even more difficult to identify lesions with a large heterogeneity. This study employed deep learning methods to automatically combine characteristics of PET and CT for whole-body MM bone lesion detection in a 3D manner. Two convolutional neural networks (CNNs, V-Net and W-Net, were adopted to segment and detect the lesions. The feasibility of deep learning for lesion detection on 68Ga-Pentixafor PET/CT was first verified on digital phantoms generated using realistic PET simulation methods. Then the proposed methods were evaluated on real 68Ga-Pentixafor PET/CT scans of MM patients. The preliminary results showed that deep learning method can leverage multimodal information for spatial feature representation, and W-Net obtained the best result for segmentation and lesion detection. It also outperformed traditional machine learning methods such as random forest classifier (RF, k-Nearest Neighbors (k-NN, and support vector machine (SVM. The proof-of-concept study encourages further development of deep learning approach for MM lesion detection in population study.

  14. Positron emission mammography (PEM): Effect of activity concentration, object size, and object contrast on phantom lesion detection

    International Nuclear Information System (INIS)

    MacDonald, Lawrence R.; Wang, Carolyn L.; Eissa, Marna; Haseley, David; Kelly, Mary M.; Liu, Franklin; Parikh, Jay R.; Beatty, J. David; Rogers, James V.

    2012-01-01

    Purpose: To characterize the relationship between lesion detection sensitivity and injected activity as a function of lesion size and contrast on the PEM (positron emission mammography) Flex Solo II scanner using phantom experiments. Methods: Phantom lesions (spheres 4, 8, 12, 16, and 20 mm diameter) were randomly located in uniform background. Sphere activity concentrations were 3 to 21 times the background activity concentration (BGc). BGc was a surrogate for injected activity; BGc ranged from 0.44–4.1 kBq/mL, corresponding to 46–400 MBq injections. Seven radiologists read 108 images containing zero, one, or two spheres. Readers used a 5-point confidence scale to score the presence of spheres. Results: Sensitivity was 100% for lesions ≥12 mm under all conditions except for one 12 mm sphere with the lowest contrast and lowest BGc (60% sensitivity). Sensitivity was 100% for 8 mm spheres when either contrast or BGc was high, and 100% for 4 mm spheres only when both contrast and BGc were highest. Sphere contrast recovery coefficients (CRC) were 49%, 34%, 26%, 14%, and 2.8% for the largest to smallest spheres. Cumulative specificity was 98%. Conclusions: Phantom lesion detection sensitivity depends more on sphere size and contrast than on BGc. Detection sensitivity remained ≥90% for injected activities as low as 100 MBq, for lesions ≥8 mm. Low CRC in 4 mm objects results in moderate detection sensitivity even for 400 MBq injected activity, making it impractical to optimize injected activity for such lesions. Low CRC indicates that when lesions <8 mm are observed on PEM images they are highly tracer avid with greater potential of clinical significance. High specificity (98%) suggests that image statistical noise does not lead to false positive findings. These results apply to the 85 mm thick object used to obtain them; lesion detectability should be better (worse) for thinner (thicker) objects based on the reduced (increased) influence of photon attenuation.

  15. Human papillomavirus in oral lesions Virus papiloma humano en lesiones orales

    Directory of Open Access Journals (Sweden)

    Joaquín V. Gónzalez

    2007-08-01

    Full Text Available Growing evidence suggests a role for human papillomavirus (HPV in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases; the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell samples from normal oral mucosa were used as controls. HPV detection and typing were performed by polymerase chain reaction (PCR using primers MY09, 11, combined with RFLP or alternatively PCR using primers GP5+, 6+ combined with dot blot hybridization. HPV was detected in 91.0% of HPV- associated benign lesions, 14.3% of non-HPV associated benign lesions, 51.5% of preneoplasias and 60.0% of cancers. No control sample tested HPV positive. In benign HPV- associated lesions, 30.0% of HPV positive samples harbored high-risk types, while in preneoplastic lesions the value rose to 59.9%. In cancer lesions, HPV detection in verrucous carcinoma was 88.9% and in squamous cell carcinoma 43.8%, with high-risk type rates of 75.5% and 85.6%, respectively. The high HPV frequency detected in preneoplastic and neoplastic lesions supports an HPV etiological role in at least a subset of oral cancers.Crecientes evidencias sugieren que el virus Papiloma humano (HPV tiene un rol en el cáncer oral; sin embargo su participación es todavía controvertida. Este estudio evalúa la frecuencia de ADN de HPV en una variedad de lesiones orales de pacientes de Argentina. Se seleccionaron 77 muestras de tejido oral de 66 pacientes (casos; el diagnóstico histo-patológico correspondió a: 11 lesiones benignas asociadas a HPV, 8 lesiones benignas no asociadas a HPV, 33 lesiones premalignas y 25 cánceres. Como controles se usaron 60 muestras de células exfoliadas de mucosa oral normal. La

  16. Impact of real-time virtual sonography, a coordinated sonography and MRI system that uses an image fusion technique, on the sonographic evaluation of MRI-detected lesions of the breast in second-look sonography.

    Science.gov (United States)

    Nakano, Shogo; Kousaka, Junko; Fujii, Kimihito; Yorozuya, Kyoko; Yoshida, Miwa; Mouri, Yukako; Akizuki, Miwa; Tetsuka, Rie; Ando, Takahito; Fukutomi, Takashi; Oshima, Yukihiko; Kimura, Junko; Ishiguchi, Tsuneo; Arai, Osamu

    2012-08-01

    The aim of this study was to verify the utility of second-look sonography using real-time virtual sonography (RVS)-a coordinated sonography with an MRI system that uses an image fusion technique with magnetic navigation-on the sonographic evaluation of MRI-detected lesions of the breast. Of the 196 consecutive patients who were examined with breast MRI in our hospital from 2006 to 2009, those patients who underwent second-look sonography to identify MRI-detected lesions were enrolled in this study. MRI was performed using a 1.5-T imager with the patient in a supine position. To assess the efficacy benefits of RVS, the correlations between lesion detection rates, MRI features, distribution, and histopathological classification on second-look sonography using conventional B-mode or RVS were analyzed. Of the 196 patients, 55 (28 %) demonstrated 67 lesions initially detected by MRI, followed by second-look sonography. Of the 67 MRI-detected lesions, 18 (30 %) were identified with second-look sonography using conventional B-mode alone, whereas 60 (90 %) lesions were detected with second-look sonography using RVS (p use of RVS on second-look sonography significantly increases the sonographic detection rate of MRI-detected lesions without operator dependence.

  17. Lesions of reuniens and rhomboid thalamic nuclei impair radial maze win-shift performance.

    Science.gov (United States)

    Hembrook, Jacqueline R; Mair, Robert G

    2011-08-01

    The reuniens (Re) and rhomboid (Rh) nuclei are major sources of thalamic input to hippocampus and medial prefrontal cortex. We compared effects of lesions in ReRh and other parts of the midline-intralaminar complex on tasks affected by lesions in terminal fields innervated by these nuclei, including: visuospatial reaction time (VSRT), a measure of sensory guided responding; serial VSRT, a measure of action sequence learning; and win/shift radial arm maze (RAM) measures of spatial memory. ReRh lesions affected RAM, but not VSRT or serial VSRT performance. The effects of caudal intralaminar lesions were doubly dissociated from ReRh lesions, affecting VSRT, but not RAM or serial VSRT performance. Rostral intralaminar lesions did not produce significant impairments, other than a subgroup with larger lesions that were impaired performing a delayed RAM task. Combined lesions damaging all three sites produced RAM deficits comparable to ReRh lesions and VSRT deficits comparable to caudal intralaminar lesions. Thus there was no indication that deficits produced by lesions in one site were exacerbated significantly by the cumulative effect of damage in other parts of the midline-intralaminar complex. The effects of ReRh lesions provide evidence that these nuclei affect memory functions of hippocampus and medial prefrontal cortex. The double dissociation observed between the effects of ReRh and caudal intralaminar nuclei provides evidence that different nuclei within the midline-intralaminar complex affect distinct aspects of cognition consistent with the effects of lesions in the terminal fields they innervate. Copyright © 2010 Wiley-Liss, Inc.

  18. Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT

    International Nuclear Information System (INIS)

    Wu, Size; Tu, Rong; Nan, Ruixia; Liu, Guang Qing; Cui, Xiao Jing; Liang, Xian

    2016-01-01

    The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonography were compared with them. The number of focal liver lesions in groups I and II were 501 and 413, respectively. The ultrasonographic detection rates of focal liver lesions in groups I and II were 86.8% (435/501) and 94.2% (389/413), respectively. Comparison of the detection of the focal lesions between patients with and without fatty liver or different grades of fatty liver were as follows: mild fatty liver (162/177) vs. liver without fat infiltration (389/413) (P=0.277); mild fatty liver (162/177) vs. moderate fatty liver (190/212) (P=0.604); mild fatty liver (162/177) vs. severe fatty liver (83/112) (P<0.001); moderate fatty liver (190/212) vs. liver without fat infiltration (389/413) (P=0.051); moderate fatty liver (190/212) vs. severe fatty liver (83/112) (P<0.001); severe fatty liver (83/112) vs. liver without fat infiltration (389/413) (P<0.001); and fatty liver (435/501) vs. liver without fat infiltration (389/413) (P<0.001). Mild and moderate fatty liver are not significantly associated with the visualization of the lesion, while severe fatty liver usually impairs the detection of focal lesions in the liver. If a patient with severe fatty liver is suspected to have a liver tumor, ultrasonography should only be chosen cautiously in case of a missed diagnosis

  19. Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Size; Tu, Rong; Nan, Ruixia; Liu, Guang Qing; Cui, Xiao Jing; Liang, Xian [Affiliated Hospital of Hainan Medical College, Haikou (China)

    2016-01-15

    The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonography were compared with them. The number of focal liver lesions in groups I and II were 501 and 413, respectively. The ultrasonographic detection rates of focal liver lesions in groups I and II were 86.8% (435/501) and 94.2% (389/413), respectively. Comparison of the detection of the focal lesions between patients with and without fatty liver or different grades of fatty liver were as follows: mild fatty liver (162/177) vs. liver without fat infiltration (389/413) (P=0.277); mild fatty liver (162/177) vs. moderate fatty liver (190/212) (P=0.604); mild fatty liver (162/177) vs. severe fatty liver (83/112) (P<0.001); moderate fatty liver (190/212) vs. liver without fat infiltration (389/413) (P=0.051); moderate fatty liver (190/212) vs. severe fatty liver (83/112) (P<0.001); severe fatty liver (83/112) vs. liver without fat infiltration (389/413) (P<0.001); and fatty liver (435/501) vs. liver without fat infiltration (389/413) (P<0.001). Mild and moderate fatty liver are not significantly associated with the visualization of the lesion, while severe fatty liver usually impairs the detection of focal lesions in the liver. If a patient with severe fatty liver is suspected to have a liver tumor, ultrasonography should only be chosen cautiously in case of a missed diagnosis.

  20. Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT

    Directory of Open Access Journals (Sweden)

    Size Wu

    2016-01-01

    Full Text Available Purpose: The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. Methods: A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonography were compared with them. Results: The number of focal liver lesions in groups I and II were 501 and 413, respectively. The ultrasonographic detection rates of focal liver lesions in groups I and II were 86.8% (435/501 and 94.2% (389/413, respectively. Comparison of the detection of the focal lesions between patients with and without fatty liver or different grades of fatty liver were as follows: mild fatty liver (162/177 vs. liver without fat infiltration (389/413 (P=0.277; mild fatty liver (162/177 vs. moderate fatty liver (190/212 (P=0.604; mild fatty liver (162/177 vs. severe fatty liver (83/112 (P<0.001; moderate fatty liver (190/212 vs. liver without fat infiltration (389/413 (P=0.051; moderate fatty liver (190/212 vs. severe fatty liver (83/112 (P<0.001; severe fatty liver (83/112 vs. liver without fat infiltration (389/413 (P<0.001; and fatty liver (435/501 vs. liver without fat infiltration (389/413 (P<0.001. Conclusion: Mild and moderate fatty liver are not significantly associated with the visualization of the lesion, while severe fatty liver usually impairs the detection of focal lesions in the liver. If a patient with severe fatty liver is suspected to have a liver tumor, ultrasonography should only be chosen cautiously in case of a missed diagnosis.

  1. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    International Nuclear Information System (INIS)

    Deana, A M; Jesus, S H C; Koshoji, N H; Bussadori, S K; Oliveira, M T

    2013-01-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture. (paper)

  2. Image covariance and lesion detectability in direct fan-beam x-ray computed tomography.

    Science.gov (United States)

    Wunderlich, Adam; Noo, Frédéric

    2008-05-21

    We consider noise in computed tomography images that are reconstructed using the classical direct fan-beam filtered backprojection algorithm, from both full- and short-scan data. A new, accurate method for computing image covariance is presented. The utility of the new covariance method is demonstrated by its application to the implementation of a channelized Hotelling observer for a lesion detection task. Results from the new covariance method and its application to the channelized Hotelling observer are compared with results from Monte Carlo simulations. In addition, the impact of a bowtie filter and x-ray tube current modulation on reconstruction noise and lesion detectability are explored for full-scan reconstruction.

  3. Image covariance and lesion detectability in direct fan-beam x-ray computed tomography

    International Nuclear Information System (INIS)

    Wunderlich, Adam; Noo, Frederic

    2008-01-01

    We consider noise in computed tomography images that are reconstructed using the classical direct fan-beam filtered backprojection algorithm, from both full- and short-scan data. A new, accurate method for computing image covariance is presented. The utility of the new covariance method is demonstrated by its application to the implementation of a channelized Hotelling observer for a lesion detection task. Results from the new covariance method and its application to the channelized Hotelling observer are compared with results from Monte Carlo simulations. In addition, the impact of a bowtie filter and x-ray tube current modulation on reconstruction noise and lesion detectability are explored for full-scan reconstruction

  4. Evaluation of capsule endoscopy to detect mucosal lesions associated with gastrointestinal bleeding in dogs.

    Science.gov (United States)

    Davignon, D L; Lee, A C Y; Johnston, A N; Bowman, D D; Simpson, K W

    2016-03-01

    The objective of this study was to examine the utility of capsule endoscopy to detect mucosal abnormalities in dogs with gastrointestinal haemorrhage. Capsules were administered to 2 healthy controls and 8 patients with gastrointestinal haemorrhage. Images were evaluated for quality, gastric emptying time, small intestinal transit time and presence of lesions. There were no adverse effects of capsule endoscopy in dogs weighing from 7·7 to 58 kg. The capsule traversed the entire gastrointestinal tract in 5 of 8 patients, with high quality images obtained in the stomach and small intestine. Gastric emptying time and small intestinal transit time ranged from 1 to 270 and 15 to 180 minutes, respectively. In 3 of 8 patients, the capsule remained in the stomach despite pro-kinetics. Gastric lesions included mild haemorrhage and pinpoint erosion (4 of 8), a mass (1) and thickened bleeding pyloric mucosa (2). Two of 3 dogs with capsule retention had gastric lesions. Intestinal lesions included a healing duodenal ulcer, abnormal villi, ileal ulceration and colonic bleeding. Lesions identified by capsule endoscopy were considered a significant source of haemorrhage in 4 of 7 dogs with active bleeding. The relevance of pinpoint gastric mucosal erosions to blood loss is unclear. Capsule endoscopy can enable the non-invasive detection of gastric and small intestinal mucosal lesions in dogs presenting for evaluation of gastrointestinal bleeding. © 2016 British Small Animal Veterinary Association.

  5. Whole-body low-dose computed tomography in multiple myeloma staging: Superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extraskeletal findings compared to radiography with similar radiation exposure.

    Science.gov (United States)

    Lambert, Lukas; Ourednicek, Petr; Meckova, Zuzana; Gavelli, Giampaolo; Straub, Jan; Spicka, Ivan

    2017-04-01

    The primary objective of the present prospective study was to compare the diagnostic performance of conventional radiography (CR) and whole-body low-dose computed tomography (WBLDCT) with a comparable radiation dose reconstructed using hybrid iterative reconstruction technique, in terms of the detection of bone lesions, skeletal fractures, vertebral compressions and extraskeletal findings. The secondary objective was to evaluate lesion attenuation in relation to its size. A total of 74 patients underwent same-day skeletal survey by CR and WBLDCT. In CR and WBLDCT, two readers assessed the number of osteolytic lesions at each region and stage according to the International Myeloma Working Group (IMWG) criteria. A single reader additionally assessed extraskeletal findings and their significance, the number of vertebral compressions and bone fractures. The radiation exposure was 2.7±0.9 mSv for WBLDCT and 2.5±0.9 mSv for CR (P=0.054). CR detected bone involvement in 127 out of 486 regions (26%; Prib fractures compared with CR (188 vs. 47; Pfractures, vertebral compressions and extraskeletal findings, which results in up- or downstaging in 24% patients according to the IMWG criteria. The attenuation of osteolytic lesions can be measured with the avoidance of the partial volume effect.

  6. How often do surgeons intervene on shoulder labral lesions detected at MR examination? A retrospective review of MR examinations correlated with arthroscopy

    Science.gov (United States)

    2014-01-01

    Objective: We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examinations and how surgeons describe labral tears seen at MR examinations in their arthroscopy reports. Methods: A retrospective review of 100 consecutive patients aged 50 years or younger who had shoulder labral tears on MR and went on to have surgery performed. It was determined whether surgical intervention was performed on the MR lesions. Results: Of these 100 patients, 72 had superior labral anterior to posterior (SLAP) tears, 38 had posterior labral tears and 28 had anterior labral tears on MR examination. All 100 patients went on to arthroscopy. All lesions described on MRI were described on arthroscopy. Of the 72 SLAP tears, 64 were described as fraying on arthroscopy with 51 debrided. The remaining eight SLAP tears were tacked surgically. Of the 38 posterior labral tears, 36 were described as fraying on arthroscopy with 29 debrided and 2 had surgical tacking performed. Of the 28 anterior labral tears described on MR examination, 26 had surgical tacking performed and 2 were debrided. There were four SLAP tears, two anterior labral tears and three posterior labral tears seen on arthroscopy but not seen on MR examination. Conclusion: In this series, a high percentage of SLAP tears and posterior labral tears described on MR examination did not have surgical tacking. Most anterior labral tears had surgical tacking. Based on the above, our surgeons request we describe superior and posterior labral lesions as fraying and/or tearing, unless we can see a displaced tear. Most anterior labral lesions are treated with surgical tacking. Advances in knowledge: MRI allows for sensitive detection of labral tears. The tears often are not clinically significant. PMID:24712320

  7. Automated detection of diabetic retinopathy lesions on ultrawidefield pseudocolour images.

    Science.gov (United States)

    Wang, Kang; Jayadev, Chaitra; Nittala, Muneeswar G; Velaga, Swetha B; Ramachandra, Chaithanya A; Bhaskaranand, Malavika; Bhat, Sandeep; Solanki, Kaushal; Sadda, SriniVas R

    2018-03-01

    We examined the sensitivity and specificity of an automated algorithm for detecting referral-warranted diabetic retinopathy (DR) on Optos ultrawidefield (UWF) pseudocolour images. Patients with diabetes were recruited for UWF imaging. A total of 383 subjects (754 eyes) were enrolled. Nonproliferative DR graded to be moderate or higher on the 5-level International Clinical Diabetic Retinopathy (ICDR) severity scale was considered as grounds for referral. The software automatically detected DR lesions using the previously trained classifiers and classified each image in the test set as referral-warranted or not warranted. Sensitivity, specificity and the area under the receiver operating curve (AUROC) of the algorithm were computed. The automated algorithm achieved a 91.7%/90.3% sensitivity (95% CI 90.1-93.9/80.4-89.4) with a 50.0%/53.6% specificity (95% CI 31.7-72.8/36.5-71.4) for detecting referral-warranted retinopathy at the patient/eye levels, respectively; the AUROC was 0.873/0.851 (95% CI 0.819-0.922/0.804-0.894). Diabetic retinopathy (DR) lesions were detected from Optos pseudocolour UWF images using an automated algorithm. Images were classified as referral-warranted DR with a high degree of sensitivity and moderate specificity. Automated analysis of UWF images could be of value in DR screening programmes and could allow for more complete and accurate disease staging. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Articular cartilage and labral lesions of the glenohumeral joint: diagnostic performance of 3D water-excitation true FISP MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Dietrich, Tobias Johannes [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Kantonsspital Muensterlingen, Department of Radiology, PO Box 8596, Muensterlingen (Switzerland); Zanetti, Marco; Saupe, Nadja; Pfirrmann, Christian W.A.; Hodler, Juerg [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Fucentese, Sandro F. [Hospital Balgrist, Department of Orthopedic Surgery, Orthopedic University, Zurich (Switzerland)

    2010-05-15

    To evaluate the diagnostic performance of MR arthrography in the detection of articular cartilage and labral lesions of the glenohumeral joint using a transverse 3D water-excitation true fast imaging with steady-state precession (FISP) sequence. Seventy-five shoulders were included retrospectively. Shoulder arthroscopy was performed within 6 months of MR arthrography. MR images were evaluated separately by two radiologists. They were blinded to clinical and arthroscopic information. Arthroscopy served as the reference standard. For the detection of humeral cartilage lesions, sensitivities and specificities were 86% (12/14)/89% (50/56) for observer 1 and 93%/86% for observer 2) for the transverse true FISP sequence and 64%/86% (50%/82% for observer 2) for the coronal intermediate-weighted spin-echo images. The corresponding values for the glenoidal cartilage were 60% (6/10)/88% (51/58) (80%/76% for observer 2) and 70%/86% (60%/74% for observer 2) respectively. For the detection of abnormalities of the anterior labrum (only assessed on true FISP images) the values were 94% (15/16)/84% (36/43) (88%/79% for observer 2). The corresponding values for the posterior labrum were 67% (8/12)/77% (36/47) (observer 2: 25%/74%). The kappa values for the grading of the humeral and glenoidal cartilage lesions were 0.81 and 0.55 for true FISP images compared with 0.49 and 0.43 for intermediate-weighted fast spin-echo images. Kappa values for true FISP evaluation of the anterior and posterior part of the labrum were 0.81 and 0.70. Transverse 3D true FISP MR arthrography images are useful for the difficult diagnosis of glenohumeral cartilage lesions and suitable for detecting labral abnormalities. (orig.)

  9. Detection of glass particles on bone lesions using SEM-EDS.

    Science.gov (United States)

    Montoriol, Romain; Guilbeau-Frugier, Céline; Chantalat, Elodie; Roumiguié, Mathieu; Delisle, Marie-Bernadette; Payré, Bruno; Telmon, Norbert; Savall, Frédéric

    2017-09-01

    The problem of identifying the wounding agent in forensic cases is recurrent. Moreover, when several tools are involved, distinguishing the origin of lesions can be difficult. Scanning electron microscopy (SEM)/energy dispersive X-ray analysis (EDS) equipment is increasingly available to the scientific and medical community, and some studies have reported its use in forensic anthropology. However, at our knowledge, no study has reported the use of SEM-EDS in forensic cases involving glass tools, whether in case reports or experiments. We performed an experimental study on human rib fragments, on which we manually created wounds using fragments of window and mirror glass. SEM-EDS was executed on samples without any further preparation on low vacuum mode, then on the same samples after defleshing them completely by boiling them. Window and mirror glass particles were detected on experimental wounds. Both had silica in their spectra, and the opaque side of the mirror contained titanium, allowing for their identification. Boiling and defleshing the bone samples involved a loss of information in terms of the number of wounds detected as positive for glass particles and in the number of glass particles detected, for both window and mirror glass. We suggest the analysis of wounds with suspected glass particles using low vacuum mode and with no defleshment by boiling.

  10. Postmortem verification of MS cortical lesion detection with 3D DIR

    NARCIS (Netherlands)

    Seewann, A.M.; Kooi, E.J.; Roosendaal, S.D.; Pouwels, P.J.W.; Wattjes, M.P.; van der Valk, P.; Barkhof, F.; Polman, C.H.; Geurts, J.J.G.

    2012-01-01

    Objective: To assess the sensitivity and specificity of 3D double inversion recovery (DIR) MRI for detecting multiple sclerosis (MS) cortical lesions (CLs) using a direct postmortem MRI to histopathology comparison. Methods: Single-slab 3D DIR and 3D fluid-attenuated inversion recovery (FLAIR)

  11. Detection of atherosclerotic lesions and intimal macrophages using CD36-targeted nanovesicles.

    Science.gov (United States)

    Nie, Shufang; Zhang, Jia; Martinez-Zaguilan, Raul; Sennoune, Souad; Hossen, Md Nazir; Lichtenstein, Alice H; Cao, Jun; Meyerrose, Gary E; Paone, Ralph; Soontrapa, Suthipong; Fan, Zhaoyang; Wang, Shu

    2015-12-28

    Current approaches to the diagnosis and therapy of atherosclerosis cannot target lesion-determinant cells in the artery wall. Intimal macrophage infiltration promotes atherosclerotic lesion development by facilitating the accumulation of oxidized low-density lipoproteins (oxLDL) and increasing inflammatory responses. The presence of these cells is positively associated with lesion progression, severity and destabilization. Hence, they are an important diagnostic and therapeutic target. The objective of this study was to noninvasively assess the distribution and accumulation of intimal macrophages using CD36-targeted nanovesicles. Soy phosphatidylcholine was used to synthesize liposome-like nanovesicles. 1-(Palmitoyl)-2-(5-keto-6-octene-dioyl) phosphatidylcholine was incorporated on their surface to target the CD36 receptor. All in vitro data demonstrate that these targeted nanovesicles had a high binding affinity for the oxLDL binding site of the CD36 receptor and participated in CD36-mediated recognition and uptake of nanovesicles by macrophages. Intravenous administration into LDL receptor null mice of targeted compared to non-targeted nanovesicles resulted in higher uptake in aortic lesions. The nanovesicles co-localized with macrophages and their CD36 receptors in aortic lesions. This molecular target approach may facilitate the in vivo noninvasive imaging of atherosclerotic lesions in terms of intimal macrophage accumulation and distribution and disclose lesion features related to inflammation and possibly vulnerability thereby facilitate early lesion detection and targeted delivery of therapeutic compounds to intimal macrophages. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. The method for detecting small lesions in medical image based on sliding window

    Science.gov (United States)

    Han, Guilai; Jiao, Yuan

    2016-10-01

    At present, the research on computer-aided diagnosis includes the sample image segmentation, extracting visual features, generating the classification model by learning, and according to the model generated to classify and judge the inspected images. However, this method has a large scale of calculation and speed is slow. And because medical images are usually low contrast, when the traditional image segmentation method is applied to the medical image, there is a complete failure. As soon as possible to find the region of interest, improve detection speed, this topic attempts to introduce the current popular visual attention model into small lesions detection. However, Itti model is mainly for natural images. But the effect is not ideal when it is used to medical images which usually are gray images. Especially in the early stages of some cancers, the focus of a disease in the whole image is not the most significant region and sometimes is very difficult to be found. But these lesions are prominent in the local areas. This paper proposes a visual attention mechanism based on sliding window, and use sliding window to calculate the significance of a local area. Combined with the characteristics of the lesion, select the features of gray, entropy, corner and edge to generate a saliency map. Then the significant region is segmented and distinguished. This method reduces the difficulty of image segmentation, and improves the detection accuracy of small lesions, and it has great significance to early discovery, early diagnosis and treatment of cancers.

  13. Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity

    Energy Technology Data Exchange (ETDEWEB)

    Arponen, Otso; Masarwah, Amro; Taina, Mikko [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sutela, Anna; Koenoenen, Mervi; Hakumaeki, Juhana; Sudah, Mazen [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sironen, Reijo [Kuopio University Hospital, Kuopio University Hospital, Department of Pathology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Clinical Pathology and Forensic Medicine, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland); Vanninen, Ritva [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland)

    2016-12-15

    To evaluate the value of adding T2- and diffusion-weighted imaging (DWI) to the BI-RADS registered classification in MRI-detected lesions. This retrospective study included 112 consecutive patients who underwent 3.0T structural breast MRI with T2- and DWI on the basis of EUSOMA recommendations. Morphological and kinetic features, T2 signal intensity (T2 SI) and apparent diffusion coefficient (ADC) findings were assessed. Thirty-three (29.5 %) patients (mean age 57.0 ± 12.7 years) had 36 primarily MRI-detected incidental lesions of which 16 (44.4 %) proved to be malignant. No single morphological or kinetic feature was associated with malignancy. Both low T2 SI (P = 0.009) and low ADC values (≤0.87 x 10{sup -3} mm{sup 2}s{sup -1}, P < 0.001) yielded high specificity (80.0 %/80.0 %). The BI-RADS classification supplemented with information from DWI and T2-WI improved the diagnostic performance of the BI-RADS classification as sensitivity remained 100 % and specificity improved from 30 % to 65.0 %. The numbers of false positive lesions declined from 39 % (N = 14) to 19 % (N = 7). MRI-detected incidental lesions may be challenging to characterize as they have few specific malignancy indicating features. The specificity of MRI can be improved by incorporating T2 SI and ADC values into the BI-RADS assessment. (orig.)

  14. Revised PROPELLER for T2-weighted imaging of the prostate at 3 Tesla: impact on lesion detection and PI-RADS classification

    International Nuclear Information System (INIS)

    Meier-Schroers, Michael; Marx, Christian; Schmeel, Frederic Carsten; Wolter, Karsten; Block, Wolfgang; Sprinkart, Alois Martin; Traeber, Frank; Schild, Hans Heinz; Kukuk, Guido Matthias; Gieseke, Juergen; Willinek, Winfried

    2018-01-01

    To evaluate revised PROPELLER (RevPROP) for T2-weighted imaging (T2WI) of the prostate as a substitute for turbo spin echo (TSE). Three-Tesla MR images of 50 patients with 55 cancer-suspicious lesions were prospectively evaluated. Findings were correlated with histopathology after MRI-guided biopsy. T2 RevPROP, T2 TSE, diffusion-weighted imaging, dynamic contrast enhancement, and MR-spectroscopy were acquired. RevPROP was compared to TSE concerning PI-RADS scores, lesion size, lesion signal-intensity, lesion contrast, artefacts, and image quality. There were 41 carcinomas in 55 cancer-suspicious lesions. RevPROP detected 41 of 41 carcinomas (100%) and 54 of 55 lesions (98.2%). TSE detected 39 of 41 carcinomas (95.1%) and 51 of 55 lesions (92.7%). RevPROP showed fewer artefacts and higher image quality (each p < 0.001). No differences were observed between single and overall PI-RADS scores based on RevPROP or TSE (p = 0.106 and p = 0.107). Lesion size was not different (p = 0.105). T2-signal intensity of lesions was higher and T2-contrast of lesions was lower on RevPROP (each p < 0.001). For prostate cancer detection RevPROP is superior to TSE with respect to motion robustness, image quality and detection rates of lesions. Therefore, RevPROP might be used as a substitute for T2WI. (orig.)

  15. Revised PROPELLER for T2-weighted imaging of the prostate at 3 Tesla: impact on lesion detection and PI-RADS classification

    Energy Technology Data Exchange (ETDEWEB)

    Meier-Schroers, Michael; Marx, Christian; Schmeel, Frederic Carsten; Wolter, Karsten; Block, Wolfgang; Sprinkart, Alois Martin; Traeber, Frank; Schild, Hans Heinz; Kukuk, Guido Matthias [University Hospital Bonn, Department of Radiology, Bonn (Germany); Gieseke, Juergen [Philips Healthcare Germany, Hamburg (Germany); Willinek, Winfried [Hospital of Barmherzige Brueder, Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Trier (Germany)

    2018-01-15

    To evaluate revised PROPELLER (RevPROP) for T2-weighted imaging (T2WI) of the prostate as a substitute for turbo spin echo (TSE). Three-Tesla MR images of 50 patients with 55 cancer-suspicious lesions were prospectively evaluated. Findings were correlated with histopathology after MRI-guided biopsy. T2 RevPROP, T2 TSE, diffusion-weighted imaging, dynamic contrast enhancement, and MR-spectroscopy were acquired. RevPROP was compared to TSE concerning PI-RADS scores, lesion size, lesion signal-intensity, lesion contrast, artefacts, and image quality. There were 41 carcinomas in 55 cancer-suspicious lesions. RevPROP detected 41 of 41 carcinomas (100%) and 54 of 55 lesions (98.2%). TSE detected 39 of 41 carcinomas (95.1%) and 51 of 55 lesions (92.7%). RevPROP showed fewer artefacts and higher image quality (each p < 0.001). No differences were observed between single and overall PI-RADS scores based on RevPROP or TSE (p = 0.106 and p = 0.107). Lesion size was not different (p = 0.105). T2-signal intensity of lesions was higher and T2-contrast of lesions was lower on RevPROP (each p < 0.001). For prostate cancer detection RevPROP is superior to TSE with respect to motion robustness, image quality and detection rates of lesions. Therefore, RevPROP might be used as a substitute for T2WI. (orig.)

  16. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Sharma, Madhurima; Sandhu, Manavjit Singh; Gorsi, Ujjwal; Gupta, Dheeraj; Khandelwal, Niranjan

    2015-01-01

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  17. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Madhurima, E-mail: madhurimashrm88@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Sandhu, Manavjit Singh, E-mail: manavjitsandhu@yahoo.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gorsi, Ujjwal, E-mail: ujjwalgorsi@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gupta, Dheeraj, E-mail: dheeraj1910@gmail.com [Department of Pulmonary Medicine, PGIMER, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India)

    2015-09-15

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  18. Simultaneous Whole-Brain Segmentation and White Matter Lesion Detection Using Contrast-Adaptive Probabilistic Models

    DEFF Research Database (Denmark)

    Puonti, Oula; Van Leemput, Koen

    2016-01-01

    In this paper we propose a new generative model for simultaneous brain parcellation and white matter lesion segmentation from multi-contrast magnetic resonance images. The method combines an existing whole-brain segmentation technique with a novel spatial lesion model based on a convolutional...... restricted Boltzmann machine. Unlike current state-of-the-art lesion detection techniques based on discriminative modeling, the proposed method is not tuned to one specific scanner or imaging protocol, and simultaneously segments dozens of neuroanatomical structures. Experiments on a public benchmark dataset...... in multiple sclerosis indicate that the method’s lesion segmentation accuracy compares well to that of the current state-of-the-art in the field, while additionally providing robust whole-brain segmentations....

  19. Does Computer-aided Detection Assist in the Early Detection of Breast Cancer?

    International Nuclear Information System (INIS)

    Hukkinen, K.; Pamilo, M.

    2005-01-01

    Purpose: To evaluate whether breast cancers detected at screening are visible in previous mammograms, and to assess the performance of a computer-aided detection (CAD) system in detecting lesions in preoperative and previous mammograms. Material and Methods: Initial screening detected 67 women with 69 surgically verified breast cancers (Group A). An experienced screening radiologist retrospectively analyzed previous mammograms for visible lesions (Group B), noting in particular their size and morphology. Preoperative and previous mammograms were analyzed with CAD; a relatively inexperienced resident also analyzed previous mammograms. The performances of CAD and resident were then compared. Results: Of the 69 lesions identified, 36 were visible in previous mammograms. Of these 36 'missed' lesions, 14 were under 10 mm in diameter and 29 were mass lesions. The sensitivity of CAD was 81% in Group A and 64% in Group B. Small mass lesions were harder for CAD to detect. The specificity of CAD was 3% in Group A and 9% in Group B. Together, CAD and the resident found more 'missed' lesions than separately. Conclusion: Of the 69 breast cancers, 36 were visible in previous mammograms. CAD's sensitivity in detecting cancer lesions ranged from 64% to 81%, while specificity ranged from 9% to as low as 3%. CAD may be helpful if the radiologist is less subspecialized in mammography

  20. Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal lesions.

    Science.gov (United States)

    Pereira, Cássio V; Stipp, Rafael N; Fonseca, Douglas C; Pereira, Luciano J; Höfling, José F

    2011-12-01

    Microbial agents in root canal systems can induce periodontal inflammation. The aims of this study are to detect anaerobic microorganisms in endodontic-periodontal lesions, determine the genetic diversity among them, and assess the simultaneous colonization of the pulp and periodontal microenvironments by a single clone. Twenty-seven teeth of patients with endodontic-periodontal lesions were selected. Samples were spread on an agar-blood medium, the detection of each species was performed using a polymerase chain reaction, and the determination of the simultaneous presence of the same species in the microenvironments by one or more clones was determined using arbitrarily primed PCR. Prevotella intermedia (Pi) was the most prevalent species of the colonies in periodontal pockets, whereas Porphyromonas gingivalis (Pg) and Pi were the more prevalent in root canals. Isolates of Pi and Pg were simultaneously identified in root canals and periodontal pockets. Eighteen percent of teeth exhibited the simultaneous colonization by Pg, Tannerella forsythia (previously T. forsythensis), and Porphyromonas endodontalis in the pulp and periodontal microenvironments. The presence of these species was noted even in niches from which no colonies were isolated. Seventeen different genotypes were found in periodontal and pulp sites, with the majority of sites colonized by one or two different genotypes. A high degree of genotype similarity was found for samples of Pg isolated from only one site as well as for those isolated from both microenvironments. Different clones of Pi and Pg with a high intraspecific genotype similarity were found to colonize the same anatomic sites in endodontic-periodontal infections.

  1. Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

    Science.gov (United States)

    Petruzziello, Carmelina; Onali, Sara; Calabrese, Emma; Zorzi, Francesca; Ascolani, Marta; Condino, Giovanna; Lolli, Elisabetta; Naccarato, Paola; Pallone, Francesco; Biancone, Livia

    2010-01-01

    AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn’s disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum. PMID:20614486

  2. Impact of respiratory motion correction and spatial resolution on lesion detection in PET: a simulation study based on real MR dynamic data

    Science.gov (United States)

    Polycarpou, Irene; Tsoumpas, Charalampos; King, Andrew P.; Marsden, Paul K.

    2014-02-01

    The aim of this study is to investigate the impact of respiratory motion correction and spatial resolution on lesion detectability in PET as a function of lesion size and tracer uptake. Real respiratory signals describing different breathing types are combined with a motion model formed from real dynamic MR data to simulate multiple dynamic PET datasets acquired from a continuously moving subject. Lung and liver lesions were simulated with diameters ranging from 6 to 12 mm and lesion to background ratio ranging from 3:1 to 6:1. Projection data for 6 and 3 mm PET scanner resolution were generated using analytic simulations and reconstructed without and with motion correction. Motion correction was achieved using motion compensated image reconstruction. The detectability performance was quantified by a receiver operating characteristic (ROC) analysis obtained using a channelized Hotelling observer and the area under the ROC curve (AUC) was calculated as the figure of merit. The results indicate that respiratory motion limits the detectability of lung and liver lesions, depending on the variation of the breathing cycle length and amplitude. Patients with large quiescent periods had a greater AUC than patients with regular breathing cycles and patients with long-term variability in respiratory cycle or higher motion amplitude. In addition, small (less than 10 mm diameter) or low contrast (3:1) lesions showed the greatest improvement in AUC as a result of applying motion correction. In particular, after applying motion correction the AUC is improved by up to 42% with current PET resolution (i.e. 6 mm) and up to 51% for higher PET resolution (i.e. 3 mm). Finally, the benefit of increasing the scanner resolution is small unless motion correction is applied. This investigation indicates high impact of respiratory motion correction on lesion detectability in PET and highlights the importance of motion correction in order to benefit from the increased resolution of future

  3. Impact of respiratory motion correction and spatial resolution on lesion detection in PET: a simulation study based on real MR dynamic data

    International Nuclear Information System (INIS)

    Polycarpou, Irene; Tsoumpas, Charalampos; King, Andrew P; Marsden, Paul K

    2014-01-01

    The aim of this study is to investigate the impact of respiratory motion correction and spatial resolution on lesion detectability in PET as a function of lesion size and tracer uptake. Real respiratory signals describing different breathing types are combined with a motion model formed from real dynamic MR data to simulate multiple dynamic PET datasets acquired from a continuously moving subject. Lung and liver lesions were simulated with diameters ranging from 6 to 12 mm and lesion to background ratio ranging from 3:1 to 6:1. Projection data for 6 and 3 mm PET scanner resolution were generated using analytic simulations and reconstructed without and with motion correction. Motion correction was achieved using motion compensated image reconstruction. The detectability performance was quantified by a receiver operating characteristic (ROC) analysis obtained using a channelized Hotelling observer and the area under the ROC curve (AUC) was calculated as the figure of merit. The results indicate that respiratory motion limits the detectability of lung and liver lesions, depending on the variation of the breathing cycle length and amplitude. Patients with large quiescent periods had a greater AUC than patients with regular breathing cycles and patients with long-term variability in respiratory cycle or higher motion amplitude. In addition, small (less than 10 mm diameter) or low contrast (3:1) lesions showed the greatest improvement in AUC as a result of applying motion correction. In particular, after applying motion correction the AUC is improved by up to 42% with current PET resolution (i.e. 6 mm) and up to 51% for higher PET resolution (i.e. 3 mm). Finally, the benefit of increasing the scanner resolution is small unless motion correction is applied. This investigation indicates high impact of respiratory motion correction on lesion detectability in PET and highlights the importance of motion correction in order to benefit from the increased resolution of future

  4. Diagnostic Accuracy and Inter-Observer Agreement of Shoulder Magnetic Resonance Arthrography in the Detection of Labral Lesion and Assessment of Lesion Location

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Young; Song, Sook Yun; Choi, Jin Ha; Shin, Sang Jin [School of Medicine, Ewha Womans University, Mokdong Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To evaluate the diagnostic accuracy and inter-observer agreement of magnetic resonance (MR) arthrography in the detection of labral lesions by location and to describe useful MR imaging findings of labral tears. Sixty-eight patients who underwent both pre-operative MR arthrography and arthroscopy were included. The location of the labrum was classified into anterior (2-6 o'clock), superior (12-2 o'clock), and posterior (6-12 o'clock). Sensitivity, specificity, accuracy, and inter-observer agreement of MR arthrography for the diagnosis of labral lesions by location were calculated. Frequency of MR imaging findings such as detachment, high signal intensity cleft, contour change, absence, and signal change of the labrum by location were analyzed. 35 anterior, 44 superior and 15 posterior labral lesions were detected by arthroscopy. The corresponding sensitivities were 91.4%, 79.5%, and 40.0%, specificities were 90.9%, 20.8%, and 86.8%, accuracies were 91.2%, 58.8%, and 76.5%, and kappa values were 0.823, 0.252, and 0.394, for anterior, superior, posterior lesions, respectively. The most common MR imaging findings were detachment in 60.0% of anterior labrums, high signal intensity cleft in 52.3% of superior labrums, and normal in 60.0% of posterior labrums. Diagnostic accuracy and inter-observer agreement of MR arthrography in the diagnosis of labral lesions are high in anterior labrums and low in superior or posterior labrums. The useful MR imaging findings of labral tears were different according to labral location.

  5. Comparison between immediate and delayed imaging after gadolinium chelate injection for detecting enhanced lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    Alizadeh, A.; Roudbari, A.; Heidarzadeh, A.; Kouhsari, M.

    2010-01-01

    Magnetic resonance imaging is a noninvasive and valuable method in the diagnosis of Multiple Sclerosis. Compared with other modalities, the sensitivity of Magnetic resonance imaging for detection of the lesion increases using magnetization transfer and delayed imaging. Our aim was to compare the two methods in detecting Multiple Sclerosis lesions. Patients and Methods: In this double-blind clinical trial, twenty-one patients with the definite diagnosis of Multiple Sclerosis referred to Poursina Hospital, Rasht were included. Two radiologists evaluated all the images. First, images without contrast were conducted, then 0.1 mmol/kg contrast material (Dotarem, single dose) was injected and after 30 minutes, T1W and magnetization transfer images were obtained. Seventy-two hours later, T1W images were obtained immediately after injection of 0.2 mmol/kg contrast material (double dose). The data were analyzed using Fisher's and McNemar tests by SPSS for Windows. Results: Delayed magnetization transfer showed 44 enhanced lesions using magnetization transfer (69.84%) and 29 lesions using T1 (46.03%). In addition, the number of enhanced lesions in the delayed method were significantly more than those in the immediate method (p value=0.003). Conclusion: The use of single dose in combination with magnetization transfer and delayed images after 20-30 minutes enables us to detect more enhanced lesions.

  6. Time-resolved optical mammography between 637 and 985 nm: clinical study on the detection and identification of breast lesions

    International Nuclear Information System (INIS)

    Taroni, Paola; Torricelli, Alessandro; Spinelli, Lorenzo; Pifferi, Antonio; Arpaia, Francesco; Danesini, Gianmaria; Cubeddu, Rinaldo

    2005-01-01

    The first time-resolved optical mammograph operating beyond 900 nm was tested in a retrospective clinical study involving 194 patients with malignant and benign lesions, to investigate the diagnostic potential for the detection and characterization of breast lesions. For the first part of the study (101 patients with 114 lesions), the system was operated at 683, 785, 913 and 975 nm. Subsequently, to improve the spectral content of optical images, the number of wavelengths was increased (up to 7) and the spectral range was extended (637-985 nm). Late gated intensity and scattering images provide sensitivity to tissue composition (oxy- and deoxyhaemoglobin, water and lipids) and physiology (total haemoglobin content and oxygen saturation), as well as to structural changes. Tumours are typically identified because of the strong blood absorption at short wavelengths (637-685 nm), while cysts are characterized by low scattering, leading to a detection rate of approximately 80% for both lesion types, when detection is required in both cranio-caudal and oblique views. The detection rate for other benign lesions, such as fibroadenomas, is presently much lower (<40%). The effectiveness of the technique in localizing and identifying different lesion types was analysed as a function of various parameters (lesion size, compressed breast thickness, age, body mass index, breast parenchymal pattern). The possibility that physiologic changes due to the development of a malignant lesion could affect the entire breast was investigated. The capacity to assess the density of breast based on the average scattering properties was also tested

  7. Effects of neostriatal 6-OHDA lesion on performance in a rat sequential reaction time task.

    Science.gov (United States)

    Domenger, D; Schwarting, R K W

    2008-10-31

    Work in humans and monkeys has provided evidence that the basal ganglia, and the neurotransmitter dopamine therein, play an important role for sequential learning and performance. Compared to primates, experimental work in rodents is rather sparse, largely due to the fact that tasks comparable to the human ones, especially serial reaction time tasks (SRTT), had been lacking until recently. We have developed a rat model of the SRTT, which allows to study neural correlates of sequential performance and motor sequence execution. Here, we report the effects of dopaminergic neostriatal lesions, performed using bilateral 6-hydroxydopamine injections, on performance of well-trained rats tested in our SRTT. Sequential behavior was measured in two ways: for one, the effects of small violations of otherwise well trained sequences were examined as a measure of attention and automation. Secondly, sequential versus random performance was compared as a measure of sequential learning. Neurochemically, the lesions led to sub-total dopamine depletions in the neostriatum, which ranged around 60% in the lateral, and around 40% in the medial neostriatum. These lesions led to a general instrumental impairment in terms of reduced speed (response latencies) and response rate, and these deficits were correlated with the degree of striatal dopamine loss. Furthermore, the violation test indicated that the lesion group conducted less automated responses. The comparison of random versus sequential responding showed that the lesion group did not retain its superior sequential performance in terms of speed, whereas they did in terms of accuracy. Also, rats with lesions did not improve further in overall performance as compared to pre-lesion values, whereas controls did. These results support previous results that neostriatal dopamine is involved in instrumental behaviour in general. Also, these lesions are not sufficient to completely abolish sequential performance, at least when acquired

  8. Skin lesion-associated pathogens from Octopus vulgaris: first detection of Photobacterium swingsii, Lactococcus garvieae and betanodavirus.

    Science.gov (United States)

    Fichi, G; Cardeti, G; Perrucci, S; Vanni, A; Cersini, A; Lenzi, C; De Wolf, T; Fronte, B; Guarducci, M; Susini, F

    2015-07-23

    The common octopus Octopus vulgaris Cuvier, 1798 is extremely important in fisheries and is a useful protein source in most Mediterranean countries. Here we investigated pathogens associated with skin lesions in 9 naturally deceased specimens that included both cultured and wild common octopus. Within 30 min after death, each octopus was stored at 4°C and microbiologically examined within 24 h. Bacterial colonies, cultured from swabs taken from the lesions, were examined using taxonomical and biochemical analyses. Vibrio alginolyticus and V. parahaemolyticus were only isolated from cultured animals. A conventional PCR targeting the 16S ribosomal RNA (rRNA) gene and sequencing were performed on 2 bacterial isolates that remained unidentified after taxonomical and biochemical analysis. The sequence results indicated that the bacteria had a 99% identity with Lactococcus garvieae and Photobacterium swingsii. L. garvieae was confirmed using a specific PCR based on the 16S-23S rRNA internal transcribed spacer region, while P. swingsii was confirmed by phylogenetic analyses. Although all animals examined were found to be infected by the protozoan species Aggregata octopiana localised in the intestines, it was also present in skin lesions of 2 of the animals. Betanodavirus was detected in both cultured and wild individuals by cell culture, PCR and electron microscopy. These findings are the first report of L. garvieae and betanodavirus from skin lesions of common octopus and the first identification of P. swingsii both in octopus skin lesions and in marine invertebrates in Italy.

  9. Computer-aided detection of pulmonary nodules: influence of nodule characteristics on detection performance

    International Nuclear Information System (INIS)

    Marten, K.; Engelke, C.; Seyfarth, T.; Grillhoesl, A.; Obenauer, S.; Rummeny, E.J.

    2005-01-01

    AIM: To evaluate prospectively the influence of pulmonary nodule characteristics on detection performances of a computer-aided diagnosis (CAD) tool and experienced chest radiologists using multislice CT (MSCT). MATERIALS AND METHODS: MSCT scans of 20 consecutive patients were evaluated by a CAD system and two independent chest radiologists for presence of pulmonary nodules. Nodule size, position, margin, matrix characteristics, vascular and pleural attachments and reader confidence were recorded and data compared with an independent standard of reference. Statistical analysis for predictors influencing nodule detection or reader performance included chi-squared, retrograde stepwise conditional logistic regression with odds ratios and nodule detection proportion estimates (DPE), and ROC analysis. RESULTS: For 135 nodules, detection rates for CAD and readers were 76.3, 52.6 and 52.6%, respectively; false-positive rates were 0.55, 0.25 and 0.15 per examination, respectively. In consensus with CAD the reader detection rate increased to 93.3%, and the false-positive rate dropped to 0.1/scan. DPEs for nodules ≤5 mm were significantly higher for ICAD than for the readers (p<0.05). Absence of vascular attachment was the only significant predictor of nodule detection by CAD (p=0.0006-0.008). There were no predictors of nodule detection for reader consensus with CAD. In contrast, vascular attachment predicted nodule detection by the readers (p=0.0001-0.003). Reader sensitivity was higher for nodules with vascular attachment than for unattached nodules (sensitivities 0.768 and 0.369; 95% confidence intervals=0.651-0.861 and 0.253-0.498, respectively). CONCLUSION: CAD increases nodule detection rates, decreases false-positive rates and compensates for deficient reader performance in detection of smallest lesions and of nodules without vascular attachment

  10. 18F-PET imaging: frequency, distribution and appearance of benign lesions

    International Nuclear Information System (INIS)

    Schirrmeister, H.; Kotzerke, J.; Rentschler, M.; Traeger, H.; Fenchel, S.; Diederichs, C.G.; Reske, S.N.; Nuessle, K.

    1998-01-01

    Purpose: We evaluated the frequency, distribution and appearance of benign lesions in 18 F-PET scans. Methods: Between March 1996 and May 1997, 18 F-PET scans were performed in 59 patients in addition to conventional planar bone scintigraphy. Eleven patients were subjected to additional SPECT imaging. The main indication was searching for bone metastases (58 pat.). The diagnosis was confirmed radiologically. Results: With 18 F-PET in 39 patients (66,1%) 152 benign lesions, mostly located in the spine were detected. 99m Tc bone scans revealed 45 lesions in 10 patients. Osteoarthritis of the intervertebral articulations (69%) or of the acromioclavicular joint (15%) were the most common reasons for degenerative lesions detected with 18 F-PET. Osteophytes appeared as hot lesions located at two adjacent vertebral endplates. Osteoarthritis of the intervertebral articulations showed an enhanced tracer uptake at these localizations, whereas endplate fractures of the vertebral bodies appeared very typically; solitary fractures of the ribs could not be differentiated from metastases. Rare benign lesions were not studied. Conclusion: Most of the degenerative lesions (84%) detected with 18 F-PET had a very typical appearance and could be detected with the improved spatial resolution and advantages of a tomographic technique. 18 F-PET had an increased accuracy in detecting degenerative bone lesions. (orig.) [de

  11. Molecular detection of Leptospira spp. from canine kidney tissues and its association with renal lesions

    Directory of Open Access Journals (Sweden)

    Biswajit R. Dash

    2018-04-01

    Full Text Available Aim: The study aimed to detect the prevalence of Leptospira spp. in kidney tissues collected during necropsy and to establish its association with renal lesions in dogs of Mumbai region. Materials and Methods: Kidney tissues from 40 dogs were collected during necropsy after gross examination and then fixed in neutral buffered formalin and Bouin's fluid for histopathology and histochemistry, respectively. Kidney tissues were also collected for the detection of Leptospira spp. by polymerase chain reaction (PCR in a sterile container and stored at -80°C until further processing. Results: Of 40 cases studied, 13 (32.5% cases showed lesions of nephritis of varying histotype and severity. Glomerulonephritis was reported as the most common type of nephritis in 9 (69.23% cases, and interstitial nephritis was recorded in 4 (30.76% cases. Chronic and acute interstitial nephritis was observed in two cases each. Renal failure as a cause of death was found in 7 (17.5% dogs. Of a total of 40 cases, 9 were found positive for pathogenic Leptospira spp. genome by PCR. However, of nine PCR-positive cases, only four cases showed lesions in kidneys as glomerulonephritis and interstitial nephritis in two cases each. The rest five cases positive for Leptospira spp. by PCR did not show any appreciable lesions in the kidneys. Conclusion: Leptospiral DNA was detected in 9 (22.5% cases by PCR. Of these nine cases, only four cases showed renal lesions. Other five cases which were positive for Leptospira spp. by PCR did not show any appreciable gross and microscopic lesions in the kidneys which might be carriers for Leptospira spp. Considering variable reports on types of nephritis in Leptospira spp. infection and also the prevalence of non-pathogenic Leptospira spp., it is important to conduct an extensive study on the prevalence of Leptospira spp. and its association with renal lesions involving batteries of tests.

  12. Computer-aided detection (CAD) and assessment of malignant lesions in the liver and lung using a novel PET/CT software tool. Initial results

    International Nuclear Information System (INIS)

    Hahn, Steffen; Heusner, T.; Forsting, M.; Antoch, G.; Zhou, X.; Zhan, Y.; Peng, Z.; Hamami, M.; Bockisch, A.

    2010-01-01

    Purpose: To determine the feasibility of a PET/CT software tool (PET computer-aided detection: PET-CAD) for automated detection and assessment of pulmonary and hepatic lesions. Materials and Methods: 20 consecutive patients with colorectal liver metastases and 20 consecutive patients suffering from non-small cell lung cancer (NSCLC) were examined with FDG-PET/CT. In a first step the maximum standardized uptake values (SUV max ) of non-tumorous liver and lung tissues were determined manually. This value was used as a threshold value for software-based lesion detection. The number of lesions detected, their SUV max , and their sizes in the x, y, and z-planes, as automatically provided by PET-CAD, were compared to visual lesion detection and manual measurements on CT. Results: The sensitivity for automated detection was 96% (86-99%) for colorectal liver metastases and 90% (70-99%) for lung lesions. The positive predictive value was 80% for liver and 68% for lung lesions. The mean SUV max of all lung lesions was 9.3 and 8.8 for the liver lesions. When assessed by PET-CAD, the mean lesion sizes for liver lesions in the x, y, and z-planes were 4.3 cm, 4.6 cm, and 4.2 cm compared to 3.5 cm, 3.8 cm, and 3.6 cm for manual measurements. The mean lesion sizes of lung lesions were 7.4 cm, 7.7 cm, and 8.4 cm in the x, y, and z-planes when assessed by PET-CAD compared to 5.8 cm, 6.1 cm, and 7.1 cm when measured manually. Using manual assessment, the lesion sizes were significantly smaller in all planes (p < 0.005). Conclusion: Software tools for automated lesion detection and assessment are expected to improve the clinical PET/CT workflow. Before implementation in the clinical routine, further improvements to the measurement accuracy are required. (orig.)

  13. PET-CT detection rate of primary breast cancer lesions. Correlation with the clinicopathological factors

    International Nuclear Information System (INIS)

    Ogawa, Tomoko; Tozaki, Mitsuhiro; Fukuma, Eisuke

    2008-01-01

    One hundred and forty lesions of primary breast cancer underwent positron emission tomography (PET)-CT between June 2006 and May 2007. The PET-CT detection rate of primary breast cancer lesions was 72.1%. The detection rate was 52.1% for invasive cancer ≤20 mm, 92.8% for invasive breast cancers >20 mm, and these results were significant. In the present study, no significant relationship was observed between tumor types, however, invasive lobular carcinoma showed a lower detection rate, 58.3%. The PET-CT results were not significantly affected by either estrogen and progesterone receptors or distant metastasis. A significant correlation regarding the detection rate of PET-CT was found with HER2 status, tumor grade, and axillary lymph node status. The detection rate was 100% for invasive cancer ≤20 mm when the interval between prior diagnostic Mammotome biopsies and PET-CT was less than 3 weeks, 18.8% for invasive cancer ≤20 mm when the interval was more than 3 weeks, and these results were significant. Mammotome biopsies may therefore affect the detection rate of PET-CT. Invasive cancers ≤20 mm showed a low detection rate, therefore, it is considered to be insufficient to use PET-CT for the detection of early breast cancer. (author)

  14. Influence of attenuation correction and reconstruction techniques on the detection of hypoperfused lesions in brain SPECT studies

    International Nuclear Information System (INIS)

    Ghoorun, S.; Groenewald, W.A.; Baete, K.; Nuyts, J.; Dupont, P.

    2004-01-01

    Full text: Aim: To study the influence of attenuation correction and the reconstruction technique on the detection of hypoperfused lesions in brain SPECT imaging, Material and Methods: A simulation experiment was used in which the effects of attenuation and reconstruction were decoupled, A high resolution SPECT phantom was constructed using the BrainWeb database, In this phantom, activity values were assigned to grey and white matter (ratio 4:1) and scaled to obtain counts of the same magnitude as in clinical practice, The true attenuation map was generated by assigning attenuation coefficients to each tissue class (grey and white matter, cerebral spinal fluid, skull, soft and fatty tissue and air) to create a non-uniform attenuation map, The uniform attenuation map was calculated using an attenuation coefficient of 0.15 cm-1, Hypoperfused lesions of varying intensities and sizes were added. The phantom was then projected as typical SPECT projection data, taking into account attenuation and collimator blurring with the addition of Poisson noise, The projection data was reconstructed using four different methods of reconstruction: (1) filtered backprojection (FBP) with the uniform attenuation map; (2) FBP using the true attenuation map; (3) ordered subset expectation maximization (OSEM) (equivalent to 423 iterations) with a uniform attenuation map; and (4) OSEM with a true attenuation map. Different Gaussian postsmooth kernels were applied to the reconstructed images. Results: The analysis of the reconstructed data was performed using figures of merit such as signal to noise ratio (SNR), bias and variance. The results illustrated that uniform attenuation correction offered slight deterioration (less than 2%) with regard to SNR when compared to the ideal attenuation map. which in reality is not known. The iterative techniques produced superior signal to noise ratios (increase of 5 - 20 % depending on the lesion and the postsmooth) in comparison to the FBP methods

  15. The reliability of magnetic resonance imaging in traumatic brain injury lesion detection

    NARCIS (Netherlands)

    Geurts, B.H.J.; Andriessen, T.M.J.C.; Goraj, B.M.; Vos, P.E.

    2012-01-01

    Objective: This study compares inter-rater-reliability, lesion detection and clinical relevance of T2-weighted imaging (T2WI), Fluid Attenuated Inversion Recovery (FLAIR), T2*-gradient recalled echo (T2*-GRE) and Susceptibility Weighted Imaging (SWI) in Traumatic Brain Injury (TBI). Methods: Three

  16. Utility of fractional anisotropy imaging analyzed by statistical parametric mapping for detecting minute brain lesions in chronic-stage patients who had mild or moderate traumatic brain injury

    International Nuclear Information System (INIS)

    Asano, Yoshitaka; Shinoda, Jun; Okumura, Ayumi; Aki, Tatsuki; Takenaka, Shunsuke; Miwa, Kazuhiro; Yamada, Mikito; Ito, Takeshi; Yokohama, Kazutoshi

    2012-01-01

    Diffusion tensor imaging (DTI) has recently evolved as valuable technique to investigate diffuse axonal injury (DAI). This study examined whether fractional anisotropy (FA) images analyzed by statistical parametric mapping (FA-SPM images) are superior to T 2 *-weighted gradient recalled echo (T2*GRE) images or fluid-attenuated inversion recovery (FLAIR) images for detecting minute lesions in traumatic brain injury (TBI) patients. DTI was performed in 25 patients with cognitive impairments in the chronic stage after mild or moderate TBI. The FA maps obtained from the DTI were individually compared with those from age-matched healthy control subjects using voxel-based analysis and FA-SPM images (p<0.001). Abnormal low-intensity areas on T2*GRE images (T2* lesions) were found in 10 patients (40.0%), abnormal high-intensity areas on FLAIR images in 4 patients (16.0%), and areas with significantly decreased FA on FA-SPM image in 16 patients (64.0%). Nine of 10 patients with T2* lesions had FA-SPM lesions. FA-SPM lesions topographically included most T2* lesions in the white matter and the deep brain structures, but did not include T2* lesions in the cortex/near-cortex or lesions containing substantial hemosiderin regardless of location. All 4 patients with abnormal areas on FLAIR images had FA-SPM lesions. FA-SPM imaging is useful for detecting minute lesions because of DAI in the white matter and the deep brain structures, which may not be visualized on T2*GRE or FLAIR images, and may allow the detection of minute brain lesions in patients with post-traumatic cognitive impairment. (author)

  17. Comparative diagnostic performance of multidetector computed tomography and MRI for characterization of pancreatic cystic lesions

    International Nuclear Information System (INIS)

    Moon, Sung Min; Shin, Sang Soo; Park, Jin Gyoon; Jeong, Yong Yeon

    2015-01-01

    To compare the diagnostic performance of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in characterization of pancreatic cystic lesions. We conducted a retrospective study on 34 patients with histopathologically proven cystic pancreatic lesions who underwent both preoperative MDCT and MRI. CT and MRI were independently evaluated for differentiating mucinous vs. non-mucinous lesions, differentiating aggressive vs. non-aggressive lesion, analyzing morphological features, and evaluating specific leading diagnoses. Sensitivity, specificity, and accuracy were determined. Competency assessment of lesional morphology analysis was performed using the kappa values of the 2 tests. The sensitivity, specificity, and accuracy of MRI for differentiating mucinous vs. non-mucinous lesions were higher than CT (p = 0.03). For differentiating aggressiveness, the sensitivity of MRI was better than CT, but the specificity of CT was better than MRI. In evaluation of morphologic features, MRI showed better performance in characterization of septa and wall. Otherwise, the 2 modalities showed similarly good performance. MRI was better than CT in determining a specific diagnosis (58.8% vs. 47.2%, respectively). CT and MRI are reasonable diagnostic methods for characterization of pancreatic cystic lesions. However, MRI enables more confident assessment than CT in differentiating mucinous vs. non-mucinous lesions and characterization of the septa and wall

  18. Performance of human observers and an automatic 3-dimensional computer-vision-based locomotion scoring method to detect lameness and hoof lesions in dairy cows

    NARCIS (Netherlands)

    Schlageter-Tello, Andrés; Hertem, Van Tom; Bokkers, Eddie A.M.; Viazzi, Stefano; Bahr, Claudia; Lokhorst, Kees

    2018-01-01

    The objective of this study was to determine if a 3-dimensional computer vision automatic locomotion scoring (3D-ALS) method was able to outperform human observers for classifying cows as lame or nonlame and for detecting cows affected and nonaffected by specific type(s) of hoof lesion. Data

  19. Detection of up to 65% of Precancerous Lesions of the Human Colon and Rectum by Mutation Analysis of APC, K-Ras, B-Raf and CTNNB1

    International Nuclear Information System (INIS)

    Schneider, Mandy; Scholtka, Bettina; Gottschalk, Uwe; Faiss, Siegbert; Schatz, Daniela; Berghof-Jäger, Kornelia; Steinberg, Pablo

    2010-01-01

    In the present study a recently conceived 4-gene marker panel covering the Wnt and Ras-Raf-MEK-MAPK signaling pathways was used to analyze 20 colorectal serrated lesions and 41 colorectal adenoma samples and to determine the percentage of each of the above-mentioned potentially precancerous lesions carrying at least one of the four above-mentioned genes in a mutated form. CTNNB1 and B-Raf were screened by PCR-single-strand conformation polymorphism analysis, K-Ras by restriction fragment length polymorphism analysis and the APC gene mutation cluster region (codons 1243–1567) by direct DNA sequencing. APC mutations were only detected in 10% of the serrated lesions but in 34% of the adenomas. Twenty percent of the serrated lesions and 14% of the adenomas carried a mutated K-Ras. B-Raf was found to be mutated in 50% of the serrated lesions and in 22% of the adenomas. CTNNB1 was altered in 12% of the adenomas, but not in serrated lesions. By using the above gene marker panel it could be shown that 65% of the serrated lesions and 61% of the adenomas carried at least one of the four genes in a mutated form. Based on its excellent performance in detecting mutations in sporadic preneoplastic (in this study) and neoplastic lesions (in a previous study) of the human colon and rectum, this primer combination might also be suited to efficiently and non-invasively detect genetic alterations in stool DNA of patients with early colorectal cancer

  20. Detection of up to 65% of Precancerous Lesions of the Human Colon and Rectum by Mutation Analysis of APC, K-Ras, B-Raf and CTNNB1

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Mandy; Scholtka, Bettina, E-mail: scholtka@uni-potsdam.de [Chair of Nutritional Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur- Scheunert-Allee 114-116, 14558 Nuthetal (Germany); Gottschalk, Uwe [Maria Heimsuchung Caritas-Klinik Pankow, Breite Straße 46/47, 13187 Berlin (Germany); Faiss, Siegbert [III. Medizinische Abteilung - Gastroenterologie und Hepatologie, Asklepios Klinik Barmbek, Rubenkamp 220, 22291 Hamburg (Germany); Schatz, Daniela; Berghof-Jäger, Kornelia [BIOTECON Diagnostics GmbH, Hermannswerder Haus 17, 14473 Potsdam (Germany); Steinberg, Pablo, E-mail: scholtka@uni-potsdam.de [Chair of Nutritional Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur- Scheunert-Allee 114-116, 14558 Nuthetal (Germany); Institute for Food Toxicology and Analytical Chemistry, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173 Hannover (Germany)

    2010-12-29

    In the present study a recently conceived 4-gene marker panel covering the Wnt and Ras-Raf-MEK-MAPK signaling pathways was used to analyze 20 colorectal serrated lesions and 41 colorectal adenoma samples and to determine the percentage of each of the above-mentioned potentially precancerous lesions carrying at least one of the four above-mentioned genes in a mutated form. CTNNB1 and B-Raf were screened by PCR-single-strand conformation polymorphism analysis, K-Ras by restriction fragment length polymorphism analysis and the APC gene mutation cluster region (codons 1243–1567) by direct DNA sequencing. APC mutations were only detected in 10% of the serrated lesions but in 34% of the adenomas. Twenty percent of the serrated lesions and 14% of the adenomas carried a mutated K-Ras. B-Raf was found to be mutated in 50% of the serrated lesions and in 22% of the adenomas. CTNNB1 was altered in 12% of the adenomas, but not in serrated lesions. By using the above gene marker panel it could be shown that 65% of the serrated lesions and 61% of the adenomas carried at least one of the four genes in a mutated form. Based on its excellent performance in detecting mutations in sporadic preneoplastic (in this study) and neoplastic lesions (in a previous study) of the human colon and rectum, this primer combination might also be suited to efficiently and non-invasively detect genetic alterations in stool DNA of patients with early colorectal cancer.

  1. Comparison of Digital Tomosynthesis and Chest Radiography for the Detection of Noncalcified Pulmonary and Hilar Lesions.

    Science.gov (United States)

    Galea, Angela; Adlan, Tarig; Gay, David; Roobottom, Carl; Dubbins, Paul; Riordan, Richard

    2015-09-01

    The aim of this study was to compare the sensitivity and specificity of chest digital tomosynthesis (DTS) with chest radiography (CXR) for the detection of noncalcified pulmonary nodules and hilar lesions using computed tomography (CT) as the reference standard. A total of 78 patients with suspected noncalcified pulmonary lesions on CXR were included in the study. Two radiologists, blinded to the history and CT, analyzed the CXR and the DTS images (separately), whereas a third radiologist analyzed the CXR and DTS images together. Noncalcified intrapulmonary nodules and hilar lesions were recorded for analysis. The interobserver agreement for CXR and DTS was assessed, and the time taken to report the images was recorded. A total of 202 lesions were recorded in 78 patients. There were 111 true lesions confirmed on CT in 53 patients; in 25 patients subsequent CT excluded a lesion. The overall sensitivity was 32% for CXR and 49% for DTS. This improved to 54% when the posteroanterior CXR and DTS were reviewed together (CXR-DTS). The overall specificities for CXR, DTS, and CXR-DTS were 49%, 96%, and 98%, respectively. There were 56 suspected hilar lesions with subgroup sensitivities of 76% for CXR, 65% for DTS, and 76% for CXR-DTS. The specificity for hilar lesions was 59%, 92%, and 97% for CXR, DTS, and CXR-DTS, respectively. DTS significantly improves the detectability of noncalcified nodules when compared with and when used in combination with CXR. The specificity and interobserver agreement of DTS in the diagnosis of suspected noncalcified pulmonary nodules and hilar lesions are significantly better than those of CXR and approaches those of CT.

  2. Automatic detection and recognition of multiple macular lesions in retinal optical coherence tomography images with multi-instance multilabel learning

    Science.gov (United States)

    Fang, Leyuan; Yang, Liumao; Li, Shutao; Rabbani, Hossein; Liu, Zhimin; Peng, Qinghua; Chen, Xiangdong

    2017-06-01

    Detection and recognition of macular lesions in optical coherence tomography (OCT) are very important for retinal diseases diagnosis and treatment. As one kind of retinal disease (e.g., diabetic retinopathy) may contain multiple lesions (e.g., edema, exudates, and microaneurysms) and eye patients may suffer from multiple retinal diseases, multiple lesions often coexist within one retinal image. Therefore, one single-lesion-based detector may not support the diagnosis of clinical eye diseases. To address this issue, we propose a multi-instance multilabel-based lesions recognition (MIML-LR) method for the simultaneous detection and recognition of multiple lesions. The proposed MIML-LR method consists of the following steps: (1) segment the regions of interest (ROIs) for different lesions, (2) compute descriptive instances (features) for each lesion region, (3) construct multilabel detectors, and (4) recognize each ROI with the detectors. The proposed MIML-LR method was tested on 823 clinically labeled OCT images with normal macular and macular with three common lesions: epiretinal membrane, edema, and drusen. For each input OCT image, our MIML-LR method can automatically identify the number of lesions and assign the class labels, achieving the average accuracy of 88.72% for the cases with multiple lesions, which better assists macular disease diagnosis and treatment.

  3. Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT

    OpenAIRE

    Wu, Size; Tu, Rong; Nan, Ruixia; Liu, Guangqing; Cui, Xiaojing; Liang, Xian

    2015-01-01

    Purpose: The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. Methods: A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonog...

  4. The value of digital tomosynthesis of the chest as a problem-solving tool for suspected pulmonary nodules and hilar lesions detected on chest radiography.

    Science.gov (United States)

    Galea, Angela; Dubbins, Paul; Riordan, Richard; Adlan, Tarig; Roobottom, Carl; Gay, David

    2015-05-01

    To assess the capability of digital tomosynthesis (DTS) of the chest compared to a postero-anterior (PA) and lateral chest radiograph (CXR) in the diagnosis of suspected but unconfirmed pulmonary nodules and hilar lesions detected on a CXR. Computed tomography (CT) was used as the reference standard. 78 patients with suspected non-calcified pulmonary nodules or hilar lesions on their CXR were included in the study. Two radiologists, blinded to the history and CT, prospectively analysed the CXR (PA and lateral) and the DTS images using a picture archiving and communication workstation and were asked to designate one of two outcomes: true intrapulmonary lesion or false intrapulmonary lesion. A CT of the chest performed within 4 weeks of the CXR was used as the reference standard. Inter-observer agreement and time to report the modalities were calculated for CXR and DTS. There were 34 true lesions confirmed on CT, 12 were hilar lesions and 22 were peripheral nodules. Of the 44 false lesions, 37 lesions were artefactual or due to composite shadow and 7 lesions were real but extrapulmonary simulating non-calcified intrapulmonary lesions. The PA and lateral CXR correctly classified 39/78 (50%) of the lesions, this improved to 75/78 (96%) with DTS. The sensitivity and specificity was 0.65 and 0.39 for CXR and 0.91 and 1 for DTS. Based on the DTS images, readers correctly classified all the false lesions but missed 3/34 true lesions. Two of the missed lesions were hilar in location and one was a peripheral nodule. All three missed lesions were incorrectly classified on DTS as composite shadow. DTS improves diagnostic confidence when compared to a repeat PA and lateral CXR in the diagnosis of both suspected hilar lesions and pulmonary nodules detected on CXR. DTS is able to exclude most peripheral pulmonary nodules but caution and further studies are needed to assess its ability to exclude hilar lesions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Cindy L. Lamerson

    2012-01-01

    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  6. Real-time MRI navigated US: Role in diagnosis and guided biopsy of incidental breast lesions and axillary lymph nodes detected on breast MRI but not on second look US

    Energy Technology Data Exchange (ETDEWEB)

    Pons, Elena Pastor, E-mail: elenapastorpons@gmail.com; Azcón, Francisco Miras, E-mail: frmiaz00@gmail.com; Casas, María Culiañez, E-mail: mariacc1980@gmail.com; Meca, Salvador Martínez, E-mail: isalvaa@hotmail.com; Espona, José Luis García, E-mail: gespona@hotmail.com

    2014-06-15

    Objectives: To prospectively evaluate the accuracy of real-time ultrasound combined with supine-MRI using volume navigation technique (RtMR-US) in diagnosis and biopsy of incidental breast lesions (ILSM) and axillary lymph nodes (LNSM) suspicious of malignancy on contrast enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Five hundred and seventy-seven women were examined using breast CE-MRI. Those with incidental breast lesions not identified after second-look ultrasound (US) were recruited for RtMR-US. Biopsy was performed in ILSM. Breast lesions were categorized with BI-RADS system and Fisher’ exact test. Axillary lymph nodes morphology was described. To assess efficacy of RtMR-US, diagnostic accuracy, sensitivity, specificity, detection rate and Kappa index of conventional-US and RtMR-US were calculated. Results: Forty-three lesions were detected on CE-MRI before navigation. Eighteen were carcinomas and 25 ILSM. Of these, 21 underwent a RtMR-US. Detection rate on RtMR-US (90.7%) was higher than on conventional-US (43%) (p < 0.001). Agreement between both techniques was low (k = 0.138). Twenty ILSM and 2 LNSM were biopsied. Sixty-five percent were benign (100% of BI-RADS3 and 56% of BI-RADS4-5). Diagnostic performance of RtMR-US identifying malignant nodules for overall lesions and for the subgroup of ILSM was respectively: sensitivity 96.3% and 100%, specificity 18.8% and 30.7%, positive predictive value 66.7% and 43.7%, negative predictive value 75% and 100%. In addition RtMR-US enabled biopsy of 2 metastatic lymph nodes. Conclusions: Real time-US with supine-MRI using a volume navigation technique increases the detection of ILSM. RtMR-US may be used to detect occult breast carcinomas and to assess cancer extension, preventing unnecessary MRI-guided biopsies and sentinel lymph node biopsies. Incidental lesions BI-RADS 3 non-detected on conventional-US are probably benign.

  7. Detection of small human cerebral cortical lesions with MRI under different levels of Gaussian smoothing: applications in epilepsy

    Science.gov (United States)

    Cantor-Rivera, Diego; Goubran, Maged; Kraguljac, Alan; Bartha, Robert; Peters, Terry

    2010-03-01

    The main objective of this study was to assess the effect of smoothing filter selection in Voxel-Based Morphometry studies on structural T1-weighted magnetic resonance images. Gaussian filters of 4 mm, 8 mm or 10 mm Full Width at High Maximum are commonly used, based on the assumption that the filter size should be at least twice the voxel size to obtain robust statistical results. The hypothesis of the presented work was that the selection of the smoothing filter influenced the detectability of small lesions in the brain. Mesial Temporal Sclerosis associated to Epilepsy was used as the case to demonstrate this effect. Twenty T1-weighted MRIs from the BrainWeb database were selected. A small phantom lesion was placed in the amygdala, hippocampus, or parahippocampal gyrus of ten of the images. Subsequently the images were registered to the ICBM/MNI space. After grey matter segmentation, a T-test was carried out to compare each image containing a phantom lesion with the rest of the images in the set. For each lesion the T-test was repeated with different Gaussian filter sizes. Voxel-Based Morphometry detected some of the phantom lesions. Of the three parameters considered: location,size, and intensity; it was shown that location is the dominant factor for the detection of the lesions.

  8. Detection and Characterization of Focal Hepatic lesions using Magnetic resonance Imaging

    International Nuclear Information System (INIS)

    Pulgarin, Luis G; Delgado, Jorge Andres; Toro Nancy

    2008-01-01

    A retrospective one year study was performed from June 2006 to June 2007. A total of ten focal liver lesions in 60 patients were examined, describing their magnetic resonance (MR) characteristics, using T1, T2 and dynamic Gd-enhanced T1 weighted sequences with and without fat suppression. Lesions were classified into benign or malignant tumors and a diagnosis was proposed. Specific diagnoses such as simple cyst, abscess, hemangioma, focal nodular hyperplasia, hepatocellular carcinoma, and cholangiocarcinoma were reported.

  9. Lesion detection and vascular assessment with modified CTAP and MR imaging of liver

    International Nuclear Information System (INIS)

    Thoeni, R.F.; Werthmuller, W.C.; Warren, R.S.; Mulvihill, S.J.

    1990-01-01

    This paper reports on a special CT arterial portography (CTAP) method with immediate and delayed scans compared to MR imaging of liver with fat-saturation images and angiographic portogram to determine whether CTAP and MR imaging could obviate the angiographic portogram and which imaging method best detects lesions. In 13 patients, CTAP was obtained on a FASTRAK CT scanner in an immediate and delayed dynamic mode with 0.4-sec sections. These CT results were compared to the angiographic portogram and MR results of T1-weighted SR (TR 300, TE 20, NEX 4) and T2-weighted SE (TR 2,000--2,500; TE 20/70; NEX 2) W=with and without fat saturation. CT/MR features analyzed included lesion detection, involvement of portal and hepatic veins, and adenopathy. Features were ranked from 0 = definitely normal to 4 = definitely abnormal

  10. Detecting ICRS grade 1 cartilage lesions in anterior cruciate ligament injury using T1ρ and T2 mapping

    Energy Technology Data Exchange (ETDEWEB)

    Nishioka, Hiroaki, E-mail: kinuhnishiok@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Hirose, Jun, E-mail: hirojun-mk@umin.ac.jp [Department of Orthopaedic Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Nakamura, Eiichi, E-mail: h@kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Okamoto, Nobukazu, E-mail: nobuoka9999@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Karasugi, Tatsuki, E-mail: tatsukik@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Taniwaki, Takuya, E-mail: takuyataniwaki@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Okada, Tatsuya, E-mail: tatsuya-okada@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Yamashita, Yasuyuki, E-mail: yama@kumamoto-u.ac.jp [Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan); Mizuta, Hiroshi, E-mail: mizuta@kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556 (Japan)

    2013-09-15

    Objective: The purpose of this study was to clarify the detectability of the International Cartilage Repair Society (ICRS) grade 1 cartilage lesions in anterior cruciate ligament (ACL)–injured knees using T1ρ and T2 mapping. Materials and Methods: We performed preoperative T1ρ and T2 mapping and 3D gradient–echo with water–selective excitation (WATS) sequences on 37 subjects with ACL injuries. We determined the detectability on 3D WATS based on arthroscopic findings. The T1ρ and T2 values (ms) were measured in the regions of interest that were placed on the weight–bearing cartilage of the femoral condyle. The receiver operating characteristic (ROC) curve based on these values was constructed using the arthroscopic findings as a reference standard. The evaluation of cartilage was carried out only in the weight–bearing cartilage. The cut–off values for determining the presence of a cartilage injury were determined using each ROC curve, and the detectability was calculated for the T1ρ and T2 mapping. Results: The cut–off values for the T1ρ and T2 were 41.6 and 41.2, respectively. The sensitivity and specificity of T1ρ were 91.2% and 89.5%, respectively, while those of T2 were 76.5% and 81.6%, respectively. For the 3D WATS images, the same values were 58.8% and 78.9%, respectively. Conclusions: Our study demonstrated that the T1ρ and T2 values were significantly higher for ICRS grade 1 cartilage lesions than for normal cartilage and that the two mappings were able to non–invasively detect ICRS grade 1 cartilage lesions in the ACL–injured knee with a higher detectability than were 3D WATS images.

  11. Early Detection of Bone Lesions by Photoscanning with Radioactive Strontium-87m

    Energy Technology Data Exchange (ETDEWEB)

    Kostamis, P.; Constantinides, C.; Papavasiliou, C.; Binopoulos, D.; Sfontouris, J.; Malamos, B. [University of Athens Medical School, ' Alexandra' Hospital, Athens (Greece)

    1969-05-15

    Patients with proven and suspected bone lesions were scanned from 30 min to 3 h after an intravenous injection of 400 {mu}Ci to 1 mCi of {sup 87m}Sr. Many different types of bone tumours were detected, such as osteogenic sarcoma and metastatic cancer of breast, thyroid, lung and other organs. {sup 87m}Sr photoscanning easily demonstrates obvious tumours of the bone which have been visualized on the roentgenogram, but the most important purpose of the present study is the visualization of lesions which were not demonstrated on the conventional roentgenogram. The analysis of the examined cases is discussed. (author)

  12. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging

    International Nuclear Information System (INIS)

    Kinoshita, Toshibumi; Moritani, Toshio; Hiwatashi, Akio; Wang, Henry Z.; Shrier, David A.; Numaguchi, Yuji; Westesson, Per-Lennart A.

    2005-01-01

    Objective: (1) To detect diffuse axonal injury (DAI) lesions by diffusion-weighted imaging (DWI), as compared with fluid-attenuated inversion recovery (FLAIR) imaging and (2) to evaluate hemorrhagic DAI lesions by b 0 images obtained from DWI, as compared with gradient-echo (GRE) imaging. Methods: We reviewed MR images of 36 patients with a diagnosis of DAI. MR imaging was performed 20 h to 14 days (mean, 3.7 days) after traumatic brain injury. We evaluated: (1) conspicuity of lesions on DWI and FLAIR and (2) conspicuity of hemorrhage in DAI lesions on b 0 images and GRE imaging. Results: DWI clearly depicted high-signal DAI lesions. The sensitivity of DWI to lesional conspicuity in DAI lesions was almost equal to that of FLAIR. The sensitivity of b 0 images to identification of hemorrhagic DAI lesions was inferior to that of GRE. Conclusion: DWI is as useful as FLAIR in detecting DAI lesions. GRE imaging is still the superior tool for the evaluation of hemorrhagic DAI

  13. Is 3D MPRAGE better than the combination DIR/PSIR for cortical lesion detection at 3T MRI?

    Science.gov (United States)

    Nelson, Flavia; Poonawalla, Aziz; Datta, Sushmita; Wolinsky, Jerry; Narayana, Ponnada

    2014-03-01

    Based on the application of newer magnetic resonance imaging (MRI) acquisition sequences, the detection of cortical lesions (CL) in multiple sclerosis (MS) has significantly improved. Double inversion recovery (DIR) at 3T has increased the detection sensitivity and classification specificity when combined with phase sensitive inversion recovery (PSIR). Previous findings with 3D magnetization prepared rapid acquisition with gradient echo (MPRAGE) sequences, showed improved classification specificity of purely intracortical (IC) and mixed (MX) lesions, compared to the classification based on DIR/PSIR. Direct comparison between the detection of CL by 3D MPRAGE and by DIR/PSIR at 3T has not been evaluated. Eleven subjects were imaged on a 3T magnet. DIR/PSIR and 3D MPRAGE images were reviewed independently. Each image set was reviewed twice; only lesions detected on both sessions were scored. Review time per scan was ~5min for DIR/PSIR and ~15min for 3D MPRAGE. We identified 141 CL (62 IC+79 MX) based on DIR/PSIR images vs. 93 (38 IC+55 MX) based on MPRAGE from all eleven patients. MPRAGE under-detected the number of CL in seven cases and over-detected the number of CL in three, only one case had the same number of CL on both sets of images. Combination DIR/PSIR at 3T is superior to 3D MPRAGE for detection of cortical gray matter lesions in MS. The contrast-to-noise ratio of CL appears to be inferior on the MPRAGE images relative to DIR/PSIR. © 2013 Published by Elsevier B.V.

  14. Brain lesions in congenital nystagmus as detected by computed tomography

    International Nuclear Information System (INIS)

    Lo, Chin-Ying

    1982-01-01

    Computed tomography (CT) was performed in a series of 60 cases with congenital nystagmus. The type of nystagmus was pendular in 20 and jerky in 40 cases. The age ranged from 3 months to 13 years. Abnormal CT findings of the central nervous system were detected in 31 cases (52%). There were 5 major CT findings: midline anomalies, cortical atrophy, ventricular dilatation, brain stem atrophy and low density area. The midline anomalies involved cavum septi pellucidi, cavum Vergae, cavum veli interpositi and partial agenesis of corpus callosum. The abnormal CT findings were more prominent in pendular type than in jerky type. The incidence of congenital nystagmus and positive CT findings were the same in the first and the second birth. There was a history of abnormalities during the prenatal or perinatal period in 28 out of the 60 cases (47%). This feature seemed to play a significant role in the occurrence of congenital nystagmus. The observed organic lesions in the central nervous system by CT would contribute to the elucidation of pathomechanism of congenital nystagmus. (author)

  15. A basic study on lesion detectability for hot spot imaging of positron emitters with dedicated PET and positron coincidence gamma camera

    International Nuclear Information System (INIS)

    Zhang, Hong; Inoue, Tomio; Tian, Mei; Alyafei, Saleh; Oriuchi, Noboru; Khan, Nasim; Endo, Keigo; Li Sijin

    2001-01-01

    The aim of this study was to explore the correlations of detectability and the semi-quantification for hot spot imaging with positron emitters in positron emission tomography (PET) and with a positron coincidence detection system (PCD). Phantom study results for the measurement of the lesion-to-background (L/B) ratio ranged from 2.0 to 30.3, and detectability for hot spot lesion of PET and PCD were performed to correspond to clinical conditions. The detectability and semi-quantitative evaluation of hot spots from 4.4 mm to 36.9 mm in diameter were performed from the PET and PCD images. There were strong correlations between the L/B ratios derived from PET and PCD hot spot images and actual L/B ratios; but the L/B ratio derived from PET was higher than that from PCD with a significant difference of 10% to 54.8%. The detectability of hot spot imaging of PCD was lower than that of PET at 64.8% (PCD) versus 77.8% (PET). Even the actual L/B ratio was 8.0, hot spots more than 10.6 mm in diameter could be clearly identified with PCD imaging. The same identification could be achieved with PET imaging even when the actual L/B ratio was 4.0. This detailed investigation indicated that FDG PCD yielded results comparable to FDG PET on visual analysis and semi-quantitative analysis in detecting hot spots in phantoms, but semi-quantitative analysis of the L/B ratio with FDG PCD was inferior to that with FDG PET and the detectability of PCD in smaller hot spots was significantly poor. (author)

  16. Diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting trochlear ridge osteochondrosis lesions in the equine stifle.

    Science.gov (United States)

    Beccati, Francesca; Chalmers, Heather J; Dante, Sara; Lotto, Eleonora; Pepe, Marco

    2013-01-01

    Osteochondrosis lesions commonly occur on the femoral trochlear ridges in horses and radiography and ultrasonography are routinely used to diagnose these lesions. However, poor correlation has been found between radiographic and arthroscopic findings of affected trochlear ridges. Interobserver agreement for ultrasonographic diagnoses and correlation between ultrasonographic and arthroscopic findings have not been previously described. Objectives of this study were to describe diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting and grading osteochondrosis lesions of the equine trochlear ridges, using arthroscopy as the reference standard. Twenty-two horses were sampled. Two observers independently recorded radiographic and ultrasonographic findings without knowledge of arthroscopic findings. Imaging findings were compared between observers and with arthroscopic findings. Agreement between observers was moderate to excellent (κ 0.48-0.86) for detecting lesions using radiography and good to excellent (κ 0.74-0.87) for grading lesions using radiography. Agreement between observers was good to excellent (κ 0.78-0.94) for detecting lesions using ultrasonography and very good to excellent (κ 0.86-0.93) for grading lesions using ultrasonography. Diagnostic sensitivity was 84-88% for radiography and 100% for ultrasonography. Diagnostic specificity was 89-100% for radiography and 60-82% for ultrasonography. Agreement between radiography and arthroscopy was good (κ 0.64-0.78). Agreement between ultrasonography and arthroscopy was very good to excellent (κ 0.81-0.87). Findings from this study support ultrasound as a preferred method for predicting presence and severity of osteochondrosis lesions involving the femoral trochlear ridges in horses. © 2012 Veterinary Radiology & Ultrasound.

  17. Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

    Energy Technology Data Exchange (ETDEWEB)

    Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C. [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany); Gabbert, H.E. [University Dusseldorf, Medical Faculty, Department of Pathology, Dusseldorf (Germany)

    2016-11-15

    This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

  18. Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

    International Nuclear Information System (INIS)

    Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G.; Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C.; Gabbert, H.E.

    2016-01-01

    This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

  19. Nonhemorrhagic brain lesions detected by magnetic resonance imaging in closed head injured patients

    International Nuclear Information System (INIS)

    Kinoshita, Yoshihiro; Hiraide, Atsushi; Yoshioka, Toshiji; Sugimoto, Tadashi; Ichimura, Teruhisa; Saito, Akira; Ohno, Yoshioki.

    1990-01-01

    This study evaluated the diagnostic usefulness of magnetic resonance imaging (MRI) in 83 closed head injured patients in whom CT failed to detect focal intra or extraaxial hematoma and/or apparent brain contusion. The patients were divided into three groups on the basis of unconsciousness duration: Group 1 comprised 50 patients diagnosed as having classical cerebral concussion; group 2 comprised 19 patients who presented to the hospital with 6-hr unconsciousness and was recovered within a week; and group 3 comprised 14 patients whose unconsciousness persisted for a week or more. There was no CT evidence of abnormal findings for group 1; and intraventricular hemorrhage and subarachnoid hemorrhage were visualized on CT in 26% and 16%, respectively, for group 2 and 71% and 14% for group 3. Intraaxial nonhemorrhagic lesions were detected on T2-weighted MRI. According to high signal intensity, diffuse axonal injury and cortical contusion could be distinguished; i.e., in the former the corpus callosum, basal ganglia, or brain stem showed a high signal intensity, and in the latter the frontal, temporal, or parietal lobe adjacent to the skull showed a low signal intensity. T2-weighted MRI revealed cortical contusion in 6% for group 1, 37% for group 2, and 14% for group 3; and diffuse axonal injury in 42% for group 2 and 79% for group 3. For 62 patients with normal CT findings, diffuse axonal injury was detected in 88%. There was a good correlation between intraventricular hemorrhage on CT and diffuse axonal injury on MRI. In conclusion, T2-weighted MRI was significantly superior to CT in detecting nonhemorrhagic lesions, and it was of great help for predicting neurologic recovery in closed head injured patients without apparent focal lesions on CT. (N.K.)

  20. Comparison of the prevalence of human papilloma virus infection in histopathologically confirmed premalignant oral lesions and healthy oral mucosa by brush smear detection.

    Science.gov (United States)

    Dalla Torre, Daniel; Burtscher, Doris; Edlinger, Michael; Sölder, Elisabeth; Widschwendter, Andreas; Rasse, Michael; Puelacher, Wolfgang

    2015-03-01

    The role of human papilloma virus (HPV) infections in oral carcinogenesis is an important topic of research in maxillofacial oncology. Nevertheless, the association between such infections in the oral cavity and the development of oral precancerous lesions remains unclear. The aim of this study was to evaluate the association between oral HPV infections and oral leukoplakia or erythroplakia. The case control study included 118 patients with manifest oral leukoplakia or erythroplakia, who underwent surgical biopsy, including a histopathologic grading of the lesion, and 100 control patients without any oral lesions. HPV detection was achieved with a noninvasive brush smear method (Digene Cervical Sampler, Hybrid Capture II-Test). Logistic regression analysis was performed to assess the associations. A significant association was found between high-risk oral HPV infection and the presence of oral premalignant lesions (P = .001). Among all other evaluated parameters, only smoking showed a significant association with the presence of oral lesions. Oral HPV infections may play a role in the pathogenesis of premalignant oral lesions. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Detection of retinal lesions in diabetic retinopathy: comparative evaluation of 7-field digital color photography versus red-free photography.

    Science.gov (United States)

    Venkatesh, Pradeep; Sharma, Reetika; Vashist, Nagender; Vohra, Rajpal; Garg, Satpal

    2015-10-01

    Red-free light allows better detection of vascular lesions as this wavelength is absorbed by hemoglobin; however, the current gold standard for the detection and grading of diabetic retinopathy remains 7-field color fundus photography. The goal of this study was to compare the ability of 7-field fundus photography using red-free light to detect retinopathy lesions with corresponding images captured using standard 7-field color photography. Non-stereoscopic standard 7-field 30° digital color fundus photography and 7-field 30° digital red-free fundus photography were performed in 200 eyes of 103 patients with various grades of diabetic retinopathy ranging from mild to moderate non-proliferative diabetic retinopathy to proliferative diabetic retinopathy. The color images (n = 1,400) were studied with corresponding red-free images (n = 1,400) by one retina consultant (PV) and two senior residents training in retina. The various retinal lesions [microaneurysms, hemorrhages, hard exudates, soft exudates, intra-retinal microvascular anomalies (IRMA), neovascularization of the retina elsewhere (NVE), and neovascularization of the disc (NVD)] detected by all three observers in each of the photographs were noted followed by determination of agreement scores using κ values (range 0-1). Kappa coefficient was categorized as poor (≤0), slight (0.01-0.20), fair (0.2 -0.40), moderate (0.41-0.60), substantial (0.61-0.80), and almost perfect (0.81-1). The number of lesions detected by red-free images alone was higher for all observers and all abnormalities except hard exudates. Detection of IRMA was especially higher for all observers with red-free images. Between image pairs, there was substantial agreement for detection of hard exudates (average κ = 0.62, range 0.60-0.65) and moderate agreement for detection of hemorrhages (average κ = 0.52, range 0.45-0.58), soft exudates (average κ = 0.51, range 0.42-0.61), NVE (average κ = 0.47, range 0.39-0.53), and NVD

  2. Tissue resonance interaction accurately detects colon lesions: A double-blind pilot study.

    Science.gov (United States)

    Dore, Maria P; Tufano, Marcello O; Pes, Giovanni M; Cuccu, Marianna; Farina, Valentina; Manca, Alessandra; Graham, David Y

    2015-07-07

    To investigated the performance of the tissue resonance interaction method (TRIM) for the non-invasive detection of colon lesions. We performed a prospective single-center blinded pilot study of consecutive adults undergoing colonoscopy at the University Hospital in Sassari, Italy. Before patients underwent colonoscopy, they were examined by the TRIMprobe which detects differences in electromagnetic properties between pathological and normal tissues. All patients had completed the polyethylene glycol-containing bowel prep for the colonoscopy procedure before being screened. During the procedure the subjects remained fully dressed. A hand-held probe was moved over the abdomen and variations in electromagnetic signals were recorded for 3 spectral lines (462-465 MHz, 930 MHz, and 1395 MHz). A single investigator, blind to any clinical information, performed the test using the TRIMprob system. Abnormal signals were identified and recorded as malignant or benign (adenoma or hyperplastic polyps). Findings were compared with those from colonoscopy with histologic confirmation. Statistical analysis was performed by χ(2) test. A total of 305 consecutive patients fulfilling the inclusion criteria were enrolled over a period of 12 months. The most frequent indication for colonoscopy was abdominal pain (33%). The TRIMprob was well accepted by all patients; none spontaneously complained about the procedure, and no adverse effects were observed. TRIM proved inaccurate for polyp detection in patients with inflammatory bowel disease (IBD) and they were excluded leaving 281 subjects (mean age 59 ± 13 years; 107 males). The TRIM detected and accurately characterized all 12 adenocarcinomas and 135/137 polyps (98.5%) including 64 adenomatous (100%) found. The method identified cancers and polyps with 98.7% sensitivity, 96.2% specificity, and 97.5% diagnostic accuracy, compared to colonoscopy and histology analyses. The positive predictive value was 96.7% and the negative predictive

  3. Effectiveness of core biopsy for screen-detected breast lesions under 10 mm: implications for surgical management.

    Science.gov (United States)

    Farshid, Gelareh; Downey, Peter; Pieterse, Steve; Gill, P Grantley

    2017-09-01

    Technical advances have improved the detection of small mammographic lesions. In the context of mammographic screening, accurate sampling of these lesions by percutaneous biopsy is crucial in limiting diagnostic surgical biopsies, many of which show benign results. Women undergoing core biopsy between January 1997 and December 2007 for core histology, 345 women (43.0%) were immediately cleared of malignancy and 300 (37.4%) were referred for definitive cancer treatment. A further 157 women (19.6%) required diagnostic surgical biopsy because of indefinite or inadequate core results or radiological-pathological discordance, and one woman (0.1%) needed further imaging in 12 months. The open biopsies were malignant in 46 (29.3%) cases. The positive predictive value of malignant core biopsy was 100%. The negative predictive value for benign core results was 97.7%, and the false-negative rate was 2.6%. The lesion could not be visualized after core biopsy in 5.1% of women and in 4.0% of women with malignant core biopsies excision specimens did not contain residual malignancy. Excessive delays in surgery because of complications of core biopsy were not reported. Even at this small size range, core biopsy evaluation of screen-detected breast lesions is highly effective and accurate. A lesion miss rate of 3.1% and under-representation of lesions on core samples highlight the continued need for multidisciplinary collaboration and selective use of diagnostic surgical biopsy. © 2015 Royal Australasian College of Surgeons.

  4. IMAGE PROCESSING FOR DETECTION OF ORAL WHITE SPONGE NEVUS LESIONS

    Directory of Open Access Journals (Sweden)

    Rajdeep Mitra

    2016-12-01

    Full Text Available White Sponge Nevus is a rear hereditary disease in human causes incurable white lesions in oral mucosa. Appropriate history, clinical examination along with biopsy and cytological studies are helpful for diagnosis of this disorder. Identification can also be made in alternative way by applying image processing technique using Watershed segmentation with MATLAB software. The applied techniques are effective and reliable for early accurate detection of the disease as alternative of expertise clinical and time taking laboratory investigations.

  5. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    International Nuclear Information System (INIS)

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni; Houssami, Nehmat; Campanino, Pier Paolo; Bussone, Riccardo; Castellano, Isabella; Sapino, Anna

    2015-01-01

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  6. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)

    2015-09-15

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  7. An Optimized Clustering Approach for Automated Detection of White Matter Lesions in MRI Brain Images

    Directory of Open Access Journals (Sweden)

    M. Anitha

    2012-04-01

    Full Text Available Settings White Matter lesions (WMLs are small areas of dead cells found in parts of the brain. In general, it is difficult for medical experts to accurately quantify the WMLs due to decreased contrast between White Matter (WM and Grey Matter (GM. The aim of this paper is to
    automatically detect the White Matter Lesions which is present in the brains of elderly people. WML detection process includes the following stages: 1. Image preprocessing, 2. Clustering (Fuzzy c-means clustering, Geostatistical Possibilistic clustering and Geostatistical Fuzzy clustering and 3.Optimization using Particle Swarm Optimization (PSO. The proposed system is tested on a database of 208 MRI images. GFCM yields high sensitivity of 89%, specificity of 94% and overall accuracy of 93% over FCM and GPC. The clustered brain images are then subjected to Particle Swarm Optimization (PSO. The optimized result obtained from GFCM-PSO provides sensitivity of 90%, specificity of 94% and accuracy of 95%. The detection results reveals that GFCM and GFCMPSO better localizes the large regions of lesions and gives less false positive rate when compared to GPC and GPC-PSO which captures the largest loads of WMLs only in the upper ventral horns of the brain.

  8. Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting: Comparison of several anti-embolic protection devices.

    Science.gov (United States)

    Taha, Mahmoud M; Maeda, Masayuki; Sakaida, Hiroshi; Kawaguchi, Kenji; Toma, Naoki; Yamamoto, Akitaka; Hirose, Tomofumi; Miura, Youichi; Fujimoto, Masashi; Matsushima, Satoshi; Taki, Waro

    2009-09-01

    Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm(3) vs. 86.9 mm(3), respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm(3)) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm(3) and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions.

  9. Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting. Comparison of several anti-embolic protection devices

    International Nuclear Information System (INIS)

    Taha, M.M.; Maeda, Masayuki; Sakaida, Hiroshi

    2009-01-01

    Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm 3 vs. 86.9 mm 3 , respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm 3 ) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm 3 and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions. (author)

  10. Breast vibro-acoustography: initial experience in benign lesions

    International Nuclear Information System (INIS)

    Alizad, Azra; Mehrmohammadi, Mohammad; Ghosh, Karthik; Glazebrook, Katrina N; Carter, Rickey E; Karaberkmez, Leman Gunbery; Whaley, Dana H; Fatemi, Mostafa

    2014-01-01

    Vibro-acoustography (VA) is a newly developed imaging technology that is based on low-frequency vibrations induced in the object by the radiation force of ultrasound. VA is sensitive to the dynamic characteristics of tissue. Here, we evaluate the performance of VA in identifying benign lesions and compare the results to those of mammography. An integrated mammography-VA system designed for in vivo breast imaging was tested on a group of female volunteers, age ≥ 18 years, with suspected breast lesions based on clinical examination. A set of VA scans was acquired after each corresponding mammography. Most lesions were classified as benign based on their histological results. However, in 4 cases, initial diagnosis based on clinical imaging determined that the lesions were cysts. These cysts were aspirated with needle aspiration and disappeared completely under direct ultrasound visualization. Therefore, no biopsies were performed on these cases and lesions were classified as benign based on clinical findings per clinical standards. To define the VA characteristics of benign breast masses, we adopted the features that are normally attributed to such masses in mammography. In a blinded assessment, three radiologists evaluated the VA images independently. The diagnostic accuracy of VA for detection of benign lesions was assessed by comparing the reviewers’ evaluations with clinical data. Out of a total 29 benign lesions in the group, the reviewers were able to locate all lesions on VA images and mammography, 100% with (95% confidence interval (CI): 88% to 100%). Two reviewers were also able to correctly classify 83% (95% CI: 65% to 92%), and the third reviewer 86% (95% CI: 65% to 95%) of lesions, as benign on VA images and 86% (95% CI: 69% to 95%) on mammography. The results suggest that the mammographic characteristics of benign lesion may also be used to identify such lesions in VA. Furthermore, the results show the ability of VA to detect benign breast

  11. Black-pigmented anaerobic rods in closed periapical lesions.

    Science.gov (United States)

    Bogen, G; Slots, J

    1999-05-01

    This study determined the frequency of Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens in 20 closed periapical lesions associated with symptomatic and asymptomatic refractory endodontic disease. To deliniate possible oral sources of P. endodontalis, the presence of the organism was assessed in selected subgingival sites and saliva in the same study patients. Periapical samples were obtained by paper points during surgical endodontic procedures using methods designed to minimize contamination by non-endodontic microorganisms. Subgingival plaque samples were obtained by paper points from three periodontal pockets and from the pocket of the tooth associated with the closed periapical lesion. Unstimulated saliva was collected from the surface of the soft palate. Bacterial identification was performed using a species-specific polymerase chain reaction (PCR) detection method. P. endodontalis was not identified in any periapical lesion, even though subgingival samples from eight patients (40%) revealed the P. endodontalis-specific amplicon. P. gingivalis occurred in one periapical lesion that was associated with moderate pain. P. nigrescens, P. endodontalis and P. intermedia were not detected in any periapical lesion studied. Black-pigmented anaerobic rods appear to be infrequent inhabitants of the closed periapical lesion.

  12. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Toshibumi [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States)]. E-mail: kino@grape.med.tottori-u.ac.jp; Moritani, Toshio [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Hiwatashi, Akio [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Wang, Henry Z. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Shrier, David A. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Numaguchi, Yuji [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Westesson, Per-Lennart A. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States)

    2005-10-01

    Objective: (1) To detect diffuse axonal injury (DAI) lesions by diffusion-weighted imaging (DWI), as compared with fluid-attenuated inversion recovery (FLAIR) imaging and (2) to evaluate hemorrhagic DAI lesions by b{sub 0} images obtained from DWI, as compared with gradient-echo (GRE) imaging. Methods: We reviewed MR images of 36 patients with a diagnosis of DAI. MR imaging was performed 20 h to 14 days (mean, 3.7 days) after traumatic brain injury. We evaluated: (1) conspicuity of lesions on DWI and FLAIR and (2) conspicuity of hemorrhage in DAI lesions on b{sub 0} images and GRE imaging. Results: DWI clearly depicted high-signal DAI lesions. The sensitivity of DWI to lesional conspicuity in DAI lesions was almost equal to that of FLAIR. The sensitivity of b{sub 0} images to identification of hemorrhagic DAI lesions was inferior to that of GRE. Conclusion: DWI is as useful as FLAIR in detecting DAI lesions. GRE imaging is still the superior tool for the evaluation of hemorrhagic DAI.

  13. Detection and analysis of human papillomavirus 16 and 18 homologous DNA sequences in oral lesions.

    Science.gov (United States)

    Wen, S; Tsuji, T; Li, X; Mizugaki, Y; Hayatsu, Y; Shinozaki, F

    1997-01-01

    The prevalence of human papillomavirus (HPV) 16 and 18 was investigated in oral lesions of the population of northeast China including squamous cell carcinomas (SCCs), candida leukoplakias, lichen planuses and papillomas, by southern blot hybridization with polymerase chain reaction (PCR). Amplified HPV16 and 18 E6 DNA was analyzed by cycle sequence. HPV DNA was detected in 14 of 45 SCCs (31.1%). HPV18 E6 DNA and HPV16 E6. DNA were detected in 24.4% and 20.0% of SCCs. respectively. Dual infection of both HPV 16 and HPV 18 was detected in 6 of 45 SCCs (13.3%), but not in other oral lesions. HPV 18 E6 DNA was also detected in 2 of 3 oral candida leukoplakias, but in none of the 5 papillomas. Our study indicated that HPV 18 infection might be more frequent than HPV 16 infection in oral SCCs in northeast Chinese, dual infection of high risk HPV types was restricted in oral SCCs, and that HPV infection might be involved in the pathogenesis of oral candida leukoplakia.

  14. A comparison of lesion detection and conspicuity on T2-weighted images (T2 FFE), FLAIR and diffusion-weighted images in patients with traumatic brain injury

    International Nuclear Information System (INIS)

    Kwon, Eun Yong; Lee, Myeong sub; Kim, Myung Soon; Hong, In Soo; Kim, Young Ju; Whang, Gum

    2001-01-01

    To compare the lesion detectability and conspicuity in traumatic brain injury on T-2 FFE, FLAIR and diffusion weighted imaging (DWI) sequences. Thirty-three patients who underwent MR brain imaging after traumatic brain injury were reviewed. T-2 FFE, FLAIR and diffusion-weighted MR sequences were obtained and were compared in terms of the detectability and conspicuity of intra- and extra-axial lesions which showed abnormal signal intensities. Among 33 patients, a total of 108 lesions were found, T-2 FFE sequences detected 88(81%) of these, FLAIR sequences 91%(84%), and diffusion-weighted sequences 57(52%). In the case of petechial hemorrhagic lesions, 16 were detected by T-2 FFE imaging but only one by FLAIR and one by DWI. Sixteen extra-axial lesions (73%) were detected by T-2 FFE, 21 (95%) by FLAIR, and 11(50%) by DWI. Lesion conspicuity on FLAIR images was judged superior to that on T-2 FFE and diffusion-weighted images in 42 lesions (75%). Eleven extra-axial Lesions (92%) were more conspicuous on FLAIR than on T-2 FFE and DWI. For detecting traumatic brain lesions and determining their conspicuity, FLAIR imaging was more useful than T-2 FFE and diffusion weighting , while T-2 FFE imaging was more sensitive for the detecion of petechial hemorrhage. Although diffusion-weighted imaging was generally inferior to both FLAIR and T-2 FFE in terms of lesion detection and conspicuity, for some lesions it was superior. The results suggest that images obtained at each pulse sequence can be used as complementary imaging sequences, and that in traumatic brain injury, the acquisition of FLAIR, T-2 FFE and diffusion-weighted images is useful

  15. Detection of precancerous lesions in the oral cavity using oblique polarized reflectance spectroscopy: a clinical feasibility study

    Science.gov (United States)

    Bailey, Maria J.; Verma, Nishant; Fradkin, Leonid; Lam, Sylvia; MacAulay, Calum; Poh, Catherine; Markey, Mia K.; Sokolov, Konstantin

    2017-06-01

    We developed a multifiber optical probe for oblique polarized reflectance spectroscopy (OPRS) in vivo and evaluated its performance in detection of dysplasia in the oral cavity. The probe design allows the implementation of a number of methods to enable depth resolved spectroscopic measurements including polarization gating, source-detector separation, and differential spectroscopy; this combination was evaluated in carrying out binary classification tasks between four major diagnostic categories: normal, benign, mild dysplasia (MD), and severe dysplasia (SD). Multifiber OPRS showed excellent performance in the discrimination of normal from benign, MD, SD, and MD plus SD yielding sensitivity/specificity values of 100%/93%, 96%/95%, 100%/98%, and 100%/100%, respectively. The classification of benign versus dysplastic lesions was more challenging with sensitivity and specificity values of 80%/93%, 71%/93%, and 74%/80% in discriminating benign from SD, MD, and SD plus MD categories, respectively; this challenge is most likely associated with a strong and highly variable scattering from a keratin layer that was found in these sites. Classification based on multiple fibers was significantly better than that based on any single detection pair for tasks dealing with benign versus dysplastic sites. This result indicates that the multifiber probe can perform better in the detection of dysplasia in keratinized tissues.

  16. Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Holzapfel, Konstantin; Waldt, Simone; Bruegel, Melanie; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Paul, Jochen; Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Klinikum rechts der Isar, Munich (Germany); Heinrich, Petra [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany)

    2010-03-15

    The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers for the presence and type of SLAP lesions. MR arthrograms were reviewed twice by each reader with a time interval of 4 months between the two readings. Inter- and intraobserver agreement for detection and classification of SLAP lesions were calculated using {kappa} coefficients. Arthroscopy confirmed 48 SLAP lesions: type I (n = 4), type II (n = 37), type III (n = 3), type IV (n = 4). Sensitivity and specificity for detecting SLAP lesions with MR arthrography for each reader were 88.6%/93.3%, 90.9%/80.0% and 86.4%/76.7%. MR arthrographic and arthroscopic grading were concurrent for 72.7%, 68.2% and 70.5% of SLAP lesions for readers 1-3, respectively. Interobserver agreement was excellent ({kappa} = 0.82) for detection and substantial ({kappa} = 0.63) for classification of SLAP lesions. For each reader intraobserver agreement was excellent for detection ({kappa} = 0.93, {kappa} = 0.97, {kappa} = 0.97) and classification ({kappa} = 0.94, {kappa} = 0.84, {kappa} = 0.93) of SLAP lesions. MR arthrography allows reliable and accurate detection of SLAP lesions. In addition, SLAP lesions can be diagnosed and classified with substantial to excellent inter- and intraobserver agreement. (orig.)

  17. Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation

    International Nuclear Information System (INIS)

    Holzapfel, Konstantin; Waldt, Simone; Bruegel, Melanie; Rummeny, Ernst J.; Woertler, Klaus; Paul, Jochen; Imhoff, Andreas B.; Heinrich, Petra

    2010-01-01

    The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers for the presence and type of SLAP lesions. MR arthrograms were reviewed twice by each reader with a time interval of 4 months between the two readings. Inter- and intraobserver agreement for detection and classification of SLAP lesions were calculated using κ coefficients. Arthroscopy confirmed 48 SLAP lesions: type I (n = 4), type II (n = 37), type III (n = 3), type IV (n = 4). Sensitivity and specificity for detecting SLAP lesions with MR arthrography for each reader were 88.6%/93.3%, 90.9%/80.0% and 86.4%/76.7%. MR arthrographic and arthroscopic grading were concurrent for 72.7%, 68.2% and 70.5% of SLAP lesions for readers 1-3, respectively. Interobserver agreement was excellent (κ = 0.82) for detection and substantial (κ = 0.63) for classification of SLAP lesions. For each reader intraobserver agreement was excellent for detection (κ = 0.93, κ = 0.97, κ = 0.97) and classification (κ = 0.94, κ = 0.84, κ = 0.93) of SLAP lesions. MR arthrography allows reliable and accurate detection of SLAP lesions. In addition, SLAP lesions can be diagnosed and classified with substantial to excellent inter- and intraobserver agreement. (orig.)

  18. Quantitative performance evaluation of 124I PET/MRI lesion dosimetry in differentiated thyroid cancer

    Science.gov (United States)

    Wierts, R.; Jentzen, W.; Quick, H. H.; Wisselink, H. J.; Pooters, I. N. A.; Wildberger, J. E.; Herrmann, K.; Kemerink, G. J.; Backes, W. H.; Mottaghy, F. M.

    2018-01-01

    The aim was to investigate the quantitative performance of 124I PET/MRI for pre-therapy lesion dosimetry in differentiated thyroid cancer (DTC). Phantom measurements were performed on a PET/MRI system (Biograph mMR, Siemens Healthcare) using 124I and 18F. The PET calibration factor and the influence of radiofrequency coil attenuation were determined using a cylindrical phantom homogeneously filled with radioactivity. The calibration factor was 1.00  ±  0.02 for 18F and 0.88  ±  0.02 for 124I. Near the radiofrequency surface coil an underestimation of less than 5% in radioactivity concentration was observed. Soft-tissue sphere recovery coefficients were determined using the NEMA IEC body phantom. Recovery coefficients were systematically higher for 18F than for 124I. In addition, the six spheres of the phantom were segmented using a PET-based iterative segmentation algorithm. For all 124I measurements, the deviations in segmented lesion volume and mean radioactivity concentration relative to the actual values were smaller than 15% and 25%, respectively. The effect of MR-based attenuation correction (three- and four-segment µ-maps) on bone lesion quantification was assessed using radioactive spheres filled with a K2HPO4 solution mimicking bone lesions. The four-segment µ-map resulted in an underestimation of the imaged radioactivity concentration of up to 15%, whereas the three-segment µ-map resulted in an overestimation of up to 10%. For twenty lesions identified in six patients, a comparison of 124I PET/MRI to PET/CT was performed with respect to segmented lesion volume and radioactivity concentration. The interclass correlation coefficients showed excellent agreement in segmented lesion volume and radioactivity concentration (0.999 and 0.95, respectively). In conclusion, it is feasible that accurate quantitative 124I PET/MRI could be used to perform radioiodine pre-therapy lesion dosimetry in DTC.

  19. Computerized tomographic evaluation of chronic ischemic lesions in cerebral white matter

    International Nuclear Information System (INIS)

    Yamanouchi, Hiroshi; Tohgi, Hideo; Iio, Masahiro; Tomonaga, Masanori.

    1981-01-01

    The purpose of this study is to clarify the correlation between the low density areas and periventricular lucency (PVL) on CT and the histopathologic changes of chronic ischemic lesions in cerebral white matter. Thirty seven brains from chronic cases with stroke and 17 brains from patients who showed PVLs on CT were examined histologically. CT scans were performed using GE CT/T. Chronic ischemic lesions with severe demyelination or diffuse cavitation were detected as low density areas on CT. But if associated with severe gliosis, those lesions could not be detected on CT. Areas with myelin pallor could not be detected on CT. In some cases diffuse ischemic lesions as demyelination and cavitation were found in the areas corresponding to PVLs on CT. However, they were not always expressed on CT. Other cases with PVL had no histological changes in the frontal white matter. In conclusion, chronic ischemic lesions in the cerebral white matter could not always be detected as low density areas on CT. This may be partly because decreased density due to demyelination and cavitation was counterbalanced by severe gliosis which tends to increase the density. In some cases PVLs were related to diffuse ischemic lesions in the frontal white matter, but this was not always the case. (author)

  20. The value of digital tomosynthesis of the chest as a problem-solving tool for suspected pulmonary nodules and hilar lesions detected on chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Galea, Angela, E-mail: galeaangie@gmail.com [Peninsula Radiology Academy, William Prance Road, Plymouth PL65WR (United Kingdom); Dubbins, Paul, E-mail: Paul.dubbins@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Riordan, Richard, E-mail: richardriordan@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Adlan, Tarig, E-mail: tarig.adlan@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Roobottom, Carl, E-mail: carl.roobotoom@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom); Gay, David, E-mail: davegay@nhs.net [Plymouth Hospital NHS Trust, Plymouth PL68DH (United Kingdom)

    2015-05-15

    Graphical abstract: When compared to CXR, DTS has: • Superior resolution • Better assessment of location in the AP dimension (better at locating a pleural or intrapulmonary lesion) • Better characterisation (better at distinguishing between calcified plaque and soft tissue) • Removes composite artefact caused by overlying anatomical structures (such as the ribs or pulmonary vessels) DTS has improved sensitivity, specificity and accuracy when compared to CXR. - Highlights: • DTS is a type of limited angle tomography. Sixty coronal reconstructed images of the chest are produced that combine the superior resolution of radiography with the tomographic benefits of computed tomography. • The sensitivity for detecting a suspected lung lesions is 0.65 with CXR and 0.91 for DTS. • The high specificity of DTS (1) and the high negative predictive value (0.94) are similar to CT and suggest that if the DTS is normal patients do not need further assessment with CT with significant potential dose savings. • 50% of suspected lesions were resolved with CXR, this improved to 96% with DTS. - Abstract: Objectives: To assess the capability of digital tomosynthesis (DTS) of the chest compared to a postero-anterior (PA) and lateral chest radiograph (CXR) in the diagnosis of suspected but unconfirmed pulmonary nodules and hilar lesions detected on a CXR. Computed tomography (CT) was used as the reference standard. Materials and method: 78 patients with suspected non-calcified pulmonary nodules or hilar lesions on their CXR were included in the study. Two radiologists, blinded to the history and CT, prospectively analysed the CXR (PA and lateral) and the DTS images using a picture archiving and communication workstation and were asked to designate one of two outcomes: true intrapulmonary lesion or false intrapulmonary lesion. A CT of the chest performed within 4 weeks of the CXR was used as the reference standard. Inter-observer agreement and time to report the modalities

  1. The value of digital tomosynthesis of the chest as a problem-solving tool for suspected pulmonary nodules and hilar lesions detected on chest radiography

    International Nuclear Information System (INIS)

    Galea, Angela; Dubbins, Paul; Riordan, Richard; Adlan, Tarig; Roobottom, Carl; Gay, David

    2015-01-01

    Graphical abstract: When compared to CXR, DTS has: • Superior resolution • Better assessment of location in the AP dimension (better at locating a pleural or intrapulmonary lesion) • Better characterisation (better at distinguishing between calcified plaque and soft tissue) • Removes composite artefact caused by overlying anatomical structures (such as the ribs or pulmonary vessels) DTS has improved sensitivity, specificity and accuracy when compared to CXR. - Highlights: • DTS is a type of limited angle tomography. Sixty coronal reconstructed images of the chest are produced that combine the superior resolution of radiography with the tomographic benefits of computed tomography. • The sensitivity for detecting a suspected lung lesions is 0.65 with CXR and 0.91 for DTS. • The high specificity of DTS (1) and the high negative predictive value (0.94) are similar to CT and suggest that if the DTS is normal patients do not need further assessment with CT with significant potential dose savings. • 50% of suspected lesions were resolved with CXR, this improved to 96% with DTS. - Abstract: Objectives: To assess the capability of digital tomosynthesis (DTS) of the chest compared to a postero-anterior (PA) and lateral chest radiograph (CXR) in the diagnosis of suspected but unconfirmed pulmonary nodules and hilar lesions detected on a CXR. Computed tomography (CT) was used as the reference standard. Materials and method: 78 patients with suspected non-calcified pulmonary nodules or hilar lesions on their CXR were included in the study. Two radiologists, blinded to the history and CT, prospectively analysed the CXR (PA and lateral) and the DTS images using a picture archiving and communication workstation and were asked to designate one of two outcomes: true intrapulmonary lesion or false intrapulmonary lesion. A CT of the chest performed within 4 weeks of the CXR was used as the reference standard. Inter-observer agreement and time to report the modalities

  2. Observer performance in detecting multiple radiographic signals: prediction and analysis using a generalized ROC approach

    International Nuclear Information System (INIS)

    Metz, C.E.; Starr, S.J.; Lusted, L.B.

    1975-01-01

    The theories of decision processes and signal detection provide a framework for the evaluation of observer performance. Some radiologic procedures involve a search for multiple similar lesions, as in gallstone or pneumoconiosis examinations. A model is presented which attempts to predict, from the conventional receiver operating characteristic (ROC) curve describing the detectability of a single visual signal in a radiograph, observer performance in an experiment requiring detection of more than one such signal. An experiment is described which tests the validity of this model for the case of detecting the presence of zero, one, or two low-contrast radiographic images of a two-mm.-diameter lucite bead embedded in radiographic mottle. Results from six observers, including three radiologists, confirm the validity of the model and suggest that human observer performance for relatively complex detection tasks can be predicted from the results of simpler experiments

  3. The Problems with the Kappa Statistic as a Metric of Interobserver Agreement on Lesion Detection Using a Third-reader Approach When Locations Are Not Prespecified.

    Science.gov (United States)

    Shih, Joanna H; Greer, Matthew D; Turkbey, Baris

    2018-03-16

    To point out the problems with Cohen kappa statistic and to explore alternative metrics to determine interobserver agreement on lesion detection when locations are not prespecified. Use of kappa and two alternative methods, namely index of specific agreement (ISA) and modified kappa, for measuring interobserver agreement on the location of detected lesions are presented. These indices of agreement are illustrated by application to a retrospective multireader study in which nine readers detected and scored prostate cancer lesions in 163 consecutive patients (n = 110 cases, n = 53 controls) using the guideline of Prostate Imaging Reporting and Data System version 2 on multiparametric magnetic resonance imaging. The proposed modified kappa, which properly corrects for the amount of agreement by chance, is shown to be approximately equivalent to the ISA. In the prostate cancer data, average kappa, modified kappa, and ISA equaled 30%, 55%, and 57%, respectively, for all lesions and 20%, 87%, and 87%, respectively, for index lesions. The application of kappa could result in a substantial downward bias in reader agreement on lesion detection when locations are not prespecified. ISA is recommended for assessment of reader agreement on lesion detection. Published by Elsevier Inc.

  4. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1997-11-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.

  5. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik

    1997-01-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US

  6. Wallerian degeneration of the corticodescending tract in the cerebral peduncle following a supratentorial cerebrovascular lesion detected by MRI

    International Nuclear Information System (INIS)

    Waragai, Masaaki; Iwabuchi, Sadamu

    1993-01-01

    We studied Wallerian degeneration of the corticodescending tract in the cerebral peduncle following a supratentorial cerebrovascular lesion by MRI. A total of 57 patients with palsy following a supratenotorial cerebrovascular lesion were prospectively studied. Wallerian degeneration was detected as a high signal intensity (HSI) in 37 patients between 70 days and 100 days after the onset, but not detected in the remaining 27 patients. Patient with as HSI in all areas of the cerebral peduncle had a large lesion involving the hemisphere. Patient with an HSI at the center of the cerebral peduncle had a lesion confined to the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. Patient with an HSI at the lateral side of the cerebral peduncle had a lesion of parietal lobe or temporal lobe which spares the corticospinal tract originating from the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. These findings suggest that as HSI at the center of the cerebral peduncle may reveal Wallerian degeneration of the corticospinal tract, and an HSI at the lateral side of the cerebral peduncle may show Wallerian degeneration of the corticopontine tract. The functional recovery of paresis was poor in all patients with an HSI at the center of the cerebral peduncle, while it was good in all patients without an HSI in that region. Our data suggested that somatotopical localization of the corticodescending tract in the cerebral peduncle may be identified by detecting Wallerian degeneration following a supratentorial lesion, and the functional recovery of patients with paresis could be predicted according to presence or absence of Wallerian degeneration at the center of the cerebral peduncle. (author)

  7. Comparison of 3- and 20-Gradient Direction Diffusion-Weighted Imaging in a Clinical Subacute Cohort of Patients with Transient Ischemic Attack: Application of Standard Vendor Protocols for Lesion Detection and Final Infarct Size Projection

    Directory of Open Access Journals (Sweden)

    Inger Havsteen

    2017-12-01

    Full Text Available ObjectiveDiffusion tensor imaging may aid brain ischemia assessment but is more time consuming than conventional diffusion-weighted imaging (DWI. We compared 3-gradient direction DWI (3DWI and 20-gradient direction DWI (20DWI standard vendor protocols in a hospital-based prospective cohort of patients with transient ischemic attack (TIA for lesion detection, lesion brightness, predictability of persisting infarction, and final infarct size.MethodsWe performed 3T-magnetic resonance imaging including diffusion and T2-fluid attenuated inversion recovery (FLAIR within 72 h and 8 weeks after ictus. Qualitative lesion brightness was assessed by visual inspection. We measured lesion area and brightness with manual regions of interest and compared with homologous normal tissue.Results117 patients with clinical TIA showed 78 DWI lesions. 2 lesions showed only on 3DWI. No lesions were uniquely 20DWI positive. 3DWI was visually brightest for 34 lesions. 12 lesions were brightest on 20DWI. The median 3DWI lesion area was larger for lesions equally bright, or brightest on 20DWI [median (IQR 39 (18–95 versus 18 (10–34 mm2, P = 0.007]. 3DWI showed highest measured relative lesion signal intensity [median (IQR 0.77 (0.48–1.17 versus 0.58 (0.34–0.81, P = 0.0006]. 3DWI relative lesion signal intensity was not correlated to absolute signal intensity, but 20DWI performed less well for low-contrast lesions. 3DWI lesion size was an independent predictor of persistent infarction. 3-gradient direction apparent diffusion coefficient areas were closest to 8-week FLAIR infarct size.Conclusion3DWI detected more lesions and had higher relative lesion SI than 20DWI. 20DWI appeared blurred and did not add information.Clinical Trial Registrationhttp://www.clinicaltrials.gov. Unique Identifier NCT01531946.

  8. Respiratory gated PET/CT in a European multicentre retrospective study: added diagnostic value in detection and characterization of lung lesions

    Energy Technology Data Exchange (ETDEWEB)

    Guerra, Luca; Elisei, Federica [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); De Ponti, Elena [San Gerardo Hospital, Medical Physics, Monza (Italy); Bettinardi, Valentino; Picchio, Maria [San Raffaele Scientific Institute, Nuclear Medicine, Milan (Italy); National Research Council, Institute for Bioimaging and Molecular Physiology, Milan (Italy); Landoni, Claudio [San Raffaele Scientific Institute, Nuclear Medicine, Milan (Italy); University of Milano-Bicocca, Milan (Italy); Gilardi, Maria Carla [San Raffaele Scientific Institute, Nuclear Medicine, Milan (Italy); National Research Council, Institute for Bioimaging and Molecular Physiology, Milan (Italy); University of Milano-Bicocca, Tecnomed Foundation, Milan (Italy); Versari, Annibale [Scientific Institute Santa Maria Nuova Hospital, Nuclear Medicine, Reggio Emilia (Italy); Fioroni, Federica [Scientific Institute Santa Maria Nuova Hospital, Medical Physics, Reggio Emilia (Italy); Dziuk, Miroslaw [Masovian PET-CT Centre, Department of Nuclear Medicine, Military Institute of Medicine, Warsaw (Poland); Koza, Magdalena [Masovian PET-CT Centre, Euromedic Diagnostic, Warsaw (Poland); Ahond-Vionnet, Renee; Collin, Bertrand [Hopital Pierre Beregovoy, Service de Medecine Nucleaire, Nevers (France); Messa, Cristina [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); National Research Council, Institute for Bioimaging and Molecular Physiology, Milan (Italy); University of Milano-Bicocca, Tecnomed Foundation, Milan (Italy)

    2012-09-15

    The aim of our work is to evaluate the added diagnostic value of respiratory gated (4-D) positron emission tomography/computed tomography (PET/CT) in lung lesion detection/characterization in a large patient population of a multicentre retrospective study. The data of 155 patients (89 men, 66 women, mean age 63.9 {+-} 11.1 years) from 5 European centres and submitted to standard (3-D) and 4-D PET/CT were retrospectively analysed. Overall, 206 lung lesions were considered for the analysis (mean {+-} SD lesions dimension 14.7 {+-} 11.8 mm). Maximum standardized uptake values (SUV{sub max}) and lesion detectability were assessed for both 3-D and 4-D PET/CT studies; 3-D and 4-D PET/CT findings were compared to clinical follow-up as standard reference. Mean {+-} SD 3-D and 4-D SUV{sub max} values were 5.2 {+-} 5.1 and 6.8 {+-} 6.1 (p < 0.0001), respectively, with an average percentage increase of 30.8 %. In 3-D PET/CT, 86 of 206 (41.7 %) lesions were considered positive, 70 of 206 (34 %) negative and 50 of 206 (24.3 %) equivocal, while in 4-D PET/CT 117 of 206 (56.8 %) lesions were defined as positive, 80 of 206 (38.8 %) negative and 9 of 206 (4.4 %) equivocal. In 34 of 50 (68 %) 3-D equivocal lesions follow-up data were available and the presence of malignancy was confirmed in 21 of 34 (61.8 %) lesions, while in 13 of 34 (38.2 %) was excluded. In 31 of these 34 controlled lesions, 20 of 34 (58.8 %) and 11 of 34 (32.4 %) were correctly classified by 4-D PET/CT as positive and negative, respectively; 3 of 34 (8.8 %) remained equivocal. With equivocal lesions classified as positive, the overall accuracy of 3-D and 4-D was 85.7 and 92.8 %, respectively, while the same figures were 80.5 and 94.2 % when equivocal lesions were classified as negative. The respiratory gated PET/CT technique is a valuable clinical tool in diagnosing lung lesions, improving quantification and confidence in reporting, reducing 3-D undetermined findings and increasing the overall accuracy in lung

  9. Dual contrast enhanced magnetic resonance imaging of the liver with superparamagnetic iron oxide followed by gadolinium for lesion detection and characterization

    International Nuclear Information System (INIS)

    Kubaska, Samantha; Sahani, Dushyant V.; Saini, Sanjay; Hahn, Peter F.; Halpern, Elkan

    2001-01-01

    AIM: Iron oxide contrast agents are useful for lesion detection, and extracellular gadolinium chelates are advocated for lesion characterization. We undertook a study to determine if dual contrast enhanced liver imaging with sequential use of ferumoxides particles and gadolinium (Gd)-DTPA can be performed in the same imaging protocol. MATERIALS AND METHODS: Sixteen patients underwent dual contrast magnetic resonance imaging (MRI) of the liver for evaluation of known/suspected focal lesions which included, metastases (n = 5), hepatocellular carcinoma (HCC;n = 3), cholangiocharcinoma(n = 1) and focal nodular hyperplasia (FNH;n = 3). Pre- and post-iron oxide T1-weighted gradient recalled echo (GRE) and T2-weighted fast spin echo (FSE) sequences were obtained, followed by post-Gd-DTPA (0.1 mmol/kg) multi-phase dynamic T1-weighted out-of-phase GRE imaging. Images were analysed in a blinded fashion by three experts using a three-point scoring system for lesion conspicuity on pre- and post-iron oxide T1 images as well as for reader's confidence in characterizing liver lesions on post Gd-DTPA T1 images. RESULTS: No statistically significant difference in lesion conspicuity was observed on pre- and post-iron oxide T1-GRE images in this small study cohort. The presence of iron oxide did not appreciably diminish image quality of post-gadolinium sequences and did not prevent characterization of liver lesions. CONCLUSION: Our results suggest that characterization of focal liver lesion with Gd-enhanced liver MRI is still possible following iron oxide enhanced imaging. Kubaska, S. et al. (2001)

  10. Comparision between biphasic helical CT and dynamic gadolinium-enhanced MR in the detection and characterization of focal hepatic lesions in cirrhotic patients

    International Nuclear Information System (INIS)

    Puig, J.; Martin, J.; Donoso, L.; Falco, J.; Rue, M.

    1997-01-01

    To assess the agreement between biphasic helical computerized tomography (BHCT) and dynamic gadolinium-enhanced magnetic resonance (MR) in the detection and characterization of focal hepatic lesions in a group of cirrhotic patients. A prospective study was done in 50 cirrhotic patients suspected of having hepatocarcinoma (HC) on the basis of ultrasonographic images evaluated by means of BHCT and dynamic gadolinium-enhanced MR using fast low-angle shot (FLASH) sequences (110-135/4/90 degree centigree). The images were assessed jointly by four radiologists. Between the two techniques, a total of 83 lesions were detected. MR disclosed more lesions (n=79) than BHCT (n=67) (p<0.005). Moreover, 25 of the lesions that were visible by both techniques were more clearly evident in MR images (p<0.01). MR correctly classified 6 of 7 benign lesions (85%) and 49 of 66 malignant ones (74%). BHCT correctly classifed 2 of 7 benign lesions (28%) and 32 of 66 malignant ones (48%). The sensitivities of MR and BHCT for the characterization of these lesions were 74% and 48%, respectively (p=0.0009), while the respective specificities were 86% and 29% (P<0.001). Dynamic gadolinium-enhanced MR with FLASH sequences is more efficient than BHCT in the detection and characterization of focal lesions in cirrhotic patients. (Author) 37 refs

  11. Detection of early lung cancer lesions in surgical resections and in bronchial and transbronchial biopsies

    International Nuclear Information System (INIS)

    Rott, T.; Jerse, M.; Tercelj, M.; Erzen, J.

    2006-01-01

    Background. Overall bad prognosis of lung cancer is mostly due to too late detection of early lung cancer, which may be treated with good success. Therefore, different diagnostic methods are developing for more efficient detection of early lung cancer: besides modern radiological, bronchoscopic methods with additional fluorescence techniques, quantitative cytological investigations, also histological and molecular investigations are included. Histology may reveal early preinvasive lung cancer lesions, associated early during multistep lung carcinogenesis with molecular genetic changes. Patients and methods. Preinvasive epithelial lung cancer lesions we searched in two groups of patients. In the first group of 316 patients from the period March 2003 - August 2006, 498 bronchial and transbronchial biopsies were examined for squamous metaplasia and dysplasia, carcinoma in situ, and invasive tumours. In the second group of 238 patients from the period January 2004 - August 2006, resected primary lung tumours were analysed for preinvasive and invasive neuroendocrine tumours and atypical adenomatous hyperplasia. Results. The most frequent changes in bronchial and transbronchial biopsies were squamous metaplasia (46.5%), simple or goblet cell hyperplasia of the bronchial epithelium (44.3%), malignant tumours (20.66%) and squamous dysplasia (16.1%), but rare carcinoma in situ (0.63%). Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia was found in 15 (6.3%) cases in the vicinity of 238 resected lung cancer specimens, carcinoid in 12 patients (5%), and mostly combined large cell neuroendocrine cancer in 21 patients (8.8%). Atypical adenomatous hyperplasia was found in 2 patients. Conclusions. Classical histological analysis should be focused on detection of early preinvasive epithelial lung cancer lesions. Additional available molecular investigations may reveal gradual genetic changes characteristic for a series of the preinvasive epithelial histological changes

  12. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Boronat, Susana [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States); Universitat Autonoma de Barcelona, Department of Pediatric Neurology, Vall d' Hebron Hospital, Barcelona (Spain); Barber, Ignasi [Universitat Autonoma de Barcelona, Department of Pediatric Radiology, Vall d' Hebron Hospital, Barcelona (Spain); Pargaonkar, Vivek [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States); Chang, Joshua; Thiele, Elizabeth A. [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States)

    2016-05-15

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  13. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Boronat, Susana; Barber, Ignasi; Pargaonkar, Vivek; Chang, Joshua; Thiele, Elizabeth A.

    2016-01-01

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  14. Performance of visual inspection with acetic acid and human papillomavirus testing for detection of high-grade cervical lesions in HIV positive and HIV negative Tanzanian women

    DEFF Research Database (Denmark)

    Dartell, Myassa Arkam; Rasch, Vibeke; Iftner, Thomas

    2014-01-01

    The aim of this cross sectional study was to assess type distribution of human papillomavirus (HPV) among HIV positive and HIV negative women who underwent cervical cancer screening, and to examine the ability of visual inspection with acetic acid (VIA), the standard detection method in Tanzania......, and HPV-testing to detect cytologically diagnosed high grade lesions or cancer (HSIL+). Women from different areas in Tanzania were invited by public announcement to cervical cancer screening organized by Ocean Road Cancer Institute (Dar-es-Salaam). A total of 3,767 women were enrolled. Women underwent...

  15. Adaptive lesion formation using dual mode ultrasound array system

    Science.gov (United States)

    Liu, Dalong; Casper, Andrew; Haritonova, Alyona; Ebbini, Emad S.

    2017-03-01

    We present the results from an ultrasound-guided focused ultrasound platform designed to perform real-time monitoring and control of lesion formation. Real-time signal processing of echogenicity changes during lesion formation allows for identification of signature events indicative of tissue damage. The detection of these events triggers the cessation or the reduction of the exposure (intensity and/or time) to prevent overexposure. A dual mode ultrasound array (DMUA) is used for forming single- and multiple-focus patterns in a variety of tissues. The DMUA approach allows for inherent registration between the therapeutic and imaging coordinate systems providing instantaneous, spatially-accurate feedback on lesion formation dynamics. The beamformed RF data has been shown to have high sensitivity and specificity to tissue changes during lesion formation, including in vivo. In particular, the beamformed echo data from the DMUA is very sensitive to cavitation activity in response to HIFU in a variety of modes, e.g. boiling cavitation. This form of feedback is characterized by sudden increase in echogenicity that could occur within milliseconds of the application of HIFU (see http://youtu.be/No2wh-ceTLs for an example). The real-time beamforming and signal processing allowing the adaptive control of lesion formation is enabled by a high performance GPU platform (response time within 10 msec). We present results from a series of experiments in bovine cardiac tissue demonstrating the robustness and increased speed of volumetric lesion formation for a range of clinically-relevant exposures. Gross histology demonstrate clearly that adaptive lesion formation results in tissue damage consistent with the size of the focal spot and the raster scan in 3 dimensions. In contrast, uncontrolled volumetric lesions exhibit significant pre-focal buildup due to excessive exposure from multiple full-exposure HIFU shots. Stopping or reducing the HIFU exposure upon the detection of such an

  16. Improved detection and biopsy of solid liver lesions using pulse-inversion ultrasound scanning and contrast agent infusion

    DEFF Research Database (Denmark)

    Skjoldbye, B.; Pedersen, Morten Høgholm; Struckmann, J.

    2002-01-01

    The purpose of this study was to assess the ability of pulse-inversion ultrasound (US) scanning (PIUS), combined with an IV contrast agent, to detect malignant liver lesions and its impact on patient management (resectability). Additionally, to determine the feasibility of US-guided biopsy of new...... PIUS-findings at the same session. A total of 30 patients with known or clinically suspected cancer underwent conventional B-mode scanning and PIUS with IV-administered contrast agent. The number of liver metastases in the right and the left liver lobe, respectively, was recorded. All patients...... findings were performed in 17 of 18 patients. All biopsies of additional findings confirmed malignancy. PIUS with an IV contrast agent increased the ability to detect liver metastases compared to conventional US scanning. The technique had a high impact on patient management. The results showed that PIUS...

  17. Harmonizing FDG PET quantification while maintaining optimal lesion detection: prospective multicentre validation in 517 oncology patients

    International Nuclear Information System (INIS)

    Quak, Elske; Le Roux, Pierre-Yves; Robin, Philippe; Bourhis, David; Salaun, Pierre-Yves; Hofman, Michael S.; Callahan, Jason; Binns, David; Hicks, Rodney J.; Desmonts, Cedric; Aide, Nicolas

    2015-01-01

    Point-spread function (PSF) or PSF + time-of-flight (TOF) reconstruction may improve lesion detection in oncologic PET, but can alter quantitation resulting in variable standardized uptake values (SUVs) between different PET systems. This study aims to validate a proprietary software tool (EQ.PET) to harmonize SUVs across different PET systems independent of the reconstruction algorithm used. NEMA NU2 phantom data were used to calculate the appropriate filter for each PSF or PSF+TOF reconstruction from three different PET systems, in order to obtain EANM compliant recovery coefficients. PET data from 517 oncology patients were reconstructed with a PSF or PSF+TOF reconstruction for optimal tumour detection and an ordered subset expectation maximization (OSEM3D) reconstruction known to fulfil EANM guidelines. Post-reconstruction, the proprietary filter was applied to the PSF or PSF+TOF data (PSF EQ or PSF+TOF EQ ). SUVs for PSF or PSF+TOF and PSF EQ or PSF+TOF EQ were compared to SUVs for the OSEM3D reconstruction. The impact of potential confounders on the EQ.PET methodology including lesion and patient characteristics was studied, as was the adherence to imaging guidelines. For the 1380 tumour lesions studied, Bland-Altman analysis showed a mean ratio between PSF or PSF+TOF and OSEM3D of 1.46 (95 %CI: 0.86-2.06) and 1.23 (95 %CI: 0.95-1.51) for SUV max and SUV peak , respectively. Application of the proprietary filter improved these ratios to 1.02 (95 %CI: 0.88-1.16) and 1.04 (95 %CI: 0.92-1.17) for SUV max and SUV peak , respectively. The influence of the different confounding factors studied (lesion size, location, radial offset and patient's BMI) was less than 5 %. Adherence to the European Association of Nuclear Medicine (EANM) guidelines for tumour imaging was good. These data indicate that it is not necessary to sacrifice the superior lesion detection and image quality achieved by newer reconstruction techniques in the quest for harmonizing quantitative

  18. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...

  19. Detection and excision of non-palpable breast lesions by radio guided surgery and air injection for radiological control

    International Nuclear Information System (INIS)

    Machado, Rafael Henrique Szymanski; Gutfilen, Bianca; Fonseca, Lea Mirian Barbosa da

    2005-01-01

    Purpose: to asses the efficiency of the radioguided localization and removal of occult breast lesions using radiopharmaceuticals injected directly into the lesions or close to them with posterior air injection as a radiological control. Methods: twenty-nine consecutive patients with thirty-two occult breast lesions detected mammographically or by ultrasound, and categorized 3, 4 and 5 BI-RADS, were included in this observational study with results expressed in percentages. The radiopharmaceutical used was human serum albumin labeled with 99m Tc-HSA injected inside or close to the lesion using mammographic or ultrasonographic guidance. The injection of the radiopharmaceutical was followed immediately by air injection through the needle used for stereotaxis as a radiological control of the radiopharmaceutical placement. The excision biopsy was carried out with the aid of a hand-held gamma-detecting probe and the entire removal of the lesion was verified by X-ray of the surgical specimens or by intraoperative frozen section examination. Results: breast cancer was found in 10.0% (1/10) of the 3 BI-RADS lesions, in 31.5% (6/19) of the 4 BI-RADS and in 66.6% (2/3) of the 5 BI-RADS. The radiotracer was correctly positioned in 96.8% of the specimens (31/32) allowing the removal of also 96.8% of the studied non-palpable breast lesions. To show the entire removal, X-ray was used in 23 cases (71.8%), intraoperative frozen section study in 21.8% (7/32) and both methods in 6.2% (2/32). Conclusions: radioguided surgery showed to be an important tool in the removal of non-palpable breast lesions, as a simple, fast and feasible method that can be implemented in the clinical routine of these patients. (author)

  20. Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM)

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, Davide, E-mail: davide.atena@tiscalinet.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Besostri, Valeria, E-mail: valeriabesostri@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Bonaffini, Pietro Andrea, E-mail: pa.bonaffini@gmail.com [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Rossini, Fausto, E-mail: valeriabesostri@hotmail.it [Department of Hematology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Di Lelio, Alessandro, E-mail: valebeso@libero.it [Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy); Sironi, Sandro, E-mail: sandrosironi@libero.it [School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB) (Italy); Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB) (Italy)

    2013-12-01

    Purpose: To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of patients with suspicion of multiple myeloma (MM). Materials and methods: A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50–81 years), with early MM, underwent WBLDCT protocol study, performed on 16-slice scanner (Brilliance, Philips Medical System, Eindhoven, The Netherlands): tube voltage 120 kV; tube current time product 40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformatted images, whereas the assessment of spinal misalignment and fracture was done by using multiplanar reformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personal informed consent, as required by our institution guidelines. Results: The diagnosis was established either by histopathology or imaging follow-up (size increase of over a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification of multiple myeloma patients. WBLDCT showed a total of 328 pathologic bone findings in 81/138 patients. CT scanning resulted in complete evaluation of the bone lesions in these areas of the skeleton: skull (42), humerus (15), femur (20), ribs (7), scapulae (13), pelvis (35), clavicle (13), sternum (10), cervical (39), dorsal (65), lombar (48) and sacral rachis (21). In 40/81 bone involvement detected by CT was the only CRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients (11 infective, 9 as MM localizations) and 1 renal neoplasia. Conclusion: WBLDCT, detecting bone marrow localizations and demonstrating extra-osseous findings, with a fast scanning time and high resolution images, is a reliable imaging-based tool for a proper management of MM patients.

  1. Incidental enhancing lesions found on preoperative breast MRI: management and role of second-look ultrasound.

    Science.gov (United States)

    Luciani, M L; Pediconi, F; Telesca, M; Vasselli, F; Casali, V; Miglio, E; Passariello, R; Catalano, C

    2011-09-01

    This study prospectively assessed second-look ultrasound (US) for the evaluation of incidental enhancing lesions identified on preoperative breast magnetic resonance imaging (MRI). Between 2004 and 2007, 182 patients with malignant breast lesions detected on US and/or X-ray mammography and confirmed by cytology/histology underwent preoperative breast contrast-enhanced (CE)-MRI. Patients with incidental lesions on breast MRI underwent second-look high-resolution US directed at the site of the incidental finding. Diagnosis of incidental lesions was based on biopsy or 24-month follow-up. Breast MRI detected 55 additional lesions in 46/182 (25.2%) patients. Forty-two of 55 (76.3%) lesions were detected on second-look US in 38/46 (82.6%) patients. Malignancy was confirmed for 24/42 (57.1%) correlate lesions compared with 7/13 (53.8%) noncorrelate lesions. Second-look US depicted 8/9 (88.8%) Breast Imaging Reporting and Data System (BI-RADS) 5, 16/22 (72.7%) BI-RADS 4 and 18/24 (75%) BI-RADS 3 lesions. Sensitivity, specificity, accuracy and positive and negative predictive values for lesion detection/diagnosis was 100%, 88.9%, 94.6%, 90.3% and 100% for MRI and 64.3%, 70.4%, 67.3%, 69.2% and 65.5% for second-look US. Improved performance for US was obtained when masslike lesions only were considered. Second-look US is a confirmatory method for incidental findings on breast MRI, particularly for mass-like lesions.

  2. Prospective evaluation of reduced dose computed tomography for the detection of low-contrast liver lesions. Direct comparison with concurrent standard dose imaging

    International Nuclear Information System (INIS)

    Pooler, B.D.; Lubner, Meghan G.; Kim, David H.; Chen, Oliver T.; Li, Ke; Chen, Guang-Hong; Pickhardt, Perry J.

    2017-01-01

    To prospectively compare the diagnostic performance of reduced-dose (RD) contrast-enhanced CT (CECT) with standard-dose (SD) CECT for detection of low-contrast liver lesions. Seventy adults with non-liver primary malignancies underwent abdominal SD-CECT immediately followed by RD-CECT, aggressively targeted at 60-70 % dose reduction. SD series were reconstructed using FBP. RD series were reconstructed with FBP, ASIR, and MBIR (Veo). Three readers - blinded to clinical history and comparison studies - reviewed all series, identifying liver lesions ≥4 mm. Non-blinded review by two experienced abdominal radiologists - assessing SD against available clinical and radiologic information - established the reference standard. RD-CECT mean effective dose was 2.01 ± 1.36 mSv (median, 1.71), a 64.1 ± 8.8 % reduction. Pooled per-patient performance data were (sensitivity/specificity/PPV/NPV/accuracy) 0.91/0.78/0.60/0.96/0.81 for SD-FBP compared with RD-FBP 0.79/0.75/0.54/0.91/0.76; RD-ASIR 0.84/0.75/0.56/0.93/0.78; and RD-MBIR 0.84/0.68/0.49/0.92/0.72. ROC AUC values were 0.896/0.834/0.858/0.854 for SD-FBP/RD-FBP/RD-ASIR/RD-MBIR, respectively. RD-FBP (P = 0.002) and RD-MBIR (P = 0.032) AUCs were significantly lower than those of SD-FBP; RD-ASIR was not (P = 0.052). Reader confidence was lower for all RD series (P < 0.001) compared with SD-FBP, especially when calling patients entirely negative. Aggressive CT dose reduction resulted in inferior diagnostic performance and reader confidence for detection of low-contrast liver lesions compared to SD. Relative to RD-ASIR, RD-FBP showed decreased sensitivity and RD-MBIR showed decreased specificity. (orig.)

  3. Prospective evaluation of reduced dose computed tomography for the detection of low-contrast liver lesions. Direct comparison with concurrent standard dose imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pooler, B.D.; Lubner, Meghan G.; Kim, David H.; Chen, Oliver T. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Li, Ke; Chen, Guang-Hong [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, Department of Radiology, Madison, WI (United States)

    2017-05-15

    To prospectively compare the diagnostic performance of reduced-dose (RD) contrast-enhanced CT (CECT) with standard-dose (SD) CECT for detection of low-contrast liver lesions. Seventy adults with non-liver primary malignancies underwent abdominal SD-CECT immediately followed by RD-CECT, aggressively targeted at 60-70 % dose reduction. SD series were reconstructed using FBP. RD series were reconstructed with FBP, ASIR, and MBIR (Veo). Three readers - blinded to clinical history and comparison studies - reviewed all series, identifying liver lesions ≥4 mm. Non-blinded review by two experienced abdominal radiologists - assessing SD against available clinical and radiologic information - established the reference standard. RD-CECT mean effective dose was 2.01 ± 1.36 mSv (median, 1.71), a 64.1 ± 8.8 % reduction. Pooled per-patient performance data were (sensitivity/specificity/PPV/NPV/accuracy) 0.91/0.78/0.60/0.96/0.81 for SD-FBP compared with RD-FBP 0.79/0.75/0.54/0.91/0.76; RD-ASIR 0.84/0.75/0.56/0.93/0.78; and RD-MBIR 0.84/0.68/0.49/0.92/0.72. ROC AUC values were 0.896/0.834/0.858/0.854 for SD-FBP/RD-FBP/RD-ASIR/RD-MBIR, respectively. RD-FBP (P = 0.002) and RD-MBIR (P = 0.032) AUCs were significantly lower than those of SD-FBP; RD-ASIR was not (P = 0.052). Reader confidence was lower for all RD series (P < 0.001) compared with SD-FBP, especially when calling patients entirely negative. Aggressive CT dose reduction resulted in inferior diagnostic performance and reader confidence for detection of low-contrast liver lesions compared to SD. Relative to RD-ASIR, RD-FBP showed decreased sensitivity and RD-MBIR showed decreased specificity. (orig.)

  4. Additional lesions detected in therapeutic scans with 177Lu-DOTATATE reflect higher affinity of 177Lu-DOTATATE for somatostatin receptors.

    Science.gov (United States)

    Mirzaei, Siroos; Bastati, Brigitte; Lipp, Rainer W; Knoll, Peter; Zojer, Niklas; Ludwig, Heinz

    2011-01-01

    Peptide receptor-targeted radionuclide therapy (PRRT) of somatostatin receptor (SR)-expressing neuroendocrine tumors (NETs) has become an established therapeutic option in patients with advanced NETs. The aim of this study was to compare the lesion detection rate of (99m)Tc-EDDA/HYNIC-TOC, a newly developed tracer for NET imaging, with (177)Lu-DOTATATE used for PRRT. 8 patients (4 women, 4 men, age range 46-76 years) with histologically proven NETs, who showed high SR loads by (99m)Tc-EDDA/HYNIC-TOC scintigraphy, were treated with (177)Lu-DOTATATE. After treatment, all patients were subjected to whole-body scintigraphy with additional low-dose single-photon emission computed tomography (SPECT-CT) of the chest and abdomen. All patients demonstrated (177)Lu-DOTATATE accumulation in all lesions previously detected by (99m)Tc- EDDA/HYNIC-TOC scintigraphy. Three patients showed additional lesions in the liver and lungs. SPECT-CT after (177)Lu-DOTATATE therapy may be helpful in detecting additional lesions not seen using (99m)Tc-EDDA/HYNIC-TOC. This could reflect the broader affinity of (177)Lu-DOTATATE for SRs compared with (99m)Tc-EDDA/HYNIC-TOC. Copyright © 2011 S. Karger AG, Basel.

  5. US-guided preoperative hook-wire localization of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong

    2000-01-01

    To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

  6. US-guided preoperative hook-wire localization of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

    2000-12-15

    To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

  7. Respiratory function after lesions in medulla oblongata.

    Science.gov (United States)

    Woischneck, Dieter; Kapapa, Thomas; Heissler, Hans E; Reissberg, Steffen; Skalej, Martin; Firsching, Raimund

    2009-12-01

    To evaluate the correlation of lesions of the brain as visualized in cranial magnetic resonance imaging (MRI) and the ability of spontaneous respiration. In a prospective concept, cranial MRI after traumatic brain injury or spontaneous intracerebral hemorrhage was performed in 250 subjects at an early stage. All MRI findings were correlated with respiratory conditions on the day of examination. Sedation was performed only to facilitate toleration of the artificial ventilation, as and when necessary. Spontaneous respiration could hence be registered clinically. Thirteen subjects (5.2%) had no spontaneous respiration. In these cases, a bilateral lesion of the distal medulla oblongata could be displayed. In four of these cases, no additional injuries of the brainstem were detected. These subjects awoke 2 days after the impact with tetraparesis and apnea. Combined lesions of the medulla oblongata and other brainstem regions were found in nine subjects. All these patients died without awakening. In the absence of a bilateral lesion of the caudal medulla oblongata, spontaneous respiration was always possible. A unilateral lesion of the caudal medulla oblongata was visualized in one patient who had the ability of spontaneous respiration. This work confirms the presence of autonomous respiratory centers within the caudal medulla oblongata that allows sufficient adequate respiration in coma. Respiration ceases in the presence of a bilateral lesion of this area.

  8. Performance evaluation for volumetric segmentation of multiple sclerosis lesions using MATLAB and computing engine in the graphical processing unit (GPU)

    Science.gov (United States)

    Le, Anh H.; Park, Young W.; Ma, Kevin; Jacobs, Colin; Liu, Brent J.

    2010-03-01

    Multiple Sclerosis (MS) is a progressive neurological disease affecting myelin pathways in the brain. Multiple lesions in the white matter can cause paralysis and severe motor disabilities of the affected patient. To solve the issue of inconsistency and user-dependency in manual lesion measurement of MRI, we have proposed a 3-D automated lesion quantification algorithm to enable objective and efficient lesion volume tracking. The computer-aided detection (CAD) of MS, written in MATLAB, utilizes K-Nearest Neighbors (KNN) method to compute the probability of lesions on a per-voxel basis. Despite the highly optimized algorithm of imaging processing that is used in CAD development, MS CAD integration and evaluation in clinical workflow is technically challenging due to the requirement of high computation rates and memory bandwidth in the recursive nature of the algorithm. In this paper, we present the development and evaluation of using a computing engine in the graphical processing unit (GPU) with MATLAB for segmentation of MS lesions. The paper investigates the utilization of a high-end GPU for parallel computing of KNN in the MATLAB environment to improve algorithm performance. The integration is accomplished using NVIDIA's CUDA developmental toolkit for MATLAB. The results of this study will validate the practicality and effectiveness of the prototype MS CAD in a clinical setting. The GPU method may allow MS CAD to rapidly integrate in an electronic patient record or any disease-centric health care system.

  9. Coordinating Center: Molecular and Cellular Findings of Screen-Detected Lesions | Division of Cancer Prevention

    Science.gov (United States)

    The Molecular and Cellular Characterization of Screen‐Detected Lesions ‐ Coordinating Center and Data Management Group will provide support for the participating studies responding to RFA CA14‐10. The coordinating center supports three main domains: network coordination, statistical support and computational analysis and protocol development and database support. Support for

  10. Fusion of classifiers for REIS-based detection of suspicious breast lesions

    Science.gov (United States)

    Lederman, Dror; Wang, Xingwei; Zheng, Bin; Sumkin, Jules H.; Tublin, Mitchell; Gur, David

    2011-03-01

    After developing a multi-probe resonance-frequency electrical impedance spectroscopy (REIS) system aimed at detecting women with breast abnormalities that may indicate a developing breast cancer, we have been conducting a prospective clinical study to explore the feasibility of applying this REIS system to classify younger women (breast cancer. The system comprises one central probe placed in contact with the nipple, and six additional probes uniformly distributed along an outside circle to be placed in contact with six points on the outer breast skin surface. In this preliminary study, we selected an initial set of 174 examinations on participants that have completed REIS examinations and have clinical status verification. Among these, 66 examinations were recommended for biopsy due to findings of a highly suspicious breast lesion ("positives"), and 108 were determined as negative during imaging based procedures ("negatives"). A set of REIS-based features, extracted using a mirror-matched approach, was computed and fed into five machine learning classifiers. A genetic algorithm was used to select an optimal subset of features for each of the five classifiers. Three fusion rules, namely sum rule, weighted sum rule and weighted median rule, were used to combine the results of the classifiers. Performance evaluation was performed using a leave-one-case-out cross-validation method. The results indicated that REIS may provide a new technology to identify younger women with higher than average risk of having or developing breast cancer. Furthermore, it was shown that fusion rule, such as a weighted median fusion rule and a weighted sum fusion rule may improve performance as compared with the highest performing single classifier.

  11. A Novel Fuzzy Topological Approach to the Detection of Mammographic Lesions and Quantification of Parenchymal Density

    National Research Council Canada - National Science Library

    Udupa, Jayaram

    2001-01-01

    .... During this project period, the following have been accomplished: The development and validation of a new method of lesion and density detection based on fuzzy connectedness that utilizes the relative strength of connectedness among objects...

  12. Primary (recurrent) and metastatic lesions detection in cervical cancer: A comparison of positron emission tomography, CT and/or MRI image and pathological study

    International Nuclear Information System (INIS)

    Yen, T.C.; Tzen, K.Y.; Ma, S.Y.; Ng, K.K.; Hsueh, S.; Lai, C.H.

    2002-01-01

    Aim: This prospective study is to compare the results of primary (recurrence) and metastatic lesions detection, based on pathologic results, with computed tomography (CT) and/or magnetic resonance imaging (MRI) and positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose (FDG) in invasive cervical cancer (ICC). Materials and Methods: An FDG PET scan was performed in 136 patients with ICC (107 squamous cell carcinoma [SCC], 18 adenocarcinoma [AdenoCa], 5 adeosquamous cell carcinoma, 4 small cell carcinoma, and 2 poorly differentiated carcinoma; from FIGO staging IB to IVB prior to operation). CT and/or MRI image were performed within one week before or after FDG PET scan was done. The accuracy of lymph node status was based on histological result or a second FDG PET combined with a CT and/or MRI image images. Results: Totally, 68 main tumor and 147 metastatic lesions were recognized by either histopathology or a follow up study. On a lesion basis, CT and/or MRI image images demonstrated 63 (92.6 %) main tumor and 103 (70.1 %) metastatic lesions. For lymph node metastatic lesions detection, there were 6(75 %) enlarged inguinal lymph nodes, 38(76 %) enlarged pelvic lymph nodes (PLN), 28(73.7 %) enlarged para-aortic lymph nodes (PAN), 8(50 %) enlarged supraclavicular lymph nodes (SLNs), and 5(62.5 %) enlarged mediastinal lymph nodes (MLNs). Liver metastases were found in 4(100 %), in lung in 7(70 %) and in bone in 5(83.3 %). Peritoneal metastases were found in 2(28.6 %). FDG PET demonstrated 63 (92.6 %) and 135 (91.8 %) metastatic lesions. For lymph node metastases, FDG PET found 8(100 %) enlarged inguinal lymph nodes, 44(88 %) enlarged PLNs, 36(94.7 %) enlarged PANs, 15(93.8 %) enlarged SLNs, and 8(100 %) enlarged MLNs. Liver metastases were found in 4(100 %), in lung in 9(90 %) and in bone in 6(100 %). Peritoneal metastases were found in 5(71.4 %). On a patient basis, with FDG PET scan, 31(22.8%) were upstaging while 4(2.9%) were down staging. 35

  13. Improved assessment of multiple sclerosis lesion segmentation agreement via detection and outline error estimates

    Directory of Open Access Journals (Sweden)

    Wack David S

    2012-07-01

    Full Text Available Abstract Background Presented is the method “Detection and Outline Error Estimates” (DOEE for assessing rater agreement in the delineation of multiple sclerosis (MS lesions. The DOEE method divides operator or rater assessment into two parts: 1 Detection Error (DE -- rater agreement in detecting the same regions to mark, and 2 Outline Error (OE -- agreement of the raters in outlining of the same lesion. Methods DE, OE and Similarity Index (SI values were calculated for two raters tested on a set of 17 fluid-attenuated inversion-recovery (FLAIR images of patients with MS. DE, OE, and SI values were tested for dependence with mean total area (MTA of the raters' Region of Interests (ROIs. Results When correlated with MTA, neither DE (ρ = .056, p=.83 nor the ratio of OE to MTA (ρ = .23, p=.37, referred to as Outline Error Rate (OER, exhibited significant correlation. In contrast, SI is found to be strongly correlated with MTA (ρ = .75, p  Conclusions The DE and OER indices are proposed as a better method than SI for comparing rater agreement of ROIs, which also provide specific information for raters to improve their agreement.

  14. Performance of five research-domain automated WM lesion segmentation methods in a multi-center MS study

    DEFF Research Database (Denmark)

    de Sitter, Alexandra; Steenwijk, Martijn D; Ruet, Aurélie

    2017-01-01

    (Lesion-TOADS); and k-Nearest Neighbor with Tissue Type Priors (kNN-TTP). Main software parameters were optimized using a training set (N = 18), and formal testing was performed on the remaining patients (N = 52). To evaluate volumetric agreement with the reference segmentations, intraclass correlation......BACKGROUND AND PURPOSE: In vivoidentification of white matter lesions plays a key-role in evaluation of patients with multiple sclerosis (MS). Automated lesion segmentation methods have been developed to substitute manual outlining, but evidence of their performance in multi-center investigations......-one-center-out design to exclude the center of interest from the training phase to evaluate the performance of the method on 'unseen' center. RESULTS: Compared to the reference mean lesion volume (4.85 ± 7.29 mL), the methods displayed a mean difference of 1.60 ± 4.83 (Cascade), 2.31 ± 7.66 (LGA), 0.44 ± 4.68 (LPA), 1...

  15. The spatial resolution of the porcine multifocal electroretinogram for detection of laser-induced retinal lesions

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Scherfig, Erik

    2008-01-01

    This study aimed to investigate the spatial resolution of a porcine multifocal electroretinogram (mfERG) protocol by testing its ability to detect laser-induced retinal lesions. Furthermore, we wanted to describe time-dependent changes in implicit time and amplitude of the different mfERG peaks...

  16. Rapid noninvasive detection of experimental atherosclerotic lesions with novel 99mTc-labeled diadenosine tetraphosphates

    Science.gov (United States)

    Elmaleh, David R.; Narula, Jagat; Babich, John W.; Petrov, Artiom; Fischman, Alan J.; Khaw, Ban-An; Rapaport, Eliezer; Zamecnik, Paul C.

    1998-01-01

    The development of a noninvasive imaging procedure for identifying atherosclerotic lesions is extremely important for the clinical management of patients with coronary artery and peripheral vascular disease. Although numerous radiopharmaceuticals have been proposed for this purpose, none has demonstrated the diagnostic accuracy required to replace invasive angiography. In this report, we used the radiolabeled purine analog, 99mTc diadenosine tetraphosphate (Ap4A; AppppA, P1,P4-di(adenosine-5′)-tetraphosphate) and its analogue 99mTc AppCHClppA for imaging experimental atherosclerotic lesions in New Zealand White rabbits. Serial gamma camera images were obtained after intravenous injection of the radiolabeled dinucleotides. After acquiring the final images, the animals were sacrificed, ex vivo images of the aortas were recorded, and biodistribution was measured. 99mTc-Ap4A and 99mTc AppCHClppA accumulated rapidly in atherosclerotic abdominal aorta, and lesions were clearly visible within 30 min after injection in all animals that were studied. Both radiopharmaceuticals were retained in the lesions for 3 hr, and the peak lesion to normal vessel ratio was 7.4 to 1. Neither of the purine analogs showed significant accumulation in the abdominal aorta of normal (control) rabbits. The excised aortas showed lesion patterns that were highly correlated with the in vivo and ex vivo imaging results. The present study demonstrates that purine receptors are up-regulated in experimental atherosclerotic lesions and 99mTc-labeled purine analogs have potential for rapid noninvasive detection of plaque formation. PMID:9435254

  17. Improved detection reveals active β-papillomavirus infection in skin lesions from kidney transplant recipients.

    Science.gov (United States)

    Borgogna, Cinzia; Lanfredini, Simone; Peretti, Alberto; De Andrea, Marco; Zavattaro, Elisa; Colombo, Enrico; Quaglia, Marco; Boldorini, Renzo; Miglio, Umberto; Doorbar, John; Bavinck, Jan N Bouwes; Quint, Koen D; de Koning, Maurits N C; Landolfo, Santo; Gariglio, Marisa

    2014-08-01

    The aim of this study was to determine whether detection of β-HPV gene products, as defined in epidermodysplasia verruciformis skin cancer, could also be observed in lesions from kidney transplant recipients alongside the viral DNA. A total of 111 samples, corresponding to 79 skin lesions abscised from 17 kidney transplant recipients, have been analyzed. The initial PCR analysis demonstrated that β-HPV-DNA was highly present in our tumor series (85%). Using a combination of antibodies raised against the E4 and L1 proteins of the β-genotypes, we were able to visualize productive infection in 4 out of 19 actinic keratoses, and in the pathological borders of 1 out of 14 squamous cell carcinomas and 1 out of 31 basal cell carcinomas. Increased expression of the cellular proliferation marker minichromosome maintenance protein 7 (MCM7), that extended into the upper epithelial layers, was a common feature of all the E4-positive areas, indicating that cells were driven into the cell cycle in areas of productive viral infections. Although the present study does not directly demonstrate a causal role of these viruses, the detection of E4 and L1 positivity in actinic keratosis and the adjacent pathological epithelium of skin cancer, clearly shows that β-HPV are actively replicating in the intraepidermal precursor lesions of kidney transplant recipients and can therefore cooperate with other carcinogenic agents, such as UVB, favoring skin cancer promotion.

  18. Virtual gastroscopy using spiral CT in gastric lesions

    International Nuclear Information System (INIS)

    Shin, Sang Soo; Kang, Heoung Keun; Jeong, Yong Yeon; Yoon, Man Won; Song, Sang Gook; Jeong, Gwang Woo

    1998-01-01

    To compare virtual gastroscopy using spiral CT with conventional endoscopy for the detection and evaluation of gastric lesions. During a previous six-month period, 30 patients with pathologically-proven gastric lesions underwent conventional endoscopy and virtual gastroscopy using spiral CT. There were 18 cases of advanced gastric carcinoma, eight benign ulcers, and four submucosal tumors(two leiomyomas, two lymphomas). Source images of virtual gastroscopy were three-dim-ensionally reconstructed within an Advantage Windows Workstation and virtual gastroscopic images were obtained using Navigator Software. On analysis, images were graded according to their quality(excellent, good, poor). Virtual gastroscopic images were interpreted by two radiologists blinded to conventional endoscopic findings, and were subsequently compared with endoscopic findings in terms of detectability and findings. In the cases of advanced gastric carcinoma, lesions were classified according to Borrmann's system. For virtual gastroscopy, overall image quality was excellent in 21 cases(70%), good in five(17%), and poor in four(13%). Lesions were detected in 25 cases(83%). Among the 18 advanced gastric carcinomas, virtual gastroscopy image quality was excellent in 14 cases(78%), good in two(11%), and poor in two(11%). Lesions were detected in 16 cases(89%). Two Borrmann type IV cases were not detected. Among the eight benign ulcers, virtual gastroscopy image quality was excellent in three cases(38%), good in three(38%), and poor in two(25%). The detection of lesion was possible in five cases(63%). In all submucosal tumors, virtual gastroscopy image quality was excellent. Lesions were detected in all cases. Virtual gastroscopy using spiral CT is safe and noninvasive, and for the evaluation of gastric lesions may be complementary to axial CT. It successfully detects gastric lesions, and in depicting the pattern of gastric folds its image quality is excellent.=20

  19. OCT investigation of dental lesions

    Science.gov (United States)

    Osiac, Eugen; Popescu, Sanda Mihaela; Scrieciu, Monica; Mercuţ, Rǎzvan; Mercuţ, Veronica; Vǎtu, Mihaela

    2018-03-01

    There are several important non carious lesions affecting the tooth structure, lesions which may be classified into four clinical forms of dental wear: abfraction, erosion, attrition and abrasion, and different types of root resorption. Search for new, non-invasive and fast methods able to detect and describe such injuries is of utmost importance. Optical coherence tomography (OCT) proved itself as an appropriate investigation method for several medical fields including ophthalmology, dermatology, cardiology etc. Our study reveals OCT preliminary investigations as a promising tool for detecting and evaluating of the mentioned lesions.

  20. Lesion-based detection of early chemosensitivity using serial static FDG PET/CT in metastatic colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Buvat, Irene; Necib, Hatem [IMNC UMR 8165 CNRS - Paris 7 and Paris 11 Universities, Orsay cedex (France); Garcia, Camilo; Wagner, Antoine; Vanderlinden, Bruno; Flamen, Patrick [Universite Libre de Bruxelles, Nuclear Medicine Department, Institut Jules Bordet, Brussels (Belgium); Emonts, Patrick [Universite Libre de Bruxelles, Radiology Department, Institut Jules Bordet, Brussels (Belgium); Hendlisz, Alain [Universite Libre de Bruxelles, Digestive Oncology, Institut Jules Bordet, Brussels (Belgium)

    2012-10-15

    Medical oncology needs early identification of patients that are not responding to systemic therapy. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) performed before and early during treatment has been proposed for this purpose. However, the best way to assess the change in FDG uptake between two scans has not been identified. We studied cutoff thresholds to identify responding tumours as a function of the method used to measure tumour uptake. The study included 28 metastatic colorectal cancer (mCRC) patients who underwent 2 FDG PET/CT scans (baseline and at day 14 of the first course of polychemotherapy). For 78 tumour lesions, 4 standardized uptake value (SUV) indices were measured: maximum SUV (SUV{sub max}) and mean SUV in a region obtained using an isocontour (SUV{sub 40} {sub %}), with each of these SUV normalized either by the patient body weight (BW) or body surface area (BSA). The per cent change and absolute change in tumour uptake between the baseline and the early PET scans were measured based on these four indices. These changes were correlated to the RECIST 1.0-based response using contrast-enhanced CT at baseline and at 6-8 weeks on treatment. The 78 tumours were classified as non-responding (NRL, n = 58) and responding lesions (RL, n = 20). Receiver-operating characteristic (ROC) curves characterizing the performance in NRL/RL classification using early FDG PET uptake had areas under the curve between 0.75 and 0.84, without significant difference between the indices. The cutoff threshold in FDG uptake per cent change to get a 95 % sensitivity of RL detection depended on the way uptake was measured: -14 % (specificity of 53 %) and -22 % (specificity of 64 %) for SUV{sub max} and SUV{sub 40} {sub %}, respectively. Thresholds expressed as absolute SUV decrease instead of per cent change were less sensitive to the SUV definition: an SUV decline by 1.2 yielded a sensitivity of RL detection of 95 % for SUV{sub max} and SUV{sub 40

  1. Detection of fat in focal liver lesions using chemical-shift MR imaging: its significance in patients with and without hepatic cirrhosis

    International Nuclear Information System (INIS)

    Martin, J.

    1999-01-01

    To determine the utility of the chemical shift technique in MRI for the detection of fact in focal hepatic lesions and to see its significance in patients with and without hepatic cirrhosis. 159 patients with 207 hepatic lesions were studied using MRI (IT). Two groups were established: a) patients with hepatic cirrhosis (n=63 with 69 lesions) and b) patients without cirrhosis (n=96 with 138 lesions). Images were obtained in phase (P) and in opposite phase (OP) with gradient echo sequences (RG). The parameter used to differentiate the lesions with fat from those without fat was the variation percentage of the intensity of the signal (VIS) between the images in P and in OP. The statistical valuation was carried out using Student's t tests and the area under the ROC curve. The chemical shift technique detected fat in 25 lesions (12%), 10 hepatocarcinomas in the patients with cirrhosis and two angiomyolipomas and 13 nodular fat infiltrations in the patients who did not have cirrhosis. The average VIS percentage in the 10 hepatocarcinomas was 174.77% (ranging from 88.64% to 369.33%) while in the remaining 59 hepatocarcinomas it was -4.03% (ranging from 12.79% to -19.10%) (p=0.003). In the patients who did not have cirrhosis the average VIS percentage of the lesions with fat was 161.23 (ranging from 19.82 to 605.78) while in the lesions without fat it was -0.41 (ranging from -18.96 to 19.52) (p=0.003). The area under the ROC curve was 1 for the VIS parameter. The chemical shift technique allowed for fat to be detected within hepatic lesions. Based on our study, a nodule with fat in a patient with hepatic cirrhosis is suspected to have hepatocarcinomas while in patients who do not suffer from cirrhosis the existence of fat in a nodule favours its bening nature. (Author) 39 refs

  2. Claudin-4-targeted optical imaging detects pancreatic cancer and its precursor lesions.

    Science.gov (United States)

    Neesse, Albrecht; Hahnenkamp, Anke; Griesmann, Heidi; Buchholz, Malte; Hahn, Stefan A; Maghnouj, Abdelouahid; Fendrich, Volker; Ring, Janine; Sipos, Bence; Tuveson, David A; Bremer, Christoph; Gress, Thomas M; Michl, Patrick

    2013-07-01

    Novel imaging methods based on specific molecular targets to detect both established neoplasms and their precursor lesions are highly desirable in cancer medicine. Previously, we identified claudin-4, an integral constituent of tight junctions, as highly expressed in various gastrointestinal tumours including pancreatic cancer. Here, we investigate the potential of targeting claudin-4 with a naturally occurring ligand to visualise pancreatic cancer and its precursor lesions in vitro and in vivo by near-infrared imaging approaches. A non-toxic C-terminal fragment of the claudin-4 ligand Clostridium perfringens enterotoxin (C-CPE) was labelled with a cyanine dye (Cy5.5). Binding of the optical tracer was analysed on claudin-4 positive and negative cells in vitro, and tumour xenografts in vivo. In addition, two genetically engineered mouse models for pancreatic intraepithelial neoplasia (PanIN) and pancreatic cancer were used for in vivo validation. Optical imaging studies were conducted using 2D planar fluorescence reflectance imaging (FRI) technology and 3D fluorescence-mediated tomography (FMT). In vitro, the peptide-dye conjugate showed high binding affinity to claudin-4 positive CAPAN1 cells, while claudin-4 negative HT1080 cells revealed little or no fluorescence. In vivo, claudin-4 positive tumour xenografts, endogenous pancreatic tumours, hepatic metastases, as well as preinvasive PanIN lesions, were visualised by FRI and FMT up to 48 h after injection showing a significantly higher average of fluorochrome concentration as compared with claudin-4 negative xenografts and normal pancreatic tissue. C-CPE-Cy5.5 combined with novel optical imaging methods enables non-invasive visualisation of claudin-4 positive murine pancreatic tumours and their precursor lesions, representing a promising modality for early diagnostic imaging.

  3. Radiographic-guided fine-needle aspiration of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Helvie, M.A.; Baker, D.E.; Adler, D.D.; Andersson, I.; Naylor, B.; Buckwalter, K.

    1989-01-01

    The authors have performed radiographically guided fine-needle aspirations (FNA) on 215 nonpalpable mammographically detected breast lesions, using a coordinate grid localization system. Aspirates were classified into five cytologic groups. With the most stringent cytologic criteria, the sensitivity was 98% and the specificity 95% for the detection of carcinoma. However, according to these strict cytologic criteria, only 46% of aspirates contained representative material. Forty-two of 74 lesions undergoing biopsy proved malignant. Sixteen percent of patients did not compete adequate mammographic follow-up. High sensitivity and specificity can be achieved with radiographically guided FNA. However, management decisions ultimately require integration of mammographic findings with cytologic results. Close cooperation between mammographer, surgeon, cytopathologist, and patients is mandatory for successful operation

  4. Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle

    Directory of Open Access Journals (Sweden)

    Panjnoush M.

    2008-12-01

    Full Text Available "n  "nBackground and Aim: Digital subtraction Radiography (DSR is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9% (p<0.0001. "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

  5. Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

    International Nuclear Information System (INIS)

    Cornelis, F.; Silk, M.; Takaki, H.; Durack, J.C.; Erinjeri, J.P.; Sofocleous, C.T.; Siegelbaum, R.H.; Maybody, M.; Solomon, S.B.; Schoder, H.

    2014-01-01

    We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18 F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging. From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed. Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106). Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. (orig.)

  6. mHealth App for Risk Assessment of Pigmented and Nonpigmented Skin Lesions-A Study on Sensitivity and Specificity in Detecting Malignancy.

    Science.gov (United States)

    Thissen, Monique; Udrea, Andreea; Hacking, Michelle; von Braunmuehl, Tanja; Ruzicka, Thomas

    2017-12-01

    With the advent of smartphone devices, an increasing number of mHealth applications that target melanoma identification have been developed, but none addresses the general context of melanoma and nonmelanoma skin cancer identification. In this study a smartphone application using fractal and classical image analysis for the risk assessment of skin lesions is systematically evaluated to determine its sensitivity and specificity in the diagnosis of melanoma and nonmelanoma skin cancer along with actinic keratosis and Bowen's disease. In the Department of Dermatology, Catharina Hospital Eindhoven, The Netherlands, 341 melanocytic and nonmelanocytic lesions were imaged using SkinVision app; 239 underwent histopathological examination, while the rest of 102 lesions were clinically diagnosed as clearly benign and not removed. The algorithm has been calibrated using the images of the first 233 lesions. The calibrated version of the algorithm was used in a subset of 108 lesions, and the obtained results were compared with the medical findings. On the 108 cases used for evaluation the algorithm scored 80% sensitivity and 78% specificity in detecting (pre)malignant conditions. Although less accurate than the dermatologist's clinical eye, the app may offer support to other professionals who are less familiar with differentiating between benign and malignant lesions. An mHealth application for the risk assessment of skin lesions was evaluated. It adds value to diagnosis tools of its type by taking into consideration pigmented and nonpigmented lesions all together and detecting signs of malignancy with high sensitivity.

  7. Value of Fat-Suppressed Proton-Density-Weighted Turbo Spin-Echo Sequences in Detecting Meniscal Lesions: Comparison with Arthroscopy

    International Nuclear Information System (INIS)

    Schaefer, F.K.W.; Schaefer, P.J.; Brossmann, J.; Frahm, C.; Hilgert, R.E.; Heller, M.; Jahnke, T.

    2006-01-01

    Purpose: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging (MRI) compared to arthroscopy in the detection of meniscal lesions. Material and Methods: In a prospective study, 31 knee joints were imaged on a 1.5T MR scanner before arthroscopy using the following sequences: (a) coronal and sagittal FS-PDw TSE (TR/TE: 4009/15 ms); (b) coronal T1w SE (TR/TE: 722/20 ms), and sagittal PDw TSE (TR/TE: 3800/15 ms). Other imaging parameters were: slice thickness 3 mm, FOV 160 mm, matrix 256x256. A total of 186 meniscal regions (62 menisci; anterior horn, body, posterior horn) were evaluated. Standard of reference was arthroscopy. Sensitivity, specificity, negative predictive value (npv), positive predictive value (ppv), and accuracy were calculated. Results: Arthroscopically, meniscal lesions were detected in 55/186 segments (35 medial and 20 lateral meniscal lesions). Sensitivity, specificity, npv, ppv, and accuracy for combination of coronal and sagittal FS PDw TSE were 91.4%, 98.3%, 95%, 97%, and 93.5% for the medial meniscus, and 90%, 98.6%, 97.3%, 94.7%, and 96.8% for the lateral. The results were comparable to the combination of coronal T1w SE and sagittal PDw TSE for the medial (88.6%, 98.3%, 93.4%, 96.9%, 91.4%) and the lateral (90%, 95.9%, 97.2%, 85.7%, 92.5%) meniscus. Conclusion: FS PDw TSE-MR sequences are an excellent alternative for the detection of meniscal lesions in comparison with diagnostic arthroscopy

  8. Postoperative quality of life outcome and employment in patients undergoing resection of epileptogenic lesions detected by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Moritake, Kouzo; Akiyama, Yasuhiko; Nagai, Hidemasa; Maruyama, Nobuyuki; Takada, Daikei; Daisu, Mitsuhiro; Nagasako, Noriko; Mikuni, Nobuhiro; Hashimoto, Nobuo

    2009-01-01

    The long-term postoperative improvement of quality of life (QOL) and employment were investigated in patients undergoing resection of epileptogenic lesions detected by magnetic resonance (MR) imaging to identify the associated preoperative factors. Thirty of 47 patients who underwent lesionectomy between 1987-2001 replied to questionnaires. Patients with extratemporal resection outnumbered those with temporal lobe resection. The mean follow-up period was 12.4±3.7 years. An arbitrary score for quantitatively assessing QOL was assigned. The mean increases in QOL score points were significantly higher in the late childhood onset group than those in the early childhood onset group, and were also significantly higher in the temporal resection group and extratemporal resection of non-dysplastic cortical pathology group than in the extratemporal resection of dysplastic cortical pathology group. Postoperative QOL improvement and occupational status of patients depended on the completeness of seizure control. Resection of lesions detected by MR imaging in patients with intractable epilepsy resulted in effective long-term QOL improvement and postoperative occupational status. Favorable outcome was related mainly to the pathology of the epileptogenic lesions, whether the lesion site was temporal or extratemporal, and the completeness of seizure control. (author)

  9. Quantitative computer-aided diagnostic algorithm for automated detection of peak lesion attenuation in differentiating clear cell from papillary and chromophobe renal cell carcinoma, oncocytoma, and fat-poor angiomyolipoma on multiphasic multidetector computed tomography.

    Science.gov (United States)

    Coy, Heidi; Young, Jonathan R; Douek, Michael L; Brown, Matthew S; Sayre, James; Raman, Steven S

    2017-07-01

    To evaluate the performance of a novel, quantitative computer-aided diagnostic (CAD) algorithm on four-phase multidetector computed tomography (MDCT) to detect peak lesion attenuation to enable differentiation of clear cell renal cell carcinoma (ccRCC) from chromophobe RCC (chRCC), papillary RCC (pRCC), oncocytoma, and fat-poor angiomyolipoma (fp-AML). We queried our clinical databases to obtain a cohort of histologically proven renal masses with preoperative MDCT with four phases [unenhanced (U), corticomedullary (CM), nephrographic (NP), and excretory (E)]. A whole lesion 3D contour was obtained in all four phases. The CAD algorithm determined a region of interest (ROI) of peak lesion attenuation within the 3D lesion contour. For comparison, a manual ROI was separately placed in the most enhancing portion of the lesion by visual inspection for a reference standard, and in uninvolved renal cortex. Relative lesion attenuation for both CAD and manual methods was obtained by normalizing the CAD peak lesion attenuation ROI (and the reference standard manually placed ROI) to uninvolved renal cortex with the formula [(peak lesion attenuation ROI - cortex ROI)/cortex ROI] × 100%. ROC analysis and area under the curve (AUC) were used to assess diagnostic performance. Bland-Altman analysis was used to compare peak ROI between CAD and manual method. The study cohort comprised 200 patients with 200 unique renal masses: 106 (53%) ccRCC, 32 (16%) oncocytomas, 18 (9%) chRCCs, 34 (17%) pRCCs, and 10 (5%) fp-AMLs. In the CM phase, CAD-derived ROI enabled characterization of ccRCC from chRCC, pRCC, oncocytoma, and fp-AML with AUCs of 0.850 (95% CI 0.732-0.968), 0.959 (95% CI 0.930-0.989), 0.792 (95% CI 0.716-0.869), and 0.825 (95% CI 0.703-0.948), respectively. On Bland-Altman analysis, there was excellent agreement of CAD and manual methods with mean differences between 14 and 26 HU in each phase. A novel, quantitative CAD algorithm enabled robust peak HU lesion detection

  10. Measuring telomere length for the early detection of precursor lesions of esophageal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Lin, Shih-Wen; Wang, Guo-Qing; Wei, Wen-Qiang; Lu, Ning; Taylor, Philip R; Qiao, You-Lin; Dawsey, Sanford M; Abnet, Christian C; Freedman, Neal D; Murphy, Gwen; Risques, Rosana; Prunkard, Donna; Rabinovitch, Peter; Pan, Qin-Jing; Roth, Mark J

    2013-01-01

    Esophageal cancer is the sixth leading cause of cancer death worldwide; current early detection screening tests are inadequate. Esophageal balloon cytology successfully retrieves exfoliated and scraped superficial esophageal epithelial cells, but cytologic reading of these cells has poor sensitivity and specificity for detecting esophageal squamous dysplasia (ESD), the precursor lesion of esophageal squamous cell carcinoma (ESCC). Measuring telomere length, a marker for chromosomal instability, may improve the utility of balloon cytology for detecting ESD and early ESCC. We examined balloon cytology specimens from 89 asymptomatic cases of ESD (37 low-grade and 52 high-grade) and 92 age- and sex-matched normal controls from an esophageal cancer early detection screening study. All subjects also underwent endoscopy and biopsy, and ESD was diagnosed histopathologically. DNA was extracted from the balloon cytology cells, and telomere length was measured by quantitative PCR. A receiver operating characteristic (ROC) curve was plotted for telomere length as a diagnostic marker for high-grade dysplasia. Telomere lengths were comparable among the low- and high-grade dysplasia cases and controls, with means of 0.96, 0.96, and 0.92, respectively. The area under the ROC curve was 0.55 for telomere length as a diagnostic marker for high-grade dysplasia. Further adjustment for subject characteristics, including sex, age, smoking, drinking, hypertension, and body mass index did not improve the use of telomere length as a marker for ESD. Telomere length of esophageal balloon cytology cells was not associated with ESCC precursor lesions. Therefore, telomere length shows little promise as an early detection marker for ESCC in esophageal balloon samples

  11. Comparison between gadolinium-enhanced 2D T1-weighted gradient-echo and spin-echo sequences in the detection of active multiple sclerosis lesions on 3.0T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Aymerich, F.X. [Hospital Universitari Vall d' Hebron, Universitat Autonoma de Barcelona, MR Unit. Department of Radiology (IDI), Barcelona (Spain); Universitat Politecnica de Catalunya - Barcelona Tech (UPC), Department of Automatic Control (ESAII), Barcelona (Spain); Auger, C.; Alcaide-Leon, P.; Pareto, D.; Huerga, E.; Corral, J.F.; Mitjana, R.; Rovira, A. [Hospital Universitari Vall d' Hebron, Universitat Autonoma de Barcelona, MR Unit. Department of Radiology (IDI), Barcelona (Spain); Sastre-Garriga, J.; Montalban, X. [Hospital Universitari Vall d' Hebron, Universitat Autonoma de Barcelona, Centre d' Esclerosi Multiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology, Barcelona (Spain)

    2017-04-15

    To compare the sensitivity of enhancing multiple sclerosis (MS) lesions in gadolinium-enhanced 2D T1-weighted gradient-echo (GRE) and spin-echo (SE) sequences, and to assess the influence of visual conspicuity and laterality on detection of these lesions. One hundred MS patients underwent 3.0T brain MRI including gadolinium-enhanced 2D T1-weighted GRE and SE sequences. The two sets of contrast-enhanced scans were evaluated in random fashion by three experienced readers. Lesion conspicuity was assessed by the image contrast ratio (CR) and contrast-to-noise ratio (CNR). The intracranial region was divided into four quadrants and the impact of lesion location on detection was assessed in each slice. Six hundred and seven gadolinium-enhancing MS lesions were identified. GRE images were more sensitive for lesion detection (0.828) than SE images (0.767). Lesions showed a higher CR in SE than in GRE images, whereas the CNR was higher in GRE than SE. Most misclassifications occurred in the right posterior quadrant. The gadolinium-enhanced 2D T1-weighted GRE sequence at 3.0T MRI enables detection of enhancing MS lesions with higher sensitivity and better lesion conspicuity than 2D T1-weighted SE. Hence, we propose the use of gadolinium-enhanced GRE sequences rather than SE sequences for routine scanning of MS patients at 3.0T. (orig.)

  12. Applying a new unequally weighted feature fusion method to improve CAD performance of classifying breast lesions

    Science.gov (United States)

    Zargari Khuzani, Abolfazl; Danala, Gopichandh; Heidari, Morteza; Du, Yue; Mashhadi, Najmeh; Qiu, Yuchen; Zheng, Bin

    2018-02-01

    Higher recall rates are a major challenge in mammography screening. Thus, developing computer-aided diagnosis (CAD) scheme to classify between malignant and benign breast lesions can play an important role to improve efficacy of mammography screening. Objective of this study is to develop and test a unique image feature fusion framework to improve performance in classifying suspicious mass-like breast lesions depicting on mammograms. The image dataset consists of 302 suspicious masses detected on both craniocaudal and mediolateral-oblique view images. Amongst them, 151 were malignant and 151 were benign. The study consists of following 3 image processing and feature analysis steps. First, an adaptive region growing segmentation algorithm was used to automatically segment mass regions. Second, a set of 70 image features related to spatial and frequency characteristics of mass regions were initially computed. Third, a generalized linear regression model (GLM) based machine learning classifier combined with a bat optimization algorithm was used to optimally fuse the selected image features based on predefined assessment performance index. An area under ROC curve (AUC) with was used as a performance assessment index. Applying CAD scheme to the testing dataset, AUC was 0.75+/-0.04, which was significantly higher than using a single best feature (AUC=0.69+/-0.05) or the classifier with equally weighted features (AUC=0.73+/-0.05). This study demonstrated that comparing to the conventional equal-weighted approach, using an unequal-weighted feature fusion approach had potential to significantly improve accuracy in classifying between malignant and benign breast masses.

  13. Contrast-enhanced spectral mammography (CESM) versus breast magnetic resonance imaging (MRI): A retrospective comparison in 66 breast lesions.

    Science.gov (United States)

    Li, L; Roth, R; Germaine, P; Ren, S; Lee, M; Hunter, K; Tinney, E; Liao, L

    2017-02-01

    The purpose of this study was to retrospectively compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with that of breast magnetic resonance imaging (BMRI) in breast cancer detection using parameters, including sensitivity, positive predictive value (PPV), lesion size, morphology, lesion and background enhancement, and examination time. A total of 48 women (mean age, 56years±10.6 [SD]) with breast lesions detected between October 2012 and March 2014 were included. Both CESM and BMRI were performed for each patient within 30 days. The enhancement intensity of lesions and breast background parenchyma was subjectively assessed for both modalities and was quantified for comparison. Statistical significance was analyzed using paired t-test for mean size of index lesions in all malignant breasts (an index lesion defined as the largest lesion in each breast), and a mean score of enhancement intensity for index lesions and breast background. PPV, sensitivity, and accuracy were calculated for both CESM and BMRI. The average duration time of CESM and MRI examinations was also compared. A total of 66 lesions were identified, including 62 malignant and 4 benign lesions. Both CESM and BMRI demonstrated a sensitivity of 100% for detection of breast cancer. There was no statistically significant difference between the mean size of index lesions (P=0.108). The enhancement intensity of breast background was significantly lower for CESM than for BMRI (P0.05). The average examination time for CESM was significantly shorter than that of BMRI (P<0.01). CESM has similar sensitivity than BMRI in breast cancer detection, with higher PPV and less background enhancement. CESM is associate with significantly shorter exam time thus a more accessible alternative to BMRI, and has the potential to play an important tool in breast cancer detection and staging. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights

  14. Clinical performance of two visual scoring systems in detecting and assessing activity status of occlusal caries in primary teeth

    DEFF Research Database (Denmark)

    Braga, M M; Ekstrand, K R; Martignon, S

    2010-01-01

    This study aimed to compare the clinical performance of two sets of visual scoring criteria for detecting caries severity and assessing caries activity status in occlusal surfaces. Two visual scoring systems--the Nyvad criteria (NY) and the ICDAS-II including an adjunct system for lesion activity...

  15. Performance of immunochromatographic and ELISA tests for detecting fallow deer infected with Mycobacterium bovis.

    Science.gov (United States)

    Boadella, M; Barasona, J A; Diaz-Sanchez, S; Lyashchenko, K P; Greenwald, R; Esfandiari, J; Gortazar, C

    2012-04-01

    Fallow deer (Dama dama) are widely distributed as natural or naturalised populations, as well as in game parks and deer farms. We used 157 fallow deer sampled in populations considered to be Mycobacterium tuberculosis complex (MTC) free and 73 Mycobacterium bovis-infected fallow deer confirmed postmortem by culture to evaluate the diagnostic performance of two tests for the detection of anti-mycobacterial antibodies: the dual path platform (DPP) VetTB assay and the bovine purified protein derivative (bPPD) ELISA. We also compared their sensitivity with that of the skin test, analyzed the effect of haemolysis degree on the antibody detection and described the relationship between the test readings and presence/absence of gross tuberculosis (TB) compatible lesions. Sensitivity of bPPD ELISA was 51% at a specificity of 96%. Depending on the cut-off value selected, the sensitivity of DPP VetTB ranged from 62 to 71%, while its specificity was 88-95%. In the subgroup of M. bovis-infected deer for which the skin test data were available (33 of 73); this method detected 76% of culture-positive animals, although the specificity of the intradermal test was not determined in this study. When the DPP VetTB and skin test data were combined, the resulting sensitivity obtained in this sub-group of M. bovis-infected deer increased to 97%. Gross pathology identified TB compatible lesions (TBL) in 89% culture-confirmed fallow deer. The infected animals with visible lesions had significantly higher readings in the DPP VetTB, but not in the bPPD ELISA. Only high levels of haemolysis decreased antibody test sensitivity and this effect was more evident for the bPPD ELISA. The results allowed inferring a number of management recommendations for rapid detection of MTC infection in live fallow deer and in surveys on hunter-harvested cervids. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. The diagnostic value of magnetic resonance arthrography of the shoulder in detection and grading of SLAP lesions: Comparison with arthroscopic findings

    International Nuclear Information System (INIS)

    Amin, Mohammed Farghally; Youssef, Ahmed Omar

    2012-01-01

    Purpose: The purpose of the study is to determine the usefulness of magnetic resonance arthrography (MRA) in diagnosis and grading of superior labrum anterior to posterior (SLAP) lesions of the Glenoid Labrum Compared with surgery Material and methods: This was a prospective study including fifty nine clinically diagnosed SLAP patients. The study was done during the period from January 2008 to June 2010. All patients were submitted to history taking, clinical examination and conventional MRI examination of the shoulder, MRA was done in patients with negative conventional MRI, all of these patients underwent arthroscopy for diagnosis wither open or arthroscopy for diagnosis and treatment and results were compared with MRA findings. Main outcome measures: Sensitivity, specificity, positive and negative predictive values, and overall accuracy of MR arthrography in detection and grading of SLAP lesions of the gelnoid labrum. Results: Out of fifty nine patients, 25 patients had positive MR findings in conventional MRI, and 34 patients had negative MR findings, who underwent MR arthrography; 10 out of them had normal arthrogram (only 6 of them underwent arthroscopy), 22 had SLAP (superior labrum anterior to posterior) lesions, one had Bankart's lesion and one had internal impingement syndrome. These results were compared with arthroscopy results. The overall sensitivity of MRA in detection of SLAP lesions was 90% while the specificity was 50%, negative predictive value (NPV) was 66.6% and positive predicative value (PPV) was 81.8%. MRA and arthroscopy results were concurrent in 79.3% patients. Conclusion: MR arthrography is a sensitive minimally invasive technique for detection and grading of SLAP lesions, it can help in avoiding patients unnecessary diagnostic arthroscopy

  17. The diagnostic value of magnetic resonance arthrography of the shoulder in detection and grading of SLAP lesions: Comparison with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Amin, Mohammed Farghally, E-mail: Mohammed_amin37@yahoo.com [Department of Radiodiagnosis ElMinya University, ElMinya High Road, ElMinya (Egypt); Youssef, Ahmed Omar [Department of Orthropedic Surgery El Minya University, ElMinya (Egypt)

    2012-09-15

    Purpose: The purpose of the study is to determine the usefulness of magnetic resonance arthrography (MRA) in diagnosis and grading of superior labrum anterior to posterior (SLAP) lesions of the Glenoid Labrum Compared with surgery Material and methods: This was a prospective study including fifty nine clinically diagnosed SLAP patients. The study was done during the period from January 2008 to June 2010. All patients were submitted to history taking, clinical examination and conventional MRI examination of the shoulder, MRA was done in patients with negative conventional MRI, all of these patients underwent arthroscopy for diagnosis wither open or arthroscopy for diagnosis and treatment and results were compared with MRA findings. Main outcome measures: Sensitivity, specificity, positive and negative predictive values, and overall accuracy of MR arthrography in detection and grading of SLAP lesions of the gelnoid labrum. Results: Out of fifty nine patients, 25 patients had positive MR findings in conventional MRI, and 34 patients had negative MR findings, who underwent MR arthrography; 10 out of them had normal arthrogram (only 6 of them underwent arthroscopy), 22 had SLAP (superior labrum anterior to posterior) lesions, one had Bankart's lesion and one had internal impingement syndrome. These results were compared with arthroscopy results. The overall sensitivity of MRA in detection of SLAP lesions was 90% while the specificity was 50%, negative predictive value (NPV) was 66.6% and positive predicative value (PPV) was 81.8%. MRA and arthroscopy results were concurrent in 79.3% patients. Conclusion: MR arthrography is a sensitive minimally invasive technique for detection and grading of SLAP lesions, it can help in avoiding patients unnecessary diagnostic arthroscopy.

  18. Differences in the location and activity of intestinal Crohn's disease lesions between adult and paediatric patients detected with MRI

    International Nuclear Information System (INIS)

    Maccioni, Francesca; Carrozzo, Federica; Pino, Anna Rosaria; Staltari, Ilaria; Ansari, Najwa Al; Marini, Mario; Viola, Franca; Di Nardo, Giovanni; Cucchiara, Salvatore; Vestri, Annarita; Signore, Alberto

    2012-01-01

    To prospectively compare paediatric patients (PP) and adult patients (AP) affected by Crohn's disease (CD) in terms of the location and activity of intestinal lesions. Forty-three children (mean age 15 years) and 43 adults (mean age 48 years) with proven CD underwent magnetic resonance enterography (MRE) to localise lesions and detect their activity in 9 segments of the small and large bowel. The results were analysed on a per patient and per segment basis. Ileo-colonoscopy was performed in all patients. P values less than 0.05 were considered statistically significant. Involvement of terminal ileum was significantly different in the two groups: observed in 100 % of AP (43/43) versus 58 % (23/43) of PP (P < 0.0001). Conversely, the colon was diseased in 84 % of PP versus 64 % of AP. In particular, left colonic segments were significantly more involved in PP (descending colon 53 % versus 21 %, P < 0.01; rectum 67 % versus 23 %, P < 0.0001; sigmoid colon 56 % versus 37 %, not significant), whereas caecal involvement was equal in both groups. In children the maximal disease activity was found in left colonic segments, whereas in adults it was in the terminal ileum. MRE detected significant differences between the two populations, showing a more extensive and severe involvement of the left colon in children but the distal ileum in adults. (orig.)

  19. Brain MR post-gadolinium contrast in multiple sclerosis: the role of magnetization transfer and image subtraction in detecting more enhancing lesions

    Energy Technology Data Exchange (ETDEWEB)

    Gavra, M.M.; Gouliamos, A.D.; Vlahos, L.J. [Department of Radiology, ' ' Aretaieion' ' Hospital,University of Athens Medical School, Athens (Greece); Voumvourakis, C.; Sfagos, C. [Department of Neurology, ' ' Eginiteion' ' Hospital, University of Athens Medical School, Athens (Greece)

    2004-03-01

    Our purpose was to evaluate the role of magnetization transfer and image subtraction in detecting more enhancing lesions in brain MR imaging of patients with multiple sclerosis (MS). Thirty-one MS patients underwent MR imaging of the brain with T1-weighted spin echo sequences without and with magnetization transfer (MT) using a 1.5 T imager. Both sequences were acquired before and after intravenous injection of a paramagnetic contrast agent. Subtraction images in T1-weighted sequences were obtained by subtracting the pre-contrast images from the post-contrast ones. A significant difference was found between the numbers of enhanced areas in post-gadolinium T1-weighted images without and with MT (p=0.020). The post-gadolinium T1-weighted images with MT allowed the detection of an increased (13) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. A significant difference was also found between the numbers of enhanced areas in post-gadolinium T1-weighted images without MT and subtraction images without MT (p=0.020). The subtraction images without MT allowed the detection of an increased (10) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. Magnetization transfer contrast and subtraction techniques appear to be the simplest and least time-consuming applications to improve the conspicuity and detection of contrast-enhancing lesions in patients with MS. (orig.)

  20. Brain MR post-gadolinium contrast in multiple sclerosis: the role of magnetization transfer and image subtraction in detecting more enhancing lesions

    International Nuclear Information System (INIS)

    Gavra, M.M.; Gouliamos, A.D.; Vlahos, L.J.; Voumvourakis, C.; Sfagos, C.

    2004-01-01

    Our purpose was to evaluate the role of magnetization transfer and image subtraction in detecting more enhancing lesions in brain MR imaging of patients with multiple sclerosis (MS). Thirty-one MS patients underwent MR imaging of the brain with T1-weighted spin echo sequences without and with magnetization transfer (MT) using a 1.5 T imager. Both sequences were acquired before and after intravenous injection of a paramagnetic contrast agent. Subtraction images in T1-weighted sequences were obtained by subtracting the pre-contrast images from the post-contrast ones. A significant difference was found between the numbers of enhanced areas in post-gadolinium T1-weighted images without and with MT (p=0.020). The post-gadolinium T1-weighted images with MT allowed the detection of an increased (13) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. A significant difference was also found between the numbers of enhanced areas in post-gadolinium T1-weighted images without MT and subtraction images without MT (p=0.020). The subtraction images without MT allowed the detection of an increased (10) number of enhancing lesions compared with post-gadolinium T1-weighted images without MT. Magnetization transfer contrast and subtraction techniques appear to be the simplest and least time-consuming applications to improve the conspicuity and detection of contrast-enhancing lesions in patients with MS. (orig.)

  1. Evaluation of a radiographic method to detect tibial dyschondroplasia lesions in broilers

    Directory of Open Access Journals (Sweden)

    K Pelicia

    2012-06-01

    Full Text Available This study aimed at developing radiographic techniques for the early detection of dyschondroplastic lesions in the tibia of broilers. The experiment was carried out at the facilities of UNIFOR/MG and Formiga and UNIFENAS/ Alfenas with 420 one-day-old male Cobb broilers. At 20 days of age, all birds were radiographed and identified with an alpha-numeric metal ring in the right leg. At 40 days of age, 42 broilers previously selected as a function of bone mineral density and lesion thickness scores were again radiographed and scored, and then sacrificed. Their right tibia was removed for gross and histological examination of the growth plate. The results showed that radiographic techniques are correlated with gross and histological examination and that there was no significant differences among techniques (P>0.05. it was concluded that the use of radiographic examination to identify tibial dyschondroplasia in broilers precludes the use of bone mineral density to diagnose this condition. The non-parametric statistical Chi-square test at 5% significance level was used to analyze the results.

  2. Diffusion-weighted MRI in prostatic lesions: Diagnostic performance of normalized ADC using normal peripheral prostatic zone as a reference

    Directory of Open Access Journals (Sweden)

    Tamer F. Taha Ali

    2018-03-01

    Full Text Available Aim of study: Evaluate the potential value of the normal peripheral zone as a reference organ to normalize prostatic lesion apparent diffusion coefficient (ADC to improve its evaluation of prostatic lesions. Patients and methods: This prospective study included 38 patients with clinical suspicion of cancer prostate (increased PSA levels (>4 ng/ml, hard prostate in digital rectal examination and who are scheduled to undergo a TRUS-guided biopsy. Conventional and DW-MRI was done and ADC was calculated. The normalized ADC value was calculated by dividing the ADC of lesion by ADC of reference site (healthy peripheral zone. DWI-MRI results were compared to the results of biopsy. Comparison of ADCs and nADCs of benign and malignant lesions was done. Receiver operating characteristics (ROC curve analysis was done. Results: The patients were classified by histopathology into non-malignant group (16 patients and malignant group (22 patients. Significant negative correlation between ADC and normalized ADC (nADC and malignancy was detected. There was no significant difference between the mean ADC of peripheral health prostatic zones (PZ between benign and malignant cases (2.221 ± 0.356 versus 1.99 ± 0.538x10−3 mm2/sec, p = 0.144.There was significant difference between the mean ADC and mean nADC in benign and malignant lesions (1.049 ± 0.217 versus 0.659 ± 0.221x10−3 mm2/sec, p < 0.001 and (0.475 ± 0.055 versus 0.328 ± 0.044, p < 0.001 respectively.There was significant higher diagnostic performance of nADC than ADC with ADC Cut-off value 0.75 × 10−3 mm2/sec and nADC cut-off value 0.39 could significantly differentiate between benign and malignant lesion with sensitivity, specificity, PPV,NPV of 86.36,75,82.61 and 80% respectively, p < 0.0001 for ADC and 95.45, 93.75, 95.45 and 93.75%, p < 0.0001 for nADC. Conclusion: diagnostic performance of nADC using normal peripheral zone is higher than

  3. Autofluorescence of pigmented skin lesions using a pulsed UV laser with synchronized detection: clinical results

    DEFF Research Database (Denmark)

    Cheng, Haynes Pak Hay; Svenmarker, Pontus; Tidemand-Lichtenberg, Peter

    2010-01-01

    signal, which may in turn produce high contrast images that improve diagnosis, even in the presence of ambient room light. The synchronized set-up utilizes a compact, diode pumped, pulsed UV laser at 355 nm which is coupled to a CCD camera and a liquid crystal tunable filter. The excitation and image......We report preliminary clinical results of autofluorescence imaging of malignant and benign skin lesions, using pulsed 355 nm laser excitation with synchronized detection. The novel synchronized detection system allows high signal-to-noise ratio to be achieved in the resulting autofluorescence...

  4. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

    2013-08-15

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  5. NEOPLASTIC LESIONS OF THE APPENDIX

    Directory of Open Access Journals (Sweden)

    Piotr Bryk

    2013-11-01

    Full Text Available The aim of the research was to present the clinical observations of neoplastic lesions of the appendix (one carcinoid and two mucous cysts and to discuss various manners of treatment and prognosis. Material and methods: The authors of the following paper present a description of three cases of appendix tumours, two patients with a mucous cyst and a patient with carcinoid, against the background of all the appendectomies performed at the Clinical Department of General, Endocrine and Oncological Surgery of the Provincial Polyclinical Hospital in Kielce in the years 2005–2011. Results : Within the 7-year period, a total of 11 719 surgical operations have been performed, where 834 (7.1% were that of appendectomy. Among all of the removed vermiform appendixes, neoplastic lesions occurred in three cases constituting a mere 0.3% of all of the appendectomies performed within that period. In two of the cases there was a suspicion of mucous cysts before the surgical operation. In none of the above-mentioned cases was is possible to ultimately establish the diagnosis before the operation. The patients were subjected to a simple appendectomy. The patients are in good clinical health, with no signs of relapse. Conclusions : The presented cases of patients with appendix tumours illustrate the difficulty of preoperative detection of a neoplastic lesion. This is mainly due to a scantily symptomatic course or symptoms typical of appendicitis. In light of this, histopathological examination of each appendix should be treated as obligatory.

  6. Role of MRI in differentiating benign from malignant breast lesions ...

    African Journals Online (AJOL)

    Mohamed Ahmed Youssef

    2017-02-15

    Feb 15, 2017 ... detecting breast lesions than either T1- or T2-weighted imaging, but it is better to be performed in con- junction with contrast ... of MRI in several aspects of breast cancer diagnosis and management.2 ..... Hayes DF.: Normal ...

  7. Globular domain of adiponectin: promising target molecule for detection of atherosclerotic lesions

    Science.gov (United States)

    Almer, Gunter; Saba-Lepek, Matthias; Haj-Yahya, Samih; Rohde, Eva; Strunk, Dirk; Fröhlich, Eleonore; Prassl, Ruth; Mangge, Harald

    2011-01-01

    Background: Adiponectin, an adipocyte-specific plasma protein, has been shown to accumulate in injured endothelial cells during development of atherosclerotic lesions. In this study, we investigated the potential of different adiponectin subfractions with special emphasis on globular adiponectin (gAd) to recognize and visualize atherosclerotic lesions. Methods: Recombinant mouse gAd and subfractions of full-length adiponectin (ie, trimeric, hexameric, and oligomeric forms) were fluorescence-labeled. Aortas of wild-type and apoprotein E-deficient mice fed a high cholesterol diet were dissected and incubated with the labeled biomarkers. Imaging was performed using confocal laser scanning microscopy. Results: Confocal laser scanning microscopic images showed that gAd binds more strongly to atherosclerotic plaques than full-length adiponectin subfractions. Further, we showed that gAd accumulates preferentially in endothelial cells and the fibrous cap area of plaques. Here we demonstrate for the first time that gAd recognizes atherosclerotic plaques on aortic sections of apoprotein E-deficient mice. Conclusion: These results suggest that gAd, in addition to its physiological properties, is also suitable as a target molecule for prospective diagnostic strategies in imaging atherosclerotic lesions. PMID:22022204

  8. 201Tl scintigraphy in the evaluation of palpable and nonpalpable breast lesions: correlation with mammography and ultrasonography

    International Nuclear Information System (INIS)

    Vural, G.; Atasever, T.; Oezdemir, A.; Oeznur, I.; Karabacak, N.I.; Goekcora, N.; Isik, S.; Uenlue, M.

    1997-01-01

    Tl-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of Tl-201. Visual and semiquantitative interpretation was performed. Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. Tl-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by Tl-201 scintigraphy. The smallest mass lesion detected by Tl-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. Tl-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed Tl-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated Tl-201. Tl-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by Tl-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58±0.38 (mean±SD) and 1.48±0.32 (p>0.05), 1.87±0.65 and 1.34±0.20 (p 0.05). (orig./MG) [de

  9. Breath-hold [68Ga]DOTA-TOC PET/CT in neuroendocrine tumors: detection of additional lesions and effects on quantitative parameters.

    Science.gov (United States)

    Zirnsak, Mariana; Bärwolf, Robert; Freesmeyer, Martin

    2016-11-08

    Respiratory motion during PET/CT acquisition generates artifacts in the form of breath-related blurring, which influences the lesion detectability and diagnostic accuracy. The goal of this study was to verify whether breath-hold [68Ga]DOTA-TOC PET/CT (bhPET) allows detection of additional foci compared to free-breathing PET/CT (fbPET), and to assess the impact of breath-holding on standard uptake values (SUV) and isocontoured volume (Vic40) in patients with neuroendocrine tumors (NET). Patients with NET (n=39) were included in this study. BhPET and fbPET characteristics of 96 lesions were compared, and correlated with standard contrast-enhanced (ce) CT and MRI for lesion verification. Quantitative parameters SUV (max and mean) and Vic40 were assessed for both methods and evaluated by linear regression and Spearman's correlation. The impact of lesion size, localization and time interval between investigations was also analyzed. bhPET identified one additional metastasis not seen at fbPET but visible at ceMRI. Another additional bhPET focus did not have a morphological correlate. At bhPET, the SUVmax and SUVmean proved significantly higher and the Vic40 significantly lower than at fbPET. Lesion size, localization and time intervals did not impact significantly on SUV or Vic40. Currently, routine use of breath-hold [68Ga]DOTA-TOC PET/CT cannot be recommended as only one additional lesion was identified. Therefore, bhPET has currently no indication in patients with NET. If technical improvements regarding PET/CT scanner sensitivity are available, bhPET should be reevaluated in the future.

  10. Gd-EOB-DTPA-enhanced 3.0-Tesla MRI findings for the preoperative detection of focal liver lesions: Comparison with iodine-enhanced multi-detector computed tomography

    Science.gov (United States)

    Park, Hyong-Hu; Goo, Eun-Hoe; Im, In-Chul; Lee, Jae-Seung; Kim, Moon-Jib; Kwak, Byung-Joon; Chung, Woon-Kwan; Dong, Kyung-Rae

    2012-12-01

    The safety of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic-acid (Gd-EOB-DTPA) has been confirmed, but more study is needed to assess the diagnostic accuracy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in patients with a hepatocellular carcinoma (HCC) for whom surgical treatment is considered or with a metastatic hepatoma. Research is also needed to examine the rate of detection of hepatic lesions compared to multi-detector computed tomography (MDCT), which is used most frequently to localize and characterize a HCC. Gd-EOB-DTPA-enhanced MRI and iodine-enhanced MDCT imaging were compared for the preoperative detection of focal liver lesions. The clinical usefulness of each method was examined. The current study enrolled 79 patients with focal liver lesions who preoperatively underwent MRI and MDCT. In these patients, there was less than one month between the two diagnostic modalities. Imaging data were taken before and after contrast enhancement in both methods. To evaluate the images, we analyzed the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) in the lesions and the liver parenchyma. To compare the sensitivity of the two methods, we performed a quantitative analysis of the percentage signal intensity of the liver (PSIL) on a high resolution picture archiving and communication system (PACS) monitor (paired-samples t-test, p DTPA-enhanced MRI findings and the iodine-enhanced MDCT by using an adjusted x2 test. The SNRs, CNRs, and PSIL all had a greater detection rate in Gd-EOB-DTPA enhanced MRI than in iodine-enhanced MDCT. Hepatocyte-selective uptake was observed 20 minutes after the injection in the focal nodular hyperplasia (FNH, 9/9), adenoma (9/10), and highly-differentiated HCC (grade G1, 27/30). Rim enhancement was detected in all metastases (30/30). During the arterial and the delayed phases, good overall agreement between the gadoxetic-acid-enhanced MR and CT was observed (x2 test, p DTPA-enhanced MRI had a higher

  11. Benign fibroosseous lesions

    Directory of Open Access Journals (Sweden)

    Cansu Köseoğlu Seçgin

    2016-05-01

    Full Text Available Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification.

  12. CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing.

    Science.gov (United States)

    Tian, Panwen; Wang, Ye; Li, Lei; Zhou, Yongzhao; Luo, Wenxin; Li, Weimin

    2017-02-01

    Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions. This study included CT-guided TCNB with 18-gauge cutting needles in 560 consecutive patients with small (≤3 cm) pulmonary lesions from January 2012 to January 2015. There were 323 males and 237 females, aged 51.8±12.7 years. The size of the pulmonary lesions was 1.8±0.6 cm. The sensitivity, specificity, accuracy and complications of the biopsies were investigated. The risk factors of diagnostic failure were assessed using univariate and multivariate analyses. The sample's adequacy for molecular testing of non-small cell lung cancer (NSCLC) was analyzed. The overall sensitivity, specificity, and accuracy for diagnosis of malignancy were 92.0% (311/338), 98.6% (219/222), and 94.6% (530/560), respectively. The incidence of bleeding complications was 22.9% (128/560), and the incidence of pneumothorax was 10.4% (58/560). Logistic multivariate regression analysis showed that the independent risk factors for diagnostic failure were a lesion size ≤1 cm [odds ratio (OR), 3.95; P=0.007], lower lobe lesions (OR, 2.83; P=0.001), and pneumothorax (OR, 1.98; P=0.004). Genetic analysis was successfully performed on 95.45% (168/176) of specimens diagnosed as NSCLC. At least 96.8% of samples with two or more passes from a lesion were sufficient for molecular testing. The diagnostic yield of small pulmonary lesions by CT-guided TCNB is high, and the procedure is relatively safe. A lesion size ≤1 cm, lower lobe lesions, and pneumothorax are independent risk factors for biopsy diagnostic failure. TCNB specimens could provide adequate tissues for molecular testing.

  13. What affects detectability of lesion–deficit relationships in lesion studies?

    Directory of Open Access Journals (Sweden)

    Kayo Inoue

    2014-01-01

    Our simulations offer a quantitative basis for interpreting lesion studies in cognitive neuroscience. We suggest ways in which lesion simulation and analysis frameworks could be productively extended.

  14. A Third-Generation Adaptive Statistical Iterative Reconstruction Technique: Phantom Study of Image Noise, Spatial Resolution, Lesion Detectability, and Dose Reduction Potential.

    Science.gov (United States)

    Euler, André; Solomon, Justin; Marin, Daniele; Nelson, Rendon C; Samei, Ehsan

    2018-06-01

    The purpose of this study was to assess image noise, spatial resolution, lesion detectability, and the dose reduction potential of a proprietary third-generation adaptive statistical iterative reconstruction (ASIR-V) technique. A phantom representing five different body sizes (12-37 cm) and a contrast-detail phantom containing lesions of five low-contrast levels (5-20 HU) and three sizes (2-6 mm) were deployed. Both phantoms were scanned on a 256-MDCT scanner at six different radiation doses (1.25-10 mGy). Images were reconstructed with filtered back projection (FBP), ASIR-V with 50% blending with FBP (ASIR-V 50%), and ASIR-V without blending (ASIR-V 100%). In the first phantom, noise properties were assessed by noise power spectrum analysis. Spatial resolution properties were measured by use of task transfer functions for objects of different contrasts. Noise magnitude, noise texture, and resolution were compared between the three groups. In the second phantom, low-contrast detectability was assessed by nine human readers independently for each condition. The dose reduction potential of ASIR-V was estimated on the basis of a generalized linear statistical regression model. On average, image noise was reduced 37.3% with ASIR-V 50% and 71.5% with ASIR-V 100% compared with FBP. ASIR-V shifted the noise power spectrum toward lower frequencies compared with FBP. The spatial resolution of ASIR-V was equivalent or slightly superior to that of FBP, except for the low-contrast object, which had lower resolution. Lesion detection significantly increased with both ASIR-V levels (p = 0.001), with an estimated radiation dose reduction potential of 15% ± 5% (SD) for ASIR-V 50% and 31% ± 9% for ASIR-V 100%. ASIR-V reduced image noise and improved lesion detection compared with FBP and had potential for radiation dose reduction while preserving low-contrast detectability.

  15. Autofluorescence of pigmented skin lesions using a pulsed UV laser with synchronized detection: clinical results

    Science.gov (United States)

    Cheng, Haynes P. H.; Svenmarker, Pontus; Xie, Haiyan; Tidemand-Lichtenberg, Peter; Jensen, Ole B.; Bendsoe, Niels; Svanberg, Katarina; Petersen, Paul Michael; Pedersen, Christian; Andersson-Engels, Stefan; Andersen, Peter E.

    2010-04-01

    We report preliminary clinical results of autofluorescence imaging of malignant and benign skin lesions, using pulsed 355 nm laser excitation with synchronized detection. The novel synchronized detection system allows high signal-tonoise ratio to be achieved in the resulting autofluorescence signal, which may in turn produce high contrast images that improve diagnosis, even in the presence of ambient room light. The synchronized set-up utilizes a compact, diode pumped, pulsed UV laser at 355 nm which is coupled to a CCD camera and a liquid crystal tunable filter. The excitation and image capture is sampled at 5 kHz and the resulting autofluorescence is captured with the liquid crystal filter cycling through seven wavelengths between 420 nm and 580 nm. The clinical study targets pigmented skin lesions and evaluates the prospects of using autofluorescence as a possible means in differentiating malignant and benign skin tumors. Up to now, sixteen patients have participated in the clinical study. The autofluorescence images, averaged over the exposure time of one second, will be presented along with histopathological results. Initial survey of the images show good contrast and diagnostic results show promising agreement based on the histopathological results.

  16. Dissociation of Detection and Discrimination of Pure Tones following Bilateral Lesions of Auditory Cortex

    Science.gov (United States)

    Dykstra, Andrew R.; Koh, Christine K.; Braida, Louis D.; Tramo, Mark Jude

    2012-01-01

    It is well known that damage to the peripheral auditory system causes deficits in tone detection as well as pitch and loudness perception across a wide range of frequencies. However, the extent to which to which the auditory cortex plays a critical role in these basic aspects of spectral processing, especially with regard to speech, music, and environmental sound perception, remains unclear. Recent experiments indicate that primary auditory cortex is necessary for the normally-high perceptual acuity exhibited by humans in pure-tone frequency discrimination. The present study assessed whether the auditory cortex plays a similar role in the intensity domain and contrasted its contribution to sensory versus discriminative aspects of intensity processing. We measured intensity thresholds for pure-tone detection and pure-tone loudness discrimination in a population of healthy adults and a middle-aged man with complete or near-complete lesions of the auditory cortex bilaterally. Detection thresholds in his left and right ears were 16 and 7 dB HL, respectively, within clinically-defined normal limits. In contrast, the intensity threshold for monaural loudness discrimination at 1 kHz was 6.5±2.1 dB in the left ear and 6.5±1.9 dB in the right ear at 40 dB sensation level, well above the means of the control population (left ear: 1.6±0.22 dB; right ear: 1.7±0.19 dB). The results indicate that auditory cortex lowers just-noticeable differences for loudness discrimination by approximately 5 dB but is not necessary for tone detection in quiet. Previous human and Old-world monkey experiments employing lesion-effect, neurophysiology, and neuroimaging methods to investigate the role of auditory cortex in intensity processing are reviewed. PMID:22957087

  17. Dissociation of detection and discrimination of pure tones following bilateral lesions of auditory cortex.

    Science.gov (United States)

    Dykstra, Andrew R; Koh, Christine K; Braida, Louis D; Tramo, Mark Jude

    2012-01-01

    It is well known that damage to the peripheral auditory system causes deficits in tone detection as well as pitch and loudness perception across a wide range of frequencies. However, the extent to which to which the auditory cortex plays a critical role in these basic aspects of spectral processing, especially with regard to speech, music, and environmental sound perception, remains unclear. Recent experiments indicate that primary auditory cortex is necessary for the normally-high perceptual acuity exhibited by humans in pure-tone frequency discrimination. The present study assessed whether the auditory cortex plays a similar role in the intensity domain and contrasted its contribution to sensory versus discriminative aspects of intensity processing. We measured intensity thresholds for pure-tone detection and pure-tone loudness discrimination in a population of healthy adults and a middle-aged man with complete or near-complete lesions of the auditory cortex bilaterally. Detection thresholds in his left and right ears were 16 and 7 dB HL, respectively, within clinically-defined normal limits. In contrast, the intensity threshold for monaural loudness discrimination at 1 kHz was 6.5 ± 2.1 dB in the left ear and 6.5 ± 1.9 dB in the right ear at 40 dB sensation level, well above the means of the control population (left ear: 1.6 ± 0.22 dB; right ear: 1.7 ± 0.19 dB). The results indicate that auditory cortex lowers just-noticeable differences for loudness discrimination by approximately 5 dB but is not necessary for tone detection in quiet. Previous human and Old-world monkey experiments employing lesion-effect, neurophysiology, and neuroimaging methods to investigate the role of auditory cortex in intensity processing are reviewed.

  18. Dissociation of detection and discrimination of pure tones following bilateral lesions of auditory cortex.

    Directory of Open Access Journals (Sweden)

    Andrew R Dykstra

    Full Text Available It is well known that damage to the peripheral auditory system causes deficits in tone detection as well as pitch and loudness perception across a wide range of frequencies. However, the extent to which to which the auditory cortex plays a critical role in these basic aspects of spectral processing, especially with regard to speech, music, and environmental sound perception, remains unclear. Recent experiments indicate that primary auditory cortex is necessary for the normally-high perceptual acuity exhibited by humans in pure-tone frequency discrimination. The present study assessed whether the auditory cortex plays a similar role in the intensity domain and contrasted its contribution to sensory versus discriminative aspects of intensity processing. We measured intensity thresholds for pure-tone detection and pure-tone loudness discrimination in a population of healthy adults and a middle-aged man with complete or near-complete lesions of the auditory cortex bilaterally. Detection thresholds in his left and right ears were 16 and 7 dB HL, respectively, within clinically-defined normal limits. In contrast, the intensity threshold for monaural loudness discrimination at 1 kHz was 6.5 ± 2.1 dB in the left ear and 6.5 ± 1.9 dB in the right ear at 40 dB sensation level, well above the means of the control population (left ear: 1.6 ± 0.22 dB; right ear: 1.7 ± 0.19 dB. The results indicate that auditory cortex lowers just-noticeable differences for loudness discrimination by approximately 5 dB but is not necessary for tone detection in quiet. Previous human and Old-world monkey experiments employing lesion-effect, neurophysiology, and neuroimaging methods to investigate the role of auditory cortex in intensity processing are reviewed.

  19. Visual Inspection for Caries Detection

    DEFF Research Database (Denmark)

    Gimenez, T; Piovesan, C; Braga, M M

    2015-01-01

    July 2014 to identify published and nonpublished studies in English. Studies of visual inspection were included that 1) assessed accuracy of the method in detecting caries lesions; 2) were performed on occlusal, proximal, or free smooth surfaces in primary or permanent teeth; 3) had a reference...... (from 5,808 articles initially identified) and 1 abstract (from 168) met the inclusion criteria. In general, the analysis demonstrated that the visual method had good accuracy for detecting caries lesions. Although laboratory and clinical studies have presented similar accuracy, clinically obtained...... caries detection method has good overall performance. Furthermore, although the identified studies had high heterogeneity and risk of bias, the use of detailed and validated indices seems to improve the accuracy of the method....

  20. Computer-aided detection in computed tomography colonography. Current status and problems with detection of early colorectal cancer

    International Nuclear Information System (INIS)

    Morimoto, Tsuyoshi; Nakijima, Yasuo; Iinuma, Gen; Arai, Yasuaki; Shiraishi, Junji; Moriyama, Noriyuki; Beddoe, G.

    2008-01-01

    The aim of this study was to evaluate the usefulness of computer-aided detection (CAD) in diagnosing early colorectal cancer using computed tomography colonography (CTC). A total of 30 CTC data sets for 30 early colorectal cancers in 30 patients were retrospectively reviewed by three radiologists. After primary evaluation, a second reading was performed using CAD findings. The readers evaluated each colorectal segment for the presence or absence of colorectal cancer using five confidence rating levels. To compare the assessment results, the sensitivity and specificity with and without CAD were calculated on the basis of the confidence rating, and differences in these variables were analyzed by receiver operating characteristic (ROC) analysis. The average sensitivities for the detection without and with CAD for the three readers were 81.6% and 75.6%, respectively. Among the three readers, only one reader improved sensitivity with CAD compared to that without. CAD decreased specificity in all three readers. CAD detected 100% of protruding lesions but only 69.2% of flat lesions. On ROC analysis, the diagnostic performance of all three readers was decreased by use of CAD. Currently available CAD with CTC does not improve diagnostic performance for detecting early colorectal cancer. An improved CAD algorithm is required for detecting fiat lesions and reducing the false-positive rate. (author)

  1. Comparision between biphasic helical CT and dynamic gadolinium-enhanced MR in the detection and characterization of focal hepatic lesions in cirrhotic patients; Estudio comparativo entre TC helicoidal bifasica y RM dinamica con gadolinio en la deteccion y caracterizacion de lesiones focales hepticas en pacientes cirrticos

    Energy Technology Data Exchange (ETDEWEB)

    Puig, J; Martn, J; Donoso, L; Falco, J; Rue, M [Consorcio Hospitalario del Parc Taul. Sabadell. Barcelona (Spain)

    1998-12-31

    To assess the agreement between biphasic helical computerized tomography (BHCT) and dynamic gadolinium-enhanced magnetic resonance (MR) in the detection and characterization of focal hepatic lesions in a group of cirrhotic patients. A prospective study was done in 50 cirrhotic patients suspected of having hepatocarcinoma (HC) on the basis of ultrasonographic images evaluated by means of BHCT and dynamic gadolinium-enhanced MR using fast low-angle shot (FLASH) sequences (110-135/4/90 degree centigree). The images were assessed jointly by four radiologists. Between the two techniques, a total of 83 lesions were detected. MR disclosed more lesions (n=79) than BHCT (n=67) (p<0.005). Moreover, 25 of the lesions that were visible by both techniques were more clearly evident in MR images (p<0.01). MR correctly classified 6 of 7 benign lesions (85%) and 49 of 66 malignant ones (74%). BHCT correctly classifed 2 of 7 benign lesions (28%) and 32 of 66 malignant ones (48%). The sensitivities of MR and BHCT for the characterization of these lesions were 74% and 48%, respectively (p=0.0009), while the respective specificities were 86% and 29% (P<0.001). Dynamic gadolinium-enhanced MR with FLASH sequences is more efficient than BHCT in the detection and characterization of focal lesions in cirrhotic patients. (Author) 37 refs.

  2. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according toselective removal to firm dentine.In deep cavitated lesions in primary......The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental...

  3. Unenhanced breast MRI (STIR, T2-weighted TSE, DWIBS): An accurate and alternative strategy for detecting and differentiating breast lesions.

    Science.gov (United States)

    Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe; Moschetta, Marco

    2015-10-01

    To assess the role of STIR, T2-weighted TSE and DWIBS sequences for detecting and characterizing breast lesions and to compare unenhanced (UE)-MRI results with contrast-enhanced (CE)-MRI and histological findings, having the latter as the reference standard. Two hundred eighty consecutive patients (age range, 27-73 years; mean age±standard deviation (SD), 48.8±9.8years) underwent MR examination with a diagnostic protocol including STIR, T2-weighted TSE, THRIVE and DWIBS sequences. Two radiologists blinded to both dynamic sequences and histological findings evaluated in consensus STIR, T2-weighted TSE and DWIBS sequences and after two weeks CE-MRI images searching for breast lesions. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for UE-MRI and CE-MRI were calculated. UE-MRI results were also compared with CE- MRI. UE-MRI sequences obtained sensitivity, specificity, diagnostic accuracy, PPV and NPV values of 94%, 79%, 86%, 79% and 94%, respectively. CE-MRI sequences obtained sensitivity, specificity, diagnostic accuracy, PPV and NPV values of 98%, 83%, 90%, 84% and 98%, respectively. No statistically significant difference between UE-MRI and CE-MRI was found. Breast UE-MRI could represent an accurate diagnostic tool and a valid alternative to CE-MRI for evaluating breast lesions. STIR and DWIBS sequences allow to detect breast lesions while T2-weighted TSE sequences and ADC values could be useful for lesion characterization. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography?

    Energy Technology Data Exchange (ETDEWEB)

    Schreinemachers, Saskia A.; Hulst, Victor P.M. van der; Woude, Henk-Jan van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Jaap Willems, W. [Onze Lieve Vrouwe Gasthuis, Orthopaedic Surgery, Amsterdam (Netherlands); Bipat, Shandra [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands)

    2009-07-15

    The purpose of this study is to retrospectively compare accuracy of single magnetic resonance (MR) arthrography series in Abduction External Rotation (ABER) with conventional MR arthrography for detection and characterisation of anteroinferior labroligamentous lesions, with arthroscopy as reference standard. Inter-observer variability of both protocols was determined. Institutional review board approval was obtained; informed consent was waived. MR arthrograms, including oblique axial fat suppressed T1-weighted images in ABER position and conventional imaging directions of 250 patients (170 men, 80 women; mean age, 36 years), were retrospectively and independently evaluated by three reviewers. Reviewers were blinded to clinical information and arthroscopic results. Labroligamentous lesions were registered in both ABER and MRa. The lesions were sub-classified (Bankart, Perthes, anterior labrum periosteal sleeve avulsion (ALPSA) or lesions not otherwise specified). Inter-observer agreement was assessed by Kappa statistics for all 250 patients. Ninety-two of 250 patients underwent arthroscopy. Sensitivity, specificity and accuracy of ABER versus conventional MR arthrography were calculated and compared using paired McNemar test. Kappa values of the ABER and conventional MR arthrography ranged from 0.44 to 0.56 and 0.44 to 0.62, respectively. According to arthroscopy, 45 of 92 patients had an intact anteroinferior labrum, and in 44 patients, a labroligamentous lesion (eight Bankart, seven Perthes, 29 ALPSA and three lesions not otherwise specified) was diagnosed. There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (85-89%, 89-96%), specificity (82-91%, 84-89%) and overall accuracy (50-62%, 53-63%). The results of a single MR arthrography series in ABER position are comparable with those of conventional MR arthrography for detecting anteroinferior labroligamentous lesions. (orig.)

  5. Fully automatic acute ischemic lesion segmentation in DWI using convolutional neural networks

    Directory of Open Access Journals (Sweden)

    Liang Chen

    2017-01-01

    Full Text Available Stroke is an acute cerebral vascular disease, which is likely to cause long-term disabilities and death. Acute ischemic lesions occur in most stroke patients. These lesions are treatable under accurate diagnosis and treatments. Although diffusion-weighted MR imaging (DWI is sensitive to these lesions, localizing and quantifying them manually is costly and challenging for clinicians. In this paper, we propose a novel framework to automatically segment stroke lesions in DWI. Our framework consists of two convolutional neural networks (CNNs: one is an ensemble of two DeconvNets (Noh et al., 2015, which is the EDD Net; the second CNN is the multi-scale convolutional label evaluation net (MUSCLE Net, which aims to evaluate the lesions detected by the EDD Net in order to remove potential false positives. To the best of our knowledge, it is the first attempt to solve this problem and using both CNNs achieves very good results. Furthermore, we study the network architectures and key configurations in detail to ensure the best performance. It is validated on a large dataset comprising clinical acquired DW images from 741 subjects. A mean accuracy of Dice coefficient obtained is 0.67 in total. The mean Dice scores based on subjects with only small and large lesions are 0.61 and 0.83, respectively. The lesion detection rate achieved is 0.94.

  6. Fully automatic acute ischemic lesion segmentation in DWI using convolutional neural networks.

    Science.gov (United States)

    Chen, Liang; Bentley, Paul; Rueckert, Daniel

    2017-01-01

    Stroke is an acute cerebral vascular disease, which is likely to cause long-term disabilities and death. Acute ischemic lesions occur in most stroke patients. These lesions are treatable under accurate diagnosis and treatments. Although diffusion-weighted MR imaging (DWI) is sensitive to these lesions, localizing and quantifying them manually is costly and challenging for clinicians. In this paper, we propose a novel framework to automatically segment stroke lesions in DWI. Our framework consists of two convolutional neural networks (CNNs): one is an ensemble of two DeconvNets (Noh et al., 2015), which is the EDD Net; the second CNN is the multi-scale convolutional label evaluation net (MUSCLE Net), which aims to evaluate the lesions detected by the EDD Net in order to remove potential false positives. To the best of our knowledge, it is the first attempt to solve this problem and using both CNNs achieves very good results. Furthermore, we study the network architectures and key configurations in detail to ensure the best performance. It is validated on a large dataset comprising clinical acquired DW images from 741 subjects. A mean accuracy of Dice coefficient obtained is 0.67 in total. The mean Dice scores based on subjects with only small and large lesions are 0.61 and 0.83, respectively. The lesion detection rate achieved is 0.94.

  7. Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Bannas, Peter; Hentschel, Hannah B.; Bley, Thorsten A.; Derlin, Thorsten; Yamamura, Jin; Adam, Gerhard; Weber, Christoph [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Treszl, Andras; Eulenburg, Christine [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Stuebig, Thomas; Kroeger, Nicolaus [University Medical Center Hamburg-Eppendorf, Department of Stem Cell Transplantation, Hamburg (Germany)

    2012-09-15

    To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation. Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters. Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission. WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission. (orig.)

  8. Dental radiography: efficacy in the assessment of intraosseous lesions of the face and jaws in asymptomatic patients

    International Nuclear Information System (INIS)

    Zeichner, S.J.; Ruttimann, U.E.; Webber, R.L.

    1987-01-01

    In this investigation the efficacy of dental radiography for the detection of occult intraosseous lesions of the face and jaws was evaluated. An analysis of 30 million health insurance records indicated that the period prevalence of malignant lesions was less than 5 cases/million/year, and for benign lesions approximately 100 cases/million/year. Data from a controlled observer-performance study showed that radiographic sensitivities ranged between 50% and 80%. The cost per true-positive finding was estimated to be +8.6 million per malignant case and +430,000 per benign case. An assessment of the dosimetric literature indicated that the benefits of radiographic screening as a means for early detection of a malignancy appear to be counterbalanced by the risk of causing a radiation-induced malignancy. Taken together, these data demonstrate that dental radiography is not efficacious for the purpose of detecting occult lesions

  9. Value of fat-suppressed PD-weighted TSE-sequences for detection of anterior and posterior cruciate ligament lesions-Comparison to arthroscopy

    International Nuclear Information System (INIS)

    Schaefer, Fritz K.W.; Schaefer, Philipp J.; Brossmann, Joachim; Frahm, Christian; Muhle, Claus; Hilgert, Ralf Erik; Heller, Martin; Jahnke, Thomas

    2006-01-01

    Objective: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging for the detection of anterior and posterior cruciate ligament lesions in comparison to arthroscopy. Materials and methods: In a prospective study 31 knee joints were imaged on a 1.5 T MR scanner (Vision[reg], Siemens, Erlangen) prior to arthroscopy using following sequences: (a) sagittal FS-PDw/T2w TSE (TR/TE: 4009/15/105 ms); (b) sagittal PDw/T2w TSE (TR/TE:3800/15/105 ms). Further imaging parameters: slice thickness 3 mm, FOV 160 mm, matrix 256 x 256. A total of 62 anterior and posterior cruciate ligaments (ACL/PCL) were evaluated, standard of reference was arthroscopy. Sensitivity, specificity, positive (ppv) and negative predictive value (npv) and accuracy were calculated. Results: Twenty-one cruciate ligament ruptures were detected in arthroscopy, 19 ACL- and 2 PCL-ruptures (on MRI 34/124, 25/62 ACL, 9/62 PCL lesions). For all four sequences in the 31 patients with arthroscopic correlation sensitivity, specificity, ppv, npv and accuracy were 86%, 98%, 95%, 93% and 94% for detection of tears, and 84%, 100%, 100%, 80% and 90% for ACL-ruptures respectively. The two PCL-ruptures were true positive in all sequences, one intact PCL was diagnosed as torn (false positive). Conclusions: Fat-suppressed PDw/T2w TSE-MR sequences are comparable to PDw TSE sequences for the detection of ACL/PCL-lesions

  10. Efficacy of diagnostic magnetic resonance imaging for articular cartilage lesions of the glenohumeral joint in patients with instability

    International Nuclear Information System (INIS)

    Hayes, Meredith L.; Collins, Mark S.; Wenger, Doris E.; Morgan, Joseph A.; Dahm, Diane L.

    2010-01-01

    The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions. A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy. Mean patient age was 27.0 ± 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89). Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non

  11. Efficacy of diagnostic magnetic resonance imaging for articular cartilage lesions of the glenohumeral joint in patients with instability

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, Meredith L.; Collins, Mark S.; Wenger, Doris E. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Morgan, Joseph A.; Dahm, Diane L. [Mayo Clinic, Department of Orthopaedic Surgery, Rochester, MN (United States)

    2010-12-15

    The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions. A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy. Mean patient age was 27.0 {+-} 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89). Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non

  12. Detection of human cytomegalovirus and Epstein-Barr Virus in symptomatic and asymptomatic apical periodontitis lesions by real-time PCR.

    Science.gov (United States)

    Ozbek, Selcuk-M; Ozbek, Ahmet; Yavuz, Muhammed-Selim

    2013-09-01

    Recent studies have investigated the occurrence of human cytomegalovirus and Epstein-Barr Virus in samples from apical periodontitis lesions and a role in the pathogenesis of this disease has been suggested. Because genotype distribution and seroprevalence of EBV and HCMV differ among populations, it is important to determine the presence of these viruses in endodontic periapical lesions of different populations. The aims of this study were to determine the presence of HCMV and EBV DNAs in samples from Turkish patients with symptomatic and asymptomatic apical periodontitis lesions using real-time polymerase chain reaction method and to evaluate their presence in both symptomatic and asymptomatic apical periodontitis lesions. Periapical samples were collected from 12 asymptomatic and 16 symptomatic periapical lesions in conjunction with apicectomy. HCMV and EBV DNAs were identified in the samples by real-time PCR. The chi-squared test with Yates's correction or the Fisher's exact test was used to analyse the significance of differences. HCMV DNA was detected in 10 of the 16 (62.5%) symptomatic and in five of the 12 (41.7 %) asymptomatic periapical study lesions. The EBV DNA was identified in seven of the 16 (43.7 %) symptomatic and three of the 12 (25 %) asymptomatic periapical lesions. The difference in occurrence of HCMV and EBV DNA between symptomatic and asymptomatic periapical lesions was not statistically significant. (All comparisons have p > 0.05). Our findings suggest that HCMV and EBV is a frequent inhabitant of both symptomatic and asymptomatic apical periodontitis lesions of endodontic origin in Turkish population.

  13. A systematic review and meta-analysis of diagnostic test of MRA versus MRI for detection superior labrum anterior to posterior lesions type II-VII

    Energy Technology Data Exchange (ETDEWEB)

    Arirachakaran, Alisara; Pituckanotai, Kwanchai [Police General Hospital, Orthopedics Department, Bangkok (Thailand); Boonard, Manusak [Khon Kean University, Department of Orthopaedics, Faculty of Medicine, Khonkaen (Thailand); Chaijenkij, Kornkit [Mahidol University, Orthopedics Department, College of Sports Science and Technology, Bangkok (Thailand); Prommahachai, Akom [Udon Thani Hospital, Orthopedic Department, Udonthani (Thailand); Kongtharvonskul, Jatupon [Faculty of Medicine Ramathibodi Hospital, Section for Clinical Epidemiology and Biostatistics, Bangkok (Thailand)

    2017-02-15

    To determine the diagnostic performance of magnetic resonance arthrography (MRA) and magnetic resonance imaging (MRI) in superior labrum anterior to posterior lesions (type II-VII) of the shoulder. PubMed and Scopus search engines, an electronic search of articles was performed from inception to February 19, 2016. Diagnostic performance of index tests was compared by the summary area under receiver operator characteristic curve (AUROC). In all, 117 of 493 studies were eligible and 32 studies (2,013 shoulders) and 11 studies (1,498 shoulders) were evaluated with MRA and MRI. The summary sensitivity, specificity, likelihood ratio (positive and negative) and AUROC were 0.87 (95 % confidence interval, CI: 0.82, 0.91), 0.92 (95 %CI: 0.85, 0.95), 10.28 (95 %CI: 5.84, 18.08), 0.14 (95 %CI: 0.10, 0.20) and 0.94 (95 %CI: 0.92, 0.96) respectively for MRA, and 0.76 (95 %CI: 0.61, 0.86), 0.87 (95 %CI: 0.71, 0.95), 5.89 (95 %CI: 2.5, 13.86), 0.28 (95 %CI: 0.17, 0.47) and 0.94 (95 %CI: 0.92, 0.96) respectively for MRI. The diagnostic performance of MRA was superior to MRI by both direct and indirect comparisons for the detection of SLAP lesions. (orig.)

  14. A systematic review and meta-analysis of diagnostic test of MRA versus MRI for detection superior labrum anterior to posterior lesions type II-VII

    International Nuclear Information System (INIS)

    Arirachakaran, Alisara; Pituckanotai, Kwanchai; Boonard, Manusak; Chaijenkij, Kornkit; Prommahachai, Akom; Kongtharvonskul, Jatupon

    2017-01-01

    To determine the diagnostic performance of magnetic resonance arthrography (MRA) and magnetic resonance imaging (MRI) in superior labrum anterior to posterior lesions (type II-VII) of the shoulder. PubMed and Scopus search engines, an electronic search of articles was performed from inception to February 19, 2016. Diagnostic performance of index tests was compared by the summary area under receiver operator characteristic curve (AUROC). In all, 117 of 493 studies were eligible and 32 studies (2,013 shoulders) and 11 studies (1,498 shoulders) were evaluated with MRA and MRI. The summary sensitivity, specificity, likelihood ratio (positive and negative) and AUROC were 0.87 (95 % confidence interval, CI: 0.82, 0.91), 0.92 (95 %CI: 0.85, 0.95), 10.28 (95 %CI: 5.84, 18.08), 0.14 (95 %CI: 0.10, 0.20) and 0.94 (95 %CI: 0.92, 0.96) respectively for MRA, and 0.76 (95 %CI: 0.61, 0.86), 0.87 (95 %CI: 0.71, 0.95), 5.89 (95 %CI: 2.5, 13.86), 0.28 (95 %CI: 0.17, 0.47) and 0.94 (95 %CI: 0.92, 0.96) respectively for MRI. The diagnostic performance of MRA was superior to MRI by both direct and indirect comparisons for the detection of SLAP lesions. (orig.)

  15. Experimental phantom lesion detectability study using a digital breast tomosynthesis prototype system

    International Nuclear Information System (INIS)

    Schulz-Wendtland, R.; Wenkel, E.; Lell, M.; Boehner, C.; Bautz, W.A.; Mertelmeier, T.

    2006-01-01

    Purpose: To compare the sensitivity of conventional two-dimensional (2D) projection imaging with tomosynthesis with respect to the detectability of mammographic phantom lesions. Materials and Methods: Using a breast tomosynthesis prototype based on a commercial FFDM system (Siemens MAMMOMAT Novation DR ), but modified for a wide angle tube motion and equipped with a fast read-out amorphous selenium detector, we acquired standard 2D images and tomosynthesis series of projection views. We used the Wisconsin mammographic random phantom, model RMI 152A. The anode filter combinations Mo/Mo and W/Rh at two different doses were used as typical radiographic techniques. Slice images through the phantom parallel to the detector were reconstructed with a distance of 1 mm employing a filtered back-projection algorithm. The image data sets were read by five radiologists and evaluated with respect to the detectability of the phantom details. Results: For all studied radiographic techniques, the detection rate in the tomosynthesis mode was 100%, i.e. 75 true positive findings out of 75 possible hits. In contrast, the conventional projection mode yielded a detection rate between 80 and 93% (corresponding to 60 and 70 detected details) depending on the dose and X-ray spectrum. Conclusion: Tomosynthesis has the potential to increase the sensitivity of digital mammography. Overlapping structures from out-of-plane tissue can be removed in the tomosynthesis reconstruction process, thereby enhancing the diagnostic accuracy. (orig.)

  16. An object-based approach for detecting small brain lesions: application to Virchow-Robin spaces.

    Science.gov (United States)

    Descombes, Xavier; Kruggel, Frithjof; Wollny, Gert; Gertz, Hermann Josef

    2004-02-01

    This paper is concerned with the detection of multiple small brain lesions from magnetic resonance imaging (MRI) data. A model based on the marked point process framework is designed to detect Virchow-Robin spaces (VRSs). These tubular shaped spaces are due to retraction of the brain parenchyma from its supplying arteries. VRS are described by simple geometrical objects that are introduced as small tubular structures. Their radiometric properties are embedded in a data term. A prior model includes interactions describing the clustering property of VRS. A Reversible Jump Markov Chain Monte Carlo algorithm (RJMCMC) optimizes the proposed model, obtained by multiplying the prior and the data model. Example results are shown on T1-weighted MRI datasets of elderly subjects.

  17. ROC evaluation of SPECT myocardial lesion detectability with and without single iteration non-uniform Chang attenuation compensation using an anthropomorphic female phantom

    International Nuclear Information System (INIS)

    Jang, S.; Jaszczak, R.J.; Duke Univ. Medical Center, Durham, NC; Gilland, D.R.; Turkington, T.G.; Coleman, R.E.; Tsui, B.M.W.; Metz, C.E.

    1998-01-01

    The purpose of this work was to evaluate lesion detectability with and without nonuniform attenuation compensation (AC) in myocardial perfusion SPECT imaging in women using an anthropomorphic phantom and receiver operating characteristics (ROC) methodology. Breast attenuation causes artifacts in reconstructed images and may increase the difficulty of diagnosis of myocardial perfusion imaging in women. The null hypothesis tested using the ROC study was that nonuniform AC does not change the lesion detectability in myocardial perfusion SPECT imaging in women. The authors used a filtered backprojection (FBP) reconstruction algorithm and Chang's single iteration method for AC. In conclusion, with the proposed myocardial defect model nuclear medicine physicians demonstrated no significant difference for the detection of the anterior wall defect; however, a greater accuracy for the detection of the inferior wall defect was observed without nonuniform AC than with it. Medical physicists did not demonstrate any statistically significant difference in defect detection accuracy with or without nonuniform AC in the female phantom

  18. Joint line tenderness and McMurray tests for the detection of meniscal lesions: what is their real diagnostic value?

    Science.gov (United States)

    Galli, Marco; Ciriello, Vincenzo; Menghi, Amerigo; Aulisa, Angelo G; Rabini, Alessia; Marzetti, Emanuele

    2013-06-01

    To assess the interobserver concordance of the joint line tenderness (JLT) and McMurray tests, and to determine their diagnostic efficiency for the detection of meniscal lesions. Prospective observational study. Orthopedics outpatient clinic, university hospital. Patients (N=60) with suspected nonacute meniscal lesions who underwent knee arthroscopy. Not applicable. Patients were examined by 3 independent observers with graded levels of experience (>10y, 3y, and 4mo of practice). The interobserver concordance was assessed by Cohen-Fleiss κ statistics. Accuracy, negative and positive predictive values for prevalence 10% to 90%, positive (LR+) and negative (LR-) likelihood ratios, and the Bayesian posttest probability with a positive or negative result were also determined. The diagnostic value of the 2 tests combined was assessed by logistic regression. Arthroscopy was used as the reference test. No interobserver concordance was determined for the JLT. The McMurray test showed higher interobserver concordance, which improved when judgments by the less experienced examiner were discarded. The whole series studied by the "best" examiner (experienced orthopedist) provided the following values: (1) JLT: sensitivity, 62.9%; specificity, 50%; LR+, 1.26; LR-, .74; (2) McMurray: sensitivity, 34.3%; specificity, 86.4%; LR+, 2.52; LR-, .76. The combination of the 2 tests did not offer advantages over the McMurray alone. The JLT alone is of little clinical usefulness. A negative McMurray test does not modify the pretest probability of a meniscal lesion, while a positive result has a fair predictive value. Hence, in a patient with a suspected meniscal lesion, a positive McMurray test indicates that arthroscopy should be performed. In case of a negative result, further examinations, including imaging, are needed. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Striatal lesions produce distinctive impairments in reaction time performance in two different operant chambers.

    Science.gov (United States)

    Brasted, P J; Döbrössy, M D; Robbins, T W; Dunnett, S B

    1998-08-01

    The dorsal striatum plays a crucial role in mediating voluntary movement. Excitotoxic striatal lesions in rats have previously been shown to impair the initiation but not the execution of movement in a choice reaction time task in an automated lateralised nose-poke apparatus (the "nine-hole box"). Conversely, when a conceptually similar reaction time task has been applied in a conventional operant chamber (or "Skinner box"), striatal lesions have been seen to impair the execution rather than the initiation of the lateralised movement. The present study was undertaken to compare directly these two results by training the same group of rats to perform a choice reaction time task in the two chambers and then comparing the effects of a unilateral excitotoxic striatal lesion in both chambers in parallel. Particular attention was paid to adopting similar parameters and contingencies in the control of the task in the two test chambers. After striatal lesions, the rats showed predominantly contralateral impairments in both tasks. However, they showed a deficit in reaction time in the nine-hole box but an apparent deficit in response execution in the Skinner box. This finding confirms the previous studies and indicates that differences in outcome are not simply attributable to procedural differences in the lesions, training conditions or tasks parameters. Rather, the pattern of reaction time deficit after striatal lesions depends critically on the apparatus used and the precise response requirements for each task.

  20. Differences in the location and activity of intestinal Crohn's disease lesions between adult and paediatric patients detected with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Maccioni, Francesca; Carrozzo, Federica; Pino, Anna Rosaria; Staltari, Ilaria; Ansari, Najwa Al; Marini, Mario [Rome University, Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Rome (Italy); Viola, Franca; Di Nardo, Giovanni; Cucchiara, Salvatore [Rome University, Department of Pediatrics, Pediatric Gastroenterology and Liver Unit Policlinico Umberto I Hospital, Rome (Italy); Vestri, Annarita [Rome University, Department of Statistical Sciences, Policlinico Umberto I Hospital, Roma (Italy); Signore, Alberto [Rome University, Nuclear Medicine Unit, Faculty Medicine and Psychology, 2nd Faculty of Medicine, S. Andrea Hospital, Rome (Italy)

    2012-11-15

    To prospectively compare paediatric patients (PP) and adult patients (AP) affected by Crohn's disease (CD) in terms of the location and activity of intestinal lesions. Forty-three children (mean age 15 years) and 43 adults (mean age 48 years) with proven CD underwent magnetic resonance enterography (MRE) to localise lesions and detect their activity in 9 segments of the small and large bowel. The results were analysed on a per patient and per segment basis. Ileo-colonoscopy was performed in all patients. P values less than 0.05 were considered statistically significant. Involvement of terminal ileum was significantly different in the two groups: observed in 100 % of AP (43/43) versus 58 % (23/43) of PP (P < 0.0001). Conversely, the colon was diseased in 84 % of PP versus 64 % of AP. In particular, left colonic segments were significantly more involved in PP (descending colon 53 % versus 21 %, P < 0.01; rectum 67 % versus 23 %, P < 0.0001; sigmoid colon 56 % versus 37 %, not significant), whereas caecal involvement was equal in both groups. In children the maximal disease activity was found in left colonic segments, whereas in adults it was in the terminal ileum. MRE detected significant differences between the two populations, showing a more extensive and severe involvement of the left colon in children but the distal ileum in adults. (orig.)

  1. The diagnostic accuracy of a laser fluorescence device and digital radiography in detecting approximal caries lesions in posterior permanent teeth: an in vivo study.

    Science.gov (United States)

    Menem, R; Barngkgei, I; Beiruti, N; Al Haffar, I; Joury, Easter

    2017-04-01

    The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18-37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P 16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen's diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth.

  2. Added diagnostic value of respiratory-gated 4D 18F-FDG PET/CT in the detection of liver lesions. A multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Crivellaro, Cinzia; Landoni, Claudio; Guerra, Luca [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); University of Milan-Bicocca, Milan (Italy); De Ponti, Elena; Morzenti, Sabrina [San Gerardo Hospital, Medical Physics, Monza (Italy); Elisei, Federica [San Gerardo Hospital, Nuclear Medicine, Monza (Italy); Picchio, Maria; Bettinardi, Valentino [IRCCS San Raffaele Scientific Institute, Nuclear Medicine, Milan (Italy); Versari, Annibale [Santa Maria Nuova Hospital IRCCS, Nuclear Medicine, Reggio Emilia (Italy); Fioroni, Federica [Santa Maria Nuova Hospital IRCCS, Medical Physics, Reggio Emilia (Italy); Dziuk, Miroslaw; Tkaczewski, Konrad [Military Institute of Medicine, Warsaw (Poland); Ahond-Vionnet, Renee; Nodari, Guillaume [Hopital Pierre Beregovoy, Service de Medecine Nucleaire, Nevers (France); Todde, Sergio [University of Milan-Bicocca, Tecnomed Foundation, Monza (Italy)

    2018-01-15

    The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18F-FDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3D-PET/CT and liver 4D-PET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4D-PET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4D-PET/CT. Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3D-PET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4D-PET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4D-PET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4D-PET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4D-PET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3D-PET (mean ± SD, 5.2 ± 2.3). Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic

  3. Magnetic resonance (MR) colonography in the detection of colorectal lesions: a systematic review of prospective studies

    International Nuclear Information System (INIS)

    Zijta, Frank M.; Bipat, Shandra; Stoker, Jaap

    2010-01-01

    To determine the diagnostic accuracy of MR-colonography for the detection of colorectal lesions. A comprehensive literature search was performed for comparative MR-colonography studies, published between May 1997 and February 2009, using the MEDLINE, EMBASE and Cochrane databases. We included studies if MR-colonography findings were prospectively compared with conventional colonoscopy in (a)symptomatic patients. Two reviewers independently extracted study design characteristics and data for summarising sensitivity and specificity. Heterogeneity in findings between studies was tested using I 2 test statistics. Sensitivity and specificity estimates with 95% confidence intervals (CI) were calculated on per patient basis and summary sensitivity on per polyp basis, using bivariate and univariate statistical models. Thirty-seven studies were found to be potentially relevant and 13 fulfilled the inclusion criteria. The study population comprised 1,285 patients with a mean disease prevalence of 44% (range 22-63%). Sensitivity for the detection of CRC was 100%. Significant heterogeneity was found for overall per patient sensitivity and specificity. For polyps with a size of 10 mm or larger, per patient sensitivity and specificity estimates were 88% (95% CI 63-97%; I 2 = 37%) and 99% (95% CI 95-100%; I 2 = 60%). On a per polyp basis, polyps of 10 mm or larger were detected with a sensitivity of 84% (95% CI 66-94%; I 2 = 51%). The data were too heterogeneous for polyps smaller than 6 mm and 6-9 mm. MR-colonography can accurately detect colorectal polyps more than 10 mm in size. (orig.)

  4. 99m Tc-MIP-1404-SPECT/CT for the detection of PSMA-positive lesions in 225 patients with biochemical recurrence of prostate cancer.

    Science.gov (United States)

    Schmidkonz, Christian; Hollweg, Claudia; Beck, Michael; Reinfelder, Julia; Goetz, Theresa I; Sanders, James C; Schmidt, Daniela; Prante, Olaf; Bäuerle, Tobias; Cavallaro, Alexander; Uder, Michael; Wullich, Bernd; Goebell, Peter; Kuwert, Torsten; Ritt, Philipp

    2018-01-01

    99m Tc-MIP-1404 (Progenics Pharmaceuticals, Inc., New York, NY) is a novel, SPECT-compatible 99m Tc-labeled PSMA inhibitor for the detection of prostate cancer. We present results of its clinical use in a cohort of 225 men with histologically confirmed prostate cancer referred for workup of biochemical relapse. From April 2013 to April 2017, 99m Tc-MIP1404-scintigraphy was performed in 225 patients for workup of PSA biochemical relapse of prostate cancer. Whole-body planar and SPECT/CT images of the lower abdomen and thorax were obtained 3-4 h p.i. of 710 ± 64 MBq 99m Tc-MIP-1404. Images were visually analyzed for presence and location of abnormal uptake. In addition, quantitative analysis of the SPECT/CT data was carried out on a subset of 125 patients. Follow-up reports of subsequent therapeutic interventions were available for 59% (139) of all patients. Tracer-positive lesions were detected in 77% (174/225) of all patients. Detections occurred at the area of local recurrence in the prostate in 25% of patients (or a total of 56), with metastases in lymph nodes in 47% (105), bone in 27% (60), lung in 5% (12), and other locations in 2% (4) of patients. Detection rates were 90% at PSA levels ≥2 ng/mL and 54% below that threshold. Lesional SUVmax values were, on average, 32.2 ± 29.6 (0.8-142.2), and tumor-to-normal ratios 146.6 ± 160.5 (1.9-1482.4). The PSA level correlated significantly with total uptake of MIP-1404 in tumors (P Tc-MIP-1404-imaging and other information, an interdisciplinary tumor board review recommended changes to treatment plans in 74% (104/139) of those patients for whom the necessary documentation was available. SPECT/CT with 99m Tc-labeled MIP-1404 has a high probability in detecting PSMA-positive lesions in patients with elevated PSA. Statistical analysis disclosed significant relationship between quantitative 99m Tc-MIP-1404 uptake, PSA level, and Gleason score. © 2017 Wiley Periodicals, Inc.

  5. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided needle localization is a helpful method that allows a precise surgical excision of the suspect area with the removal of a minimal amount of breast tissue.

  6. Characteristics, Detection Methods and Treatment of Questionable Occlusal Carious Lesions

    DEFF Research Database (Denmark)

    Makhija, S.K.; Gilbert, G.H.; Funkhouser, E.

    2014-01-01

    . The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When...... consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky...... luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p color were less common...

  7. 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions

    DEFF Research Database (Denmark)

    Franco, Eduardo Batista; Benetti, Ana Raquel; Ishikiriama, Sérgio Kiyoshi

    2006-01-01

    To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions.......To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions....

  8. Molecular detection of bacteria associated to caries activity in dentinal lesions.

    Science.gov (United States)

    Neves, Beatriz Gonçalves; Stipp, Rafael Nóbrega; da Silva Bezerra, Daniela; de Figueiredo Guedes, Sarah Florindo; Rodrigues, Lidiany Karla Azevedo

    2017-07-01

    This study aimed at identifying and quantifying Actinomyces naeslundii, Bifidobacterium spp., Streptococcus mitis group, Lactobacillus acidophilus, Lactobacillus casei group, Streptococcus gordonii, and Streptococcus mutans in active and inactive carious dentine lesions of children with early childhood caries by using quantitative polymerase chain reaction. Fifty-six dentin lesion samples, classified as active (n = 39) or inactive (n = 17), were collected from children aged from 2 to 5 years old. Dentinal-cavitated lesions were evaluated by Nyvad criteria for the assessment of caries lesion activity. Relative quantification revealed that Bifidobacterium spp. and the L. casei group were significantly more abundant in active dentin lesions (p oral microbiota related to dentin caries activity status is relevant, this study provides insights to better understand the differences in the microbiotas between active and arrested dentin cavities.

  9. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    Directory of Open Access Journals (Sweden)

    Liana Preto Webber

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

  10. {sup 68}Ga-DOTATATE PET/CT in recurrent medullary thyroid carcinoma: a lesion-by-lesion comparison with {sup 111}In-octreotide SPECT/CT and conventional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yamaga, Lilian Yuri Itaya; Cunha, Marcelo L.; Campos Neto, Guilherme C.; Garcia, Marcio R.T.; Wagner, Jairo; Funari, Marcelo B.G. [Hospital Israelita Albert Einstein, Imaging Department, Sao Paulo (Brazil); Yang, Ji H.; Camacho, Cleber P. [Universidade Federal de Sao Paulo, Multiple Neoplasia Outpatiet Clinic, Sao Paulo (Brazil)

    2017-09-15

    The aim of this study was to prospectively compare the detection rate of {sup 68}Ga-DOTATATE PET-CT with {sup 111}In-octreotide SPECT-CT and conventional imaging (CI) in medullary thyroid carcinoma (MTC) patients with increased calcitonin (Ctn) levels but negative CI after thyroidectomy. Fifteen patients with raised Ctn levels and/or CI evidence of recurrence underwent {sup 68}Ga-DOTATATE PET-CT, {sup 111}In-octreotide SPECT-CT and CI. Histopathology, CI and biochemical/clinical/imaging follow-up were used as the reference standard. PET/CT, SPECT/CT and CI were compared in a lesion-based and organ-based analysis. PET/CT evidenced recurrence in 14 of 15 patients. There were 13 true positive (TP), 1 true negative (TN), 1 false positive (FP) and no false negative (FN) cases, resulting in a sensitivity and accuracy of 100% and 93%. SPECT/CT was positive in 6 of 15 cases. There were 6 TP, 2 TN, 7 FN and no FP cases, resulting in a sensitivity of 46% and accuracy of 53%. CI procedures detected tumor lesions in 14 of 15 patients. There were 13 TP, 1TN, 1 FP and no FN cases with a sensitivity of 100% and accuracy of 93%. A significantly higher number of lesions was detected by PET/CT (112 lesions, p = 0.005) and CI (109 lesions, p = 0.005) in comparison to SPECT/CT (16 lesions). There was no significant difference between PET/CT and CI for the total number of detected lesions (p = 0.734). PET/CT detected more lesions than SPECT/CT regardless of the organ. PET/CT detected more bone lesions but missed some neck nodal metastases evidenced by CI. The number of lesions per region demonstrated by PET/CT and CI were similar in the other sites. {sup 68}Ga-DOTATATE PET/CT is superior to {sup 111}In-octreotide SPECT/CT for the detection of recurrent MTC demonstrating a significantly higher number of lesions. {sup 68}Ga-DOTATATE PET/CT showed a superior detection rate compared to CI in demonstrating bone metastases. (orig.)

  11. Detection of optic nerve lesions in optic neuritis using frequency-selective fat-saturation sequences

    International Nuclear Information System (INIS)

    Miller, D.H.; MacManus, D.G.; Bartlett, P.A.; Kapoor, R.; Morrissey, S.P.; Moseley, I.F.

    1993-01-01

    MRI was performed on seven patients with acute optic neuritis, using two sequences which suppress the signal from orbital fat: frequency-selective fat-saturation and inversion recovery with a short inversion time. Lesions were seen on both sequences in all the symptomatic optic nerves studied. (orig.)

  12. Oral mucosal lesions in Anorexia Nervosa, Bulimia Nervosa and EDNOS.

    Science.gov (United States)

    Panico, Rene; Piemonte, Eduardo; Lazos, Jerónimo; Gilligan, Gerardo; Zampini, Anibal; Lanfranchi, Héctor

    2018-01-01

    The aim of this study is to describe oral lesions in patients with eating disorders (ED), including Anorexia Nervosa (AN), Bulimia Nervosa (BN) and eating disorders not otherwise specified (EDNOS). A prospective case-control study was carried out from April 2003 to May 2004. Inclusion criteria for the study group were individuals with a diagnosis of ED; age and sex-matched individuals without ED were included as controls. Clinical data regarding ED, medical complications and oral examination were performed by previously calibrated professionals. Study group (n = 65) presented 46 cases of BN (71%), 13 of EDNOS (20%) and 6 of AN (9%); also, 94% (n = 61) showed oral lesions. The most common were: labial erythema, exfoliative cheilitis, orange-yellow palate, hemorrhagic lesions, lip-cheek biting and non-specific oral atrophies. Only two patients of the study group had dental erosions, and no case of major salivary gland swelling was found. ED display a wide array of oral mucosal lesions that can be regarded as their early manifestations. The dentist could be the first professional to detect symptoms of eating disorders, potentially improving early detection and treatment of ED. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Correlation of needle core biopsy with excision histology in screen-detected B3 lesions: the Merrion Breast Screening Unit experience.

    LENUS (Irish Health Repository)

    Hayes, B D

    2012-02-01

    AIMS: Needle core biopsy (NCB) is a widely-used technique for non-operative evaluation of screen-detected breast lesions. Although most NCBs are B2 (benign) or B5 (malignant), some fall into the B3 category of "uncertain malignant potential". This study aims to categorise the lesions prompting a B3 NCB in the Merrion Breast Screening Unit, and establish the incidence of malignancy on subsequent excision biopsy. METHODS: Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2008 who had a B3 NCB were identified. The NCB pathology reports were reviewed and the diagnosis correlated with excision histology; the latter was classified as benign, atypical or malignant. Lesion-specific positive predictive values (PPVs) for malignancy were derived. RESULTS: 141 patients with a B3 NCB were identified. The most frequent lesions on NCB were radial scar (RS; n = 57), atypical intraductal epithelial proliferation (AIDEP; n = 25) and papillary lesion (n = 24). The final diagnosis was malignant in 22 patients (16%), atypical in 40 (28%) and benign in 79 (56%). Two of the patients with a malignant diagnosis had invasive carcinoma. The lesion-specific PPVs were: lobular neoplasia 50%, AIDEP 32%, columnar cell lesion with atypia 12.5%, RS 12.3%, papillary lesion 8.3%, suspected phyllodes tumour 7.7%, and spindle cell lesion 0%. Atypia on RS NCB predicted an atypical or malignant excision diagnosis, but atypia on papillary lesion NCB did not. CONCLUSIONS: One-sixth of B3 NCBs in this series proved to be malignant on excision. The PPV for malignancy varied according to lesion type.

  14. Diagnostic Performance and Confidence of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Cystic and Cysticlike Liver Lesions.

    Science.gov (United States)

    Corvino, Antonio; Catalano, Orlando; Corvino, Fabio; Sandomenico, Fabio; Petrillo, Antonella

    2017-09-01

    The aims of this study were to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the characterization of atypical cystic and cysticlike focal liver lesions in comparison with conventional US and to determine whether the use of CEUS can reduce the need for further diagnostic workup. In a 3-year period 48 patients with 50 atypical cystic and cysticlike lesions found at conventional US underwent CEUS. Diagnostic confirmation was obtained in cytohistopathologic examinations, with other imaging modalities, and in follow-up. Overall, there were 24 cystic lesions and 26 cysticlike solid lesions, specifically 32 benign and 18 malignant lesions. The conventional US and CEUS images and cine loops were reviewed by two blinded readers independently. Sensitivity, specificity, area under the ROC curve (A z ), and interobserver agreement were calculated. Diagnostic performance improved after review of CEUS examinations by both readers (conventional US A z = 0.781 vs 0.972; CEUS A z = 0.734 vs 0.957). Interreader agreement increased, although slightly (conventional US weighted κ = 0.894; CEUS weighted κ = 0.953). In terms of differential diagnosis, the occurrence of correctly characterized lesions increased after CEUS for both readers (reader 1, 62% to 98%; reader 2, 56% to 96%). The development of low-acoustic-power CEUS has made it possible to identify several imaging features of cystic and cysticlike focal liver lesions that, in association with history and clinical findings, may help to correctly characterize them. Our data indicate the usefulness of CEUS in the evaluation of patients with these lesions.

  15. Establishing the distribution of satellite lesions in intermediate- and high-risk prostate cancer: implications for focused radiotherapy.

    Science.gov (United States)

    Hegde, J V; Margolis, D J; Wang, P-C; Reiter, R E; Huang, J; Steinberg, M L; Kamrava, M

    2017-06-01

    In focused radiotherapy for prostate cancer (PC), a full dose of radiation is delivered to the index lesion while reduced dose is delivered to the remaining prostate to reduce morbidity. As PC is commonly multifocal, we investigated whether baseline clinical characteristics or multiparametric magnetic resonance imaging (mpMRI) may be useful to predict the actual pathologic distribution of PC in men with intermediate- or high-risk PC, which may better inform how to deliver focused radiotherapy. A retrospective single-institutional study was performed on 71 consecutive men with clinically localized, intermediate- or high-risk PC who underwent mpMRI followed by radical prostatectomy (RP) from January 2012 to December 2012. Logistic regression analysis was performed to evaluate preoperative predictors for satellite lesions. Performance characteristics of mpMRI to detect satellite lesions and the extent of prostate disease (one hemi-gland vs both) were also evaluated. In all, 50.7% had satellite lesions on mpMRI. On RP specimen analysis, 66.2% had satellite lesions and 55.3% of these satellite lesions had pathologic Gleason score (pGS)⩾3+4. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for mpMRI detecting a satellite lesion being present in the RP specimen were 59.6%, 66.7%, 77.8%, 45.7% and 62.0%, respectively. The presence of MRI satellite lesions was the only preoperative predictor significantly associated with finding satellite lesions on final pathology (hazard ratio (HR), 2.95, P=0.040). There was agreement in 76.1% of the entire cohort for unilateral vs bilateral disease when incorporating both biopsy and mpMRI information and comparing with the RP specimen. In intermediate risk or greater PC, only the presence of mpMRI satellite lesions could predict for pathologic satellite lesions. While combining biopsy and mpMRI information may improve preoperative disease localization, the relatively high incidence of

  16. Early-enhancing non-neoplastic lesions on gadolinium-enhanced MRI of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Kanematsu, M. E-mail: masa-gif@umin.ac.jp; Kondo, H.; Semelka, R.C.; Matsuo, M.; Goshima, S.; Hoshi, H.; Moriyama, N.; Itai, Y

    2003-10-01

    AIM: To assess the frequency, cause, and significance of early-enhancing, non-neoplastic (EN) lesions on gadolinium-enhanced magnetic resonance imaging (MRI) of the liver performed for the detection of malignant hepatic tumours. MATERIALS AND METHODS: From September 1997 to September 2000, we reviewed the images of 125 patients, suspected of having hepatic tumours, in whom (1) gadolinium-enhanced triphasic dynamic gradient-recalled-echo (GRE) imaging in addition to unenhanced T1- and T2-weighted MRI was performed, (2) conventional angiography and combination computed tomography (CT) hepatic arteriography and CT during arterial portography were performed within 2 weeks of the MRI, and (3) definitive surgery within 2 weeks of the MRI or follow-up study by means of intravenously contrast-enhanced CT or MRI in 10 months or more was performed. Angiographic studies were correlated to determine the underlying causes of the EN lesions. RESULTS: We found 78 EN lesions in 36 patients (29%), ranging in size from 4 and 50 mm (mean, 12.2 mm). From the MR reports, our radiologists had prospectively diagnosed EN lesions as probable malignant tumours in eight (10%), possible malignant tumours in 36 (46%), and probable non-neoplastic lesion in 34 (44%). EN lesions were found in 27 of 81 (33%) cirrhotic patients and in nine of 44 (20%) non-cirrhotic patients. Fifty-one EN lesions (65%) were located along the liver edge. The shape was circular in 42 (54%), oval in 14 (18%), irregular in 12 (15%), wedge-shaped in seven (9%), and fan-shaped in three (4%). Twenty EN lesions (26%) appeared slightly hyperintense on T2-weighted images. The causes were non-neoplastic arterio-portal shunting in 48 (62%), cystic venous drainage in four (5%), rib compression in four (5%), aberrant right gastric venous drainage in two (3%), and unknown in 20 (26%). CONCLUSION: Over half the number of EN lesions were caused by non-neoplastic arterio-portal shunting, occasionally showing slight hyperintensity on

  17. Measurement of thermally ablated lesions in sonoelastographic images using level set methods

    Science.gov (United States)

    Castaneda, Benjamin; Tamez-Pena, Jose Gerardo; Zhang, Man; Hoyt, Kenneth; Bylund, Kevin; Christensen, Jared; Saad, Wael; Strang, John; Rubens, Deborah J.; Parker, Kevin J.

    2008-03-01

    The capability of sonoelastography to detect lesions based on elasticity contrast can be applied to monitor the creation of thermally ablated lesion. Currently, segmentation of lesions depicted in sonoelastographic images is performed manually which can be a time consuming process and prone to significant intra- and inter-observer variability. This work presents a semi-automated segmentation algorithm for sonoelastographic data. The user starts by planting a seed in the perceived center of the lesion. Fast marching methods use this information to create an initial estimate of the lesion. Subsequently, level set methods refine its final shape by attaching the segmented contour to edges in the image while maintaining smoothness. The algorithm is applied to in vivo sonoelastographic images from twenty five thermal ablated lesions created in porcine livers. The estimated area is compared to results from manual segmentation and gross pathology images. Results show that the algorithm outperforms manual segmentation in accuracy, inter- and intra-observer variability. The processing time per image is significantly reduced.

  18. "Blind spots" in forensic autopsy: improved detection of retrobulbar hemorrhage and orbital lesions by postmortem computed tomography (PMCT).

    Science.gov (United States)

    Flach, P M; Egli, T C; Bolliger, S A; Berger, N; Ampanozi, G; Thali, M J; Schweitzer, W

    2014-09-01

    The purpose of this study was to correlate the occurrence of retrobulbar hemorrhage (RBH) with mechanism of injury, external signs and autopsy findings to postmortem computed tomography (PMCT). Six-teen subjects presented with RBH and underwent PMCT, external inspection and conventional autopsy. External inspection was evaluated for findings of the bulbs, black eye, raccoon eyes and Battle's sign. Fractures of the viscerocranium, orbital lesions and RBH were evaluated by PMCT. Autopsy and PMCT was evaluated for orbital roof and basilar skull fracture. The leading manner of death was accident with central regulatory failure in cases of RBH (31.25%). Imaging showed a high sensitivity in detection of orbital roof and basilar skull fractures (100%), but was less specific compared to autopsy. Volume of RBH (0.1-2.4ml) correlated positively to the presence of Battle's sign (pautopsy. PMCT was superior in detecting osseous lesions, scrutinizing autopsy as the gold standard. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. 99mTc-3PRGD2 Scintimammography in Palpable and Nonpalpable Breast Lesions

    Directory of Open Access Journals (Sweden)

    Lin Liu

    2014-07-01

    Full Text Available The aim of this study was to explore the diagnostic performance of 99mTc-3(poly-(ethylene glycol,PEG4-RGD2 (99mTc-3PRGD2 scintimammography (SMM in patients with either palpable or nonpalpable breast lesions and compare SMM to mammography to assess the possible incremental value of SMM in breast cancer detection. We also investigated the αvβ3 expression in malignant and benign breast lesions. Ninety-four patients with 110 lesions were included in this study. Mammograms were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS by a specialized imaging radiologist. Prone SMM was performed 1 hour after injection of 99mTc-3PRGD2. Scintigraphic images were interpreted independently by two experienced nuclear medicine physicians using a three-point system, and the kappa value was calculated to determine the interreader agreement. The McNemar test was used to compare SMM and mammography with respect to sensitivity, specificity, and accuracy. Diagnostic values for breast cancer detection were evaluated for each lesion. Immunohistochemistry was performed to evaluate integrin αvβ3 expression. Histopathology revealed 46 malignant lesions and 64 benign lesions. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SMM were 83%, 73%, 77%, 69%, and 85%, respectively. The kappa value between the two reviewers was 0.63. The diagnostic values of SMM were higher than those of mammography in evaluating overall breast lesions. A sensitivity of 91% was achieved when SMM and mammography results were combined with 60% of all false-negative mammography findings classified as true-positive results by SMM. Integrin αvβ3 expression was positively identified using SMM imaging. SMM is a promising tool to avoid unnecessary biopsies when used in addition to mammography and can be used to image αvβ3 expression in breast cancer with good image quality.

  20. Influence of region of interest size and ultrasound lesion size on the performance of 2D shear wave elastography (SWE) in solid breast masses

    International Nuclear Information System (INIS)

    Skerl, K.; Vinnicombe, S.; Giannotti, E.; Thomson, K.; Evans, A.

    2015-01-01

    Aim: To evaluate the influence of the region of interest (ROI) size and lesion diameter on the diagnostic performance of 2D shear wave elastography (SWE) of solid breast lesions. Materials and methods: A study group of 206 consecutive patients (age range 21–92 years) with 210 solid breast lesions (70 benign, 140 malignant) who underwent core biopsy or surgical excision was evaluated. Lesions were divided into small (diameter <15 mm, n=112) and large lesions (diameter ≥15 mm, n=98). An ROI with a diameter of 1, 2, and 3 mm was positioned over the stiffest part of the lesion. The maximum elasticity (E_m_a_x), mean elasticity (E_m_e_a_n) and standard deviation (SD) for each ROI size were compared to the pathological outcome. Statistical analysis was undertaken using the chi-square test and receiver operating characteristic (ROC) analysis. Results: The ROI size used has a significant impact on the performance of E_m_e_a_n and SD but not on E_m_a_x. Youden's indices show a correlation with the ROI size and lesion size: generally, the benign/malignant threshold is lower with increasing ROI size but higher with increasing lesion size. Conclusions: No single SWE parameter has superior performance. Lesion size and ROI size influence diagnostic performance. - Highlights: • Optimal cut-off for benign/malignant differentiation depends on lesion size. • Region of interest size influences measurements of mean elasticity and standard deviation. • Large lesions are stiffer than small lesions. • Optimal cut-off for benign/malignant differentiation should increase with increasing lesion size. • Region of interest of 2 mm achieved best compromise of the diagnostic performance for all SWE parameter.

  1. Indications for diagnostic open biopsy of mammographic screen-detected lesions preoperatively diagnosed as fibroadenomas by needle biopsy and their outcomes

    International Nuclear Information System (INIS)

    Sala, M.A.; Dhillon, R.; Brookes, D.; Lagrange, C.; Metcalf, C.; Wylie, E.

    2015-01-01

    Aim: To identify the clinical, radiological, and histopathological factors that resulted in a diagnostic open biopsy of mammographic screen-detected lesions diagnosed preoperatively as fibroadenomas by needle biopsy. Materials and methods: BreastScreen WA data over 10 year period from 1 January 1999 to 31 December 2008 was reviewed. Results: Among the 760,027 women screened in Western Australia between 1999 and 2008, 31 had a fine-needle aspiration (FNA) or a core biopsy (CB) diagnosing a fibroadenoma and subsequently underwent a diagnostic open biopsy (DOB). Three were preoperatively diagnosed as fibroadenoma by initial FNA but subsequent CB showed that these were not fibroadenomas and, therefore, were excluded from the present series. Of the 28 cases, DOB identified 21 fibroadenomas, two cellular fibroadenomas, two benign phyllodes tumours, one malignant phyllodes tumour, one fibroadenoma containing ductal carcinoma in situ (DCIS), and one case of a 40 mm adenosis tumour with a small 5 mm fibroadenoma. The lesions ranged from 5–100 mm in size with an average size of 28 mm. DOB and CB results were concordant in 25 (89%) of the cases. The primary clinical indications for undergoing DOB included indeterminate histopathological findings of cellular fibroadenomas versus phyllodes tumour (n = 10), enlarging size (n = 4), large size (n = 5), fibroadenomas with atypia (n = 1), discordant radiological and pathological findings (n = 3), patient preference (n = 1), association with a second screen-detected lesion requiring excision (n = 2), and an unknown indication (n = 1). Conclusion: CB diagnosis of fibroadenomas is a safe diagnosis unless it has atypical clinical, radiological, or pathological features. - Highlights: • The aim was to identify factors that lead to excision of benign fibroadenomas. • Screen detected fibroadenomas must be adequately sampled to exclude malignancy. • Large, enlarging, cellular or atypical lesions should undergo

  2. The role of positron emission tomography in the detection of incidental gastrointestinal tract lesions in patients examined for lung cancer

    International Nuclear Information System (INIS)

    Isobe, Kazutoshi; Hata, Yoshinobu; Sakaguchi, Shinji; Takai, Yujiro; Shibuya, Kazutoshi; Takagi, Keigo; Homma, Sakae

    2010-01-01

    The purpose of this study was to clarify the clinical characteristics of lung cancer patients with abnormal accumulation in the gastrointestinal tract by fluoro-2-deoxyglucose positron emission tomography (PET). Of the 968 consecutive patients with primary lung cancer who underwent PET from October 2005 through September 2009, 26 patients had local abnormal accumulation in the gastrointestinal tract. We retrospectively compared the localization of abnormal accumulation in the gastrointestinal tract, standardized uptake value (SUV)max (1 hour), and the final clinical diagnosis. The site of abnormal accumulation was the esophagus in 1 case, the stomach in 8 and the small intestine to large intestine in 17. In 15 out of 26 (57%) cases with true PET positive results, there was esophageal cancer in 1 case, gastric cancer in 2, gastrointestinal stromal tumor in 1, colon cancer in 8, and 1 each of metastasis to the stomach, small intestine and large intestine from lung cancer. In 11 cases with false PET-positive results, there was a stomach polyp in 1 case, gastritis in 3, colon polyp in 1, diverticulitis in 1 and normal physiologic accumulation in 5. There were no differences in mean SUVmax among malignant lesions, benign lesions, and normal physiologic accumulation. We should perform endoscopy of the digestive tract to detect malignant lesions with high incidence rates when PET shows localalized abnormal accumulation in the gastrointestinal, tract in patients with lung cancer. (author)

  3. Self-organizing neural networks for automatic detection and classification of contrast-enhancing lesions in dynamic MR-mammography

    International Nuclear Information System (INIS)

    Vomweg, T.W.; Teifke, A.; Kauczor, H.U.; Achenbach, T.; Rieker, O.; Schreiber, W.G.; Heitmann, K.R.; Beier, T.; Thelen, M.

    2005-01-01

    Purpose: Investigation and statistical evaluation of 'Self-Organizing Maps', a special type of neural networks in the field of artificial intelligence, classifying contrast enhancing lesions in dynamic MR-mammography. Material and Methods: 176 investigations with proven histology after core biopsy or operation were randomly divided into two groups. Several Self-Organizing Maps were trained by investigations of the first group to detect and classify contrast enhancing lesions in dynamic MR-mammography. Each single pixel's signal/time curve of all patients within the second group was analyzed by the Self-Organizing Maps. The likelihood of malignancy was visualized by color overlays on the MR-images. At last assessment of contrast-enhancing lesions by each different network was rated visually and evaluated statistically. Results: A well balanced neural network achieved a sensitivity of 90.5% and a specificity of 72.2% in predicting malignancy of 88 enhancing lesions. Detailed analysis of false-positive results revealed that every second fibroadenoma showed a 'typical malignant' signal/time curve without any chance to differentiate between fibroadenomas and malignant tissue regarding contrast enhancement alone; but this special group of lesions was represented by a well-defined area of the Self-Organizing Map. Discussion: Self-Organizing Maps are capable of classifying a dynamic signal/time curve as 'typical benign' or 'typical malignant'. Therefore, they can be used as second opinion. In view of the now known localization of fibroadenomas enhancing like malignant tumors at the Self-Organizing Map, these lesions could be passed to further analysis by additional post-processing elements (e.g., based on T2-weighted series or morphology analysis) in the future. (orig.)

  4. Breast lesion characterization using whole-lesion histogram analysis with stretched-exponential diffusion model.

    Science.gov (United States)

    Liu, Chunling; Wang, Kun; Li, Xiaodan; Zhang, Jine; Ding, Jie; Spuhler, Karl; Duong, Timothy; Liang, Changhong; Huang, Chuan

    2018-06-01

    Diffusion-weighted imaging (DWI) has been studied in breast imaging and can provide more information about diffusion, perfusion and other physiological interests than standard pulse sequences. The stretched-exponential model has previously been shown to be more reliable than conventional DWI techniques, but different diagnostic sensitivities were found from study to study. This work investigated the characteristics of whole-lesion histogram parameters derived from the stretched-exponential diffusion model for benign and malignant breast lesions, compared them with conventional apparent diffusion coefficient (ADC), and further determined which histogram metrics can be best used to differentiate malignant from benign lesions. This was a prospective study. Seventy females were included in the study. Multi-b value DWI was performed on a 1.5T scanner. Histogram parameters of whole lesions for distributed diffusion coefficient (DDC), heterogeneity index (α), and ADC were calculated by two radiologists and compared among benign lesions, ductal carcinoma in situ (DCIS), and invasive carcinoma confirmed by pathology. Nonparametric tests were performed for comparisons among invasive carcinoma, DCIS, and benign lesions. Comparisons of receiver operating characteristic (ROC) curves were performed to show the ability to discriminate malignant from benign lesions. The majority of histogram parameters (mean/min/max, skewness/kurtosis, 10-90 th percentile values) from DDC, α, and ADC were significantly different among invasive carcinoma, DCIS, and benign lesions. DDC 10% (area under curve [AUC] = 0.931), ADC 10% (AUC = 0.893), and α mean (AUC = 0.787) were found to be the best metrics in differentiating benign from malignant tumors among all histogram parameters derived from ADC and α, respectively. The combination of DDC 10% and α mean , using logistic regression, yielded the highest sensitivity (90.2%) and specificity (95.5%). DDC 10% and α mean derived from

  5. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    Directory of Open Access Journals (Sweden)

    Aurea Simón-Soro

    2014-10-01

    Full Text Available Background: Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective: To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design: Non-cavitated enamel caries lesions (n=15 and dentin caries lesions samples (n=12 were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results: A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions: The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci

  6. The Physiologic Impact of Unilateral Recurrent Laryngeal Nerve (RLN) Lesion on Infant Oropharyngeal and Esophageal Performance.

    Science.gov (United States)

    Gould, Francois D H; Lammers, Andrew R; Ohlemacher, Jocelyn; Ballester, Ashley; Fraley, Luke; Gross, Andrew; German, Rebecca Z

    2015-12-01

    Recurrent laryngeal nerve (RLN) injury in neonates, a complication of patent ductus arteriosus corrective surgery, leads to aspiration and swallowing complications. Severity of symptoms and prognosis for recovery are variable. We transected the RLN unilaterally in an infant mammalian animal model to characterize the degree and variability of dysphagia in a controlled experimental setting. We tested the hypotheses that (1) both airway protection and esophageal function would be compromised by lesion, (2) given our design, variability between multiple post-lesion trials would be minimal, and (3) variability among individuals would be minimal. Individuals' swallowing performance was assessed pre- and post-lesion using high speed VFSS. Aspiration was assessed using the Infant Mammalian Penetration-Aspiration Scale (IMPAS). Esophageal function was assessed using two measures devised for this study. Our results indicate that RLN lesion leads to increased frequency of aspiration, and increased esophageal dysfunction, with significant variation in these basic patterns at all levels. On average, aspiration worsened with time post-lesion. Within a single feeding sequence, the distribution of unsafe swallows varied. Individuals changed post-lesion either by increasing average IMPAS score, or by increasing variation in IMPAS score. Unilateral RLN transection resulted in dysphagia with both compromised airway protection and esophageal function. Despite consistent, experimentally controlled injury, significant variation in response to lesion remained. Aspiration following RLN lesion was due to more than unilateral vocal fold paralysis. We suggest that neurological variation underlies this pattern.

  7. FFA STUDY OF MACULAR LESIONS

    Directory of Open Access Journals (Sweden)

    K. Vinayagamurthy

    2017-08-01

    Full Text Available BACKGROUND Macula is an important portion of retina that occupies the posterior pole of retina. Any disease that affects macula results in significant loss of central vision, form vision and colour vision to an extent. Macular lesions can be hereditary as well as acquired. Macular lesions occur in both younger and older individuals. Anatomically, a macular lesions can vary from a simple lesion like an RPF defect to a vision-threatening lesions like choroidal neovascular membrane. Many screening tests that are sensitive and specific are available to assess the functioning of macula called as ‘macular function test’. But, the greater understanding of the retinal vascular led to the usage of fluorescein angiogram in the detection and screening of macular, retinovascular and optic disc lesions. Through fundus fluorescein angiogram is a thirty-year-old procedure; it is still in vogue in almost all parts of the world. It has its own merits. The aim of the study is to study the role of fluorescein angiography in the evaluation of macular lesions. MATERIALS AND METHODS A hospital-based prospective randomised study was done, which included 50 patients. Detailed patient history was taken and thorough ocular and systemic examination was done. All patients were examined by ophthalmoscopy (direct and indirect and slit-lamp examination with 90D followed by fluorescein angiography. Ophthalmoscopic and fluorescein angiography findings were analysed and categorised. Patients were advised proper ocular and systemic treatment and follow up. RESULTS 50 cases with macular lesions were analysed and categorised into conditions like ARMD, CSR, macular oedema, CME, degenerations and dystrophies and miscellaneous conditions. FFA altered the diagnosis in 8% cases and categorised the cases in all cases. 16% patients developed adverse reactions like allergy, vomiting and nausea. On statistical analysis, FFA proved to be cheap and superior diagnostic tool in confirming

  8. Incidence of ischemic lesions by diffusion-weighted imaging after carotid endarterectomy with routine shunt usage

    International Nuclear Information System (INIS)

    Inoue, Tomohiro; Tsutsumi, Kazuo; Adachi, Shinobu; Tanaka, Shota; Yako, Kyoko; Saito, Kuniaki; Kunii, Naoto; Maeda, Keiitirou

    2006-01-01

    Temporary intraluminal shunt was used during 72 consecutive carotid endarterectomies (CEAs) in 61 patients (bilateral CEA in 11 patients) during October 2001 and September 2005. The medical records of these patients were retrospectively reviewed. All procedures were performed with routine shunt insertion without monitoring such as electroencephalography. Pre- and postoperative diffusion-weighted magnetic resonance (MR) imaging was used to detect ischemic complications. Postoperative angiography was performed in 70 cases to detect abnormalities such as major stenosis or dissection of the distal end. Symptomatic ischemic complication occurred in one patient at 1 month. Postoperative diffusion-weighted MR imaging detected new hyperintense lesions in three patients including the symptomatic patient. Postoperative angiography confirmed that the distal end was satisfactory in all cases. The incidence of ischemic lesions of embolic origin after CEA with routine shunt usage is acceptably low if the procedure of shunt device insertion and removal is meticulously conducted. (author)

  9. Lesion size detection in geographic atrophy by polarization-sensitive optical coherence tomography and correlation to conventional imaging techniques.

    Science.gov (United States)

    Schütze, Christopher; Bolz, Matthias; Sayegh, Ramzi; Baumann, Bernhard; Pircher, Michael; Götzinger, Erich; Hitzenberger, Christoph K; Schmidt-Erfurth, Ursula

    2013-01-28

    To investigate the reproducibility of automated lesion size detection in patients with geographic atrophy (GA) using polarization-sensitive spectral-domain optical coherence tomography (PS-OCT) and to compare findings with scanning laser ophthalmoscopy (SLO), fundus autofluorescence (FAF), and intensity-based spectral-domain OCT (SD-OCT). Twenty-nine eyes of 22 patients with GA were examined by PS-OCT, selectively identifying the retinal pigment epithelium (RPE). A novel segmentation algorithm was applied, automatically detecting and quantifying areas of RPE atrophy. The reproducibility of the algorithm was assessed, and lesion sizes were correlated with manually delineated SLO, FAF, and intensity-based SD-OCT images to validate the clinical applicability of PS-OCT in GA evaluation. Mean GA lesion size of all patients was 5.28 mm(2) (SD: 4.92) in PS-OCT. Mean variability of individual repeatability measurements was 0.83 mm(2) (minimum: 0.05; maximum: 3.65). Mean coefficient of variation was 0.07 (min: 0.01; max: 0.19). Mean GA area in SLO (Spectralis OCT) was 5.15 mm(2) (SD: 4.72) and 2.5% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area in intensity-based SD-OCT pseudo-SLO images (Cirrus OCT) was 5.14 mm(2) (SD: 4.67) and 2.7% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area of all eyes measured 5.41 mm(2) (SD: 4.75) in FAF, deviating by 2.4% from PS-OCT results (P = 0.89, Pearson correlation coefficient = 0.99, P < 0.01). PS-OCT demonstrated high reproducibility of GA lesion size determination. Results correlated well with SLO, FAF, and intensity-based SD-OCT fundus imaging. PS-OCT may therefore be a valuable and specific imaging modality for automated GA lesion size determination in scientific studies and clinical practice.

  10. Influence of region of interest size and ultrasound lesion size on the performance of 2D shear wave elastography (SWE) in solid breast masses.

    Science.gov (United States)

    Skerl, K; Vinnicombe, S; Giannotti, E; Thomson, K; Evans, A

    2015-12-01

    To evaluate the influence of the region of interest (ROI) size and lesion diameter on the diagnostic performance of 2D shear wave elastography (SWE) of solid breast lesions. A study group of 206 consecutive patients (age range 21-92 years) with 210 solid breast lesions (70 benign, 140 malignant) who underwent core biopsy or surgical excision was evaluated. Lesions were divided into small (diameter <15 mm, n=112) and large lesions (diameter ≥15 mm, n=98). An ROI with a diameter of 1, 2, and 3 mm was positioned over the stiffest part of the lesion. The maximum elasticity (Emax), mean elasticity (Emean) and standard deviation (SD) for each ROI size were compared to the pathological outcome. Statistical analysis was undertaken using the chi-square test and receiver operating characteristic (ROC) analysis. The ROI size used has a significant impact on the performance of Emean and SD but not on Emax. Youden's indices show a correlation with the ROI size and lesion size: generally, the benign/malignant threshold is lower with increasing ROI size but higher with increasing lesion size. No single SWE parameter has superior performance. Lesion size and ROI size influence diagnostic performance. Copyright © 2015. Published by Elsevier Ltd.

  11. Effect of dependency versus nondependency on lung lesion visualization

    International Nuclear Information System (INIS)

    Pechman, R.D. Jr.

    1987-01-01

    Paraffin blocks and mineral oil were used as a model to determine the effect of dependency versus nondependency on radiographic visualization of lung lesions in lateral thoracic radiographs. It was concluded that the increased opacity of the material surrounding the lesion, not contact between the heart and the lesion, was responsible for the inability to detect lung disease in the dependent lung. The results were tested in dogs with pneumonia in the right middle lung lobe. When the dog was in right lateral recumbency, the dependent right lung was increased in opacity and decreased in volume and the pulmonary lesion was difficult to detect. When the dog was in left lateral recumbency, the non dependent right lung was increased in volume and decreased in opacity and the pulmonary disease was clearly visible. A single recumbent lateral radiograph must not be used to assess a dog with suspected lung disease because lesions in the dependent lung lobes may not be detected

  12. Photoacoustic detection and optical spectroscopy of high-intensity focused ultrasound-induced thermal lesions in biologic tissue

    Energy Technology Data Exchange (ETDEWEB)

    Alhamami, Mosa; Kolios, Michael C.; Tavakkoli, Jahan, E-mail: jtavakkoli@ryerson.ca [Department of Physics, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 (Canada)

    2014-05-15

    Purpose: The aims of this study are: (a) to investigate the capability of photoacoustic (PA) method in detecting high-intensity focused ultrasound (HIFU) treatments in muscle tissuesin vitro; and (b) to determine the optical properties of HIFU-treated and native tissues in order to assist in the interpretation of the observed contrast in PA detection of HIFU treatments. Methods: A single-element, spherically concaved HIFU transducer with a centre frequency of 1 MHz was utilized to create thermal lesions in chicken breast tissuesin vitro. To investigate the detectability of HIFU treatments photoacoustically, PA detection was performed at 720 and 845 nm on seven HIFU-treated tissue samples. Within each tissue sample, PA signals were acquired from 22 locations equally divided between two regions of interest within two volumes in tissue – a HIFU-treated volume and an untreated volume. Optical spectroscopy was then carried out on 10 HIFU-treated chicken breast specimens in the wavelength range of 500–900 nm, in 1-nm increments, using a spectrophotometer with an integrating sphere attachment. The authors’ optical spectroscopy raw data (total transmittance and diffuse reflectance) were used to obtain the optical absorption and reduced scattering coefficients of HIFU-induced thermal lesions and native tissues by employing the inverse adding-doubling method. The aforementioned interaction coefficients were subsequently used to calculate the effective attenuation coefficient and light penetration depth of HIFU-treated and native tissues in the wavelength range of 500–900 nm. Results: HIFU-treated tissues produced greater PA signals than native tissues at 720 and 845 nm. At 720 nm, the averaged ratio of the peak-to-peak PA signal amplitude of HIFU-treated tissue to that of native tissue was 3.68 ± 0.25 (mean ± standard error of the mean). At 845 nm, the averaged ratio of the peak-to-peak PA signal amplitude of HIFU-treated tissue to that of native tissue was 3.75

  13. The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

    Directory of Open Access Journals (Sweden)

    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  14. Articular cartilage damage with intramedullary lesion (bone bruise) in anterior cruciate ligament rupture

    International Nuclear Information System (INIS)

    Ide, Shuya; Ohdera, Toshihiro; Tokunaga, Masami; Hiroshima, Shiro; Yoshimoto, Eiji

    2002-01-01

    We evaluated the relationship between the intramedullary lesion on MRI and cartilage damage in patients associated with acute anterior cruciate ligament (ACL) rupture. Thirty-two cases documented by MRI and arthroscopy within one month from injury underwent ACL reconstruction using ST-G, and arthroscopy was performed again after surgery. The mean term between reconstruction and postoperative arthroscopy was twelve months. The cartilage damage on arthroscopy was compared with the intramedullary lesion on MRI. Cartilage damage was observed in 9 cases (28.1%) during the initial arthroscopy and in 16 cases (50.0%) during the second arthroscopy. Intramedullary lesion was detected in all 32 cases (total: 73 lesions) on MRI. Intramedullary lesion leading to cartilage damage was common in the geographic-type lateral femoral condyle. There was significant difference between the lateral meniscus tear and the cartilage damage of the lateral compartment. (author)

  15. Pursuing shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) for concomitant detection of breast lesions and microcalcifications

    Science.gov (United States)

    Zheng, Chao; Shao, Wanting; Paidi, Santosh Kumar; Han, Bing; Fu, Tong; Wu, Di; Bi, Lirong; Xu, Weiqing; Fan, Zhimin; Barman, Ishan

    2015-10-01

    Although tissue staining followed by morphologic identification remains the gold standard for diagnosis of most cancers, such determinations relying solely on morphology are often hampered by inter- and intra-observer variability. Vibrational spectroscopic techniques, in contrast, offer objective markers for diagnoses and can afford disease detection prior to alterations in cellular and extracellular architecture by furnishing a rapid ``omics''-like view of the biochemical status of the probed specimen. Here, we report a classification approach to concomitantly detect microcalcification status and local pathological state in breast tissue, featuring a combination of vibrational spectroscopy that focuses on the tumor and its microenvironment, and multivariate data analysis of spectral markers reflecting molecular expression. We employ the unprecedented sensitivity and exquisite molecular specificity offered by Au@SiO2 shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) to probe the presence of calcified deposits and distinguish between normal breast tissues, fibroadenoma, atypical ductal hyperplasia, ductal carcinoma in situ (DCIS), and invasive ductal carcinoma (IDC). By correlating the spectra with the corresponding histologic assessment, we developed partial least squares-discriminant analysis derived decision algorithm that provides excellent diagnostic power in the fresh frozen sections (overall accuracy of 99.4% and 93.6% using SHINs for breast lesions with and without microcalcifications, respectively). The performance of this decision algorithm is competitive with or supersedes that of analogous algorithms employing spontaneous Raman spectroscopy while enabling facile detection due to the considerably higher intensity of SHINERS. Our results pave the way for rapid tissue spectral pathology measurements using SHINERS that can offer a novel stain-free route to accurate and economical diagnoses without human interpretation.Although tissue staining

  16. Magnetic resonance imaging of spinal cord lesions in 22 multiple sclerosis patients

    International Nuclear Information System (INIS)

    Kato, Hiroshi; Funakawa, Itaru; Hara, Kenji; Yasuda, Takeshi; Terao, Akira

    1994-01-01

    We reviewed MRI findings in 22 patients (37 cases) with clinically diagnosed multiple sclerosis (MS) with spinal cord lesions. The spinal cord lesions were detected in 17 (46%) of these 37 cases on MRI. The cervical cord lesions were more detectable than other spinal cord lesions. At the thoracic level, the upper lesions were more detectable than the lower ones. In this study, no correlation was found between the disease duration, the rate of functional disturbance and the detectable rate of spinal cord lesions. The characteristic findings of the lesions were swelling and the enhancement effect of Gd-DTPA in the patient group with a disease duration of less than three years, and atrophic change in the patient group with a disease duration of greater than seven years. The period of the enhancement effect of Gd-DTPA varied in each case, and it may reflect the clinical course. Syrinx-like lesions were found in four cases. In one of them, atrophic change was found in the same region six months after the follow up study. Although the precise reason for the syrinx-like lesion was unclear, a relationship between syrinx-like lesion and atrophy of the spinal cord was suggested. The MRI findings of the spinal cord lesions in MS varied in each case and in each stage of the disease. (author)

  17. Visible and occult microscopic lesions of endometriosis

    Directory of Open Access Journals (Sweden)

    Khaleque Newaz Khan

    2014-11-01

    Full Text Available Endometriosis is a multifactorial disease mostly affecting women of reproductive age and is associated with chronic pelvic pain and infertility. Even after 300 years, most of the literature claims that pathogenesis and/or pathophysiology of endometriosis is still elusive. Recurrence of pain and lesion continues to occur after effective medical or surgical therapies. Once generated within the pelvis due to retrograde entry of menstrual debris, peritoneal endometriotic lesions time-dependently change their color appearance resulting from certain biochemical change within lesions. A variable pattern of endometriotic lesions within the pelvis can be detected by laparoscopy as visible peritoneal endometriosis. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by the innate immune system in the pelvic microenvironment by their interaction with endometrial cells and immune cells. Even with the careful eyes of an expert surgeon, we may sometimes miss detecting peritoneal lesion within the peritoneal cavity or deep into the peritoneum. In such a case, random collection of normal peritoneum may carry the possibility to identify some hidden endometriotic lesions by microscopy and these lesions can be named as occult (invisible microscopic endometriosis (OME. Here, we discuss the color appearance of peritoneal lesions and activity of these lesions by analysis of a panel of activity markers. Finally we discuss our recent findings on OME, their biological and clinical significance, and try to make a possible link in the origin between visible endometriosis and OME.

  18. Clinical application of three dimensional ultrafast MR imaging to intracerebral traumatic lesions

    International Nuclear Information System (INIS)

    Enomoto, Kyoko; Amanuma, Makoto; Hasegawa, Makoto; Watabe, Tsuneya; Heshiki, Atsuko

    1994-01-01

    We applied a T1-weighted three-dimensional (3D) magnetization-prepared rapid gradient-echo sequence (MPRAGE) for the detection of intracerebral lesions associated with closed head injuries. Thirty-four patients underwent brain MR imaging on a 1.5 Tesla superconducting MR unit. We applied an MPRAGE sequence, together with spin echo (SE) and gradient echo (GRE) sequences, and evaluated the detectability of lesions with each sequence. A total of 100 intracerebral traumatic lesions (33 cortical contusion, 56 diffuse axonal injury, 11 subcortical gray matter injury) were found. Ninety-seven percent of all lesions were detected on MPRAGE images, and 67% on SE and GRE images. The detectability of lesions in each category was 91%, 98%, and 100% on MPRAGE images, and 88%, 54%, and 73% on either SE or GRE images. 3D MPRAGE is a promising method to detect intracerebral traumatic lesions, particularly those associated with diffuse axonal injury, because of its high quality of contrast and spatial resolution and the capability of image reconstruction in any plane. (author)

  19. Roentgenologic diagnostics of capsular ligament lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, C.J.; Jaeger, M.

    1981-10-01

    The X-ray diagnostic is of obvious importance and relevance in the detection of acute or old capsular ligament lesions of the limb joint. On the one hand it serves as the plain radiograph (roentgenogram without contrast medium) for the assessment of osseous secondary lesions, for the documentation of luxationary positions of the joint partners, and in old capsular ligament lesions for the detection of an already existing arthrosis. On the other hand the X-ray images are of main importance, which are made from the hand-held limb in order to permit a comparison of the two sides, and which beyond the clinical detection of a joint instability indicate the extent and the direction of this instability and which also document it, and which allow in adolescents to recognize a separation of the epiphysis as an alternative to the capsular ligament rupture. Only in particular cases arthrography can provide some additional information, so for example in the case of an isolated syndesmosis rupture, ruptures of the rosette of the rotator muscle or of a damaged triangular disk in the hand. Angiography is only required in cases of traumatic luxations of the knee in order to exclude an intimal lesion of the popliteal artery.

  20. Immunohistochemical characterization of endometriosis-associated smooth muscle cells in human peritoneal endometriotic lesions.

    Science.gov (United States)

    Barcena de Arellano, Maria L; Gericke, Jessica; Reichelt, Uta; Okuducu, Ali Fuat; Ebert, Andreas D; Chiantera, Vito; Schneider, Achim; Mechsner, Sylvia

    2011-10-01

    Smooth muscle cells (SMC) are common components of endometriotic lesions. SMC have been characterized previously in peritoneal, ovarian and deep infiltrating endometriotic lesions and adenomyosis. The aim of this retrospective study was to investigate the extent of differentiation in endometriosis-associated SMC (EMaSMC) in peritoneal endometriotic lesions. We obtained biopsies from peritoneal endometriotic lesions (n = 60) and peritoneal sites distant from the endometriotic lesion (n = 60), as well as healthy peritoneum from patients without endometriosis (control tissue, n = 10). These controls were hysterectomy specimens from patients without endometriosis or adenomyosis. Histopathological examination of peritoneal specimens using antibodies against oxytocin receptor (OTR), vasopressin receptor (VPR), smooth muscle myosin heavy chain (SM-MHC), estrogen receptor (ER) or progesterone receptor (PR) was performed. To identify SMC and their level of differentiation, antibodies for smooth muscle actin desmin and caldesmon were used. SMC were detected in all endometriotic lesions. SMC were more abundant in unaffected peritoneum of women with endometriosis (38%) compared with women without endometriosis (6%; P endometriosis.

  1. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT

    International Nuclear Information System (INIS)

    Zhou, Yifang; Scott, Alexander II; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-01-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution’s standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R 2   >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented. (paper)

  2. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT

    Science.gov (United States)

    Zhou, Yifang; Scott, Alexander, II; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-10-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution’s standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R^2  >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented.

  3. Detection of intrathoracic infectious lesions using 111In-diethylenetriamine pentaacetic bicyclic anhydride-IgG (111In-DTPA-IgG) scintigraphy

    International Nuclear Information System (INIS)

    Ota, Tomohiro; Goto, Hajime; Wada, Hiroo; Yuasa, Kazumi; Iguchi, Mari; Okamura, Tatsuru; Ieki, Ryuji; Suzuki, Kenzo

    1998-01-01

    The utility of 111 In-DTPA-IgG imaging for the detection of intrathoracic lesions was evaluated in 10 patients with the suspicion of inflammatory or infectious diseases. They were intravenously administered 40 or 80 MBq of 111 In-DTPA-IgG, and scanned after 24 or 48 hours. Of these, 8 cases, consisted of 4 cases with pneumonia and 2 cases with lung abscess and one case of pulmonary tuberculosis and one of a tuberculous pleuritis, showed true positive results. Others were one false negative case of pneumonia and one true negative case of lung cancer. Overall sensitivity and specificity were 88.9% and 100%, respectively. There were no cases which showed side effects or abnormal laboratory findings caused by the radiopharmaceuticals administered. Thus, 111 In-DTPA-IgG imaging is a useful tool for the detection of intrathoracic infectious lesions. (author)

  4. Diagnostic imaging costs before and after digital tomosynthesis implementation in patient management after detection of suspected thoracic lesions on chest radiography.

    Science.gov (United States)

    Quaia, Emilio; Grisi, Guido; Baratella, Elisa; Cuttin, Roberto; Poillucci, Gabriele; Kus, Sara; Cova, Maria Assunta

    2014-02-01

    To evaluate diagnostic imaging costs before and after DTS implementation in patients with suspected thoracic lesions on CXR. Four hundred sixty-five patients (263 male, 202 female; age, 72.47 ± 11.33 years) with suspected thoracic lesion(s) after CXR underwent DTS. Each patient underwent CT when a pulmonary non-calcified lesion was identified by DTS while CT was not performed when a benign pulmonary or extrapulmonary lesion or pseudolesion was identified. The average per-patient imaging cost was calculated by normalising the costs before and after DTS implementation. In 229/465 patients who underwent DTS after suspicious CXR, DTS showed 193 pulmonary lesions and 36 pleural lesions, while in the remaining 236/465 patients, lesions were ruled out as pseudolesions of CXR. Chest CT examination was performed in 127/465 (27 %) patients while in the remaining 338/465 patients (73 %) CXR doubtful findings were resolved by DTS. The average per-patient costs of CXR, DTS and CT were 15.15, 41.55 and 113.66. DTS allowed an annual cost saving of 8,090.2 considering unenhanced CT and 19,298.12 considering contrast-enhanced CT. Considering a DTS reimbursement rate of 62.7 the break even point corresponds to 479 DTS examinations. Per-patient diagnostic imaging costs decreased after DTS implementation in patients with suspected thoracic lesions. • Digital tomosynthesis improves the diagnostic accuracy and confidence in chest radiography • Digital tomosynthesis reduces the need for CT for a suspected pulmonary lesion • Digital tomosynthesis requires a dose level equivalent to that of around two chest radiographies • Digital tomosynthesis produces a significant per-patient saving in diagnostic imaging costs.

  5. Radiological and surgical management of nonpalpable breast lesions

    International Nuclear Information System (INIS)

    Leinung, S.; Wuerl, P.; Preusse, C.; Boerner, P.; Schoenfelder, M.; Schneider, J.P.; Schmidt, F.; Guetz, U.

    2000-01-01

    In this retrospective study the results of surgical biopsy of suspected breast cancer in 319 outpatients are reported. In 113 cases (35.4%) the lesion was palpable, in 206 cases (64.6%) it was not. Concerning the nonpalpable lesions, mammography was performed in 98 patients (47.6%) for work-up of fibrocystic changes, in 41 patients (19.9%) for initial participation in a breast cancer prevention program, and in 33 patients (16.0%) for surveillance after breast conservation therapy. Prior to operation, 84.0% (n=173) of the nonpalpable lesions were detected by mammography, 11.2% (n=23) by sonography, and 4.8% (n=10) by magnetic resonance imaging. Intra-operative specimen mammography was carried out in every case detected by mammography. In 19.4% (n=40) of 206 nonpalpable lesions a malignant tumor was found. Twenty-five percent (n=10) of all marked tumors were diagnosed and treated as in-situ stage tumors, while 65% (n=26) were diagnosed and treated as tumors in the pT1 stage. As regards the nodal stage, 85% (n=34) of the tumors were diagnosed and treated as pN0 tumors, and 100% (n=40) were found to be free from any distant metastases. Consequently, for improving prognosis and, at the same time, for reducing the rate of breast amputations as a means of curative therapy of breast cancer, regular screening in defined risk groups is necessary. Surgical treatment of patients with small and nonpalpable findings should be reserved for departments with marking and quick-freezing facilities. (orig.) [de

  6. An improved strategy for skin lesion detection and classification using uniform segmentation and feature selection based approach.

    Science.gov (United States)

    Nasir, Muhammad; Attique Khan, Muhammad; Sharif, Muhammad; Lali, Ikram Ullah; Saba, Tanzila; Iqbal, Tassawar

    2018-02-21

    Melanoma is the deadliest type of skin cancer with highest mortality rate. However, the annihilation in early stage implies a high survival rate therefore, it demands early diagnosis. The accustomed diagnosis methods are costly and cumbersome due to the involvement of experienced experts as well as the requirements for highly equipped environment. The recent advancements in computerized solutions for these diagnoses are highly promising with improved accuracy and efficiency. In this article, we proposed a method for the classification of melanoma and benign skin lesions. Our approach integrates preprocessing, lesion segmentation, features extraction, features selection, and classification. Preprocessing is executed in the context of hair removal by DullRazor, whereas lesion texture and color information are utilized to enhance the lesion contrast. In lesion segmentation, a hybrid technique has been implemented and results are fused using additive law of probability. Serial based method is applied subsequently that extracts and fuses the traits such as color, texture, and HOG (shape). The fused features are selected afterwards by implementing a novel Boltzman Entropy method. Finally, the selected features are classified by Support Vector Machine. The proposed method is evaluated on publically available data set PH2. Our approach has provided promising results of sensitivity 97.7%, specificity 96.7%, accuracy 97.5%, and F-score 97.5%, which are significantly better than the results of existing methods available on the same data set. The proposed method detects and classifies melanoma significantly good as compared to existing methods. © 2018 Wiley Periodicals, Inc.

  7. Frequency of fungal infection in biopsies of oral mucosal lesions: A prospective hospital-based study

    Directory of Open Access Journals (Sweden)

    Thimmarasa Venkappa Bhovi

    2015-01-01

    Full Text Available Aims and Objectives: To determine the frequency and common site of fungal infection in biopsies of oral mucosal lesions and also to detect the lesions most likely to be infected with fungal infection. Materials and Methods: A total of 100 patients with oral mucosal lesions were advised routine hematological examination followed by incisional biopsy under local anesthesia. The specimen were fixed in 10% neutral buffered formalin and processed. One section from the specimen was stained with hematoxylin and eosin staining for histopathological diagnosis of the lesion and a second section was stained with Periodic acid-Schiff (PAS stain for detection of fungal infection. Results: Out of the 100 patients, the most common mucosal lesion encountered was carcinoma (56% followed by lesions with dysplastic changes (28%, benign lesions (9%, squamous papilloma (2% and oral submucous fibrosis (5%. The most common anatomic location affected by the mucosal lesions were buccal mucosa, followed by the tongue, gingiva, maxillary tuberosity and floor of the mouth with values of 73%, 16%, 6%, 4% and 1%, respectively. Squamous papilloma had the highest positive association with fungal infection (100% followed by lesions with dysplastic changes (17.9% and carcinoma (8.9%. The maximum fungal positive association was encountered in the mucosal lesions over the tongue (18.7% followed by the buccal mucosa (12.3%. Conclusion: There is statistically significant association of fungal infection with dysplastic lesions and papilloma with the tongue and buccal mucosa as the most common sites. Hence a PAS stain should be performed whenever epithelial dysplasia on the tongue and buccal mucosa is diagnosed.

  8. Computed tomography in the foramen magnum and high cervical cord lesion

    Energy Technology Data Exchange (ETDEWEB)

    Isu, T.; Ito, T.; Iwasaki, Y.; Tsuru, M. (Hokkaido Univ., Sapporo (Japan). School of Medicine); Kitaoka, K.

    1981-10-01

    The value of computed tomography in the spine and spinal cord disease recently has been well documented. However, little attention is made to the role of computed tomography in foramen magnum and high cervical cord lesion. We report 16 cases of the foramen magnum and high cervical cord lesion. Method: Either EMI Head Scanner, CT 1010 (slice thickness 10 mm) or EMI Whole Body Scanner, CT 5005 (slice thickness 13 mm) was used. In 9 cases enhanced CT with intravenous injection of contrast medium was performed. Eleven cases received intrathecal injection of metrizamide. Materials: 1) control group without cervical pathology 70 cases, 2) spinal cord tumor 6 cases, 3) atlanto-axial dislocation 6 cases, 4) Chiari malformation (type 1) 3 cases, 5) spinal foreign body (acupuncture needle) 1 case. Results: 1. plain CT. 1) In control group without cervical pathology the cervical cord at C/sub 1/ level was seen as area surrounded by ring of subarachnoid space. 2) In 14 cases except for 1 case of atlanto-axial dislocation and 1 case of spinal foreign body identification of the cervical cord at C/sub 1/ level was impossible. 3) CT was of diagnostic value in detecting altanto-axial dislocation and spinal foreign body. 2. enhanded CT. Meningioma and neurinoma showed positive contrast enhancement. However, astrocytoma and herniated cerebellar tonsils were not detectable. 3. CT metrizamide myelography visualized the subarachnoid space and made it possible to localize the lesion in the spinal canal in relation to the spinal cord. Conclusion: Attention should be given to plain CT finding at C/sub 1/ level in diagnosis of foramen magnum and high cervical cord lesion. If identification of cervical cord at C/sub 1/ level is impossible, it is suspected that subarachnoid space is blocked by the lesion, and enhanced CT and CT metrizamide myelography must be performed.

  9. Computed tomography in the foramen magnum and high cervical cord lesion

    International Nuclear Information System (INIS)

    Isu, Toyohiko; Ito, Terufumi; Iwasaki, Yoshnobu; Tsuru, Mitsuo; Kitaoka, Kenichi.

    1981-01-01

    The value of computed tomography in the spine and spinal cord disease recently has been well documented. However, little attention is made to the role of computed tomography in foramen magnum and high cervical cord lesion. We report 16 cases of the foramen magnum and high cervical cord lesion. Method: Either EMI Head Scanner, CT 1010 (slice thickness 10 mm) or EMI Whole Body Scanner, CT 5005 (slice thickness 13 mm) was used. In 9 cases enhanced CT with intravenous injection of contrast medium was performed. Eleven cases received intrathecal injection of metrizamide. Materials: 1) control group without cervical pathology 70 cases, 2) spinal cord tumor 6 cases, 3) atlanto-axial dislocation 6 cases, 4) Chiari malformation (type 1) 3 cases, 5) spinal foreign body (acupuncture needle) 1 case. Results: 1. plain CT. 1) In control group without cervical pathology the cervical cord at C 1 level was seen as area surrounded by ring of subarachnoid space. 2) In 14 cases except for 1 case of atlanto-axial dislocation and 1 case of spinal foreign body identification of the cervical cord at C 1 level was impossible. 3) CT was of diagnostic value in detecting altanto-axial dislocation and spinal foreign body. 2. enhanded CT. Meningioma and neurinoma showed positive contrast enhancement. However, astrocytoma and herniated cerebellar tonsils were not detectable. 3. CT metrizamide myelography visualized the subarachnoid space and made it possible to localize the lesion in the spinal canal in relation to the spinal cord. Conclusion: Attention should be given to plain CT finding at C 1 level in diagnosis of foramen magnum and high cervical cord lesion. If identification of cervical cord at C 1 level is impossible, it is suspected that subarachnoid space is blocked by the lesion, and enhanced CT and CT metrizamide myelography must be performed. (author)

  10. Computer-aided detection system performance on current and previous digital mammograms in patients with contralateral metachronous breast cancer

    International Nuclear Information System (INIS)

    Kim, Seung Ja; Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min

    2012-01-01

    Background: The computer-aided detection (CAD) system is widely used for screening mammography. The performance of the CAD system for contralateral breast cancer has not been reported for women with a history of breast cancer. Purpose: To retrospectively evaluate the performance of a CAD system on current and previous mammograms in patients with contralateral metachronous breast cancer. Material and Methods: During a 3-year period, 4945 postoperative patients had follow-up examinations, from whom we selected 55 women with contralateral breast cancers. Among them, 38 had visible malignant signs on the current mammograms. We analyzed the sensitivity and false-positive marks of the system on the current and previous mammograms according to lesion type and breast density. Results: The total visible lesion components on the current mammograms included 27 masses and 14 calcifications in 38 patients. The case-based sensitivity for all lesion types was 63.2% (24/38) with false-positive marks of 0.71 per patient. The lesion-based sensitivity for masses and calcifications was 59.3% (16/27) and 71.4% (10/14), respectively. The lesion-based sensitivity for masses in fatty and dense breasts was 68.8% (11/16) and 45.5% (5/11), respectively. The lesion-based sensitivity for calcifications in fatty and dense breasts was 100.0% (3/3) and 63.6% (7/11), respectively. The total visible lesion components on the previous mammograms included 13 masses and three calcifications in 16 patients, and the sensitivity for all lesion types was 31.3% (5/16) with false-positive marks of 0.81 per patient. On these mammograms, the sensitivity for masses and calcifications was 30.8% (4/13) and 33.3% (1/3), respectively. The sensitivity in fatty and dense breasts was 28.6% (2/7) and 33.3% (3/9), respectively. Conclusion: In the women with a history of breast cancer, the sensitivity of the CAD system in visible contralateral breast cancer was lower than in most previous reports using the same CAD

  11. Candida spp. in oral cancer and oral precancerous lesions.

    Science.gov (United States)

    Gall, Francesca; Colella, Giuseppe; Di Onofrio, Valeria; Rossiello, Raffaele; Angelillo, Italo Francesco; Liguori, Giorgio

    2013-07-01

    To assess the presence of Candida spp. in lesions of the oral cavity in a sample of patients with precancer or cancer of the mouth and evaluate the limitations and advantages of microbiological and histological methods, 103 subjects with precancerous or cancerous lesions and not treated were observed between 2007 and 2009. The presence of Candida in the lesions was analyzed by microbiological and histological methods. Cohen's k statistic was used to assess the agreement between culture method and staining techniques. Forty-eight (47%) patients had cancer and 55 (53%) patients had precancerous lesions. Candida spp. were isolated from 31 (30%) patients with cancerous lesions and 33 (32%) with precancerous lesions. C. albicans was the most frequent species isolated in the lesions. The k value showed a fair overall agreement for comparisons between culture method and PAS (0.2825) or GMS (0.3112). This study supports the frequent presence of Candida spp. in cancer and precancerous lesions of the oral cavity. Both microbiological investigations and histological techniques were reliable for detection of Candida spp. It would be desirable for the two techniques to be considered complementary in the detection of yeast infections in these types of lesions.

  12. Breath-hold MR imaging of focal liver lesions: comparison of fast and ultrafast techniques

    International Nuclear Information System (INIS)

    Gaa, J.; Fischer, H.

    1996-01-01

    The performance of breath-hold MR imaging using two T2-weighted hybrid sequences (TSE, TGSE), two T2-weighted single-shot sequences (HASTE, EPI-SE), and one T1-weighted gradient-echo sequence (FLASH) was compared with a standard conventional T2-weighted SE sequence in 20 patients with focal liver lesions. Liver signal-to-noise ratio was highest for the FLASH sequence (54.3±8.3) and the HASTE (41.1±12.5) sequence, whereas the highest spleen-liver contrast-to-noise ratio was obtained by the TSE sequence (38.9±20.7). Lesion-liver CNR was highest with the TSE sequence (63.9±21.4). With both TSE and HASTE significantly (p<0.01) more lesions were detected as compared with SE and EPI-SE sequences. Our results indicate that breath-hold TSE and HASTE sequences will eventually replace conventional T2-weighted SE techniques due to their insensitivity to motion artifacts, superior lesions detectability and inherently short acquisition times. (orig.)

  13. Prevalence of oral lesions in pan vendor

    Directory of Open Access Journals (Sweden)

    Prakash Gadodia

    2011-01-01

    Full Text Available Background: Being a portal of entry to various smoking and smokeless tobacco products, oral cavity is prone to deleterious effects. Present study consist of epidemiological survey to elucidate oral lesions in pan vendors. Aims and objectives: To detect oral lesions in pan vendors and compare it with controls. To detect habit pattern and prevalence of OSMF and other lesions in pan vendors as compared to controls- To identify, recognize and evaluate the possible etiology for OSMF, encompassing various chewing and smoking habits. Materials and methods: Study population consist of 170 pan vendors with age ranging from 15 to 55 years and equal number of sex matched controls selected randomly. Results: Prevalence of oral lesions in pan vendors is statistically significantly higher as compared to controls. The habit of arecanut chewing in various forms was present in all cases. The habit of smoking and smokeless tobacco products was present in all cases. Conclusion: Pan vendors are at higher risk for oral lesions than controls. There is increase in relative risk with increase in duration and frequency of habit.

  14. Automatic ultrasound image enhancement for 2D semi-automatic breast-lesion segmentation

    Science.gov (United States)

    Lu, Kongkuo; Hall, Christopher S.

    2014-03-01

    Breast cancer is the fastest growing cancer, accounting for 29%, of new cases in 2012, and second leading cause of cancer death among women in the United States and worldwide. Ultrasound (US) has been used as an indispensable tool for breast cancer detection/diagnosis and treatment. In computer-aided assistance, lesion segmentation is a preliminary but vital step, but the task is quite challenging in US images, due to imaging artifacts that complicate detection and measurement of the suspect lesions. The lesions usually present with poor boundary features and vary significantly in size, shape, and intensity distribution between cases. Automatic methods are highly application dependent while manual tracing methods are extremely time consuming and have a great deal of intra- and inter- observer variability. Semi-automatic approaches are designed to counterbalance the advantage and drawbacks of the automatic and manual methods. However, considerable user interaction might be necessary to ensure reasonable segmentation for a wide range of lesions. This work proposes an automatic enhancement approach to improve the boundary searching ability of the live wire method to reduce necessary user interaction while keeping the segmentation performance. Based on the results of segmentation of 50 2D breast lesions in US images, less user interaction is required to achieve desired accuracy, i.e. < 80%, when auto-enhancement is applied for live-wire segmentation.

  15. Extirpation of a cranial lesion radio guided by scintigraphy and intraoperative detection

    International Nuclear Information System (INIS)

    Concha Julio, Enrique; Basuri, Luciano; Otayza, Felipe; Neubauer, Sonia; Mena, Ismael; Arteaga, Maria Paz

    2005-01-01

    A skull lesion may be difficult to localize, specially a small one that is not evident on the external surface. In this paper, we describe the localization and extirpation aided by intraoperative radio guidance of a 2 cm lesion compromising the internal aspect of the posterior temporal bone. The radiological expression of this lesion was poor, both on the plain radiograph's and on the computed tomography, making the intraoperative radiology and the navigation aided by computed tomography useless. The lesion was extirpated in block and the skull repaired. The biopsy confirmed a Paget's disease. There were not surgical complications (au)

  16. Conservative approach to preneoplastic cervical lesions in postmenopause.

    Science.gov (United States)

    Vetrano, Giuseppe; Aleandri, Vincenzo; Ciolli, Paola; Scardamaglia, Paola; Pacchiarotti, Arianna; Verrico, Monica; Carboni, Simona; Corosu, Roberto

    2008-01-01

    To evaluate the recurrence rate of high-grade squamous intraepithelial lesions in postmenopausal women previously submitted to laser CO2 conization and the role of persistent oncogenic HPV types. Fifty-five patients with a cytological diagnosis of high-grade squamous intraepithelial lesions were triaged with a standard colposcopy. Hormonal replacement therapy was considered as significative in influencing cervical trophism. Vaginal smears for microbiological examination were obtained. H-R HPV test was performed by PCR. The follow-up checks including cytology, colposcopy and HVP test were performed for a minimum of 5 years. Histological analysis revealed 19 CIN2 (cervical intraepithelial lesions) and 36 CIN3 lesions. The cumulative failure rate at first treatment was 14%. HPV test was positive for HPV 16 type in all patients. Forty-two patients during the follow up checks resulted negative to cytology, colposcopy and HR HPV test. At the one-year follow-up check, 7 patients revealed normal cytological and abnormal colposcopical findings and persistent positive HR HPV test. At the five-year follow-up check, 14 patients with a normal cytological smear had a recurrence of CIN2/3 and positive HR HPV test. In postmenopause, the correct management of H-R squamous intraepithelial lesions is still debated. However, a satisfactory follow-up is the main requirement for the conservative management. HPV typing in the follow-up is important to detect persistent types to identify women at risk of developing cervical abnormalities. The incidence of cervical neoplasia does not decrease with increasing age. Since HPV positivity predicted subsequent infection, testing postmenopausal patients for the virus may be a cost-effective method of disease prevention.

  17. Comparison of Multidetector CT and Gadobutrol-Enhanced MR Imaging for Evaluation of Small, Solid Pancreatic Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Lee, Jeong Min; Kim, Jung Hoon [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Yu, Mi Hye [Department of Radiology, Konkuk University Medical Center, Seoul 05030 (Korea, Republic of); Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital, Seoul 03080 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital, Seoul 03080 (Korea, Republic of)

    2016-11-01

    To compare multidetector computed tomography (MDCT) and MRI for lesion conspicuity, as well as the detection and characterization of small solid pancreatic lesions (SPLs). 193 patients with small SPLs (< 3 cm) and 52 patients with normal pancreas who underwent both multiphasic MDCT and gadobutrol-enhanced MRI were included in our study. Two radiologists blinded to the pathologic diagnoses independently reviewed those images, and determined the detection of 'SPL per se' and 'SPL in consideration of secondary features', the lesion conspicuity, the probability of pancreatic ductal adenocarcinoma (PDAC), and the most likely specific diagnosis. The sensitivity of MRI for 'detection of SPL per se' was significantly higher than that of CT in both reviewers: 92.7% (179/193) and 97.9% (189/193), respectively, for reviewer 1 (p = 0.031) and 90.7% (175/193) and 99.5% (192/193), respectively, for reviewer 2 (p < 0.001). In addition, MRI provided better lesion conspicuity than MDCT for both reviewers (p < 0.001). However, CT and MRI did not show significant difference in sensitivity for 'detection of SPL in consideration of secondary features', specificity for SPL detection, and differentiation of PDAC vs. non-PDAC (p > 0.05). The accuracies of CT and MRI for making a specific diagnosis were as follows: 85.7% (210/245) vs. 86.9% (213/245), respectively, for reviewer 1 (p = 0.736), and 91.8% (225/245) vs. 93.5% (229/245), respectively, for reviewer 2 (p = 0.454). MRI showed better lesion conspicuity than MDCT, but did not show significantly different diagnostic performance compared with MDCT for detecting and characterizing small SPLs.

  18. Real-time PCR detection of Brucella spp. DNA in lesions and viscera of bovine carcasses.

    Science.gov (United States)

    Sola, Marília Cristina; da Veiga Jardim, Eurione A G; de Freitas, Marcius Ribeiro; de Mesquita, Albenones José

    2014-09-01

    This study reports a real-time PCR assay for the detection of Brucella spp. associated with the FTA® Elute method in lesions observed during sanitary inspections in beef slaughter. Of the total 276 samples, 78 (28.3%) tested positive and 198 (71.7%) negative for Brucella spp. The real-time PCR technique associated with the FTA® Elute method proved to be an important tool for the diagnosis, judgment about and disposal of carcasses and viscera of slaughtered animals. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Usefulness of multi-plane dynamic subtraction CT (MPDS-CT) for intracranial high density lesions

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Ryo; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

    1996-02-01

    We present a new CT technique using the high speed CT scanner in detection and evaluation of temporal and spatial contrast enhancement of intracranial high density lesions. A multi-plane dynamic subtraction CT (MPDS-CT) was performed in 21 patients with intracranial high density lesions. These lesions consisted of 10 brain tumors, 7 intracerebral hemorrhages and 4 vascular malformations (2 untreated, 2 post-embolization). Baseline study was first performed, and 5 sequential planes of covering total high density lesions were selected. After obtaining the 5 sequential CT images as mask images, three series of multi-plane dynamic CT were performed for the same 5 planes with an intravenous bolus injection of contrast medium. MPDS-CT images were reconstructed by subtracting dynamic CT images from the mask ones. MPDS-CT were compared with conventional contrast-enhanced CT. MPDS-CT images showed the definite contrast enhancement of high density brain tumors and vascular malformations which were not clearly identified on conventional contrast-enhanced CT images because of calcified or hemorrhagic lesions and embolic materials, enabling us to eliminate enhanced abnormalities with non-enhanced areas such as unusual intracerebral hemorrhages. MPDS-CT will provide us further accurate and objective information and will be greatly helpful for interpreting pathophysiologic condition. (author).

  20. CT imaging of congenital lung lesions: effect of iterative reconstruction on diagnostic performance and radiation dose

    International Nuclear Information System (INIS)

    Haggerty, Jay E.; Smith, Ethan A.; Dillman, Jonathan R.; Kunisaki, Shaun M.

    2015-01-01

    Different iterative reconstruction techniques are available for use in pediatric computed tomography (CT), but these techniques have not been systematically evaluated in infants. To determine the effect of iterative reconstruction on diagnostic performance, image quality and radiation dose in infants undergoing CT evaluation for congenital lung lesions. A retrospective review of contrast-enhanced chest CT in infants (<1 year) with congenital lung lesions was performed. CT examinations were reviewed to document the type of lung lesion, vascular anatomy, image noise measurements and image reconstruction method. CTDI vol was used to calculate size-specific dose estimates (SSDE). CT findings were correlated with intraoperative and histopathological findings. Analysis of variance and the Student's t-test were used to compare image noise measurements and radiation dose estimates between groups. Fifteen CT examinations used filtered back projection (FBP; mean age: 84 days), 15 used adaptive statistical iterative reconstruction (ASiR; mean age: 93 days), and 11 used model-based iterative reconstruction (MBIR; mean age: 98 days). Compared to operative findings, 13/15 (87%), 14/15 (93%) and 11/11 (100%) lesions were correctly characterized using FBP, ASiR and MBIR, respectively. Arterial anatomy was correctly identified in 12/15 (80%) using FBP, 13/15 (87%) using ASiR and 11/11 (100%) using MBIR. Image noise was less for MBIR vs. ASiR (P < 0.0001). Mean SSDE was different among groups (P = 0.003; FBP = 7.35 mGy, ASiR = 1.89 mGy, MBIR = 1.49 mGy). Congenital lung lesions can be adequately characterized in infants using iterative CT reconstruction techniques while maintaining image quality and lowering radiation dose. (orig.)

  1. CT imaging of congenital lung lesions: effect of iterative reconstruction on diagnostic performance and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Haggerty, Jay E.; Smith, Ethan A.; Dillman, Jonathan R. [University of Michigan Health System, Section of Pediatric Radiology, Department of Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Kunisaki, Shaun M. [University of Michigan Health System, Section of Pediatric Surgery, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

    2015-07-15

    Different iterative reconstruction techniques are available for use in pediatric computed tomography (CT), but these techniques have not been systematically evaluated in infants. To determine the effect of iterative reconstruction on diagnostic performance, image quality and radiation dose in infants undergoing CT evaluation for congenital lung lesions. A retrospective review of contrast-enhanced chest CT in infants (<1 year) with congenital lung lesions was performed. CT examinations were reviewed to document the type of lung lesion, vascular anatomy, image noise measurements and image reconstruction method. CTDI{sub vol} was used to calculate size-specific dose estimates (SSDE). CT findings were correlated with intraoperative and histopathological findings. Analysis of variance and the Student's t-test were used to compare image noise measurements and radiation dose estimates between groups. Fifteen CT examinations used filtered back projection (FBP; mean age: 84 days), 15 used adaptive statistical iterative reconstruction (ASiR; mean age: 93 days), and 11 used model-based iterative reconstruction (MBIR; mean age: 98 days). Compared to operative findings, 13/15 (87%), 14/15 (93%) and 11/11 (100%) lesions were correctly characterized using FBP, ASiR and MBIR, respectively. Arterial anatomy was correctly identified in 12/15 (80%) using FBP, 13/15 (87%) using ASiR and 11/11 (100%) using MBIR. Image noise was less for MBIR vs. ASiR (P < 0.0001). Mean SSDE was different among groups (P = 0.003; FBP = 7.35 mGy, ASiR = 1.89 mGy, MBIR = 1.49 mGy). Congenital lung lesions can be adequately characterized in infants using iterative CT reconstruction techniques while maintaining image quality and lowering radiation dose. (orig.)

  2. Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications

    International Nuclear Information System (INIS)

    Clauser, Paola; Nagl, Georg; Helbich, Thomas H.; Pinker-Domenig, Katja; Weber, Michael; Kapetas, Panagiotis; Bernathova, Maria; Baltzer, Pascal A.T.

    2016-01-01

    Highlights: • Wide scan-angle DBT alone shows a high detection rate for microcalcifications. • DBT and FFDM can characterize microcalcifications at a comparable level. • Characterization is influenced by reader and by lesion type (benign vs malignant). • DBT might be used as a stand-alone technique for the assessment of microcalcifications. - Abstract: Objectives: To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications. Methods: IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients’ history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions’ characteristics and reading time were analysed. Results: Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P = 0.510). Inter-reader differences were detected (P < 0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P = 0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25 s, respectively). Conclusion: Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen.

  3. Diagnostic performance of digital breast tomosynthesis with a wide scan angle compared to full-field digital mammography for the detection and characterization of microcalcifications

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, Paola, E-mail: paola.clauser@meduniwien.ac.at [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Nagl, Georg [Department for Radiology and Interventional Radiology, Landesklinikum Horn, Spitalgasse 10, 3580 Horn (Austria); Helbich, Thomas H., E-mail: thomas.helbich@meduniwien.ac.at [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Pinker-Domenig, Katja [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Weber, Michael [Department of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Kapetas, Panagiotis; Bernathova, Maria; Baltzer, Pascal A.T. [Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)

    2016-12-15

    Highlights: • Wide scan-angle DBT alone shows a high detection rate for microcalcifications. • DBT and FFDM can characterize microcalcifications at a comparable level. • Characterization is influenced by reader and by lesion type (benign vs malignant). • DBT might be used as a stand-alone technique for the assessment of microcalcifications. - Abstract: Objectives: To assess the diagnostic performance of digital breast tomosynthesis (DBT), with a wide scan-angle, compared to full-field digital mammography (FFDM), for the detection and characterization of microcalcifications. Methods: IRB approval was obtained for this retrospective study. We selected 150 FFDM and DBT (50 benign and 50 malignant histologically verified microcalcifications, 50 cases classified as BI-RADS 1). Four radiologists evaluated, in separate sessions and blinded to patients’ history and histology, the presence of microcalcifications. Cases with microcalcifications were assessed for visibility, characteristics, and grade of suspicion using BI-RADS categories. Detection rate and diagnostic performance were calculated. Visibility, lesions’ characteristics and reading time were analysed. Results: Detection rate and visibility were good for both FFDM and DBT, without intra-reader differences (P = 0.510). Inter-reader differences were detected (P < 0.018). Only two lesions were not detected by any reader on either FFDM or DBT. Diagnostic performance with DBT was as good as that of FFDM, but a significant inter-reader difference was found (P = 0.041). High inter-reader variability in the use of the descriptors was found. Reading time for DBT was almost twice that for FFDM (44 and 25 s, respectively). Conclusion: Wide scan-angle DBT enabled the detection and characterization of microcalcifications with no significant differences from FFDM. Inter-reader variability was seen.

  4. Impact of a new respiratory amplitude-based gating technique in evaluation of upper abdominal PET lesions

    Energy Technology Data Exchange (ETDEWEB)

    Van Der Gucht, Axel, E-mail: axel.vandergucht@gmail.com [Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco (Monaco); Serrano, Benjamin [Department of Medical Physics, Centre Hospitalier Princesse Grace, Monaco (Monaco); Hugonnet, Florent; Paulmier, Benoît [Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco (Monaco); Garnier, Nicolas [Department of Medical Physics, Centre Hospitalier Princesse Grace, Monaco (Monaco); Faraggi, Marc [Department of Nuclear Medicine, Centre Hospitalier Princesse Grace, Monaco (Monaco)

    2014-03-15

    PET acquisition requires several minutes which can lead to respiratory motion blurring, to increase partial volume effect and SUV under-estimation. To avoid these artifacts, conventional 10-min phase-based respiratory gating (PBRG) can be performed but is time-consuming and difficult with a non-compliant patient. We evaluated an automatic amplitude-based gating method (AABG) which keeps 35% of the counts at the end of expiration to minimize respiratory motion. We estimated the impact of AABG on upper abdominal lesion detectability, quantification and patient management. Methods: We consecutively included 31 patients (82 hepatic and 25 perihepatic known lesions). Each patient underwent 3 acquisitions on a Siemens Biograph mCT (4 rings and time-of-flight): a standard free-breathing whole-body (SWB, 5–7 steps/2.5 min per step, 3.3 ± 0.4 MBq/kg of 18F-FDG), a 10-min PBRG with six bins and a 5-min AABG method. All gated acquisitions were performed with an ANZAI respiratory gating system. SUV{sub max} and target to background ratio (TBR, defined as the maximum SUV of the lesion divided by the mean SUV of a region of interest drawn in healthy liver) were compared. Results: All 94 lesions in SWB images were detected in the gated images. 10-min PBRG and 5-min AABG acquisitions respectively revealed 9 and 13 new lesions and relocated 7 and 8 lesions. Four lesions revealed by 5-min AABG were missed by 10-min PBRG in 3 non-compliant patients. Both gated methods failed to relocate 2 lesions seen on SWB acquisition. Compared to SWB, TBR increased significantly with 10-min PBRG and with 5-min AABG (respectively 41 ± 59%, p = 4.10–3 and 66 ± 75%, p = 6.10–5) whereas SUV{sub max} did not (respectively 14 ± 43%, p = 0.29 with 10-min PBRG, and 24 ± 46%, p = 0.11 with 5-min AABG). Conclusion: The AABG is a fast and a user-friendly respiratory gating method to increase detectability and quantification of upper abdominal lesions compared to the conventional PBRG procedure and

  5. Cystic lesion of pancreas - Intraductal papillary mucinous neoplasm

    Directory of Open Access Journals (Sweden)

    Rajiv Baijal

    2013-01-01

    Full Text Available Intraductal papillary mucinous neoplasm (IPMN of the pancreas is an intraductal mucin-producing epithelial neoplasm that arises from the main and/or branched pancreatic duct. It usually presents as cystic lesion of pancreas. There are well known differential diagnosis of cystic pancreatic lesion. Pancreatic cystic neoplasms are detected at an increasing frequency due to an increased use of abdominal imaging. The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN of the pancreas has evolved over the past decade. IPMN represents a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. IPMN has a prognosis, which is different from adenocarcinoma of the pancreas. We report a case of a 58-year-old male with intraductal papillary neoplasm involving main duct and side branches presenting to us with clinical symptoms of chronic pancreatitis with obstructive jaundice and cholangitis treated surgically.

  6. Cone-beam computed tomography versus digital periapical radiography in the detection of artificially created periapical lesions: A pilot study of the diagnostic accuracy of endodontists using both techniques

    Energy Technology Data Exchange (ETDEWEB)

    Campello, Abdrea Fagundes; Goncalves, Lucio Souza; Marques, Fabio vidal [Faculty of Dentistry, Estacio de Sa University, Rio de Janeiro (Brazil); Guedes, Fabio Ribeiro [Faculty of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)

    2017-03-15

    The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using no.1/2, no.2, no.4, and no.6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chi-square test. The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions (P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy.

  7. Performance of T2 Maps in the Detection of Prostate Cancer.

    Science.gov (United States)

    Chatterjee, Aritrick; Devaraj, Ajit; Mathew, Melvy; Szasz, Teodora; Antic, Tatjana; Karczmar, Gregory S; Oto, Aytekin

    2018-05-03

    This study compares the performance of T2 maps in the detection of prostate cancer (PCa) in comparison to T2-weighted (T2W) magnetic resonance images. The prospective study was institutional review board approved. Consenting patients (n = 45) with histologic confirmed PCa underwent preoperative 3-T magnetic resonance imaging with or without endorectal coil. Two radiologists, working independently, marked regions of interests (ROIs) on PCa lesions separately on T2W images and T2 maps. Each ROI was assigned a score of 1-5 based on the confidence in accurately detecting cancer, with 5 being the highest confidence. Subsequently, the histologically confirmed PCa lesions (n = 112) on whole-mount sections were matched with ROIs to calculate sensitivity, positive predictive value (PPV), and radiologist confidence score. Quantitative T2 values of PCa and benign tissue ROIs were measured. Sensitivity and confidence score for PCa detection were similar for T2W images (51%, 4.5 ± 0.8) and T2 maps (52%, 4.5 ± 0.6). However, PPV was significantly higher (P = .001) for T2 maps (88%) compared to T2W (72%) images. The use of endorectal coils nominally improved sensitivity (T2W: 55 vs 47%, T2 map: 54% vs 48%) compared to the use of no endorectal coils, but not the PPV and the confidence score. Quantitative T2 values for PCa (105 ± 28 milliseconds) were significantly (P = 9.3 × 10 -14 ) lower than benign peripheral zone tissue (211 ± 71 milliseconds), with moderate significant correlation with Gleason score (ρ = -0.284). Our study shows that review of T2 maps by radiologists has similar sensitivity but higher PPV compared to T2W images. Additional quantitative information obtained from T2 maps is helpful in differentiating cancer from normal prostate tissue and determining its aggressiveness. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. Microbiomes of Endodontic-Periodontal Lesions before and after Chemomechanical Preparation.

    Science.gov (United States)

    Gomes, Brenda P F A; Berber, Vanessa B; Kokaras, Alexis S; Chen, Tsute; Paster, Bruce J

    2015-12-01

    This study was conducted to evaluate the microbiomes of endodontic-periodontal lesions before and after chemomechanical preparation (CMP). Clinical samples were taken from 15 root canals (RCs) with necrotic pulp tissues and from their associated periodontal pockets (PPs) (n = 15) of teeth with endodontic-periodontal lesions before and after CMP. The Human Oral Microbe Identification using Next Generation Sequencing (NGS) protocol and viable culture were used to analyze samples from RCs and PPs. The Mann-Whitney U test and Benjamini-Hochberg corrections were performed to correlate the clinical and radiographic findings with microbial findings (P Bacteria were detected in 100% of the samples in both sites (15/15) using NGS. Firmicutes was the most predominant phylum in both sites using both methods. The most frequently detected species in the RCs before and after CMP using NGS were Enterococcus faecalis, Parvimonas micra, Mogibacterium timidum, Filifactor alocis, and Fretibacterium fastidiosum. The species most frequently detected in the PPs before and after CMP using NGS were P. micra, E. faecalis, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia, and F. alocis. Associations were found between periapical lesions ≤ 2 mm and Desulfobulbus sp oral taxon 041 and with periodontal pockets ≥ 6 mm and Dialister invisius and Peptostreptococcus stomatis (all P periodontal lesions is complex and more diverse than previously reported. It is important to note that bacteria do survive in some root canals after CMP. Finally, the similarity between the microbiota of both sites, before and after CMP, suggests there may be a pathway of infection between the pulp and periodontium. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. Development and psychometric testing of the 'Motivation and Self-Efficacy in Early Detection of Skin Lesions' index.

    Science.gov (United States)

    Dyson, Judith; Cowdell, Fiona

    2014-12-01

    To develop and psychometrically test the Motivation and Self-Efficacy in Early Detection of Skin Lesions Index. Skin cancer is the most frequently diagnosed cancer worldwide. The primary strategy used to prevent skin cancer is promotion of sun avoidance and the use of sun protection. However, despite costly and extensive campaigns, cases of skin cancer continue to increase. If found and treated early, skin cancer is curable. Early detection is, therefore, very important. The study was conducted in 2013. Instrument Development. A literature review and a survey identified barriers (factors that hinder) and levers (factors that help) to skin self-examination. These were categorized according to a the Theoretical Domains Framework and this formed the basis of an instrument, which was tested for validity and reliability using confirmatory factor analysis and Cronbach's alpha respectively. A five-factor 20-item instrument was used that tested well for reliability and construct validity. Test-retest reliability was good for all items and domains. The five factors were: (i) Outcome expectancies; (ii) Intention; (iii) Self-efficacy; (iv) Social influences; (v) Memory. The Motivation and Self-Efficacy in Early Detection of Skin Lesions Index provides a reliable and valid method of assessing barriers and levers to skin self-examination. The next step is to design a theory-based intervention that can be tailored according to individual determinants to behaviour change identified by this instrument. © 2014 John Wiley & Sons Ltd.

  10. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  11. Clinical studies on the visualization of gastric lesions using virtual CT endoscopy

    International Nuclear Information System (INIS)

    Kim, Hideki; Takashima, Sumio; Kaminou, Toshio; Hayashi, Seisyo; Nishida, Norifumi; Matsuoka, Toshiyuki; Nakamura, Kenji; Yamada, Ryusaku

    2001-01-01

    We evaluated the clinical usefulness of virtual CT gastro endoscopy (VCTGE). The subjects were 124 patients with endoscopically identified gastric lesions. VCTGE images were obtained using a GE-Navigator. We evaluated VCTGE in the visualization of gastric lesions for their presence and morphology. The detection rate of all gastric lesions by VCTGE was 76% (94 of 124 patients). The smallest detectable early gastric cancer was II c measuring 10 x 8 mm. The detection rates of each gastric lesion by VCTGE were 73% in early gastric cancer, and 90% in advanced gastric cancer. VCTGE imaging in the advanced gastric cancer was good in 12 (30%), fair in 25 (60%) and poor in 4 (10%). VCTGE imaging in early gastric cancer was good in 20 (46%), fair in 12 (27%) and poor in 12 (27%). The significance P level was 0.005 between the evaluation of the imaging of advanced and early gastric cancer. VCTGE visualized the characteristics of diverse gastric lesions and was considered useful for the detection and the diagnosis of these lesions. (author)

  12. The Doors and People Test: The effect of frontal lobe lesions on recall and recognition memory performance

    OpenAIRE

    MacPherson, S. E.; Turner, M. S.; Bozzali, M.; Cipolotti, L.; Shallice, T.

    2016-01-01

    OBJECTIVE: Memory deficits in patients with frontal lobe lesions are most apparent on free recall tasks that require the selection, initiation, and implementation of retrieval strategies. The effect of frontal lesions on recognition memory performance is less clear with some studies reporting recognition memory impairments but others not. The majority of these studies do not directly compare recall and recognition within the same group of frontal patients, assessing only recall or recognition...

  13. Robust segmentation of focal lesions on multi-sequence MRI in multiple sclerosis

    International Nuclear Information System (INIS)

    Garcia-Lorenzo, Daniel

    2010-01-01

    Multiple sclerosis (MS) affects around 80.000 people in France. Magnetic resonance imaging (MRI) is an essential tool for diagnosis of MS and MRI-derived surrogate markers such as MS lesion volumes are often used as measures in MS clinical trials for the development of new treatments. The manual segmentation of these MS lesions is a time-consuming task that shows high inter- and intra-rater variability. We developed an automatic work flow for the segmentation of focal MS lesions on MRI. The segmentation method is based on the robust estimation of a parametric model of the intensities of the brain; lesions are detected as outliers to the model. We proposed two methods to include spatial information in the segmentation using mean shift and graph cut. We performed a quantitative evaluation of our work flow using synthetic and clinical images of two different centers to verify its accuracy and robustness. (author)

  14. Exploring DeepMedic for the purpose of segmenting white matter hyperintensity lesions

    Science.gov (United States)

    Lippert, Fiona; Cheng, Bastian; Golsari, Amir; Weiler, Florian; Gregori, Johannes; Thomalla, Götz; Klein, Jan

    2018-02-01

    DeepMedic, an open source software library based on a multi-channel multi-resolution 3D convolutional neural network, has recently been made publicly available for brain lesion segmentations. It has already been shown that segmentation tasks on MRI data of patients having traumatic brain injuries, brain tumors, and ischemic stroke lesions can be performed very well. In this paper we describe how it can efficiently be used for the purpose of detecting and segmenting white matter hyperintensity lesions. We examined if it can be applied to single-channel routine 2D FLAIR data. For evaluation, we annotated 197 datasets with different numbers and sizes of white matter hyperintensity lesions. Our experiments have shown that substantial results with respect to the segmentation quality can be achieved. Compared to the original parametrization of the DeepMedic neural network, the timings for training can be drastically reduced if adjusting corresponding training parameters, while at the same time the Dice coefficients remain nearly unchanged. This enables for performing a whole training process within a single day utilizing a NVIDIA GeForce GTX 580 graphics board which makes this library also very interesting for research purposes on low-end GPU hardware.

  15. Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement: systematic review and meta-analysis.

    Science.gov (United States)

    Saied, A M; Redant, C; El-Batouty, M; El-Lakkany, M R; El-Adl, W A; Anthonissen, J; Verdonk, R; Audenaert, E A

    2017-02-16

    Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are

  16. Computer aided detection in prostate cancer diagnostics: A promising alternative to biopsy? A retrospective study from 104 lesions with histological ground truth.

    Directory of Open Access Journals (Sweden)

    Anika Thon

    Full Text Available Prostate cancer (PCa diagnosis by means of multiparametric magnetic resonance imaging (mpMRI is a current challenge for the development of computer-aided detection (CAD tools. An innovative CAD-software (Watson Elementary™ was proposed to achieve high sensitivity and specificity, as well as to allege a correlate to Gleason grade.To assess the performance of Watson Elementary™ in automated PCa diagnosis in our hospital´s database of MRI-guided prostate biopsies.The evaluation was retrospective for 104 lesions (47 PCa, 57 benign from 79, 64.61±6.64 year old patients using 3T T2-weighted imaging, Apparent Diffusion Coefficient (ADC maps and dynamic contrast enhancement series. Watson Elementary™ utilizes signal intensity, diffusion properties and kinetic profile to compute a proportional Gleason grade predictor, termed Malignancy Attention Index (MAI. The analysis focused on (i the CAD sensitivity and specificity to classify suspect lesions and (ii the MAI correlation with the histopathological ground truth.The software revealed a sensitivity of 46.80% for PCa classification. The specificity for PCa was found to be 75.43% with a positive predictive value of 61.11%, a negative predictive value of 63.23% and a false discovery rate of 38.89%. CAD classified PCa and benign lesions with equal probability (P 0.06, χ2 test. Accordingly, receiver operating characteristic analysis suggests a poor predictive value for MAI with an area under curve of 0.65 (P 0.02, which is not superior to the performance of board certified observers. Moreover, MAI revealed no significant correlation with Gleason grade (P 0.60, Pearson´s correlation.The tested CAD software for mpMRI analysis was a weak PCa biomarker in this dataset. Targeted prostate biopsy and histology remains the gold standard for prostate cancer diagnosis.

  17. Fine-needle cytology of breast lesions seen on mammograms

    International Nuclear Information System (INIS)

    Schmidt, R.A.; Ridlen, M.S.; Dowlatshahi, K.; Jokich, P.M.; Bibbo, M.

    1989-01-01

    Stereotactic fine-needle aspiration of nonpalpable breast lesions is operator dependent. The authors have analyzed 250 biopsies at our institution (comparing aspiration cytology with surgical biopsy) for sensitivity, false-negative, and insufficient-sample rates of three different interpreters. Needle aspiration as an alternative to biopsy or a follow-up for lesions of low mammographic suspicion would have resulted in detection of most, but not all, cancers. Over 40 additional biopsies would have been needed to detect each missed cancer. Eighty percent of surgical biopsies would have been needed to detect each missed cancer. Eighty percent of surgical biopsies for low-suspicion lesions could be avoided. Aspiration cytologic series should report separately insufficient samples and LCIS, and should use a consistent threshold for interpreting cytologic results

  18. High prevalence of human papillomavirus (HPV in oral mucosal lesions of patients at the Ambulatory of Oral Diagnosis of the Federal University of Sergipe, Northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Mariana Goveia Melo RIBEIRO

    Full Text Available Abstract The role of human papillomavirus (HPV in oral carcinogenesis is still controversial as detection rates of the virus in oral cavity reported in the literature varies greatly. Objective The aim of this study was to evaluate the frequency of HPV infection and its genotypes in patients with oral lesions at the Ambulatory of Oral Diagnosis of the Federal University of Sergipe, Brazil. Material and Methods We conducted a molecular study with 21 patients (15 females aged from two to 83 years with clinically detectable oral lesions. Samples were collected through exfoliation of lesions and HPV-DNA was identified using MY09/11 and GP5+/6+ primers. Genotyping was performed by multiplex PCR. Results Benign, premalignant and malignant lesions were diagnosed by histopathology. HPV was detected in 17 samples. Of these, HPV-6 was detected in 10 samples, HPV-18 in four and HPV-16 in one sample. When samples were categorized by lesion types, HPV was detected in two papilloma cases (2/3, five carcinomas (5/6, one hyperplasia (1/1 and nine dysplasia cases (9/11. Conclusion Unlike other studies in the literature, we reported high occurrence of HPV in oral lesions. Further studies are required to enhance the comprehension of natural history of oral lesions.

  19. Fate of hypointense lesions on Gd-EOB-DTPA-enhanced magnetic resonance imaging

    International Nuclear Information System (INIS)

    Akai, Hiroyuki; Matsuda, Izuru; Kiryu, Shigeru; Tajima, Taku; Takao, Hidemasa; Watanabe, Yasushi; Imamura, Hiroshi; Kokudo, Norihiro

    2012-01-01

    Purpose: To investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. Materials and methods: Forty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5 mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed. Results: Thirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2% at 1 year, 11.1% at 2 years and 15.9% at 3 years. The total occurrence rates of classical HCC (25.8% at 1 year, 52.6% at 2 years and 76.4% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0% at 1 year, 35.6% at 2 years and 44.6% at 3 years), although no significant difference was observed (p = 0.073). Conclusions: Hypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe.

  20. Supine breast US: how to correlate breast lesions from prone MRI.

    Science.gov (United States)

    Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato A; Angelelli, Giuseppe; Moschetta, Marco

    2016-01-01

    To evaluate spatial displacement of breast lesions from prone MR to supine ultrasound positions, and to determine whether the degree of displacement may be associated with breast density and lesion histotype. 380 patients underwent breast MR and second-look ultrasound. The MR and ultrasound lesion location within the breast gland, distances from anatomical landmarks (nipple, skin and pectoral muscle), spatial displacement (distance differences from the landmarks within the same breast region) and region displacement (breast region change) were prospectively evaluated. Differences between MR and ultrasound measurements, association between the degree of spatial displacement and both breast density and lesion histotypes were calculated. In 290/380 (76%) patients, 300 MR lesions were detected. 285/300 (95%) lesions were recognized on ultrasound. By comparing MR and ultrasound, spatial displacement occurred in 183/285 (64.3%) cases while region displacement in 102/285 (35.7%) cases with a circumferential movement along an arc centred on the nipple, having supine ultrasound as the reference standard. A significant association between the degree of lesion displacement and breast density was found (p < 0.00001) with a significant higher displacement in case of fatty breasts. No significant association between the degree of displacement and lesion histotype was found (p = 0.1). Lesion spatial displacement from MRI to ultrasound may occur especially in adipose breasts. Lesion-nipple distance and circumferential displacement from the nipple need to be considered for ultrasound lesion detection. Second-look ultrasound breast lesion detection could be improved by calculating the lesion-nipple distance and considering that spatial displacement from MRI occurs with a circumferential movement along an arc centred on the nipple.

  1. Triangular fibrocartilage lesions: comparison STIR sequence versus arthroscopy findings

    International Nuclear Information System (INIS)

    Wang Zhi; Meng; Xianghong; Wang Linsen; Suo Yongmei

    2013-01-01

    Objective: To explore the diagnostic value of short TI inversion recovery (STIR) sequence in evaluating triangular fibrocartilage (TFC) lesions, and to compare the findings with the arthroscopy findings. Materials and Methods: Wrist joint MR examination using STIR sequence and arthroscopy were performed in 56 patients with TFC lesions. The parameters of STIR sequence were: TR: 1164 ms, TE: 16 ms, and TI: 90 ms. The sensibility, specificity, positive predictive value, negative predictive value, and accuracy in the diagnosis of TFC lesions with STIR sequence were calculated, using arthroscopy as the standard. Results: (1) STIR manifested 10 patients with normal TFC; 6 with small edema or mucous degeneration in the body portion but not involving joint surface edge; 6 with horizontal avulsion in the body portion, but not involving joint surface edge; 6 with avulsion involving joint surface edge; 11 with perforation in central portion; 6 with avulsion in radial attached end; 5 with avulsion in ulnar attached end; 3 with avulsion in both radial and ulnar attached ends; 3 with irregular shape and thin on the whole TFC. (2) Arthroscopy manifested 21 patients with normal TFC; 8 with avulsion involving joint surface edge; 10 with perforation in central portion; 7 with avulsion in radial attached end; 5 with avulsion in ulnar attached end; 2 with avulsion in both radial and ulnar attached ends; 3 with irregular shape on the whole TFC. Using STIR sequence, the sensibility, specificity, positive predictive value, negative predictive value. and accuracy were 85.7%, 23.8%, 65.2%, 50%, and 62.5%, respectively, in detection of TFC lesions, with arthroscopy as the standard. Conclusion: STIR sequence has high diagnostic value in detection of TFC lesions. (authors)

  2. [Study on pulmonary lesions in which nontuberculous mycobacteria were detected by percutaneous aspiration--a proposal to add "culture positivity of percutaneous aspiration material" to the bacteriological diagnostic criteria of pulmonary nontuberculous mycobacterial diseases].

    Science.gov (United States)

    Nakahara, Yasuharu; Mochizuki, Yoshiro; Kawamura, Tetsuji; Sasaki, Shin; Morimoto, Akie; Mizumori, Yasuyuki; Tsukamoto, Hiroaki; Watanabe, Etsuko; Yokoyama, Toshihide

    2013-03-01

    Culture positivity of percutaneous aspiration material" is not included in the current bacteriological criteria for diagnosis of pulmonary nontuberculous mycobacterial (NTM) diseases, which were published by the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) in 2007 or those released by the Japanese Society for Tuberculosis in 2008. However, percutaneous aspiration is a reliable technique for the detection of causative microorganisms isolated from the focus of infection. We discuss the benefits of including positive culture of percutaneous aspiration material in the bacteriological diagnostic criteria of pulmonary NTM diseases. We reviewed the radiological images and clinical courses of pulmonary diseases in which NTM cultures were obtained from percutaneously aspirated materials at our hospital from 1991 to 2011. Aspiration was carried out under local anesthesia, usually with fluoroscopic guidance. After percutaneous insertion of a 22-gauge needle attached to a 20-mL syringe containing about 3 mL of saline, the lesion specimen was withdrawn together with the saline. After the needle was pulled out, the aspirated material and saline were transferred to test tubes for cytological and microbiological examinations. In patients with thin-walled cavitary lesions, saline was injected into the cavity and then aspirated. Percutaneous aspiration was performed in 2,742 patients and NTM disease was detected in 51 patients. Of these 51 patients, 12 had solitary nodular lesions, and in many of these patients, no NTM bacilli could be detected in the sputa or bronchial washing specimens. Mycobacterium avium was identified in 10 of the 12 cases. Four of these 10 patients were followed up after their diagnosis without any treatment: 3 showed spontaneous reduction in lesion size, while 1 patient's condition remained unchanged. Four of the remaining 6 cases were treated with anti-NTM medications, and lesion size reduced in 2 cases, while no change or

  3. The Colonoscopist's Expertise Affects the Characteristics of Detected Polyps

    Directory of Open Access Journals (Sweden)

    Da Kyoung Jung

    2016-01-01

    Full Text Available Background/Aims: The influence of the endoscopist on the polyp detection rate (PDR is underappreciated in clinical practice. Moreover, flat lesions or lesions of the proximal colon are more difficult to detect. Here, we evaluated the differences in the PDR and the characteristics of detected polyps according to the experience of the colonoscopist. Methods: We collected data on 2,549 patients who underwent screening colonoscopy performed by three fellows. The PDR was calculated according to the percentage of patients who had at least one polyp (method A and according to the percentage of detected lesions (method B. The primary outcome included the change in the PDR, and the secondary outcome included the change in the characteristics of the detected polyps with increasing experience of the colonoscopist. Results: No proportional correlation was found between the PDR and increasing experience in colonoscopy with method A; however, with method B, the PDR increased after 400 colonoscopies (p=0.0209. With method B, the detection rates of small polyps (<5 mm (p=0.0015 and polyps in proximal sites (p=0.0050 increased after 300 colonoscopies. Conclusions: Our study demonstrated that the quality of a colonoscopy, measured by using the PDR, may increase when performed by experienced fellows.

  4. Continuously moving table MRI with sliding multislice for rectal cancer staging: Image quality and lesion detection

    International Nuclear Information System (INIS)

    Baumann, Tobias; Ludwig, Ute; Pache, Gregor; Fautz, Hans-Peter; Kotter, Elmar; Langer, Mathias; Schaefer, Oliver

    2010-01-01

    Purpose: To determine image quality and lesion detection of sliding multislice (SMS), a recently developed moving table MRI technique, in patients with rectal cancer. Materials and methods: Twenty-seven paired SMS (Avanto, Siemens Medical Solutions) and MDCT (Sensation 64, Siemens Medical Solutions) examinations of abdomen and pelvis were performed in patients with rectal cancer and compared for detection of liver, lymph node and bone metastases by two independent observers. A contrast-enhanced, fat saturated 2D gradient echo sequence (TE, 2.0 ms; TR, 102 ms; slice, 5 mm) was acquired with SMS and a standard contrast-enhanced protocol (100 ml 2.5 ml/s; slice, 5 mm) was used for abdominal MDCT. Standard of reference consisted of a consensus evaluation of SMS, MDCT, and all available follow-up examinations after a period of 6 months. Artifact burden and image quality of SMS was assessed in comparison to stationary gradient echo sequences obtained in an age-matched group of 27 patients. Results: Whereas SMS achieved a mean quality score of 3.65 (scale, 0-4) for the liver, representing very good diagnostic properties, strong breathing artifacts in the intestinal region were observed in 19 cases by both observers. The retroperitoneum still achieved a mean quality score of 3.52, although breathing artifacts were noted in 12 and 15 cases (observers 1 and 2, respectively). The sensitivities of SMS to detect hepatic metastases were 91.2% and 94.1% for both observers, respectively, compared to 98.5%/98.5% for MDCT. The sensitivities for lymph node metastases were 87.5%/81.3% for SMS compared to 78.1%/81.3% for MDCT. The sensitivities for bone metastases were 91.7%/100% for SMS compared to 8.3%/16.7% for MDCT. Conclusion: With slightly reduced image quality in the intestinal region, SMS exhibits equal detection of lymph node and liver metastases compared to MDCT. SMS MRI proved to be superior to MDCT in detection of bone metastases.

  5. Image processing can cause some malignant soft-tissue lesions to be missed in digital mammography images.

    Science.gov (United States)

    Warren, L M; Halling-Brown, M D; Looney, P T; Dance, D R; Wallis, M G; Given-Wilson, R M; Wilkinson, L; McAvinchey, R; Young, K C

    2017-09-01

    To investigate the effect of image processing on cancer detection in mammography. An observer study was performed using 349 digital mammography images of women with normal breasts, calcification clusters, or soft-tissue lesions including 191 subtle cancers. Images underwent two types of processing: FlavourA (standard) and FlavourB (added enhancement). Six observers located features in the breast they suspected to be cancerous (4,188 observations). Data were analysed using jackknife alternative free-response receiver operating characteristic (JAFROC) analysis. Characteristics of the cancers detected with each image processing type were investigated. For calcifications, the JAFROC figure of merit (FOM) was equal to 0.86 for both types of image processing. For soft-tissue lesions, the JAFROC FOM were better for FlavourA (0.81) than FlavourB (0.78); this difference was significant (p=0.001). Using FlavourA a greater number of cancers of all grades and sizes were detected than with FlavourB. FlavourA improved soft-tissue lesion detection in denser breasts (p=0.04 when volumetric density was over 7.5%) CONCLUSIONS: The detection of malignant soft-tissue lesions (which were primarily invasive) was significantly better with FlavourA than FlavourB image processing. This is despite FlavourB having a higher contrast appearance often preferred by radiologists. It is important that clinical choice of image processing is based on objective measures. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  6. FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening

    International Nuclear Information System (INIS)

    Peng, Nang-Jing; Chou, Chen-Pin; Pan, Huay-Ben; Chang, Tsung-Hsien; Hu, Chin; Chiu, Yu-Li; Fu, Ting-Ying; Chang, Hong-Tai

    2015-01-01

    To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[ 18 F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening. Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage. A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011). FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy.

  7. Shoulder instability: the role of MR arthrography in diagnosing anteroinferior labroligamentous lesions our experience at king hussein medical center

    International Nuclear Information System (INIS)

    Hiari, A. A.

    2008-01-01

    To determine the reliability and accuracy of magnetic resonance arthrography of the shoulder for the diagnosis of anteroinferior labroligamentous lesions in patients with gleno-humeral joint instability. This retrospective study was performed at King Hussein Medical Center in Jordan. Twenty eight patients who underwent shoulder MR arthrogram and arthroscopy during a 22-month period were reviewed. All the twenty eight patients had history of previous shoulder dislocation and clinical suspicion of anteroinferior labroligamentous lesions and glenohumeral joint instability. The series included 24 males and 4 females. The mean average age of the patients was 29 years. All patients underwent shoulder MR arthrogram and the results of MR arthrogram were compared with the arthroscopic findings which were used as the reference standard. MR arthrograms were analyzed for the presence and type of labroligamentous injuries which include (Bankart, anterior labral periosteal sleeve avulsion (ALPSA), Perthes, glenolabral articular disruption (GLAD), or nonclassifiable lesion). Sensitivity, specificity and accuracy for the detection and classification of anteroinferior labroligamentous lesions with MR arthrography were calculated. At arthroscopy, 21 anteroinferior labroligamentous lesions were diagnosed, including 15 Bankart lesions, three ALPSA lesions, two Perthes lesions and one GLAD lesion. Seven labral lesions were nonclassifiable at arthroscopy, all of which occurred after a history of chronic instability. When compared with arthroscopic findings, Shoulder MR Arthrography had two false-negative results (sensitivity, 92.8%) and no false-positive results. The sensitivity of shoulder MR Arthrography in detecting anteroinferior labroligamentous lesions was 92.8% (26/28) and specificity was (100%). The overall accuracy of Shoulder MR Arthrography in detecting labroligamentous lesions in this study was 90.5% (19/21). MR arthrography of the shoulder is reliable and accurate in

  8. An automatic system to discriminate malignant from benign massive lesions on mammograms

    International Nuclear Information System (INIS)

    Retico, A.; Delogu, P.; Fantacci, M.E.; Kasae, P.

    2006-01-01

    Mammography is widely recognized as the most reliable technique for early detection of breast cancers. Automated or semi-automated computerized classification schemes can be very useful in assisting radiologists with a second opinion about the visual diagnosis of breast lesions, thus leading to a reduction in the number of unnecessary biopsies. We present a computer-aided diagnosis (CADi) system for the characterization of massive lesions in mammograms, whose aim is to distinguish malignant from benign masses. The CADi system we realized is based on a three-stage algorithm: (a) a segmentation technique extracts the contours of the massive lesion from the image; (b) 16 features based on size and shape of the lesion are computed; (c) a neural classifier merges the features into an estimated likelihood of malignancy. A data set of 226 massive lesions (109 malignant and 117 benign) has been used in this study. The system performances have been evaluated in terms of the receiver-operating characteristic (ROC) analysis, obtaining A z =0.80+/-0.04 as the estimated area under the ROC curve

  9. Histological diagnosis of ultrasound-visible breast lesions by large core needle biopsy

    International Nuclear Information System (INIS)

    Sanchis-Querol, E.; Valeros, O.; Collado, A.; Gimenez, J.; Yanguas, C.

    1999-01-01

    We present our experience in the histological diagnosis of breast lesions using ultrasound-guided large core needle biopsy (LCNB), assessing its utility as an alternative to excisional biopsy. We have studied retrospectively a series of 146 cases involving the performance of LCNB. The results were comparable with those of FNAB in 59 cases and with those of surgical aspiration biopsy in 105. Of the 113 lesions identified as malignant by percutaneous large core needle aspiration biopsy, 96 were resected. Surgical aspiration biopsy agreed with LCNB in 100% of cases. Of the 33 lesions identified as benign by LCNB, surgical biopsy detected malignancy in 5. The results obtained establish a specificity for LCNB of 100% and a sensitivity of 96%, both of which are superior to the values for FNAB. Thus, this technique can be considered valid for preoperative diagnosis. LCNB is useful in the preoperative diagnosis of breast lesions, making FNAB and surgical biopsy unnecessary. Moreover, it constitutes a significant change in the management of patients with malignant or undetermined breast lesions. (Author) 8 refs

  10. Brain scintigraphy with Tc99-pertechnetate in the evaluation of patients with cerebrovascular lesions. The diagnostic value related to age of the lesion and to the size, type and localisation revealed by CT-scan

    DEFF Research Database (Denmark)

    Olsen, T S; Christensen, J; Skriver, E B

    1983-01-01

    Brain scintigraphy with Tc99-pertechnetate (Tc99-scan) was performed 4 times in 95 consecutive stroke patients: on average 5 days, 18 days, 103 days and 194 days after the stroke. The type (infarct, hematoma), size and localisation of the lesion was evaluated by CT-scan performed 3 times in all...... identified (90%) while infarcts localised deep in the hemisphere were identified in only 20% of the patients; (ii) the size of the lesion, i.e. large deep infarcts were seen with a much higher frequency than small deep infarcts. The detection rate of the CT-scan was practically not dependent upon the time...

  11. Sonographic findings of hepatobiliary fascioliasis accompanied by extrahepatic expansion and ectopic lesions.

    Science.gov (United States)

    Teke, Memik; Önder, Hakan; Çiçek, Mutalip; Hamidi, Cihad; Göya, Cemil; Çetinçakmak, Mehmet Güli; Hattapoğlu, Salih; Ülger, Burak Veli

    2014-12-01

    The aim of the study was to describe the sonographic findings of hepatobiliary fascioliasis with extrahepatic expansion and ectopic lesions. The study included 45 patients with fascioliasis. All diagnoses were confirmed via serologic enzyme-linked immunosorbent assays. Sonographic findings in the hepatobiliary system, extrahepatic expansion, and ectopic lesions were defined. The most common hepatic lesions were subcapsular localized, small, confluent, multiple hypoechoic nodules with poorly defined borders. We also detected ectopic lesion in 5 patients (11.1%) and live parasites in the gallbladder and bile duct in 11 (24.4%). The large spectrum of entities in the differential diagnosis of hepatobiliary fascioliasis may lead to misdiagnosis and incorrect treatment. However, the diagnosis can be made when the characteristic sonographic features are seen, such as heterogeneity of the liver with multiple poorly defined hypoechoic-isoechoic lesions and multiple echogenic nonshadowing particles in the gallbladder or common bile ducts. Nonetheless, the differential diagnosis of fascioliasis versus other hepatic lesions may still be difficult. In these situations, pathologic confirmation should be performed to exclude the possibility of malignancy. © 2013 by the American Institute of Ultrasound in Medicine.

  12. Computer-Aided Diagnosis of Different Rotator Cuff Lesions Using Shoulder Musculoskeletal Ultrasound.

    Science.gov (United States)

    Chang, Ruey-Feng; Lee, Chung-Chien; Lo, Chung-Ming

    2016-09-01

    The lifetime prevalence of shoulder pain approaches 70%, which is mostly attributable to rotator cuff lesions such as inflammation, calcific tendinitis and tears. On clinical examination, shoulder ultrasound is recommended for the detection of lesions. However, there exists inter-operator variability in diagnostic accuracy because of differences in the experience and expertise of operators. In this study, a computer-aided diagnosis (CAD) system was developed to assist ultrasound operators in diagnosing rotator cuff lesions and to improve the practicality of ultrasound examination. The collected cases included 43 cases of inflammation, 30 cases of calcific tendinitis and 26 tears. For each case, the lesion area and texture features were extracted from the entire lesions and combined in a multinomial logistic regression classifier for lesion classification. The proposed CAD achieved an accuracy of 87.9%. The individual accuracy of this CAD system was 88.4% for inflammation, 83.3% for calcific tendinitis and 92.3% for tears. Cohen's k was 0.798. On the basis of its diagnostic performance, clinical use of this CAD technique has promise. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  13. Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence.

    Science.gov (United States)

    Jaworek-Korjakowska, Joanna; Kłeczek, Paweł

    2016-01-01

    Given its propensity to metastasize, and lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Different computer-aided diagnosis (CAD) systems have been proposed to increase the specificity and sensitivity of melanoma detection. Although such computer programs are developed for different diagnostic algorithms, to the best of our knowledge, a system to classify different melanocytic lesions has not been proposed yet. In this research we present a new approach to the classification of melanocytic lesions. This work is focused not only on categorization of skin lesions as benign or malignant but also on specifying the exact type of a skin lesion including melanoma, Clark nevus, Spitz/Reed nevus, and blue nevus. The proposed automatic algorithm contains the following steps: image enhancement, lesion segmentation, feature extraction, and selection as well as classification. The algorithm has been tested on 300 dermoscopic images and achieved accuracy of 92% indicating that the proposed approach classified most of the melanocytic lesions correctly. A proposed system can not only help to precisely diagnose the type of the skin mole but also decrease the amount of biopsies and reduce the morbidity related to skin lesion excision.

  14. Comparison of Onclarity Human Papillomavirus (HPV) Assay with Hybrid Capture II HPV DNA Assay for Detection of Cervical Intraepithelial Neoplasia Grade 2 and 3 Lesions

    DEFF Research Database (Denmark)

    Bottari, F; Sideri, M; Gulmini, C

    2015-01-01

    and negative HC2 results, were prospectively enrolled for the study. The overall agreement between Onclarity and HC2 was 94.6% (95% confidence intervals [CI], 92.3% to 96.2%). In this population with a high prevalence of disease, the relative sensitivities (versus adjudicated cervical intraepithelial neoplasia......, to concurrent cytology and histology results, in order to evaluate its performance in detecting high-grade cervical lesions. A population of 567 women, including 325 with ≥ASCUS (where ASCUS stands for atypical cells of undetermined significance) and any HC2 result and 242 with both negative cytology...

  15. FLAIR lesion segmentation: Application in patients with brain tumors and acute ischemic stroke

    International Nuclear Information System (INIS)

    Artzi, Moran; Aizenstein, Orna; Jonas-Kimchi, Tali; Myers, Vicki; Hallevi, Hen; Ben Bashat, Dafna

    2013-01-01

    Background: Lesion size in fluid attenuation inversion recovery (FLAIR) images is an important clinical parameter for patient assessment and follow-up. Although manual delineation of lesion areas considered as ground truth, it is time-consuming, highly user-dependent and difficult to perform in areas of indistinct borders. In this study, an automatic methodology for FLAIR lesion segmentation is proposed, and its application in patients with brain tumors undergoing therapy; and in patients following stroke is demonstrated. Materials and methods: FLAIR lesion segmentation was performed in 57 magnetic resonance imaging (MRI) data sets obtained from 44 patients: 28 patients with primary brain tumors; 5 patients with recurrent-progressive glioblastoma (rGB) who were scanned longitudinally during anti-angiogenic therapy (18 MRI scans); and 11 patients following ischemic stroke. Results: FLAIR lesion segmentation was obtained in all patients. When compared to manual delineation, a high visual similarity was observed, with an absolute relative volume difference of 16.80% and 20.96% and a volumetric overlap error of 24.87% and 27.50% obtained for two raters: accepted values for automatic methods. Quantitative measurements of the segmented lesion volumes were in line with qualitative radiological assessment in four patients who received anti-anogiogenic drugs. In stroke patients the proposed methodology enabled identification of the ischemic lesion and differentiation from other FLAIR hyperintense areas, such as pre-existing disease. Conclusion: This study proposed a replicable methodology for FLAIR lesion detection and quantification and for discrimination between lesion of interest and pre-existing disease. Results from this study show the wide clinical applications of this methodology in research and clinical practice

  16. FLAIR lesion segmentation: Application in patients with brain tumors and acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Artzi, Moran, E-mail: artzimy@gmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Aizenstein, Orna, E-mail: ornaaize@gmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Jonas-Kimchi, Tali, E-mail: talijk@tlvmc.gov.il [Radiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Myers, Vicki, E-mail: vicki_myers@hotmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Hallevi, Hen, E-mail: hen.hallevi@gmail.com [Neurology Department, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Ben Bashat, Dafna, E-mail: dafnab@tlvmc.gov.il [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-09-15

    Background: Lesion size in fluid attenuation inversion recovery (FLAIR) images is an important clinical parameter for patient assessment and follow-up. Although manual delineation of lesion areas considered as ground truth, it is time-consuming, highly user-dependent and difficult to perform in areas of indistinct borders. In this study, an automatic methodology for FLAIR lesion segmentation is proposed, and its application in patients with brain tumors undergoing therapy; and in patients following stroke is demonstrated. Materials and methods: FLAIR lesion segmentation was performed in 57 magnetic resonance imaging (MRI) data sets obtained from 44 patients: 28 patients with primary brain tumors; 5 patients with recurrent-progressive glioblastoma (rGB) who were scanned longitudinally during anti-angiogenic therapy (18 MRI scans); and 11 patients following ischemic stroke. Results: FLAIR lesion segmentation was obtained in all patients. When compared to manual delineation, a high visual similarity was observed, with an absolute relative volume difference of 16.80% and 20.96% and a volumetric overlap error of 24.87% and 27.50% obtained for two raters: accepted values for automatic methods. Quantitative measurements of the segmented lesion volumes were in line with qualitative radiological assessment in four patients who received anti-anogiogenic drugs. In stroke patients the proposed methodology enabled identification of the ischemic lesion and differentiation from other FLAIR hyperintense areas, such as pre-existing disease. Conclusion: This study proposed a replicable methodology for FLAIR lesion detection and quantification and for discrimination between lesion of interest and pre-existing disease. Results from this study show the wide clinical applications of this methodology in research and clinical practice.

  17. Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2017-07-01

    Full Text Available Introduction: The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR value for physiological evaluation of intermediate coronary lesions.Methods: In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation, the Fractional Flow Reserve (FFR study was performed and the Quantitative Coronary Angiography (QCA data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.Results: Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%. There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013. Moreover, lesion length in physiologically significant FFR group (21.07  ± 6.9 was greater than that of the non-significant FFR group (15.23 ± 6.5 (P value < 0.05. Furthermore, the correlation between QCA data and FFR values was also investigated, yet, there was only a positive correlation between FFR and Minimum Luminal Diameter (MLD values (r = 0.248 and P value = 0.04. The Receiver Operating Characteristic (ROC curve analysis for predicting the significant FFR value demonstrated that a lesion length greater than 17.5 mm was the best cut-off point for prediction of the significant FFR value with acceptable sensitivity and specificity of 83.3% and 68.8%, respectively.Conclusions: There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.

  18. Solitary sternal lesions in breast cancer. Lesiones esternales unicas en cancer de mama

    Energy Technology Data Exchange (ETDEWEB)

    Morales, R; Cano, R; Mendoza, G [Instituto Peruano de Energia Nuclear, Lima (Peru); Guzman, C; Cotrina, M; Aguilar, C [Instituto Nacional de Enfermedades Neoplasicas, Lima (Peru)

    1993-12-01

    In a retrospective review of bone scans performed in 1740 patients with breast cancer from January 1988 to April 1993, twenty had a solitary sternal lesion. Etiology was found correlating this finding with pathology, x-rays and/or final outcome. Nineteen lesions were due to metastases and one to infection. This experience suggests that solitary sternal lesions in breast cancer patients are uncommon and are most frequently (95%) associated with malignant etiology. (Authors). 10 refs., 2 figs.

  19. Multiparametric magnetic resonance imaging of the prostate with computer-aided detection: experienced observer performance study

    Energy Technology Data Exchange (ETDEWEB)

    Giannini, Valentina; Mazzetti, Simone; Armando, Enrico; Carabalona, Silvia; Russo, Filippo [FPO, IRCCS, Department of Radiology at the Candiolo Cancer Institute, Candiolo, Turin (Italy); Giacobbe, Alessandro [San Giovanni Bosco Hospital, Department of Urology, Turin (Italy); Muto, Giovanni [University Campus Biomedico, Department of Urology, Rome (Italy); Regge, Daniele [FPO, IRCCS, Department of Radiology at the Candiolo Cancer Institute, Candiolo, Turin (Italy); University of Torino, A.O.U. Citta della Salute e della Scienza, Department of Surgical Sciences, Turin (Italy)

    2017-10-15

    To compare the performance of experienced readers in detecting prostate cancer (PCa) using likelihood maps generated by a CAD system with that of unassisted interpretation of multiparametric magnetic resonance imaging (mp-MRI). Three experienced radiologists reviewed mp-MRI prostate cases twice. First, readers observed CAD marks on a likelihood map and classified as positive those suspicious for cancer. After 6 weeks, radiologists interpreted mp-MRI examinations unassisted, using their favourite protocol. Sensitivity, specificity, reading time and interobserver variability were compared for the two reading paradigms. The dataset comprised 89 subjects of whom 35 with at least one significant PCa. Sensitivity was 80.9% (95% CI 72.1-88.0%) and 87.6% (95% CI 79.8-93.2; p = 0.105) for unassisted and CAD paradigm respectively. Sensitivity was higher with CAD for lesions with GS > 6 (91.3% vs 81.2%; p = 0.046) or diameter ≥10 mm (95.0% vs 80.0%; p = 0.006). Specificity was not affected by CAD. The average reading time with CAD was significantly lower (220 s vs 60 s; p < 0.001). Experienced readers using likelihood maps generated by a CAD scheme can detect more patients with ≥10 mm PCa lesions than unassisted MRI interpretation; overall reporting time is shorter. To gain more insight into CAD-human interaction, different reading paradigms should be investigated. (orig.)

  20. Multiparametric magnetic resonance imaging of the prostate with computer-aided detection: experienced observer performance study

    International Nuclear Information System (INIS)

    Giannini, Valentina; Mazzetti, Simone; Armando, Enrico; Carabalona, Silvia; Russo, Filippo; Giacobbe, Alessandro; Muto, Giovanni; Regge, Daniele

    2017-01-01

    To compare the performance of experienced readers in detecting prostate cancer (PCa) using likelihood maps generated by a CAD system with that of unassisted interpretation of multiparametric magnetic resonance imaging (mp-MRI). Three experienced radiologists reviewed mp-MRI prostate cases twice. First, readers observed CAD marks on a likelihood map and classified as positive those suspicious for cancer. After 6 weeks, radiologists interpreted mp-MRI examinations unassisted, using their favourite protocol. Sensitivity, specificity, reading time and interobserver variability were compared for the two reading paradigms. The dataset comprised 89 subjects of whom 35 with at least one significant PCa. Sensitivity was 80.9% (95% CI 72.1-88.0%) and 87.6% (95% CI 79.8-93.2; p = 0.105) for unassisted and CAD paradigm respectively. Sensitivity was higher with CAD for lesions with GS > 6 (91.3% vs 81.2%; p = 0.046) or diameter ≥10 mm (95.0% vs 80.0%; p = 0.006). Specificity was not affected by CAD. The average reading time with CAD was significantly lower (220 s vs 60 s; p < 0.001). Experienced readers using likelihood maps generated by a CAD scheme can detect more patients with ≥10 mm PCa lesions than unassisted MRI interpretation; overall reporting time is shorter. To gain more insight into CAD-human interaction, different reading paradigms should be investigated. (orig.)

  1. Nested PCR Assay for Detection of Leishmania donovani in Slit Aspirates from Post-Kala-Azar Dermal Leishmaniasis Lesions

    Science.gov (United States)

    Sreenivas, Gannavaram; Ansari, N. A.; Kataria, Joginder; Salotra, Poonam

    2004-01-01

    A nested PCR assay to detect parasite DNA in slit aspirates from skin lesions of patients with post-kala-azar dermal lesihmaniasis (PKDL) is described. PCR results were positive in 27 of 29 (93%) samples by nested PCR assay, while only 20 of 29 (69%) were positive in a primary PCR assay. The nested PCR assay allowed reliable diagnosis of PKDL in a noninvasive manner. PMID:15071047

  2. Nested PCR Assay for Detection of Leishmania donovani in Slit Aspirates from Post-Kala-Azar Dermal Leishmaniasis Lesions

    OpenAIRE

    Sreenivas, Gannavaram; Ansari, N. A.; Kataria, Joginder; Salotra, Poonam

    2004-01-01

    A nested PCR assay to detect parasite DNA in slit aspirates from skin lesions of patients with post-kala-azar dermal lesihmaniasis (PKDL) is described. PCR results were positive in 27 of 29 (93%) samples by nested PCR assay, while only 20 of 29 (69%) were positive in a primary PCR assay. The nested PCR assay allowed reliable diagnosis of PKDL in a noninvasive manner.

  3. OCT4 and SOX2 are reliable markers in detecting stem cells in odontogenic lesions

    Directory of Open Access Journals (Sweden)

    Abhishek Banerjee

    2016-01-01

    Full Text Available Context (Background: Stem cells are a unique subpopulation of cells in the human body with a capacity to initiate differentiation into various cell lines. Tumor stem cells (TSCs are a unique subpopulation of cells that possess the ability to initiate a neoplasm and sustain self-renewal. Epithelial stem cell (ESC markers such as octamer-binding transcription factor 4 (OCT4 and sex-determining region Y (SRY-box 2 (SOX2 are capable of identifying these stem cells expressed during the early stages of tooth development. Aims: To detect the expression of the stem cell markers OCT4 and SOX2 in the normal odontogenic tissues and the odontogenic cysts and tumors. Materials and Methods: Paraffin sections of follicular tissue, radicular cyst, dentigerous cyst, odontogenic keratocyst, ameloblastoma, adenomatoid odontogenic tumor, and ameloblastic carcinoma were obtained from the archives. The sections were subjected to immunohistochemical assay by the use of mouse monoclonal antibodies to OCT4 and SOX2. Statistical Analysis: The results were evaluated by descriptive analysis. Results: The results show the presence of stem cells in the normal and lesional tissues with these stem cell identifying markers. SOX2 was found to be more consistent and reliable in the detection of stem cells. Conclusion: The stem cell expressions are maintained in the tumor transformation of tissue and probably suggest that there is no phenotypic change of stem cells in progression from normal embryonic state to its tumor component. The quantification and localization reveals interesting trends that indicate the probable role of the cells in the pathogenesis of the lesions.

  4. Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed.

    Science.gov (United States)

    Schwock, Joerg; Ko, Hyang Mi; Dubé, Valérie; Rouzbahman, Marjan; Cesari, Matthew; Ghorab, Zeina; Geddie, William R

    2016-01-01

    Stratified mucin-producing intraepithelial lesion (SMILE) is an uncommon premalignant lesion of the uterine cervix. A detailed examination of preinvasive SMILE cases including a comparison of the cytologic features with usual-type adenocarcinoma in situ (AIS) and human papillomavirus (HPV) genotyping was performed. Excisions and preceding Papanicolaou (Pap) tests were retrieved from the files of 2 tertiary care centers. Histologic review estimated the lesional SMILE proportion. Pap tests were reviewed and assessed for architectural, cellular and background features. Cobas® HPV test was performed. 13 cases were identified. Mean/median patient age was 35/33 years (range 23-51 years). Concurrent high-grade squamous intraepithelial lesion was found in 10/13 (77%) and AIS in 8/13 (62%) cases. In 6 cases, SMILE was dominant (≥50%) and represented in 5/6 corresponding Pap tests. Cytology interpretations differed more often in the SMILE-dominant group (p < 0.05). SMILE and AIS had overlapping features. Feathering and prominent nucleoli were absent in SMILE. HPV DNA was detected in all 12 cases tested. HPV 18 was most common (7/12). Excisions with positive/suspicious margins were reported in 5/6 SMILE-dominant versus 3/7 nondominant cases. SMILE is best considered as an AIS variant for cytologic, etiologic and management purposes. Cytologic features overlap with AIS, but are more subtle and easily missed. HPV testing may play a role in facilitating SMILE detection. © 2016 S. Karger AG, Basel.

  5. Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition. Detectability for pulmonary lesions compared with respiratory-gated PET/CT

    International Nuclear Information System (INIS)

    Yamashita, Shozo; Yamamoto, Haruki; Hiko, Shigeaki; Horita, Akihiro; Yokoyama, Kunihiko; Onoguchi, Masahisa; Nakajima, Kenichi

    2014-01-01

    Deep-inspiration breath-hold (DIBH) positron emission tomography (PET)/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used. (author)

  6. Imaging pattern of calvarial lesions in adults

    Energy Technology Data Exchange (ETDEWEB)

    Garfinkle, Jarred; Melancon, Denis; Cortes, Maria; Tampieri, Donatella [Montreal Neurological Institute and Hospital-McGill University Health Center, Department of Diagnostic and Interventional Neuroradiology, Montreal, Quebec (Canada)

    2011-10-15

    Calvarial lesions often present themselves as clinically silent findings on skull radiographs or as palpable masses that may cause localized pain or soreness. This review aims to explore the radiographic, computed tomography (CT), and magnetic resonance imaging (MRI) characteristics of calvarial neoplastic, inflammatory, and congenital lesions that are common in adults in order to facilitate a structured approach to their diagnosis and limit the differential diagnosis. In addition to reviewing the literature, we reviewed the records of 141 patients of the Montreal Neurological Institute and Hospital with radiologically documented calvarial lesions between 2001 and June 2009. CT is ideal for detecting bony lesions and is helpful in precisely localizing a lesion pre-surgically. MRI is best at identifying intradiploic lesions before they affect the cortical tables and is able to establish extraosseous involvement, especially when paramagnetic contrast is employed. (orig.)

  7. OASIS is Automated Statistical Inference for Segmentation, with applications to multiple sclerosis lesion segmentation in MRI.

    Science.gov (United States)

    Sweeney, Elizabeth M; Shinohara, Russell T; Shiee, Navid; Mateen, Farrah J; Chudgar, Avni A; Cuzzocreo, Jennifer L; Calabresi, Peter A; Pham, Dzung L; Reich, Daniel S; Crainiceanu, Ciprian M

    2013-01-01

    Magnetic resonance imaging (MRI) can be used to detect lesions in the brains of multiple sclerosis (MS) patients and is essential for diagnosing the disease and monitoring its progression. In practice, lesion load is often quantified by either manual or semi-automated segmentation of MRI, which is time-consuming, costly, and associated with large inter- and intra-observer variability. We propose OASIS is Automated Statistical Inference for Segmentation (OASIS), an automated statistical method for segmenting MS lesions in MRI studies. We use logistic regression models incorporating multiple MRI modalities to estimate voxel-level probabilities of lesion presence. Intensity-normalized T1-weighted, T2-weighted, fluid-attenuated inversion recovery and proton density volumes from 131 MRI studies (98 MS subjects, 33 healthy subjects) with manual lesion segmentations were used to train and validate our model. Within this set, OASIS detected lesions with a partial area under the receiver operating characteristic curve for clinically relevant false positive rates of 1% and below of 0.59% (95% CI; [0.50%, 0.67%]) at the voxel level. An experienced MS neuroradiologist compared these segmentations to those produced by LesionTOADS, an image segmentation software that provides segmentation of both lesions and normal brain structures. For lesions, OASIS out-performed LesionTOADS in 74% (95% CI: [65%, 82%]) of cases for the 98 MS subjects. To further validate the method, we applied OASIS to 169 MRI studies acquired at a separate center. The neuroradiologist again compared the OASIS segmentations to those from LesionTOADS. For lesions, OASIS ranked higher than LesionTOADS in 77% (95% CI: [71%, 83%]) of cases. For a randomly selected subset of 50 of these studies, one additional radiologist and one neurologist also scored the images. Within this set, the neuroradiologist ranked OASIS higher than LesionTOADS in 76% (95% CI: [64%, 88%]) of cases, the neurologist 66% (95% CI: [52%, 78

  8. Segmentation of Brain Lesions in MRI and CT Scan Images: A Hybrid Approach Using k-Means Clustering and Image Morphology

    Science.gov (United States)

    Agrawal, Ritu; Sharma, Manisha; Singh, Bikesh Kumar

    2018-04-01

    Manual segmentation and analysis of lesions in medical images is time consuming and subjected to human errors. Automated segmentation has thus gained significant attention in recent years. This article presents a hybrid approach for brain lesion segmentation in different imaging modalities by combining median filter, k means clustering, Sobel edge detection and morphological operations. Median filter is an essential pre-processing step and is used to remove impulsive noise from the acquired brain images followed by k-means segmentation, Sobel edge detection and morphological processing. The performance of proposed automated system is tested on standard datasets using performance measures such as segmentation accuracy and execution time. The proposed method achieves a high accuracy of 94% when compared with manual delineation performed by an expert radiologist. Furthermore, the statistical significance test between lesion segmented using automated approach and that by expert delineation using ANOVA and correlation coefficient achieved high significance values of 0.986 and 1 respectively. The experimental results obtained are discussed in lieu of some recently reported studies.

  9. Clinical performance of {sup 68}Ga-PSMA-11 PET/MRI for the detection of recurrent prostate cancer following radical prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kranzbuehler, Benedikt; Eberli, Daniel [University of Zuerich, Department of Urology, University Hospital Zuerich, Zuerich (Switzerland); Nagel, Hannes; Mueller, Julian; Huellner, Martin; Stolzmann, Paul; Muehlematter, Urs; Kaufmann, Philipp A.; Burger, Irene A. [University of Zuerich, Department of Nuclear Medicine, University Hospital Zuerich, Zuerich (Switzerland); Becker, Anton S. [University of Zuerich, Department of Radiology, University Hospital Zuerich, Zuerich (Switzerland); Guckenberger, Matthias [University of Zuerich, Department of Radiation Oncology, University Hospital Zuerich, Zuerich (Switzerland)

    2018-01-15

    Sensitive visualization of recurrent prostate cancer foci is a challenge in patients with early biochemical recurrence (EBR). The recently established {sup 68}Ga-PSMA-11 PET/CT has significantly improved the detection rate with published values of up to 55% for patients with a serum PSA concentration between 0.2-0.5 ng/mL. The increased soft tissue contrast in the pelvis using simultaneous {sup 68}Ga-PSMA-11 PET/MRI might further improve the detection rate in patients with EBR and low PSA values over PET/CT. We retrospectively analyzed a cohort of 56 consecutive patients who underwent a {sup 68}Ga-PSMA-11 PET/MRI for biochemical recurrence in our institution between April and December 2016 with three readers. Median PSA level was 0.99 ng/mL (interquartile range: 3.1 ng/mL). Detection of PSMA-positive lesions within the prostate fossa, local and distant lymph nodes, bones, or visceral organs was recorded. Agreement among observers was evaluated with Fleiss's kappa (k). Overall, in 44 of 56 patients (78.6%) PSMA-positive lesions were detected. In four of nine patients (44.4%) with a PSA < 0.2 ng/mL, suspicious lesions were detected (two pelvic and one paraaortic lymph nodes, and two bone metastases). In eight of 11 patients (72.7%) with a PSA between 0.2 and < 0.5 ng/mL, suspicious lesions were detected (two local recurrences, six lymph nodes, and one bone metastasis). Five out of 20 patients with a PSA < 0.5 ng/mL had extrapelvic disease. In 12 of 15 patients (80.0%) with a PSA between 0.5 and < 2.0 ng/mL, suspicious lesions were detected (four local recurrences, nine lymph nodes, and four bone metastases). In 20 of 21 patients (95.2%) with a PSA >2.0 ng/mL, suspicious lesions were detected. The overall interreader agreement for cancer detection was excellent (κ = 0.796, CI 0.645-0.947). Our data show that {sup 68}Ga-PSMA-11 PET/MRI has a high detection rate for recurrent prostate cancer even at very low PSA levels <0.5 ng/mL. Furthermore, even at those low

  10. Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting

    OpenAIRE

    Schaal, Marysa; Severac, Fran?ois; Labani, Aissam; Jeung, Mi-Young; Roy, Catherine; Ohana, Micka?l

    2016-01-01

    Objective To evaluate the diagnostic performance of Ultra-Low-Dose Chest CT (ULD CT) for the detection of any asbestos-related lesions (primary endpoint) and specific asbestos-related abnormalities, i.e. non-calcified and calcified pleural plaques, diffuse pleural thickening, asbestosis and significant lung nodules (secondary endpoints). Material and Methods 55 male patients (55.7?8.1 years old) with occupational asbestos exposure for at least 15 years and where CT screening was indicated wer...

  11. Significance of angio-CT on diagnosis for hepatocellular carcinoma and precancerous lesions

    International Nuclear Information System (INIS)

    Hatsuse, Kazuo; Aoki, Hideki; Murayama, Michinori; Aihara, Tsukasa; Tsuboi, Kenji; Kakihara, Minoru; Tamakuma, Syoetsu; Irie, Toshiyuki; Terahata, Shintarou

    1994-01-01

    Fifteen patients with space occupying lesions detected by ultrasonography or computed tomography during angiography (angio-CT). Detectability and diagnostic value of angio-CT for intrahepatic tumor were evaluated in comparison with conventional imaging techniques including digital subtraction angiography (DSA), magnetic resonance imaging (MRI) and lipiodol CT (Lp-CT). Twenty-three lesions detected in 15 patients were as follows: 14 hepatocellular carcinoma (HCC), 3 adenomatous hyperplasia (AH), one early hepatocellular carcinoma (eHCC), one atypical adenomatous hyperplasia (AAH), one regenerative nodule, and 3 miscellaneous lesions. With regard to 8 patients with 2 lesions, there were 2 AHs in one patient and 4 patients with advanced HCC had small HCC, eHCC, AH and AAH, respectively. These findings are suggestive of the presence of multicentric carcinogenesis in cirrhosis. The detection rate for intrahepatic tumors was 86.9% with angio-CT, 56.5% with DSA, 71.4% with MRI and 50% with Lp-CT. The detection rate for eHCC, AH and AAH was 80% with angio-CT, and 20% with DSA, MRI and Lp-CT. Angio-CT visualized AH regarded as a precancerous lesion and eHCC more frequently than other imaging techniques. The above mentioned data suggested that there was such a frequent occurrence of multicentric carcinogenesis that recognition of precancerous lesion by angio-CT was important in surgical intervention for HCC with liver cirrhosis. (author)

  12. MRI of degenerative bone marrow lesions in experimental osteoarthritis of canine knee joints

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.C.A. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Adam, G. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Buehne, M. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Aachen (Germany); Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany)

    1996-07-01

    Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo (2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography. Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated 9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images, sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from most non-degenerative subarticular lesions. (orig.). With 1 tab.

  13. Myocardial perfusion scintigraphy fi ndings in patients with mild coronary atherosclerotic lesions on coronary angiography

    Directory of Open Access Journals (Sweden)

    Zeki Dostbil

    2010-09-01

    Full Text Available Objectives: Myocardial perfusion scintigraphy (MPS iswidely used in functional assessment of myocardial per-fusion. But, some study results are in contradiction withseverity of coronary artery disease detected by coronaryangiography (CA. It is frequently encountered case thatCA is completely normal whereas MPS describes isch-emia. In this study, we aimed to investigate whether mildatherosclerotic lesions cause ischemia.Materials and methods: MPS with 99mTc-MIBI was per-formed in 52 patients who applied to cardiology clinics forhistory of chest pain and underwent diagnostic CA within3 months.Results: In 22 of 52 patients with mild atherosclerotic le-sions, ischemia in various degrees was detected on MPS.In statistical analysis, any signifi cant relationship was notfound between ischemia and gender, hypertension, DM,dyslipidemia, smoking, mitral valve insuffi ciency, left ven-tricular hypertrophy, exercise testing result and affectedcoronary artery.Conclusion: Our study fi ndings have shown that mild ath-erosclerotic lesions even at very early stage may causemyocardial ischemia

  14. Indirect MR arthrography of the wrist in the diagnosis of TFCC-lesions

    International Nuclear Information System (INIS)

    Herold, T.; Lenhart, M.; Held, P.; Feuerbach, S.; Link, J.; Babel, M.; Ruf, S.

    2001-01-01

    Purpose: The objective of this prospective study was to assess the value of the indirect MR arthrography (MR-AR) of the wrist in the detection of lesions of the TFCC. Material and methods: Indirect MR-AR was performed in 45 patients (23 f/22 m) with unclear ulnar wrist pain. After i.v. injection of 0.1 mmol/kg Gd-DTPA and after a motion-phase of the wrist (15 minutes) MRI was performed in a coronal plane. We used a STIR-, a fatsaturated (fs) T1-SE and a 3D-DESS sequence. The images were evaluated by two radiologists using a consensus score. The lesions were assigned to the system of Palmer and correlated with arthroscopy. Results: Indirect MR-AR showed in 35 of 45 patients a lesion of the TFCC, but arthroscopy only revealed a defect in 32 cases. This means three false positive but no false negative assessments by MRI. Using this MRI protocol sensitivity and specificity in the detection of TFCC lesions were calculated as 100% and 77%. The accuracy was 93%. Small degenerative changes of the fibres were most common (Palmer type IIA). In trauma patients the ligaments usually showed tears near the insertion at the ulna (Palmer type IB). The sensitivity and specificity was 88% and 95% for evaluation of the scapho-lunate (SL) ligament, the accuracy was 93%. Arthroscopy and MRI did not diagnose any rupture of the lunate-triquetral (LT) ligament. Conclusion: Indirect MR-AR is a non-invasive method with a high sensitivity in the evaluation of the TFCC and associated injuries. Therefore, it is an excellent screening procedure to assess the indication for therapeutic arthroscopy. (orig.) [de

  15. Prevalence of oral lesions among Saudi dental patients

    International Nuclear Information System (INIS)

    AlMobeeriek, Azizah; AlDosari, Abdullah M

    2009-01-01

    Few studies have been conducted in the Saudi population on oral mucosal lesions. The purpose of this study was to evaluate the type and extent of oral lesions in a study among dental patients at a college of dentistry in Saudi Arabia. Over a 3-year period, 2552 dental outpatients were interviewed and investigated clinically for the presence of oral mucosal conditions. A thorough oral clinical examination was performed, including a radiographic examination. The diagnosis was confirmed histopathologically when necessary. Of 383 (15.0%) patients found to have oral mucosal lesions, females constituted 57.7% (n=221) and males 42.3% (n=162). The age range of the patients was between 15 to 73 years with a mean age of 38.2 years. The most commonly affected age group was 31 to 40 years, which comprised 21.4% (n=82) of all affected individuals. The least affected age group were individuals older than 61 years. The most common lesion was Fordyce granules (3.8%; n=98), followed by leukoedema (3.4%; n=86) and traumatic lesions (ulcer, erosion) in 1.9% (n=48). Tongue abnormalities were present in 4.0% (n=101) of all oral conditions observed, ranging from 1.4% (n=36) for fissured tongue to 0.1% (n=2) for bifid tongue. Other findings detected were torous platinus (1.3%; n=34), mandibular tori (0.1%; n=2) aphthous ulcer (0.4%; n=10), herpes simplex (0.3%; n=7), frictional hyperkeratosis (0.9%; n=23), melanosis (0.6%; n=14), lichen planus (0.3%; n=9) and nicotinic stomatitis (0.5%; n=13). The findings of this study provide information on the types and prevalence of oral lesions among Saudi dental patients. This provides baseline data for future studies about the prevalence of oral lesions in the general population. (author)

  16. Pediatric Awake Craniotomy for Brain Lesions.

    Science.gov (United States)

    Akay, Ali; Rükşen, Mete; Çetin, H Yurday; Seval, H Özer; İşlekel, Sertaç

    2016-01-01

    Awake craniotomy is a special method to prevent motor deficits during the resection of lesions that are located in, or close to, functional areas. Although it is more commonly performed in adult patients, reports of pediatric cases undergoing awake craniotomy are limited in the literature. In our clinic, where we frequently use awake craniotomy in adult patients, we performed this method in 2 selected pediatric cases for lesion surgery. At an early age, these 2 cases diagnosed with epilepsy presented cerebral lesions, but since the lesions enclosed functional areas, surgical resection was not regarded as a treatment option at this time. In these 2 pediatric cases, we successfully completed lesion surgery with awake craniotomy. The method and the techniques employed during surgery are presented concomitant with other reports in the literature. © 2016 S. Karger AG, Basel.

  17. Clinical and analytical performance of the BD Onclarity™ HPV assay for detection of CIN2+ lesions on SurePath samples

    DEFF Research Database (Denmark)

    Ejegod, Ditte Møller; Junge, Jette; Franzmann, Maria

    2016-01-01

    BACKGROUND: The novel BD Onclarity(TM) HPV assay (Onclarity) on the BD Viper™ LT system (BD Diagnostics, Sparks, MD), detects E6/E7 DNA from 13 high-risk HPV genotypes and HPV66. We compared the analytical and clinical performance of the Onclarity Assay to that of Hybrid Capture 2 and LINEAR ARRAY...

  18. Technetium-99m labeled monoclonal antibodies in the detection of metastatic melanoma

    International Nuclear Information System (INIS)

    Serafini, A.N.; Kotler, J.; Feun, L.; Dewanjee, M.; Robinson, D.; Salk, D.; Sfakianakis, G.; Abrams, P.; Savaraj, N.; Goodwin, D.

    1989-01-01

    Twenty-six stage II/III malignant melanoma patients with 321 measurable metastatic lesions were imaged using Fab fragments of an IgG murine monoclonal antibody labeled specifically with 10-30 mCi Tc-99m with a bi-functional chelating method (NeoRx, Seattle, WA). There were no side effects or adverse reactions. Immunoscintigraphy demonstrated 66.6% of lesions larger than 1 cm and 92.5% of lesions larger than 3 cm. Most frequently detected metastases were in lymph nodes, subcutaneous areas, and bone. Of lesions less than 1 cm, 23.6% were detected if superficial cutaneous lesions were excluded. The smallest detectable lesion was 4 mm. Twenty-one additional clinically unsuspected sites were visualized in 12 of the 26 patients studied. Of these, 56% were confirmed as metastasis by other tests. There were apparent nonspecific localizations owing to other causes, including fracture, varicosities, skin abscess and pneumonitis. Increased experience in image analysis facilitates correct interpretation of these localizations. This study demonstrates that imaging with Tc-99m labeled antibody fragments detects melanoma lesions in organs routinely surveyed and in other areas not routinely assessed by other imaging techniques. The procedure is readily performed and safe. The principal advantage of the test is its ability to survey the entire body and all organs with a single test. Its principal limitation, in common with other diagnostic imaging procedures, is its poor sensitivity for detecting lesions less than 1 cm

  19. Effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up

    International Nuclear Information System (INIS)

    Masroor, I.

    2008-01-01

    To determine the effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up. Women undergoing X-ray mammography and assigned BI-RADS category-3 and recommended short-term (6-monthly) follow-up were included. Out of these, 44 patients were lost to follow-up and were excluded from the study. The lesions that remained stable after short-term follow-up were recommended routine (annual) follow-up. Needle localization and open surgical biopsy was performed, if the lesion progressed or calcifications increased in number/size and/or on physician or patient preference. The effectiveness of this approach was analyzed by determining the sensitivity, specificity, positive and negative predictive value for BI-RADS category-3. Of the 65 lesions, 55 remained stable. Of the remaining 10 lesions, two showed increase in number of microcalcification prompting biopsy. Both turned out to be ductal carcinoma in situ. Eight biopsies were performed on clinician or patient preference which turned out to be benign. The sensitivity, specificity, positive and negative predictive values were 100%, 87%, 20% and 100% respectively. Assessment with short-interval mammographic follow-up is useful to confirm the nature of most non-palpable breast lesions considered probably benign and permits detection of a small number of breast cancers at an early stage. The local setup, patient compliance is a major limitation for performing a follow-up study, as the available numbers can have a profound effect on the determined accuracy value. (author)

  20. Detection of secondary involvement of the colon from gastric carcinoma

    International Nuclear Information System (INIS)

    Miyakawa, Kunihisa

    1994-01-01

    A comparative study with CT and barium enema (BE) was performed on 60 patients (121 lesions) with secondary involvement to the colon from gastric carcinoma. The lesions were visualized as abnormally thick colonic walls (more than 5 mm in thickness) on CT as well as stenotic or striped appearance on BE. The colonic lesions were equally detected by CT and BE in 49 patients (103 lesions). Although CT was superior to BE in only one patient (one lesion), BE was more accurated in 10 patients (17 lesions). CT failed to demonstrate early changes of secondary involvement to the colon. The presence of ascites or mesenteric abnormalities was not detected by CT in 15 patients, even though spread of gastric carcinoma to the colon mainly occurred by the direct invasion along mesenteric reflections or intraperitoneal seeding. As a conclusion, it was found that BE was more accurate for the detection of secondary involvement to the colon from gastric carcinoma comparing to CT. Normal findings on CT did not eliminate the possibility of colonic metastasis, therefore, BE study was desirable if clinical findings suggest the involvement of colonic metastasis. (author)

  1. Assessment of enamel-dentin caries lesions detection using bitewing PSP digital images

    Directory of Open Access Journals (Sweden)

    Marianna Guanaes Gomes Torres

    2011-10-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the detection of enamel-dentin occlusal caries using photostimulable phosphor plates. MATERIAL AND METHODS: The ability to detect enamel-dentin occlusal caries in 607 premolars and molars from 47 patients between 10 and 18 years old, referred to the School of Dentistry of the Federal University of Bahia, Brazil, was evaluated based on clinical and radiographic examinations, using the criteria proposed in a previous study. A total of 156 bitewing digital images were obtained using Digora® (Soredex Medical Systems, Helsinki, Finland phosphor plates. The plates were scanned and the images were captured and displayed on a computer screen. Image evaluation was done using Digora® for Windows 2.1 software, Soredex®. The radiologists were allowed to use enhancement tools to obtain better visibility during scoring of the teeth based on the radiographic criteria proposed in a previous study. Descriptive analysis and chi-squared proportion tests were done at 5% significance level. RESULTS: The results of clinical examination showed a higher prevalence of teeth with a straight dark line or demineralization of the occlusal fissure (score 1 and a lower prevalence of sealed teeth (score 5. In the bitewing digital images, 47 teeth presented visible radiolucency, circumscribed, in dentin under occlusal enamel (enamel-dentin caries lesions. CONCLUSIONS: Correlating the clinical and radiographic findings, it was found that in the majority of teeth diagnosed by radiographic images as having enamel-dentin caries, no caries could be detected by clinical examination.

  2. Optical coherence tomography (OCT) evaluation of intermediate coronary lesions in patients with NSTEMI

    Energy Technology Data Exchange (ETDEWEB)

    Bogale, Nigussie, E-mail: nigussie.bogale@lyse.net [Stavanger University Hospital, Stavanger (Norway); Vancouver General Hospital, Vancouver, BC (Canada); Lempereur, Mathieu; Sheikh, Imran; Wood, David; Saw, Jacqueline; Fung, Anthony [Vancouver General Hospital, Vancouver, BC (Canada)

    2016-03-15

    Introduction: Coronary angiography is commonly performed following non-ST segment elevation myocardial infarction (NSTEMI) to assess the need for revascularization. Some of these patients have myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA). Patients without severe obstructive lesions are usually treated conservatively. However, coronary angiography has known limitations in the assessment of lesion severity. We report our experience of using coronary Optical Coherence Tomography (OCT) in a series of patients without severe obstructive coronary lesions. Methods: 165 patients underwent coronary OCT at Vancouver General Hospital. NSTEMI was the clinical presentation in 70 patients and 26 had angiographically intermediate lesions with 40%–69% diameter stenosis. Prior to OCT image acquisition, intracoronary nitroglycerin 100–200 μg was administered. Blood in the vessel was displaced using contrast media by manual injections. Results: OCT of the angiographically intermediate lesions showed larger minimal luminal area (MLA) than the angiographically severe lesions (MLA 3.3 mm{sup 2} ± 1.8 mm{sup 2} vs. 1.6 mm{sup 2} ± 0.6 mm{sup 2}, p < 0.001) and less severe % lumen area stenosis (54.2% ± 11.4% vs. 70.9% ± 6.8%, p = 0.001). Plaque rupture or intracoronary thrombus was detected in 8/26 (31%) patients. PCI with stent deployment was performed in 16 patients (62%). Conclusion: In stabilized patients with NSTEMI and angiographically intermediate disease, OCT examination confirmed the lack of severe anatomical stenosis in most patients. However, OCT also identified coronary lesions with unstable features. Further research is needed to help guide management of this subgroup of patients.

  3. Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence

    Directory of Open Access Journals (Sweden)

    Joanna Jaworek-Korjakowska

    2016-01-01

    Full Text Available Background. Given its propensity to metastasize, and lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Different computer-aided diagnosis (CAD systems have been proposed to increase the specificity and sensitivity of melanoma detection. Although such computer programs are developed for different diagnostic algorithms, to the best of our knowledge, a system to classify different melanocytic lesions has not been proposed yet. Method. In this research we present a new approach to the classification of melanocytic lesions. This work is focused not only on categorization of skin lesions as benign or malignant but also on specifying the exact type of a skin lesion including melanoma, Clark nevus, Spitz/Reed nevus, and blue nevus. The proposed automatic algorithm contains the following steps: image enhancement, lesion segmentation, feature extraction, and selection as well as classification. Results. The algorithm has been tested on 300 dermoscopic images and achieved accuracy of 92% indicating that the proposed approach classified most of the melanocytic lesions correctly. Conclusions. A proposed system can not only help to precisely diagnose the type of the skin mole but also decrease the amount of biopsies and reduce the morbidity related to skin lesion excision.

  4. Comparison of a conventional cardiac-triggered dual spin-echo and a fast STIR sequence in detection of spinal cord lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    Bot, J.C.J.; Barkhof, F.; Lycklama a Nijeholt, G.J.; Bergers, E.; Castelijns, J.A.; Polman, C.H.; Ader, H.J.

    2000-01-01

    The current optimal imaging protocol in spinal cord MR imaging in patients with multiple sclerosis includes a long TR conventional spin-echo (CSE) sequence, requiring long acquisition times. Using short tau inversion recovery fast spin-echo (fast STIR) sequences both acquisition time can be shortened and sensitivity in the detection of multiple sclerosis (MS) abnormalities can be increased. This study compares both sequences for the potential to detect both focal and diffuse spinal abnormalities. Spinal cords of 5 volunteers and 20 MS patients were studied at 1.0 T. Magnetic resonance imaging included cardiac-gated sagittal dual-echo CSE and a cardiac-gated fast STIR sequence. Images were scored regarding number, size, and location of focal lesions, diffuse abnormalities and presence/hindrance of artifacts by two experienced radiologists. Examinations were scored as being definitely normal, indeterminate, or definitely abnormal. Interobserver agreement regarding focal lesions was higher for CSE (κ=0.67) than for fast STIR (κ=0.57) but did not differ significantly. Of all focal lesions scored in consensus, 47 % were scored on both sequences, 31 % were only detected by fast STIR, and 22 % only by dual-echo CSE (n. s.). Interobserver agreement for diffuse abnormalities was lower with fast STIR (κ=0.48) than dual-echo CSE (κ=0.65; n. s.). After consensus, fast STIR showed in 10 patients diffuse abnormalities and dual-echo CSE in 3. After consensus, in 19 of 20 patients dual-echo CSE scans were considered as definitely abnormal compared with 17 for fast STIR. The fast STIR sequence is a useful adjunct to dual-echo CSE in detecting focal abnormalities and is helpful in detecting diffuse MS abnormalities in the spinal cord. Due to the frequent occurrence of artifacts and the lower observer concordance, fast STIR cannot be used alone. (orig.)

  5. Herpesviruses in asymptomatic apical periodontitis lesions: an immunohistochemical approach.

    Science.gov (United States)

    Saboia-Dantas, C J; Coutrin de Toledo, L F; Sampaio-Filho, H R; Siqueira, J F

    2007-10-01

    Human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) have been recently detected in samples from apical periodontitis lesions by means of molecular biology techniques and a role in the pathogenesis of this disease has been suggested. The present study was designed to survey asymptomatic primary apical periodontitis lesions for the presence of HCMV- and/or EBV-infected cells by means of immunohistochemistry. Apical periodontitis lesions were obtained from 35 patients [26 human immunodeficiency virus (HIV) -seronegative patients and nine HIV-seropositive patients] after tooth extraction and subjected to immunohistochemical analysis using monoclonal antibodies specific for HCMV and EBV. Fifteen of the 35 apical periodontitis lesions were positive for the target herpesviruses. Overall, EBV was found in 31% of the samples and HCMV in 23%, with 14% of the lesions showing EBV and HCMV dual infection. No association was found between HCMV or EBV with any particular histopathological type of apical periodontitis (P > 0.05). HCMV was significantly more frequent in apical periodontitis lesions from HIV-positive patients (67%) than in lesions from HIV-negative patients (8%) (P = 0.001). EBV was detected in 44% of lesions from HIV-positive patients and in 27% of lesions from HIV-negative patients, but this difference was not significant (P = 0.91). Our results showed that cells infected by HCMV and EBV can be found in apical periodontitis lesions, with a higher prevalence in HIV-positive patients. The specific role that these viruses play in the pathogenesis of apical periodontitis remains to be described.

  6. Detection of rotator cuff lesions with indirect MR angiography

    International Nuclear Information System (INIS)

    Rudolph, J.; Lorenz, M.; Schroeder, R.; Felix, R.

    2000-01-01

    Purpose: To determine the value of indirect MR arthrography in lesions of the rotator cuff, prospectively versus arthroscopy. Methods: 63 patients with suspected shoulder pathology were examined: Oblique-coronary and axial T 1 w sequences, axial FLASH-2 D sequences, furthermore oblique-coronary T 2 - and PD-weighted sequences were taken. After intravenous administration of 0.1 mmol Gd-DTPA/kilogram body weight and active motion of the shoulder T 1 w sequences were repeated. Signal intensities (SI) inside the tendon were quantitatively measured by the ROI technique (region-of-interest) and the percentual contrast-enhancement CE was calculated. In 32 patients the results were confirmed by surgical follow-up. Results: The mean SI measured in the supraspinous tendon were higher in lesions (degeneration, impingement, partial and total rupture), before as well as after contrast medium, compared to intact findings (p [de

  7. Semi-automated Robust Quantification of Lesions (SRQL Toolbox

    Directory of Open Access Journals (Sweden)

    Kaori L Ito

    2017-05-01

    Full Text Available Quantifying lesions in a reliable manner is fundamental for studying the effects of neuroanatomical changes related to recovery in the post-stroke brain. However, the wide variability in lesion characteristics across individuals makes manual lesion segmentation a challenging and often subjective process. This often makes it difficult to combine stroke lesion data across multiple research sites, due to subjective differences in how lesions may be defined. Thus, we developed the Semi-automated Robust Quantification of Lesions (SRQL; https://github.com/npnl/SRQL; DOI: 10.5281/zenodo.557114 Toolbox that performs several analysis steps: 1 a white matter intensity correction that removes healthy white matter voxels from the lesion mask, thereby making lesions slightly more robust to subjective errors; 2 an automated report of descriptive statistics on lesions for simplified comparison between or across groups, and 3 an option to perform analyses in both native and standard space to facilitate analyses in either space. Here, we describe the methods implemented in the toolbox.

  8. Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

    Directory of Open Access Journals (Sweden)

    Hajishaiha M

    2011-10-01

    Full Text Available Masomeh Hajishaiha1, Mohammad Ghasemi-rad2, Nazila Karimpour1, Nikol Mladkova3, Farzaneh Boromand11Department of Gynecology, 2Student Research Committee (SRC, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran; 3Institute of Cell and Molecular Science, London, UKPurpose: Intrauterine lesions (IULs are a common finding in women of reproductive age, particularly infertile women. Transvaginal sonography (TVS is a popular tool for IUL detection, but there are conflicting data with respect to its accuracy.Methods: Five hundred and six women were enrolled into the study. Of these, 496 underwent hysterosalpingography and subsequent TVS six different times during the course of their menstrual cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG and hysteroscopy.Results: Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early luteal phase (days 16–19 of the menstrual cycle. Accuracy of TVS during different phases was largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine adhesions in two patients.Conclusion: Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle phase, with the ovulatory and early luteal phase being the optimal time for this examination.Keywords: menstrual cycle phase, space occupying lesions, transvaginal sonography

  9. Noninvasive spectroscopic diagnosis of superficial ocular lesions and corneal infections

    Energy Technology Data Exchange (ETDEWEB)

    Mourant, J.R.; Bigio, I.J.; Johnson, T.; Shimada, T. [Los Alamos National Lab., NM (United States); Gritz, D.C.; Storey-Held, K. [Texas Univ. Health Science Center, San Antonio, TX (United States). Dept. of Ophthalmology

    1994-02-01

    The potential of a rapid noninvasive diagnostic system to detect tissue abnormalities on the surface of the eye has been investigated. The optical scatter signal from lesions and normal areas on the conjunctival sclera of the human eye were measured in vivo. It is possible to distinguish nonpigmented pingueculas from other lesions. The ability of the system to detect malignancies could not be tested because none of the measured and biopsied lesions were malignant. Optical scatter and fluorescence spectra of bacterial and fungal suspensions, and corneal irritations were also collected. Both scattering and fluorescence show potential for diagnosing corneal infections.

  10. Colposcopic triage methods for detecting cervical intraepithelial neoplasia grade 3 after cytopathological diagnosis of low-grade squamous intraepithelial lesion: a systematic review on diagnostic tests

    Directory of Open Access Journals (Sweden)

    Flávia de Miranda Corrêa

    Full Text Available CONTEXT AND OBJECTIVE: The age-stratified performance of the oncogenic HPV-DNA (human papillomavirus deoxyribonucleic acid test for triage of low-grade squamous intraepithelial lesions (LSIL requires investigation. The objective of this study was to evaluate and compare the age-stratified performance (cutoff point: 35 years of oncogenic HPV-DNA testing and repeated cytological tests, for detecting cervical intraepithelial neoplasia grade 3 (CIN3, in order to triage for LSIL. DESIGN AND SETTING: Systematic review. Studies were identified in nine electronic databases and in the reference lists of the articles retrieved. METHODS: The eligibility criteria consisted of initial cytological findings of LSIL; subsequent oncogenic HPV-DNA testing and repeated cytological tests; and CIN3 detection. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS guidelines were used for quality assessment. Qualitative information synthesis was performed. RESULTS: Out of 7,776 studies, 284 were identified as pertinent and three fulfilled the eligibility criteria. The CIN3 prevalence ranged from 6% to 12%. The HPV-DNA positivity rate ranged from 64% to 83%; sensitivity for CIN3 detection ranged from 95.2% to 100%; and specificity was available in two studies (27% and 52%. The sensitivity of repeated cytological tests, in relation to the threshold for atypical squamous cells of undetermined significance (ASCUS, was available in two studies (33% and 90.8%; and specificity was available in one study (53%. CONCLUSIONS: Currently, there is no scientific evidence available that would prove that colposcopic triage using oncogenic HPV-DNA testing to detect CIN3 performs better than repeated cytological tests, among women with LSIL aged 35 years and over.

  11. Characteristic detected on computed tomography angiography predict coronary artery plaque progression in non-culprit lesions

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Ya Hang; Zhou, Jia Zhou; Zhou, Ying; Yang, Xiaobo; Yang, Jun Jie; Chen, Yun Dai [Dept. of Cardiology, Chinese PLA General Hospital, Beijing (China)

    2017-06-15

    This study sought to determine whether variables detected on coronary computed tomography angiography (CCTA) would predict plaque progression in non-culprit lesions (NCL). In this single-center trial, we analyzed 103 consecutive patients who were undergoing CCTA and percutaneous coronary intervention (PCI) for culprit lesions. Follow-up CCTA was scheduled 12 months after the PCI, and all patients were followed for 3 years after their second CCTA examination. High-risk plaque features and epicardial adipose tissue (EAT) volume were assessed by CCTA. Each NCL stenosis grade was compared visually between two CCTA scans to detect plaque progression, and patients were stratified into two groups based on this. Logistic regression analysis was used to evaluate the factors that were independently associated with plaque progression in NCLs. Time-to-event curves were compared using the log-rank statistic. Overall, 34 of 103 patients exhibited NCL plaque progression (33%). Logistic regression analyses showed that the NCL progression was associated with a history of ST-elevated myocardial infarction (odds ratio [OR] = 5.855, 95% confidence interval [CI] = 1.391–24.635, p = 0.016), follow-up low-density lipoprotein cholesterol level (OR = 6.832, 95% CI = 2.103–22.200, p = 0.001), baseline low-attenuation plaque (OR = 7.311, 95% CI = 1.242–43.028, p = 0.028) and EAT (OR = 1.015, 95% CI = 1.000–1.029, p = 0.044). Following the second CCTA examination, major adverse cardiac events (MACEs) were observed in 12 patients, and NCL plaque progression was significantly associated with future MACEs (log rank p = 0.006). Noninvasive assessment of NCLs by CCTA has potential prognostic value.

  12. Dental lesions in the lowland tapir (Tapirus terrestris)

    DEFF Research Database (Denmark)

    Tjørnelund, Karen B.; Jonsson, Lena M.; Kortegaard, Hanne Ellen

    2015-01-01

    Dental ailments, mandibular swelling, and dentoalveolar abscesses are common in tapirs, but knowledge about prevalence or etiology of these lesions in the Tapiridae family in general, and in lowland tapirs ( Tapirus terrestris ) in particular, is scarce. A recent study identified resorptive lesions...... of unknown etiology as a common problem in the Malayan tapir ( Tapirus indicus ). In order to investigate the type and prevalence of dental lesions occurring in lowland tapirs, and to compare these with findings with the Malayan tapir, skulls and teeth from 46 deceased lowland tapirs were visually...... with associated periapical reaction (15%) and periapical reactions of various degrees without associated detectable dental pathology (13%). All these lesions likely originated from dental trauma. As in Malayan tapirs, juveniles had significantly fewer lesions than adults. This study shows that dental lesions...

  13. Wavelength comparison for laser induced breakdown spectroscopy caries detection

    Science.gov (United States)

    Amaral, Marcello M.; Raele, Marcus P.; Ana, Patrícia A.; Núñez, Sílvia C.; Zamataro, Claudia B.; Zezell, Denise M.

    2018-02-01

    Laser Induced Breakdown Spectroscopy (LIBS) is a technique capable to perform elemental analyses of a variety of samples, independent of matter state. Other spectroscopy techniques may require a destructive and time-consuming sample preparation. On the other hand, LIBS is a less destructive technique with no (or considerably less) sample preparation, using a relatively simple experimental setup. LIBS also provides a multielement analysis into one single spectrum acquisition, applying a Nd:YAG short-pulsed laser to ensure the stoichiometry between the sample and the generated plasma. LIBS have been applied on the study of carious lesions using a Nd:YAG into its fundamental emission at 1064 nm. It was shown that ratio of P/Ca and Zn/Ca can be used to monitor the cariogenic process. Another minor elements, e.g. C and Cu, associated with bacteria biofilm were also measured with the Nd:YAG laser. The fundamental wavelength emission (1064 nm) of Nd:YAG is coincident with a hydroxyapatite transmission window and it may affect the result. In order to address this issue a study used the second harmonic of the Nd:YAG laser at 532 nm. It was show that it is also possible perform LIBS on carious lesion using the Nd:YAG at 532 nm. However, there is not a work direct comparing the LIBS at 532 nm and 1064 nm for carious lesion detection. So, the aim of this work was to investigate the influence of laser wavelength on the LIBS performance for carious lesion detection. In both cases the carious lesion was detected with the advantage of no interference with hydroxyapatite at 532 nm.

  14. Detection of intrathoracic infectious lesions using {sup 111}In-diethylenetriamine pentaacetic bicyclic anhydride-IgG ({sup 111}In-DTPA-IgG) scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ota, Tomohiro; Goto, Hajime; Wada, Hiroo; Yuasa, Kazumi; Iguchi, Mari; Okamura, Tatsuru; Ieki, Ryuji; Suzuki, Kenzo [Tokyo Metropolitan Komagome General Hospital (Japan)

    1998-02-01

    The utility of {sup 111}In-DTPA-IgG imaging for the detection of intrathoracic lesions was evaluated in 10 patients with the suspicion of inflammatory or infectious diseases. They were intravenously administered 40 or 80 MBq of {sup 111}In-DTPA-IgG, and scanned after 24 or 48 hours. Of these, 8 cases, consisted of 4 cases with pneumonia and 2 cases with lung abscess and one case of pulmonary tuberculosis and one of a tuberculous pleuritis, showed true positive results. Others were one false negative case of pneumonia and one true negative case of lung cancer. Overall sensitivity and specificity were 88.9% and 100%, respectively. There were no cases which showed side effects or abnormal laboratory findings caused by the radiopharmaceuticals administered. Thus, {sup 111}In-DTPA-IgG imaging is a useful tool for the detection of intrathoracic infectious lesions. (author)

  15. Detection of pathogens from periodontal lesions

    Directory of Open Access Journals (Sweden)

    Malheiros Veruska de João

    2004-01-01

    Full Text Available OBJECTIVE: To comparatively detect A. actinomycetemcomitans and F. nucleatum from periodontal and healthy sites. METHODS: Subgingival clinical samples from 50 periodontitis adult patients and 50 healthy subjects were analyzed. Both organisms were isolated using a trypticase soy agar-bacitracin-vancomycin (TSBV medium and detected by PCR. Conventional biochemical tests were used for bacteria identification. RESULTS: A. actinomycetemcomitans and F. nucleatum were isolated in 18% and 20% of the patients, respectively, and in 2% and 24% of healthy subjects. Among A. actinomycetemcomitans isolates, biotype II was the most prevalent. Primer pair AA was 100% sensitive in the detection of A. actinomycetemcomitans from both subject groups. Primers ASH and FU were also 100% sensitive to detect this organism in healthy subject samples. Primer pair FN5047 was more sensitive to detect F. nucleatum in patients or in healthy samples than primer 5059S. Primers ASH and 5059S were more specific in the detection of A. actinomycetemcomitans and F. nucleatum, respectively, in patients and in healthy subject samples. CONCLUSIONS: PCR is an effective tool for detecting periodontal pathogens in subgingival samples, providing a faster and safer diagnostic tool of periodontal diseases. The method's sensitivity and specificity is conditioned by the choice of the set of primers used.

  16. Impact of model-based iterative reconstruction on low-contrast lesion detection and image quality in abdominal CT: a 12-reader-based comparative phantom study with filtered back projection at different tube voltages

    Energy Technology Data Exchange (ETDEWEB)

    Euler, Andre; Stieltjes, Bram; Eichenberger, Reto; Reisinger, Clemens; Hirschmann, Anna; Zaehringer, Caroline; Kircher, Achim; Streif, Matthias; Bucher, Sabine; Buergler, David; D' Errico, Luigia; Kopp, Sebastien; Wilhelm, Markus [University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel (Switzerland); Szucs-Farkas, Zsolt [Hospital Centre of Biel, Institute of Radiology, Biel (Switzerland); Schindera, Sebastian T. [University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel (Switzerland); Cantonal Hospital Aarau, Institute of Radiology, Aarau (Switzerland)

    2017-12-15

    To evaluate the impact of model-based iterative reconstruction (MBIR) on image quality and low-contrast lesion detection compared with filtered back projection (FBP) in abdominal computed tomography (CT) of simulated medium and large patients at different tube voltages. A phantom with 45 hypoattenuating lesions was placed in two water containers and scanned at 70, 80, 100, and 120 kVp. The 120-kVp protocol served as reference, and the volume CT dose index (CTDI{sub vol}) was kept constant for all protocols. The datasets were reconstructed with MBIR and FBP. Image noise and contrast-to-noise-ratio (CNR) were assessed. Low-contrast lesion detectability was evaluated by 12 radiologists. MBIR decreased the image noise by 24% and 27%, and increased the CNR by 30% and 29% for the medium and large phantoms, respectively. Lower tube voltages increased the CNR by 58%, 46%, and 16% at 70, 80, and 100 kVp, respectively, compared with 120 kVp in the medium phantom and by 9%, 18% and 12% in the large phantom. No significant difference in lesion detection rate was observed (medium: 79-82%; large: 57-65%; P > 0.37). Although MBIR improved quantitative image quality compared with FBP, it did not result in increased low-contrast lesion detection in abdominal CT at different tube voltages in simulated medium and large patients. (orig.)

  17. Effects of selective excitotoxic lesions of the nucleus accumbens core, anterior cingulate cortex, and central nucleus of the amygdala on autoshaping performance in rats.

    Science.gov (United States)

    Cardinal, Rudolf N; Parkinson, John A; Lachenal, Guillaume; Halkerston, Katherine M; Rudarakanchana, Nung; Hall, Jeremy; Morrison, Caroline H; Howes, Simon R; Robbins, Trevor W; Everitt, Barry J

    2002-08-01

    The nucleus accumbens core (AcbC), anterior cingulate cortex (ACC), and central nucleus of the amygdala (CeA) are required for normal acquisition of tasks based on stimulus-reward associations. However, it is not known whether they are involved purely in the learning process or are required for behavioral expression of a learned response. Rats were trained preoperatively on a Pavlovian autoshaping task in which pairing a visual conditioned stimulus (CS+) with food causes subjects to approach the CS+ while not approaching an unpaired stimulus (CS-). Subjects then received lesions of the AcbC, ACC, or CeA before being retested. AcbC lesions severely impaired performance; lesioned subjects approached the CS+ significantly less often than controls, failing to discriminate between the CS+ and CS-. ACC lesions also impaired performance but did not abolish discrimination entirely. CeA lesions had no effect on performance. Thus, the CeA is required for learning, but not expression, of a conditioned approach response, implying that it makes a specific contribution to the learning of stimulus-reward associations.

  18. Diagnostic Accuracy of CBCT with Different Voxel Sizes and Intraoral Digital Radiography for Detection of Periapical Bone Lesions: An Ex-Vivo Study

    Directory of Open Access Journals (Sweden)

    Shirin Sakhdari

    2016-10-01

    Full Text Available Objectives: This study sought to assess the diagnostic accuracy of cone beam computed tomography (CBCT with different voxel sizes and intraoral digital radiography with photostimulable phosphor (PSP plate for detection of periapical (PA bone lesions.Materials and Methods: In this ex vivo diagnostic study, one-millimeter defects were created in the alveolar sockets of 15 bone blocks, each with two posterior teeth. A no-defect control group was also included. Digital PA radiographs with PSP plates and CBCT scans with 200, 250 and 300μ voxel sizes were obtained. Four observers evaluated the possibility of lesion detection using a 5-point scale. Sensitivity, specificity, positive predictive value (PPV and negative predicative value (NPV were analyzed using one-way ANOVA and Tamhane’s post hoc test. Kappa and weighted kappa statistics were applied to assess intraobserver and interobserver agreements.Results: Cochrane Q test showed no significant difference between PSP and CBCT imaging modalities in terms of kappa and weighted kappa statistics (P=0.675. The complete sensitivity and complete NPV for 200 and 250 μ voxel sizes were higher than those of 300 μ voxel size and digital radiography (P<0.001. No significant difference was noted in other parameters among other imaging modalities (P=0.403.Conclusions: The results showed that high-resolution CBCT scans had higher diagnostic accuracy than PSP digital radiography for detection of artificially created PA bone lesions. Voxel size (field of view must be taken into account to minimize patient radiation dose.Keywords: Diagnosis; Cone-Beam Computed Tomography; Radiography, Dental, Digital; Periapical Periodontitis

  19. Ultrasound-guided, vacuum-assisted biopsy in evaluation of breast lesions

    International Nuclear Information System (INIS)

    Luczynska, E.; Kocurek, A.; Dyczek, S.; Skotnicki, P.; Stelmach, A.; Herman, K.

    2008-01-01

    Aim. Evaluation of the efficacy of ultrasound-guided vacuum-assisted biopsy for the verification of breast lesions. Introduction. Ultrasound breast examination is a noninvasive method of breast imaging. It is adjunct to mammography and physical examination and, in women under 30 years of age, pregnant and lactating, it is the basic examination used for the detection and diagnosing of breast diseases. It allows also to obtain cells or tissue samples with such minimally invasive techniques as fine-needle biopsy, core needle biopsy or vacuum-assisted biopsy. Material and methods. The study group consisted of 138 women, aged from 20 to 76 years, who underwent ultrasound guided vacuum-assisted biopsy between March and December 2006. Because double lesions were diagnosed in 6 patients, this resulted in 144 performed procedures. Each patient underwent ultrasound examination, performed with a 10-12 MHz transducer. Biopsies were guided by a 12 MHz transducer and performed with the Mammotome System using an 11G or an 8G needle, depending upon the size and site of the lesion. Obtained data were compared using the Chi-square test; p values of less than 0.05 were considered indicative of a significant difference. Results. The average size of the biopted lesions was estimated as 11±3,8 mm (range: 4-30 mm). However, lesions described by radiologists as apparently suspicious were not qualified for the vacuum-assisted biopsy, in the tested material 4 lesions appeared to be carcinomas (3 were invasive breast carcinomas and 1 was ductal carcinoma in situ). When compared with other changes, these lesions were most frequently equivocal (3 vs 1 determined as benign, p=0.014). There was no statistically significant difference in echogenicity (3 hypoechoic vs 1 with mixed echogenicity) nor in the shape (1 oval change, 2 lobulated and 1 irregular). Pathological examination revealed 86 cases of fibroadenoma within the tested material. Those lesions were mostly benign (77 vs 9 equivocal

  20. Effects of automatic tube potential selection on radiation dose index, image quality, and lesion detectability in pediatric abdominopelvic CT and CTA: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Brinkley, Michael F.; Choudhury, Kingshuk Roy; Frush, Donald P. [Duke University School of Medicine, Department of Radiology, DUMC Box 3808, Durham, NC (United States); Ramirez-Giraldo, Juan C. [Siemens Healthcare, Malvern (United States); Samei, Ehsan; Wilson, Joshua M.; Christianson, Olav I. [Duke University School of Medicine, Clinical Imaging Physics Group, Department of Radiology, Durham, NC (United States); Frush, Daniel J. [Duke University School of Medicine, Medical Physics, Durham, NC (United States)

    2016-01-15

    To assess the effect of automatic tube potential selection (ATPS) on radiation dose, image quality, and lesion detectability in paediatric abdominopelvic CT and CT angiography (CTA). A paediatric modular phantom with contrast inserts was examined with routine pitch (1.4) and high pitch (3.0) using a standard abdominopelvic protocol with fixed 120 kVp, and ATPS with variable kVp in non-contrast, contrast-enhanced, and CTA mode. The volume CT dose index (CTDI{sub vol}), contrast-to-noise ratio (CNR) and lesion detectability index (d') were compared between the standard protocol and ATPS examinations. CTDI{sub vol} was reduced in all routine pitch ATPS examinations, with dose reductions of 27-52 % in CTA mode (P < 0.0001), 15-33 % in contrast-enhanced mode (P = 0.0003) and 8-14 % in non-contrast mode (P = 0.03). Iodine and soft tissue insert CNR and d' were improved or maintained in all ATPS examinations. kVp and dose were reduced in 25 % of high pitch ATPS examinations and in none of the full phantom examinations obtained after a single full phantom localizer. ATPS reduces radiation dose while maintaining image quality and lesion detectability in routine pitch paediatric abdominopelvic CT and CTA, but technical factors such as pitch and imaging range must be considered to optimize ATPS benefits. (orig.)

  1. Exposure (mAs) optimisation of a multi-detector CT protocol for hepatic lesion detection: are thinner slices better?

    International Nuclear Information System (INIS)

    Dobeli, Karen L.; Lewis, Sarah J.; Meikle, Steven R.; Brennan, Patrick C.; Thiele, David L.

    2014-01-01

    The purpose of this work was to determine the exposure-optimised slice thickness for hepatic lesion detection with CT. A phantom containing spheres (diameter 9.5, 4.8 and 2.4mm) with CT density 10 HU below the background (50 HU) was scanned at 125, 100, 75 and 50 mAs. Data were reconstructed at 5-, 3- and 1-mm slice thicknesses. Noise, contrast-to-noise ratio (CNR), area under the curve (AUC) as calculated using receiver operating characteristic analysis and sensitivity representing lesion detection were calculated and compared. Compared with the 125 mAs/5mm slice thickness setting, significant reductions in AUC were found for 75 mAs (P<0.01) and 50 mAs (P<0.05) at 1- and 3-mm thicknesses, respectively; sensitivity for the 9.5-mm sphere was significantly reduced for 75 (P<0.05) and 50 mAs (P<0.01) at 1-mm thickness; sensitivity for the 4.8-mm sphere was significantly lower for 100, 75 and 50 mAs at all three slice thicknesses (P<0.05). The 2.4-mm sphere was rarely detected. At each slice thickness, noise at 100, 75 and 50 mAs exposures was approximately 10, 30 and 50% higher, respectively, than that at 125 mAs exposure. CNRs decreased in an irregular manner with reductions in exposure and slice thickness. This study demonstrated no advantage to using slices below 5mm thickness, and consequently thinner slices are not necessarily better.

  2. Diagnostic performance of 11C-choline PET/CT and bone scintigraphy in the detection of bone metastases in patients with prostate cancer.

    Science.gov (United States)

    Kitajima, Kazuhiro; Fukushima, Kazuhito; Yamamoto, Shingo; Kato, Takashi; Odawara, Soichi; Takaki, Haruyuki; Fujiwara, Masayuki; Yamakado, Koichiro; Nakanishi, Yukako; Kanematsu, Akihiro; Nojima, Michio; Hirota, Shozo

    2017-08-01

    The aim of this study was to compare 11C-choline PET/CT and bone scintigraphy (BS) for detection of bone metastases in patients with prostate cancer. Twenty-one patients with histologically proven prostate cancer underwent 11C-choline PET/CT and BS before (n = 4) or after (n = 17) treatment. Patient-, region-, and lesion-based diagnostic performances of bone metastasis of both 11C-choline PET/CT and BS were evaluated using a five-point scale by two experienced readers. Bone metastases were present in 11 (52.4%) of 21 patients and 48 (32.7%) of 147 regions; 111 lesions were found to have bone metastases. Region-based analysis showed that the sensitivity, specificity, accuracy, and area under the receiver-operating-characteristic curves (AUC) of 11C-choline PET/CT were 97.9%, 99.0%, 98.6%, and 0.9989, respectively; those of BS were 72.9%, 99.0%, 90.5%, and 0.8386, respectively. Sensitivity, accuracy, and AUC significantly differed between the two methods (McNemar test, p = 0.0015, p = 0.0015, and p PET/CT detected 110/111 metastatic lesions (99.1%); BS detected 85 (76.6%) (p PET/BS were 100%/90.3% for the blastic type, 91.7%/8.3% for the lytic type, 100%/100% for the mixed type, and 100%/53.3% for the invisible type, respectively. Significant differences in blastic, lytic, and invisible types were observed between the two methods (p = 0.013, p = 0.0044, and p = 0.023, respectively). In conclusion, 11C-choline PET/CT had greater sensitivity and accuracy than BS for detection of bone involvement in patients with prostate cancer.

  3. Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

    Science.gov (United States)

    Miglioretti, Diana L; Ichikawa, Laura; Smith, Robert A; Buist, Diana S M; Carney, Patricia A; Geller, Berta; Monsees, Barbara; Onega, Tracy; Rosenberg, Robert; Sickles, Edward A; Yankaskas, Bonnie C; Kerlikowske, Karla

    2017-10-01

    Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set. This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated. For test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant. Correlations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. Investigation of detection limits for diffuse optical tomography systems: II. Analysis of slab and cup geometry for breast imaging.

    Science.gov (United States)

    Ziegler, Ronny; Brendel, Bernhard; Rinneberg, Herbert; Nielsen, Tim

    2009-01-21

    Using a statistical (chi-square) test on simulated data and a realistic noise model derived from the system's hardware we study the performance of diffuse optical tomography systems for fluorescence imaging. We compare the predicted smallest size of detectable lesions at various positions in slab and cup geometry and model how detection sensitivity depends on breast compression and lesion fluorescence contrast. Our investigation shows that lesion detection is limited by relative noise in slab geometry and by absolute noise in cup geometry.

  5. Visual detectability of elastic contrast in real-time ultrasound images

    Science.gov (United States)

    Miller, Naomi R.; Bamber, Jeffery C.; Doyley, Marvin M.; Leach, Martin O.

    1997-04-01

    Elasticity imaging (EI) has recently been proposed as a technique for imaging the mechanical properties of soft tissue. However, dynamic features, known as compressibility and mobility, are already employed to distinguish between different tissue types in ultrasound breast examination. This method, which involves the subjective interpretation of tissue motion seen in real-time B-mode images during palpation, is hereafter referred to as differential motion imaging (DMI). The purpose of this study was to develop the methodology required to perform a series of perception experiments to measure elastic lesion detectability by means of DMI and to obtain preliminary results for elastic contrast thresholds for different lesion sizes. Simulated sequences of real-time B-scans of tissue moving in response to an applied force were generated. A two-alternative forced choice (2-AFC) experiment was conducted and the measured contrast thresholds were compared with published results for lesions detected by EI. Although the trained observer was found to be quite skilled at the task of differential motion perception, it would appear that lesion detectability is improved when motion information is detected by computer processing and converted to gray scale before presentation to the observer. In particular, for lesions containing fewer than eight speckle cells, a signal detection rate of 100% could not be achieved even when the elastic contrast was very high.

  6. Neonatal Perirhinal Lesions in Rhesus Macaques Alter Performance on Working Memory Tasks with High Proactive Interference.

    Science.gov (United States)

    Weiss, Alison R; Nadji, Ryhan; Bachevalier, Jocelyne

    2015-01-01

    The lateral prefrontal cortex is known for its contribution to working memory (WM) processes in both humans and animals. Yet, recent studies indicate that the prefrontal cortex is part of a broader network of interconnected brain areas involved in WM. Within the medial temporal lobe (MTL) structures, the perirhinal cortex, which has extensive direct interactions with the lateral and orbital prefrontal cortex, is required to form active/flexible representations of familiar objects. However, its participation in WM processes has not be fully explored. The goal of this study was to assess the effects of neonatal perirhinal lesions on maintenance and monitoring WM processes. As adults, animals with neonatal perirhinal lesions and their matched controls were tested in three object-based (non-spatial) WM tasks that tapped different WM processing domains, e.g., maintenance only (Session-unique Delayed-nonmatching-to Sample, SU-DNMS), and maintenance and monitoring (Object-Self-Order, OBJ-SO; Serial Order Memory Task, SOMT). Neonatal perirhinal lesions transiently impaired the acquisition of SU-DNMS at a short (5 s) delay, but not when re-tested with a longer delay (30 s). The same neonatal lesions severely impacted acquisition of OBJ-SO task, and the impairment was characterized by a sharp increase in perseverative errors. By contrast, neonatal perirhinal lesion spared the ability to monitor the temporal order of items in WM as measured by the SOMT. Contrary to the SU-DNMS and OBJ-SO, which re-use the same stimuli across trials and thus produce proactive interference, the SOMT uses novel objects on each trial and is devoid of interference. Therefore, the impairment of monkeys with neonatal perirhinal lesions on SU-DNMS and OBJ-SO tasks is likely to be caused by an inability to solve working memory tasks with high proactive interference. The sparing of performance on the SOMT demonstrates that neonatal perirhinal lesions do not alter working memory processes per se but

  7. Neonatal perirhinal lesions in rhesus macaques alter performance on working memory tasks with high proactive interference

    Directory of Open Access Journals (Sweden)

    Alison R Weiss

    2016-01-01

    Full Text Available The lateral prefrontal cortex is known for its contribution to working memory (WM processes in both humans and animals. Yet, recent studies indicate that the prefrontal cortex is part of a broader network of interconnected brain areas involved in WM. Within the medial temporal lobe structures, the perirhinal cortex, which has extensive direct interactions with the lateral and orbital prefrontal cortex, is required to form active/flexible representations of familiar objects. However, its participation in WM processes has not be fully explored. The goal of this study was to assess the effects of neonatal perirhinal lesions on maintenance and monitoring WM processes. As adults, animals with neonatal perirhinal lesions and their matched controls were tested in three object-based (non-spatial WM tasks that tapped different WM processing domains, e.g. maintenance only (Session-unique Delayed-nonmatching-to Sample, SU-DNMS, and maintenance and monitoring (Object-Self-Order, OBJ-SO; Serial Order Memory Task, SOMT. Neonatal perirhinal lesions transiently impaired the acquisition of SU-DNMS at a short (5s delay, but not when re-tested with a longer delay (30s. The same neonatal lesions severely impacted acquisition of OBJ-SO task, and the impairment was characterized by a sharp increase in perseverative errors. By contrast, neonatal perirhinal lesion spared the ability to monitor the temporal order of items in WM as measured by the SOMT. Contrary to the SU-DNMS and OBJ-SO, which re-use the same stimuli across trials and thus produce proactive interference, the SOMT uses novel objects on each trial and is devoid of interference. Therefore, the impairment of monkeys with neonatal perirhinal lesions on SU-DNMS and OBJ-SO tasks is likely to be caused by an inability to solve working memory tasks with high proactive interference. The sparing of performance on the SOMT demonstrates that neonatal perirhinal lesions do not alter working memory processes per se

  8. Ultrasound detection of nonpalpable mammographically occult malignancy

    International Nuclear Information System (INIS)

    Simpson, W.L.; Hermann, G.; Rausch, D.R.; Sherman, J.; Feig, S.A.; Bleiweiss, I.J.; Jaffer, S.

    2008-01-01

    To evaluate the prevalence of occult malignancy with screening breast ultrasound. All ultrasound-guided core needle breast biopsies performed between January 1, 1999, and June 30, 2001, were retrospectively reviewed. Lesions were identified during screening breast ultrasound in high-risk women with no mammographic or palpable abnormality in either breast, a unilateral mammographic or palpable abnormality in the contralateral breast, or a unilateral mammographic or palpable abnormality in a different quadrant of the same breast. All ultrasound-detected lesions were histologically verified. Six hundred and fifty-two women with a mean age of 49 years underwent 698 biopsies during the study period. Three hundred and forty-nine of these lesions were detected at screening breast ultrasound. Out of 349, 11 (3.2%) had a mammographically and clinically occult malignancy. Nine cancers were found in women with no mammographic or palpable abnormality. Two cancers were found in the same breast as the mammographic or palpable abnormality. None were found in the breast contralateral to a palpable or mammographic abnormality. Screening breast ultrasound of high-risk women has a similar detection rate for occult carcinoma as screening mammography, but has a low positive predictive value in cases where biopsy is performed. (author)

  9. Cluster analysis of signal-intensity time course in dynamic breast MRI: does unsupervised vector quantization help to evaluate small mammographic lesions?

    Energy Technology Data Exchange (ETDEWEB)

    Leinsinger, Gerda; Schlossbauer, Thomas; Scherr, Michael; Lange, Oliver; Reiser, Maximilian; Wismueller, Axel [Institute for Clinical Radiology University of Munich, Munich (Germany)

    2006-05-15

    We examined whether neural network clustering could support the characterization of diagnostically challenging breast lesions in dynamic magnetic resonance imaging (MRI). We examined 88 patients with 92 breast lesions (51 malignant, 41 benign). Lesions were detected by mammography and classified Breast Imaging and Reporting Data System (BIRADS) III (median diameter 14 mm). MRI was performed with a dynamic T1-weighted gradient echo sequence (one precontrast and five postcontrast series). Lesions with an initial contrast enhancement {>=}50% were selected with semiautomatic segmentation. For conventional analysis, we calculated the mean initial signal increase and postinitial course of all voxels included in a lesion. Secondly, all voxels within the lesions were divided into four clusters using minimal-free-energy vector quantization (VQ). With conventional analysis, maximum accuracy in detecting breast cancer was 71%. With VQ, a maximum accuracy of 75% was observed. The slight improvement using VQ was mainly achieved by an increase of sensitivity, especially in invasive lobular carcinoma and ductal carcinoma in situ (DCIS). For lesion size, a high correlation between different observers was found (R{sup 2} = 0.98). VQ slightly improved the discrimination between malignant and benign indeterminate lesions (BIRADS III) in comparison with a standard evaluation method. (orig.)

  10. A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference.

    Science.gov (United States)

    Choo, Ji Yung; Lee, Ki Yeol; Yu, Ami; Kim, Je-Hyeong; Lee, Seung Heon; Choi, Jung Won; Kang, Eun-Young; Oh, Yu Whan

    2016-09-01

    To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference. We evaluated 161 data sets from 149 patients (91 with and 70 without airway abnormalities) who had undergone radiography, DTS, and CT to detect airway problems. Radiographs and DTS were evaluated to localize and score the severity of the airway abnormalities, and to score the image quality using CT as a reference. Receiver operating characteristics (ROC), McNemar's test, weighted kappa, and the paired t-test were used for statistical analysis. The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p chest radiography (1.83, 2.74; p < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings. DTS is a more accurate and sensitive modality than radiography for detecting airway lesions that are easily obscured by soft tissue structures in the mediastinum. • Digital tomosynthesis offers new diagnostic options for airway lesions. • Digital tomosynthesis is more sensitive and accurate than radiography for airway lesions. • Digital tomosynthesis shows better image quality than radiography. • Assessment of lesion severity, via tomosynthesis is comparable to computed tomography.

  11. Detection of occlusal caries lesions using fluorescence: correlation between histology and obtained results for Diagnodent and spectroscopy; Deteccao de lesoes de carie por fluorescencia: correlacao entre a histologia e os resultados obtidos com o Diagnodent e a espectroscopia

    Energy Technology Data Exchange (ETDEWEB)

    Rocha-Cabral, Renata Maciel

    2006-07-01

    The aims of this study were to develop and test a method to detect caries lesions in vivo and in vitro, using a portable spectrometer (PS); to analyze the performance of PS as well as the commercial device Diagnodent (Dd); correlate them with the gold standard, their transversal section areas and lesions depth and between themselves. 66 occlusal pre-molars sites were examined in vivo with Dd. Sequentially, fluorescence ({lambda}exc {approx} 657 nm) was collected by an optical fiber, conducted to PS and then analyzed as spectra, which were normalized and had calculated the Ratios of their Areas Under the Curves (RAUC) of carious and sound tissues. Experiments were conducted in vitro in the same sites. Gold Standard was obtained by polarized light microscopy. Pearson correlation was used to compare the devices with transversal section area, lesions depth and between themselves. The area under ROC curve, sensitivity, specificity as well as accuracy were calculated and verified with McNemar test. Dd and RAUC showed statistically significant correlation with gold standard (p < 0.01 for Dd and p < 0.05 for RAUC) and between themselves (r = 0,83 in vivo and r = 0,87 in vitro). Although it was significant, the devices showed low correlation with depth of lesions in vivo and in vitro (r = {approx} 0.43). The transversal section area of the lesion had no influence on readings in both devices. Dd showed higher sensitivity (0.76) than PS (0.60) in vivo (p < 0.05), though this fact was not able to improve its performance. In turn, PS showed higher sensitivity (0.88) than Dd (0.79) in vitro, but this difference was not significantly. The other parameters did not show statistically significant differences (p < 0.05) between methods. PS showed positive correlation with Dd, equal correlation with lesions depth and higher ability of detecting the disease in vitro, what suggests that if accompanied with a conic and an angulated probe and a dedicated software, the PS method could be

  12. Correlation between human observer performance and model observer performance in differential phase contrast CT

    International Nuclear Information System (INIS)

    Li, Ke; Garrett, John; Chen, Guang-Hong

    2013-01-01

    Purpose: With the recently expanding interest and developments in x-ray differential phase contrast CT (DPC-CT), the evaluation of its task-specific detection performance and comparison with the corresponding absorption CT under a given radiation dose constraint become increasingly important. Mathematical model observers are often used to quantify the performance of imaging systems, but their correlations with actual human observers need to be confirmed for each new imaging method. This work is an investigation of the effects of stochastic DPC-CT noise on the correlation of detection performance between model and human observers with signal-known-exactly (SKE) detection tasks.Methods: The detectabilities of different objects (five disks with different diameters and two breast lesion masses) embedded in an experimental DPC-CT noise background were assessed using both model and human observers. The detectability of the disk and lesion signals was then measured using five types of model observers including the prewhitening ideal observer, the nonprewhitening (NPW) observer, the nonprewhitening observer with eye filter and internal noise (NPWEi), the prewhitening observer with eye filter and internal noise (PWEi), and the channelized Hotelling observer (CHO). The same objects were also evaluated by four human observers using the two-alternative forced choice method. The results from the model observer experiment were quantitatively compared to the human observer results to assess the correlation between the two techniques.Results: The contrast-to-detail (CD) curve generated by the human observers for the disk-detection experiments shows that the required contrast to detect a disk is inversely proportional to the square root of the disk size. Based on the CD curves, the ideal and NPW observers tend to systematically overestimate the performance of the human observers. The NPWEi and PWEi observers did not predict human performance well either, as the slopes of their CD

  13. Semi-automated Robust Quantification of Lesions (SRQL Toolbox

    Directory of Open Access Journals (Sweden)

    Kaori Ito

    2017-02-01

    Full Text Available Quantifying lesions in a robust manner is fundamental for studying the effects of neuroanatomical changes in the post-stroke brain on recovery. However, the wide variability in lesion characteristics across individuals makes manual lesion segmentation a challenging and often subjective process. This makes it difficult to combine stroke lesion data across multiple research sites, due to subjective differences in how lesions may be defined. We developed the Semi-automated Robust Quantification of Lesions (SRQL; https://github.com/npnl/SRQL; DOI: 10.5281/zenodo.267213 Toolbox that performs several analysis steps: 1 a white matter intensity correction that removes healthy white matter voxels from the lesion mask, thereby making lesions slightly more robust to subjective errors; 2 an automated report of descriptive statistics on lesions for simplified comparison between or across groups, and 3 an option to perform analyses in both native and standard space to facilitate analyses in either space, or comparisons between spaces. Here, we describe the methods implemented in the toolbox and demonstrate the outputs of the SRQL toolbox.

  14. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period.

    Directory of Open Access Journals (Sweden)

    Tobias Djamsched Faizy

    Full Text Available In patients with multiple sclerosis (MS, Double Inversion Recovery (DIR magnetic resonance imaging (MRI can be used to identify cortical lesions (CL. We sought to evaluate the reliability of CL detection on DIR longitudinally at multiple subsequent time-points applying the MAGNIMs scoring criteria for CLs.26 MS patients received a 3T-MRI (Siemens, Skyra with DIR at 12 time-points (TP within a 16 months period. Scans were assessed in random order by two different raters. Both raters separately marked all CLs on each scan and total lesion numbers were obtained for each scan-TP and patient. After a retrospective re-evaluation, the number of consensus CLs (conL was defined as the total number of CLs, which both raters finally agreed on. CLs volumes, relative signal intensities and CLs localizations were determined. Both ratings (conL vs. non-consensus scoring were compared for further analysis.A total number of n = 334 CLs were identified by both raters in 26 MS patients with a first agreement of both raters on 160 out of 334 of the CLs found (κ = 0.48. After the retrospective re-evaluation, consensus agreement increased to 233 out of 334 CL (κ = 0.69. 93.8% of conL were visible in at least 2 consecutive TP. 74.7% of the conL were visible in all 12 consecutive TP. ConL had greater mean lesion volumes and higher mean signal intensities compared to lesions that were only detected by one of the raters (p<0.05. A higher number of CLs in the frontal, parietal, temporal and occipital lobe were identified by both raters than the number of those only identified by one of the raters (p<0.05.After a first assessment, slightly less than a half of the CL were considered as reliably detectable on longitudinal DIR images. A retrospective re-evaluation notably increased the consensus agreement. However, this finding is narrowed, considering the fact that retrospective evaluation steps might not be practicable in clinical routine. Lesions that were not reliably

  15. The added value of contrast enhanced spectral mammography in identification of multiplicity of suspicious lesions in dense breast

    Directory of Open Access Journals (Sweden)

    Amr Farouk Ibrahim Moustafa

    2018-03-01

    Full Text Available Objective: To evaluate the additive value of Contrast Enhanced Spectral Mammography (CESM in the preoperative assessment of malignant lesions in dense breast parenchyma regarding multiplicity. Material and methods: The study included 160 women having heterogeneous dense breast parenchyma (ACR c and d with suspicious lesions identified on sono mammography examination. All patients performed contrast enhanced spectral mammography to confirm or exclude lesion multiplicity. The number of lesions was calculated in the contrast high energy subtraction images with the reference standard being histopathological analysis. Results: Adding CESM to sono-mammography the accuracy in identifying multiple malignant lesion increased from 81.8% accuracy of sono-mammography up to 100% accuracy after adding CESM. Conclusion: Contrast enhanced spectral mammogram showed an added value in the preoperative assessment of breast masses increasing the accuracy of detection of lesions and multiplicity (multifocality and multi-centricity. Keywords: Breast cancer, Contrast enhanced spectral mammogram

  16. A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 1. Factors influencing detection and the decision to refer.

    Science.gov (United States)

    Brocklehurst, P R; Baker, S R; Speight, P M

    2010-01-23

    Many oral squamous cell carcinomas present as late stage disease and so the detection of early and pre-malignancy is considered to be of paramount importance. The majority of research examining primary care dentists' experience of the detection and management of early disease has been undertaken using questionnaires, with the inherent bias this introduces. The aim of this study was to use qualitative methods to develop a richer account of practitioners' views about screening and what factors influence the decision to refer a patient. Semi-structured interviews were undertaken with eighteen dentists in Sheffield, transcribed and analysed using thematic analysis. Ten codes were identified according to the aims of the study and organized into four overarching themes. Although many dentists were screening regularly, some did not appear to be adopting a rigorous and systematic approach. A number of participants also placed more reliance on 'classical' presentations rather than the more varied presentation of potentially malignant lesions and were more influenced by the clinical history of the lesion rather than risk factors. Overall, the present research suggests that for some dentists, more rigour is required when examining for early disease.

  17. Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions

    International Nuclear Information System (INIS)

    Cakir, Ozgur; Arslan, Arzu; Inan, Nagihan; Anık, Yonca; Sarısoy, Tahsin; Gumustas, Sevtap; Akansel, Gur

    2013-01-01

    Purpose: To evaluate the diagnostic efficiency of the diffusion parameters measured by conventional diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for discrimination of malignant breast lesions from benign lesions and the normal breast. Materials and methods: The study included 52 women with 55 breast lesions (30 malignant, 25 benign). DTI and DWI were performed complementary to dynamic contrast MRI at 3T. Apparent diffusion coefficient (ADC) of DWI, mean diffusivity (MD) and fractional anisotropy (FA) values of DTI were measured for lesions and contralateral breast parenchyma in each patient. We used b factors of 0, 50, 850, 1000 and 1500 s/mm 2 for DWI and b 0 and 1000 s/mm 2 for DTI. ADC, MD and FA values were compared between malignant and benign lesions, and the normal parenchyma by univariate and multivariate analyses. Results: Diffusion parameters showed no difference according to menopausal status in the normal breast. ADC and MD values of the malignant lesions were significantly lower than benign lesions and normal parenchyma (p = 0.001). The FA showed no statistical significance. With the cut-off values of ≤1.23 × 10 −3 mm 2 /s (b 0–1000 s/mm 2 ) and ≤1.12 × 10 −3 mm 2 /s (b 0–1500 s/mm 2 ), ADC showed 92.85% and 96.15% sensitivity; 72.22% and 73.52% PPV, respectively. With a cut-off value of ≤1.27 × 10 −3 mm 2 /s (b 1000 s/mm 2 ), MD was 100% sensitive with a PPV of 65.90%. Comparing the diagnostic performance of the parameters in DTI with DWI, we obtained similar efficiency of ADC with b values of 0,1000 and 0,1500 s/mm 2 and MD with a b value of 0, 1000 s/mm 2 (AUC = 0.82 ± 0.07). Conclusion: ADC of DWI and MD of DTI values provide significant discriminative factors for benign and malignant breast lesions. FA measurement was not discriminative. Supported with clinical and dynamic contrast MRI findings, DWI and DTI findings provide significant contribution to the final radiologic decision

  18. Comparison of the diagnostic performances of diffusion parameters in diffusion weighted imaging and diffusion tensor imaging of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Cakir, Ozgur, E-mail: cakirozgur@hotmail.com; Arslan, Arzu, E-mail: arzu.s.arslan@gmail.com; Inan, Nagihan, E-mail: nagihaninan@yahoo.com.tr; Anık, Yonca, E-mail: yoncaanik@yahoo.com; Sarısoy, Tahsin, E-mail: htsarisoy@yahoo.com; Gumustas, Sevtap, E-mail: svtgumustas@yahoo.com; Akansel, Gur, E-mail: gakansel@gmail.com

    2013-12-01

    Purpose: To evaluate the diagnostic efficiency of the diffusion parameters measured by conventional diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for discrimination of malignant breast lesions from benign lesions and the normal breast. Materials and methods: The study included 52 women with 55 breast lesions (30 malignant, 25 benign). DTI and DWI were performed complementary to dynamic contrast MRI at 3T. Apparent diffusion coefficient (ADC) of DWI, mean diffusivity (MD) and fractional anisotropy (FA) values of DTI were measured for lesions and contralateral breast parenchyma in each patient. We used b factors of 0, 50, 850, 1000 and 1500 s/mm{sup 2} for DWI and b 0 and 1000 s/mm{sup 2} for DTI. ADC, MD and FA values were compared between malignant and benign lesions, and the normal parenchyma by univariate and multivariate analyses. Results: Diffusion parameters showed no difference according to menopausal status in the normal breast. ADC and MD values of the malignant lesions were significantly lower than benign lesions and normal parenchyma (p = 0.001). The FA showed no statistical significance. With the cut-off values of ≤1.23 × 10{sup −3} mm{sup 2}/s (b 0–1000 s/mm{sup 2}) and ≤1.12 × 10{sup −3} mm{sup 2}/s (b 0–1500 s/mm{sup 2}), ADC showed 92.85% and 96.15% sensitivity; 72.22% and 73.52% PPV, respectively. With a cut-off value of ≤1.27 × 10{sup −3} mm{sup 2}/s (b 1000 s/mm{sup 2}), MD was 100% sensitive with a PPV of 65.90%. Comparing the diagnostic performance of the parameters in DTI with DWI, we obtained similar efficiency of ADC with b values of 0,1000 and 0,1500 s/mm{sup 2} and MD with a b value of 0, 1000 s/mm{sup 2} (AUC = 0.82 ± 0.07). Conclusion: ADC of DWI and MD of DTI values provide significant discriminative factors for benign and malignant breast lesions. FA measurement was not discriminative. Supported with clinical and dynamic contrast MRI findings, DWI and DTI findings provide significant

  19. Contrast-enhanced ultrasound for extrahepatic lesions: preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Thorelius, Lars E-mail: lars@thorelius.com

    2004-06-01

    Ultrasound imaging (US) is a convenient, inexpensive and non-invasive investigation. Its use is limited by low sensitivity in the detection of a number of parenchymal lesions, especially those produced by trauma, such as infarctions. Contrast enhancement with SonoVue{sup [reg]} improves the sensitivity of ultrasound in the detection and characterization of focal liver lesions to such an extent, that it may replace computed tomography (CT) and magnetic resonance imaging (MRI). Preliminary experience suggests that SonoVue-enhanced sonography may be useful in the detection of lesions in which blood flow is severely reduced as compared to surrounding parenchyma, such as infarctions, lacerations, hematomas, necrotic tissue and non-vascular cysts, especially in the spleen, kidney and pancreas. This technique can also rule out occlusion of the superior mesenteric, splenic and portal veins, and dilation of the biliary tree. Clinical trials comparing contrast-enhanced sonography with contrast-enhanced computed tomography are warranted to establish the role of this inexpensive and non-invasive technique in the routine work-up of patients with abdominal trauma or presenting with sudden flank pain.

  20. Comparison of model and human observer performance for detection and discrimination tasks using dual-energy x-ray images

    International Nuclear Information System (INIS)

    Richard, Samuel; Siewerdsen, Jeffrey H.

    2008-01-01

    Model observer performance, computed theoretically using cascaded systems analysis (CSA), was compared to the performance of human observers in detection and discrimination tasks. Dual-energy (DE) imaging provided a wide range of acquisition and decomposition parameters for which observer performance could be predicted and measured. This work combined previously derived observer models (e.g., Fisher-Hotelling and non-prewhitening) with CSA modeling of the DE image noise-equivalent quanta (NEQ) and imaging task (e.g., sphere detection, shape discrimination, and texture discrimination) to yield theoretical predictions of detectability index (d ' ) and area under the receiver operating characteristic (A Z ). Theoretical predictions were compared to human observer performance assessed using 9-alternative forced-choice tests to yield measurement of A Z as a function of DE image acquisition parameters (viz., allocation of dose between the low- and high-energy images) and decomposition technique [viz., three DE image decomposition algorithms: standard log subtraction (SLS), simple-smoothing of the high-energy image (SSH), and anti-correlated noise reduction (ACNR)]. Results showed good agreement between theory and measurements over a broad range of imaging conditions. The incorporation of an eye filter and internal noise in the observer models demonstrated improved correspondence with human observer performance. Optimal acquisition and decomposition parameters were shown to depend on the imaging task; for example, ACNR and SSH yielded the greatest performance in the detection of soft-tissue and bony lesions, respectively. This study provides encouraging evidence that Fourier-based modeling of NEQ computed via CSA and imaging task provides a good approximation to human observer performance for simple imaging tasks, helping to bridge the gap between Fourier metrics of detector performance (e.g., NEQ) and human observer performance.