Journal Description
Tomography
Tomography
is an international, peer-reviewed open access journal on imaging technologies published monthly online by MDPI (from Volume 7 Issue 1-2021).
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, and other databases.
- Journal Rank: CiteScore - Q2 (Radiology, Nuclear Medicine and Imaging)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.5 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
1.9 (2022);
5-Year Impact Factor:
2.2 (2022)
Latest Articles
CT Arthrography of the Elbow: What Radiologists Should Know
Tomography 2024, 10(3), 415-427; https://doi.org/10.3390/tomography10030032 - 11 Mar 2024
Abstract
Computed tomography (CT) arthrography is a quickly available imaging modality to investigate elbow disorders. Its excellent spatial resolution enables the detection of subtle pathologic changes of intra-articular structures, which makes this technique extremely valuable in a joint with very tiny chondral layers and
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Computed tomography (CT) arthrography is a quickly available imaging modality to investigate elbow disorders. Its excellent spatial resolution enables the detection of subtle pathologic changes of intra-articular structures, which makes this technique extremely valuable in a joint with very tiny chondral layers and complex anatomy of articular capsule and ligaments. Radiation exposure has been widely decreased with the novel CT scanners, thereby increasing the indications of this examination. The main applications of CT arthrography of the elbow are the evaluation of capsule, ligaments, and osteochondral lesions in both the settings of acute trauma, degenerative changes, and chronic injury due to repeated microtrauma and overuse. In this review, we discuss the normal anatomic findings, technical tips for injection and image acquisition, and pathologic findings that can be encountered in CT arthrography of the elbow, shedding light on its role in the diagnosis and management of different orthopedic conditions. We aspire to offer a roadmap for the integration of elbow CT arthrography into routine clinical practice, fostering improved patient outcomes and a deeper understanding of elbow pathologies.
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(This article belongs to the Special Issue CT Arthrography)
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Photon Counting Computed Tomography for Accurate Cribriform Plate (Lamina Cribrosa) Imaging in Adult Patients
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Anna Klempka, Eduardo Ackermann, Sven Clausen and Christoph Groden
Tomography 2024, 10(3), 400-414; https://doi.org/10.3390/tomography10030031 - 08 Mar 2024
Abstract
Detailed visualization of the cribriform plate is challenging due to its intricate structure. This study investigates how computed tomography (CT) with a novel photon counting (PC) detector enhance cribriform plate visualization compared to traditionally used energy-integrated detectors in patients. A total of 40
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Detailed visualization of the cribriform plate is challenging due to its intricate structure. This study investigates how computed tomography (CT) with a novel photon counting (PC) detector enhance cribriform plate visualization compared to traditionally used energy-integrated detectors in patients. A total of 40 patients were included in a retrospective analysis, with half of them undergoing PC CT (Naeotom Alpha Siemens Healthineers, Forchheim, Germany) and the other half undergoing CT scans using an energy-integrated detector (Somatom Sensation 64, Siemens, Forchheim, Germany) in which the cribriform plate was visualized with a temporal bone protocol. Both groups of scans were evaluated for signal-to-noise ratio, radiation dose, the imaging quality of the whole scan overall, and, separately, the cribriform plate and the clarity of volume rendering reconstructions. Two independent observers conducted a qualitative analysis using a Likert scale. The results consistently demonstrated excellent imaging of the cribriform plate with the PC CT scanner, surpassing traditional technology. The visualization provided by PC CT allowed for precise anatomical assessment of the cribriform plate on multiplanar reconstructions and volume rendering imaging with reduced radiation dose (by approximately 50% per slice) and higher signal-to-noise ratio (by approximately 75%). In conclusion, photon-counting technology provides the possibility of better imaging of the cribriform plate in adult patients. This enhanced imaging could be utilized in skull base-associated pathologies, such as cerebrospinal fluid leaks, to visualize them more reliably for precise treatment.
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(This article belongs to the Section Neuroimaging)
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Open AccessReview
Musculoskeletal Pitfalls on Molecular Imaging Studies of Oncologic Patients: How to Stay Out of Trouble
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Brooke Sarna, Ty Subhawong, Efrosyni Sfakianaki, Richard Wang, Anna Christodoulou-Vega and Fabiano N. Cardoso
Tomography 2024, 10(3), 378-399; https://doi.org/10.3390/tomography10030030 - 08 Mar 2024
Abstract
An increasing amount of molecular imaging studies are ordered each year for an oncologic population that continues to expand and increase in age. The importance of these studies in dictating further care for oncologic patients underscores the necessity of differentiating benign from malignant
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An increasing amount of molecular imaging studies are ordered each year for an oncologic population that continues to expand and increase in age. The importance of these studies in dictating further care for oncologic patients underscores the necessity of differentiating benign from malignant findings, particularly for a population in whom incidental findings are common. The aim of this review is to provide pictorial examples of benign musculoskeletal pathologies which may be found on molecular imaging and which may be mistaken for malignant processes. Imaging examples are provided in the form of radiographs, bone scintigraphy, computed tomography, and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scans. Special attention is paid to specific features that help narrow the differential diagnosis and distinguish benign from malignant processes, with the goal of avoiding unnecessary invasive procedures.
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(This article belongs to the Special Issue Feature Reviews for Tomography 2023)
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Open AccessArticle
Intravoxel Incoherent Motion Diffusion-Weighted MRI, Fat Quantification, and Electromyography: Correlation in Polymyositis and Dermatomyositis
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Hyunjung Kim, Sang Yeol Yong, Chuluunbaatar Otgonbaatar and Seoung Wan Nam
Tomography 2024, 10(3), 368-377; https://doi.org/10.3390/tomography10030029 - 01 Mar 2024
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(1) Background: The intravoxel incoherent motion (IVIM) model can provide information about both molecular diffusion and blood flow for the evaluation of skeletal muscle inflammation. MRI-based fat quantification is advantageous for assessing fat infiltration in skeletal muscle. (2) Purpose: We aimed to quantitatively
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(1) Background: The intravoxel incoherent motion (IVIM) model can provide information about both molecular diffusion and blood flow for the evaluation of skeletal muscle inflammation. MRI-based fat quantification is advantageous for assessing fat infiltration in skeletal muscle. (2) Purpose: We aimed to quantitatively measure various parameters associated with IVIM diffusion-weighted imaging (DWI) and fat quantification in the muscles of patients with polymyositis and dermatomyositis using magnetic resonance imaging and to investigate the relationship between these parameters and electromyography (EMG) findings. (3) Material and methods: Data were retrospectively evaluated for 12 patients with polymyositis and dermatomyositis who underwent thigh MRI, including IVIM-DWI and fat quantification. The IVIM-derived parameters included the pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f). Fat fraction values were assessed using the six-point Dixon technique. Needle EMG was performed within 9 days of the MRI. (4) Results: The f values (19.02 ± 4.87%) in muscles with pathological spontaneous activity on EMG were significantly higher than those (14.60 ± 5.31) in muscles without pathological spontaneous activity (p < 0.027). There were no significant differences in D, D*, ADC, or fat fraction between muscles with and without pathologic spontaneous activity. Significant negative correlations were observed between fat fraction and amplitude (r = −0.402, p < 0.015) and between fat fraction and duration (r = −0.360, p < 0.031). (5) Conclusion: The current study demonstrates that IVIM-DWI and fat quantification using 3.0 T MRI may aid in predicting EMG findings in patients with polymyositis and dermatomyositis and promote the pathophysiological study of idiopathic inflammatory myopathies.
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Open AccessCommunication
Detection of Hyperdense Arterial Sign in Acute Ischemic Stroke with Dual-Energy Computed Tomography: Optimal Combination with X-ray Energy and Slice Thickness
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Kyo Noguchi, Aki Kido, Norihito Naruto, Mariko Doai, Toshihide Itoh, Daina Kashiwazaki, Naoki Akioka and Satoshi Kuroda
Tomography 2024, 10(3), 360-367; https://doi.org/10.3390/tomography10030028 - 28 Feb 2024
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Background: The hyperdense artery sign (HAS) in acute ischemic stroke (AIS) is considered an important marker of a thrombus on computed tomography (CT). An advantage of scanning with dual-energy CT (DECT) is its ability to reconstruct CT images with various energies using the
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Background: The hyperdense artery sign (HAS) in acute ischemic stroke (AIS) is considered an important marker of a thrombus on computed tomography (CT). An advantage of scanning with dual-energy CT (DECT) is its ability to reconstruct CT images with various energies using the virtual monochromatic imaging (VMI) technique. The aim of this study was to investigate the optimal combination of X-ray energy and slice thickness to detect HASs on DECT. Methods: A total of 32 patients with confirmed occlusion of the horizontal (M1) portion of the middle cerebral artery were included in this study. Modified contrast-to-noise ratio (modified CNR) analysis was used as a method for evaluating HASs in AIS. A region of interest (ROI) was set as an HAS, the M1 portion, and an approximately 2 cm diameter ROI was set as the background including the HAS and measured. CT images with X-ray energies from 40 to 190 keV, with increments of 10 keV, were reconstructed based on VMI with 1, 2, and 3 mm slice thicknesses. Results: The top five combinations of X-ray energy and slice thickness in descending order of the mean HAS-modified CNR were as follows: Rank 1, 60 keV-1 mm; Rank 2, 70 keV-1 mm; Rank 3, 60 keV-2 mm; Rank 4, 80 keV-2 mm; Rank 5, 60 keV-3 mm. Conclusions: Our study showed that the optimal combination to detect an HAS was 60 keV and a 1 mm slice thickness on DECT.
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Open AccessArticle
The Relationship between Liver Volume, Clinicopathological Characteristics and Survival in Patients Undergoing Resection with Curative Intent for Non-Metastatic Colonic Cancer
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Josh McGovern, Charles Mackay, Rhiannon Freireich, Allan M. Golder, Ross D. Dolan, Paul G. Horgan, David Holroyd, Nigel B. Jamieson and Donald C. McMillan
Tomography 2024, 10(3), 349-359; https://doi.org/10.3390/tomography10030027 - 28 Feb 2024
Abstract
Introduction: The prognostic value of CT-derived liver volume in terms of cancer outcomes is not clear. The aim of the present study was to examine the relationship between liver area on a single axial CT-slice and the total liver volume in patients with
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Introduction: The prognostic value of CT-derived liver volume in terms of cancer outcomes is not clear. The aim of the present study was to examine the relationship between liver area on a single axial CT-slice and the total liver volume in patients with colonic cancer. Furthermore, we examine the relationship between liver volume, determined using this novel method, clinicopathological variables and survival. Methods: Consecutive patients who underwent potentially curative surgery for colonic cancer were identified from a prospectively maintained database. Maximal liver area on axial CT-slice (cm2) and total volume (cm3), were obtained by the manual segmentation of pre-operative CT-images in a PACS viewer. The maximal liver area was normalized for body height2 to create the liver index (LI) and values, categorized into tertiles. The primary outcome of interest was overall survival (OS). Relationships between LI and clinico-pathological variables were examined using chi-square analysis and binary logistic regression. The relationship between LI and OS was examined using cox proportional hazard regression. Results: A total of 359 patients were included. A total of 51% (n = 182) of patients were male and 73% (n = 261) were aged 65 years or older. 81% (n = 305) of patients were alive 3-years post-operatively. The median maximal liver area on the axial CT slice was 178.7 (163.7–198.4) cm2. The median total liver volume was 1509.13 (857.8–3337.1) cm3. Maximal liver area strongly correlated with total liver volume (R2 = 0.749). The median LI was 66.8 (62.0–71.6) cm2/m2. On multivariate analysis, age (p < 0.001), sex (p < 0.05), BMI (p < 0.001) and T2DM (p < 0.05) remained significantly associated with LI. On univariate analysis, neither LI (continuous) or LI (tertiles) were significantly associated with OS (p = 0.582 and p = 0.290, respectively). Conclusions: The simple, reliable method proposed in this study for quantifying liver volume using CT-imaging was found to have an excellent correlation between observers and provided results consistent with the contemporary literature. This method may facilitate the further examination of liver volume in future cancer studies.
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(This article belongs to the Special Issue Imaging in Cancer Diagnosis)
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Myocardial Strain for the Differentiation of Myocardial Involvement in the Post-Acute Sequelae of COVID-19—A Multiparametric Cardiac MRI Study
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El-Sayed H. Ibrahim, Jason Rubenstein, Antonio Sosa, Jadranka Stojanovska, Amy Pan, Paula North, Hallgeir Rui and Ivor Benjamin
Tomography 2024, 10(3), 331-348; https://doi.org/10.3390/tomography10030026 - 27 Feb 2024
Abstract
Myocardial involvement was shown to be associated with an unfavorable prognosis in patients with COVID-19, which could lead to fatal outcomes as in myocardial injury-induced arrhythmias and sudden cardiac death. We hypothesized that magnetic resonance imaging (MRI) myocardial strain parameters are sensitive markers
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Myocardial involvement was shown to be associated with an unfavorable prognosis in patients with COVID-19, which could lead to fatal outcomes as in myocardial injury-induced arrhythmias and sudden cardiac death. We hypothesized that magnetic resonance imaging (MRI) myocardial strain parameters are sensitive markers for identifying subclinical cardiac dysfunction associated with myocardial involvement in the post-acute sequelae of COVID-19 (PASC). This study evaluated 115 subjects, including 65 consecutive COVID-19 patients, using MRI for the assessment of either post-COVID-19 myocarditis or other cardiomyopathies. Subjects were categorized, based on the results of the MRI exams, as having either ‘suspected’ or ‘excluded’ myocarditis. A control group of 50 matched individuals was studied. Along with parameters of global cardiac function, the MRI images were analyzed for measurements of the myocardial T1, T2, extracellular volume (ECV), strain, and strain rate. Based on the MRI late gadolinium enhancement and T1/T2/ECV mappings, myocarditis was suspected in 7 out of 22 patients referred due to concern of myocarditis and in 9 out of 43 patients referred due to concern of cardiomyopathies. The myocardial global longitudinal, circumferential, and radial strains and strain rates in the suspected myocarditis group were significantly smaller than those in the excluded myocarditis group, which in turn were significantly smaller than those in the control group. The results showed significant correlations between the strain, strain rate, and global cardiac function parameters. In conclusion, this study emphasizes the value of multiparametric MRI for differentiating patients with myocardial involvement in the PASC based on changes in the myocardial contractility pattern and tissue structure.
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(This article belongs to the Section Cardiovascular Imaging)
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Evaluation of Radiation Exposure and Influential Factors in Cone-Beam Computed Tomography (CBCT) of the Head and Abdomen during Interventional Procedures
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Mingming Li, Weiwei Qu, Dong Zhang, Binyan Zhong, Zhi Li, Zhengyu Jiang, Guanyin Ni and Caifang Ni
Tomography 2024, 10(3), 320-330; https://doi.org/10.3390/tomography10030025 - 26 Feb 2024
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Cone-beam computed tomography (CBCT) is a widely used imaging technique in interventional radiology. Although CBCT offers great advantages in terms of improving comprehension of complex angioarchitectures and guiding therapeutic decisions, its additional degree of radiation exposure has also aroused considerable concern. In this
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Cone-beam computed tomography (CBCT) is a widely used imaging technique in interventional radiology. Although CBCT offers great advantages in terms of improving comprehension of complex angioarchitectures and guiding therapeutic decisions, its additional degree of radiation exposure has also aroused considerable concern. In this study, we aimed to assess radiation exposure and its influential factors in patients undergoing CBCT scans of the head and abdomen during interventional procedures. A total of 752 patients were included in this retrospective study. Dose area product (DAP) and reference air kerma (RAK) were used as measures of patient dose. The results showed that the median values of DAP were 53.8 (50.5–64.4) Gy⋅cm2 for head CBCT and 47.4 (39.6–54.3) Gy⋅cm2 for that of the abdomen. Male gender and body mass index (BMI) were characterized by increased DAP and RAK values in both head and abdominal CBCT scans. Larger FOV size was associated with a higher DAP but a lower RAK value, especially in head CBCT scans. Exposure parameters under automatic exposure control (AEC) also varied according to patient BMI and gender. In conclusion, the patients received slightly higher radiation doses from head CBCT scans than from those applied to the abdomen. BMI, gender, and FOV size were the key factors that influenced the radiation dose administered to the patients during CBCT scans. Our results may help to define and minimize patients’ exposure to radiation.
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Open AccessReview
Dual-Energy CT in Oncologic Imaging
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Giovanni Foti, Giorgio Ascenti, Andrea Agostini, Chiara Longo, Fabio Lombardo, Alessandro Inno, Alessandra Modena and Stefania Gori
Tomography 2024, 10(3), 299-319; https://doi.org/10.3390/tomography10030024 - 23 Feb 2024
Abstract
Dual-energy CT (DECT) is an innovative technology that is increasingly widespread in clinical practice. DECT allows for tissue characterization beyond that of conventional CT as imaging is performed using different energy spectra that can help differentiate tissues based on their specific attenuation properties
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Dual-energy CT (DECT) is an innovative technology that is increasingly widespread in clinical practice. DECT allows for tissue characterization beyond that of conventional CT as imaging is performed using different energy spectra that can help differentiate tissues based on their specific attenuation properties at different X-ray energies. The most employed post-processing applications of DECT include virtual monoenergetic images (VMIs), iodine density maps, virtual non-contrast images (VNC), and virtual non-calcium (VNCa) for bone marrow edema (BME) detection. The diverse array of images obtained through DECT acquisitions offers numerous benefits, including enhanced lesion detection and characterization, precise determination of material composition, decreased iodine dose, and reduced artifacts. These versatile applications play an increasingly significant role in tumor assessment and oncologic imaging, encompassing the diagnosis of primary tumors, local and metastatic staging, post-therapy evaluation, and complication management. This article provides a comprehensive review of the principal applications and post-processing techniques of DECT, with a specific focus on its utility in managing oncologic patients.
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(This article belongs to the Section Cancer Imaging)
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Open AccessArticle
Feasibility of Low-Dose and Low-Contrast Media Volume Approach in Computed Tomography Cardiovascular Imaging Reconstructed with Model-Based Algorithm
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Davide Ippolito, Marco Porta, Cesare Maino, Luca Riva, Maria Ragusi, Teresa Giandola, Paolo Niccolò Franco, Cecilia Cangiotti, Davide Gandola, Andrea De Vito, Cammillo Talei Franzesi and Rocco Corso
Tomography 2024, 10(2), 286-298; https://doi.org/10.3390/tomography10020023 - 16 Feb 2024
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Aim: To evaluate the dose reduction and image quality of low-dose, low-contrast media volume in computed tomography (CT) examinations reconstructed with the model-based iterative reconstruction (MBIR) algorithm in comparison with the hybrid iterative (HIR) one. Methods: We prospectively enrolled a total of
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Aim: To evaluate the dose reduction and image quality of low-dose, low-contrast media volume in computed tomography (CT) examinations reconstructed with the model-based iterative reconstruction (MBIR) algorithm in comparison with the hybrid iterative (HIR) one. Methods: We prospectively enrolled a total of 401 patients referred for cardiovascular CT, evaluated with a 256-MDCT scan with a low kVp (80 kVp) reconstructed with an MBIR (study group) or a standard HIR protocol (100 kVp—control group) after injection of a fixed dose of contrast medium volume. Vessel contrast enhancement and image noise were measured by placing the region of interest (ROI) in the left ventricle, ascending aorta; left, right and circumflex coronary arteries; main, right and left pulmonary arteries; aortic arch; and abdominal aorta. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed. Subjective image quality obtained by consensus was assessed by using a 4-point Likert scale. Radiation dose exposure was recorded. Results: HU values of the proximal tract of all coronary arteries; main, right and left pulmonary arteries; and of the aorta were significantly higher in the study group than in the control group (p < 0.05), while the noise was significantly lower (p < 0.05). SNR and CNR values in all anatomic districts were significantly higher in the study group (p < 0.05). MBIR subjective image quality was significantly higher than HIR in CCTA and CTPA protocols (p < 0.05). Radiation dose was significantly lower in the study group (p < 0.05). Conclusions: The MBIR algorithm combined with low-kVp can help reduce radiation dose exposure, reduce noise, and increase objective and subjective image quality.
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Open AccessTechnical Note
Association between the Thickness of Lumbar Subcutaneous Fat Tissue and the Presence of Hernias in Adults with Persistent, Non-Traumatic Low Back Pain
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Jorge Adolfo Poot-Franco, Anuar Mena-Balan, Adrian Perez-Navarrete, Osvaldo Huchim, Hugo Azcorra-Perez and Nina Mendez-Dominguez
Tomography 2024, 10(2), 277-285; https://doi.org/10.3390/tomography10020022 - 13 Feb 2024
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We aimed to analyze the association between the average lumbar subcutaneous fat tissue thickness (LSFTT) at each intervertebral level and the presence of hernias in patients with low back pain from an insurance network hospital in Mexico. This observational prospective study included 174
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We aimed to analyze the association between the average lumbar subcutaneous fat tissue thickness (LSFTT) at each intervertebral level and the presence of hernias in patients with low back pain from an insurance network hospital in Mexico. This observational prospective study included 174 patients with non-traumatic lumbago who underwent magnetic resonance imaging with a 1.5T resonator. Two independent radiologists made the diagnosis, and a third specialist provided a quality vote when needed. The sample size was calculated with a 95% confidence interval using random order selection. Anonymized secondary information was used. Percentages and means with confidence intervals were tabulated. The area under the curve, specificity, and sensitivity of LSFTT were calculated. A regression analysis was performed to analyze the presence of hernias with LSFTT using each intervertebral level as a predictor. The odds of herniation at any intervertebral level increased directly with LSFTT. The average LSFTT predicted the overall presence of hernias; however, the LSFTT at each intervertebral level better predicted hernias for each intervertebral space. The area under the curve for LSFTT in predicting hernias was 68%. In conclusion, the average LSFTT was associated with the overall presence of hernias; patients with more hernias had higher LSFTT values.
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Open AccessArticle
Differential Assessment of Internal Jugular Vein Stenosis in Patients Undergoing CT and MRI with Contrast
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Mohamad Abdalkader, Matthew I. Miller, Piers Klein, Ferdinand K. Hui, Jeffrey J. Siracuse, Asim Z. Mian, Osamu Sakai, Thanh N. Nguyen and Bindu N. Setty
Tomography 2024, 10(2), 266-276; https://doi.org/10.3390/tomography10020021 - 11 Feb 2024
Abstract
Objective: Internal Jugular Vein Stenosis (IJVS) is hypothesized to play a role in the pathogenesis of diverse neurological diseases. We sought to evaluate differences in IJVS assessment between CT and MRI in a retrospective patient cohort. Methods: We included consecutive patients who had
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Objective: Internal Jugular Vein Stenosis (IJVS) is hypothesized to play a role in the pathogenesis of diverse neurological diseases. We sought to evaluate differences in IJVS assessment between CT and MRI in a retrospective patient cohort. Methods: We included consecutive patients who had both MRI of the brain and CT of the head and neck with contrast from 1 June 2021 to 30 June 2022 within the same admission. The degree of IJVS was categorized into five grades (0–IV). Results: A total of 35 patients with a total of 70 internal jugular (IJ) veins were included in our analysis. There was fair intermodality agreement in stenosis grades (κ = 0.220, 95% C.I. = [0.029, 0.410]), though categorical stenosis grades were significantly discordant between imaging modalities, with higher grades more frequent in MRI (χ2 = 27.378, p = 0.002). On CT-based imaging, Grade III or IV stenoses were noted in 17/70 (24.2%) IJs, whereas on MRI-based imaging, Grade III or IV stenoses were found in 40/70 (57.1%) IJs. Among veins with Grade I-IV IJVS, MRI stenosis estimates were significantly higher than CT stenosis estimates (77.0%, 95% C.I. [35.9–55.2%] vs. 45.6%, 95% C.I. [35.9–55.2%], p < 0.001). Conclusion: MRI with contrast overestimates the degree of IJVS compared to CT with contrast. Consideration of this discrepancy should be considered in diagnosis and treatment planning in patients with potential IJVS-related symptoms.
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(This article belongs to the Section Neuroimaging)
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Open AccessArticle
Differentiation of Hamartomas and Malignant Lung Tumors in Single-Phased Dual-Energy Computed Tomography
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Moritz T. Winkelmann, Sebastian Gassenmaier, Sven S. Walter, Christoph Artzner, Konstantin Nikolaou and Malte N. Bongers
Tomography 2024, 10(2), 255-265; https://doi.org/10.3390/tomography10020020 - 11 Feb 2024
Abstract
This study investigated the efficacy of single-phase dual-energy CT (DECT) in differentiating pulmonary hamartomas from malignant lung lesions using virtual non-contrast (VNC), iodine, and fat quantification. Forty-six patients with 47 pulmonary lesions (mean age: 65.2 ± 12.1 years; hamartomas-to-malignant lesions = 22:25; male:
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This study investigated the efficacy of single-phase dual-energy CT (DECT) in differentiating pulmonary hamartomas from malignant lung lesions using virtual non-contrast (VNC), iodine, and fat quantification. Forty-six patients with 47 pulmonary lesions (mean age: 65.2 ± 12.1 years; hamartomas-to-malignant lesions = 22:25; male: 67%) underwent portal venous DECT using histology, PET-CT and follow-up CTs as a reference. Quantitative parameters such as VNC, fat fraction, iodine density and CT mixed values were statistically analyzed. Significant differences were found in fat fractions (hamartomas: 48.9%; malignancies: 22.9%; p ≤ 0.0001) and VNC HU values (hamartomas: −20.5 HU; malignancies: 17.8 HU; p ≤ 0.0001), with hamartomas having higher fat content and lower VNC HU values than malignancies. CT mixed values also differed significantly (p ≤ 0.0001), but iodine density showed no significant differences. ROC analysis favored the fat fraction (AUC = 96.4%; sensitivity: 100%) over the VNC, CT mixed value and iodine density for differentiation. The study concludes that the DECT-based fat fraction is superior to the single-energy CT in differentiating between incidental pulmonary hamartomas and malignant lesions, while post-contrast iodine density is ineffective for differentiation.
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(This article belongs to the Section Cancer Imaging)
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Magnetic Resonance Image Findings and Potential Anatomic Risk Factors for Chodromalacia in Children and Adolescents Suffering from Non-Overload Atraumatic Knee Pain in the Ambulant Setting
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Wolf Bäumler, Daniel Popp, Patrick Ostheim, Marco Dollinger, Karin Senk, Johannes Weber, Christian Stroszczynski and Jan Schaible
Tomography 2024, 10(2), 243-254; https://doi.org/10.3390/tomography10020019 - 11 Feb 2024
Abstract
Purpose: To evaluate magnetic resonance image (MRI) findings in children and adolescents suffering from knee pain without traumatic or physical overload history and to identify potential anatomic risk factors. Material and Methods: A total of 507 MRIs of 6- to 20-year-old patients (251
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Purpose: To evaluate magnetic resonance image (MRI) findings in children and adolescents suffering from knee pain without traumatic or physical overload history and to identify potential anatomic risk factors. Material and Methods: A total of 507 MRIs of 6- to 20-year-old patients (251 males; 256 females) were evaluated with regard to detectable pathologies of the knee. The results were compared to a control group without pain (n = 73; 34 males; 39 females). A binary logistic regression model and t-tests for paired and unpaired samples were used to identify possible risk factors and significant anatomic differences of the study population. Results: In 348 patients (68.6%), at least one pathology was detected. The most commonly detected finding was chondromalacia of the patellofemoral (PF) joint (n = 205; 40.4%). Chondral lesions of the PF joint occurred significantly more often in knee pain patients than in the control group (40% vs. 11.0%; p = 0.001), especially in cases of a patella tilt angle > 5° (p ≤ 0.001), a bony sulcus angle > 150° (p = 0.002), a cartilaginous sulcus angle > 150° (p = 0.012), a lateral trochlear inclination < 11° (p ≤ 0.001), a lateralised patella (p = 0.023) and a Wiberg type II or III patella shape (p = 0.019). Moreover, a larger patella tilt angle (p = 0.021), a greater bony sulcus angle (p = 0.042), a larger cartilaginous sulcus angle (p = 0.038) and a lower value of the lateral trochlear inclination (p = 0.014) were detected in knee pain patients compared to the reference group. Conclusion: Chondromalacia of the PF joint is frequently observed in children and adolescents suffering from non-overload atraumatic knee pain, whereby a patella tilt angle > 5°, a bony sulcus angle > 150°, a cartilaginous sulcus angle > 150°, a lateral trochlear inclination < 11°, a lateralised patella and a Wiberg type II or III patella shape seem to represent anatomic risk factors.
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(This article belongs to the Special Issue Tomography in 2023)
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Imaging Characteristics of Embedded Tooth-Associated Cemento-Osseous Dysplasia by Retrospective Study
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Shun Nishimura, Masafumi Oda, Manabu Habu, Osamu Takahashi, Hiroki Tsurushima, Taishi Otani, Daigo Yoshiga, Nao Wakasugi-Sato, Shinobu Matsumoto-Takeda, Susumu Nishina, Shinji Yoshii, Masaaki Sasaguri, Izumi Yoshioka and Yasuhiro Morimoto
Tomography 2024, 10(2), 231-242; https://doi.org/10.3390/tomography10020018 - 08 Feb 2024
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Background: Since there are many differential diagnoses for cemento-osseous dysplasia (COD), it is very difficult for dentists to avoid misdiagnosis. In particular, if COD is related to an embedded tooth, differential diagnosis is difficult. However, there have been no reports on the characteristics
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Background: Since there are many differential diagnoses for cemento-osseous dysplasia (COD), it is very difficult for dentists to avoid misdiagnosis. In particular, if COD is related to an embedded tooth, differential diagnosis is difficult. However, there have been no reports on the characteristics of the imaging findings of COD associated with embedded teeth. The aim of the present study was to investigate the occurrence and imaging characteristics of cemento-osseous dysplasia (COD) associated with embedded teeth, in order to appropriately diagnose COD with embedded teeth. Methods: The radiographs with or without histological findings of 225 patients with COD were retrospectively analyzed. A retrospective search through the picture archiving and communication system (PACS) of the Division of Oral and Maxillofacial Radiology of Kyushu Dental University Hospital was performed to identify patients with COD between 2011 and 2022. Results: Fifteen COD-associated embedded mandibular third molars were identified in 13 patients. All 13 patients were asymptomatic. On imaging, COD associated with embedded mandibular third molars appeared as masses that included calcifications around the apex of the tooth. On panoramic tomography, COD showed inconspicuous internal calcification similar to that of odontogenic cysts or simple bone cysts, especially in patients with COD only around the mandibular third molar region. Those with prominent calcification resembled cemento-ossifying fibroma, calcifying epithelial odontogenic tumor, calcifying odontogenic cyst, adenomatoid odontogenic tumor, and so on, as categories of masses that include calcifications on panoramic tomography and computed tomography. Conclusions: The current investigation is the first to report and analyze the imaging characteristics of COD associated with embedded teeth. It is important to consider the differences between COD and other cystic lesions on panoramic tomography, and the differences between COD and masses that include calcifications on CT.
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Open AccessArticle
Identifying Diabetic Retinopathy in the Human Eye: A Hybrid Approach Based on a Computer-Aided Diagnosis System Combined with Deep Learning
by
Şükran Yaman Atcı, Ali Güneş, Metin Zontul and Zafer Arslan
Tomography 2024, 10(2), 215-230; https://doi.org/10.3390/tomography10020017 - 05 Feb 2024
Abstract
Diagnosing and screening for diabetic retinopathy is a well-known issue in the biomedical field. A component of computer-aided diagnosis that has advanced significantly over the past few years as a result of the development and effectiveness of deep learning is the use of
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Diagnosing and screening for diabetic retinopathy is a well-known issue in the biomedical field. A component of computer-aided diagnosis that has advanced significantly over the past few years as a result of the development and effectiveness of deep learning is the use of medical imagery from a patient’s eye to identify the damage caused to blood vessels. Issues with unbalanced datasets, incorrect annotations, a lack of sample images, and improper performance evaluation measures have negatively impacted the performance of deep learning models. Using three benchmark datasets of diabetic retinopathy, we conducted a detailed comparison study comparing various state-of-the-art approaches to address the effect caused by class imbalance, with precision scores of 93%, 89%, 81%, 76%, and 96%, respectively, for normal, mild, moderate, severe, and DR phases. The analyses of the hybrid modeling, including CNN analysis and SHAP model derivation results, are compared at the end of the paper, and ideal hybrid modeling strategies for deep learning classification models for automated DR detection are identified.
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(This article belongs to the Topic Deep Learning for Medical Image Analysis and Medical Natural Language Processing)
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Open AccessArticle
Patterns of Signal Intensity in CISS MRI of the Inner Ear and Eye
by
Antonia Mair, Christopher I. Song, Bela Büki and Bryan K. Ward
Tomography 2024, 10(2), 203-214; https://doi.org/10.3390/tomography10020016 - 29 Jan 2024
Abstract
Background: Constructive interference in steady state (CISS) is a gradient echo magnetic resonance imaging (MRI) pulse sequence that provides excellent contrast between cerebrospinal fluid and adjacent structures but is prone to banding artifacts due to magnetic field inhomogeneities. We aimed to characterize artifacts
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Background: Constructive interference in steady state (CISS) is a gradient echo magnetic resonance imaging (MRI) pulse sequence that provides excellent contrast between cerebrospinal fluid and adjacent structures but is prone to banding artifacts due to magnetic field inhomogeneities. We aimed to characterize artifacts in the inner ear and eye. Methods: In 30 patients (60 ears/eyes) undergoing CISS sequence MRI, nine low-signal intensity regions were identified in the inner ear and compared to temporal bone histopathology. The number and angle of bands across the eye were examined. Results: In the cochlea, all ears had regions of low signal corresponding to anatomy (modiolus (all), spiral lamina (n = 59, 98.3%), and interscalar septa (n = 50, 83.3%)). In the labyrinth, the lateral semicircular canal crista (n = 42, 70%) and utricular macula (n = 47, 78.3%) were seen. Areas of low signal in the vestibule seen in all ears may represent the walls of the membranous utricle. Zero to three banding artifacts were seen in both eyes (right: 96.7%, mean 1.5; left: 93.3%, mean 1.3). Conclusion: Low signal regions in the inner ear on CISS sequences are common and have consistent patterns; most in the inner ear represent anatomy, appearing blurred due to partial volume averaging. Banding artifacts in the eye are more variable.
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(This article belongs to the Section Neuroimaging)
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Open AccessReview
Radiation Overuse in Intensive Care Units
by
Chiara Zanon, Costanza Bini, Alessandro Toniolo, Tommaso Benetti and Emilio Quaia
Tomography 2024, 10(2), 193-202; https://doi.org/10.3390/tomography10020015 - 29 Jan 2024
Abstract
Radiological imaging is essential for acute patient management in Intensive Care Units (ICUs); however, it introduces the risk of exposure to ionizing radiation. This review synthesizes research on radiation exposure in ICU settings, highlighting its rise during the COVID-19 pandemic and the rise
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Radiological imaging is essential for acute patient management in Intensive Care Units (ICUs); however, it introduces the risk of exposure to ionizing radiation. This review synthesizes research on radiation exposure in ICU settings, highlighting its rise during the COVID-19 pandemic and the rise in repetitive imaging. Our analysis extends to radiation safety thresholds, revealing that some ICU patients exceed the diagnostic reference level, emphasizing the need to balance diagnostic utility against potential long-term risks, such as cancer. Prospective studies have demonstrated an increase in the median cumulative effective dose in patients with trauma over time, prompting calls for improved awareness and monitoring. Moreover, innovative dose-reduction strategies and optimized protocols, especially in neuro-ICUs, promise to mitigate these risks. This review highlights the essential but risky role of radiological imaging in critical care. It advocates for rigorous radiation management protocols to safeguard patient health while ensuring the continuity of high-quality medical care.
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Cerebral Microvascular Perfusion Assessed in Elderly Adults by Spin-Echo Dynamic Susceptibility Contrast MRI at 7 Tesla
by
Elles P. Elschot, Walter H. Backes, Marieke van den Kerkhof, Alida A. Postma, Abraham A. Kroon and Jacobus F. A. Jansen
Tomography 2024, 10(1), 181-192; https://doi.org/10.3390/tomography10010014 - 18 Jan 2024
Abstract
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Perfusion measures of the total vasculature are commonly derived with gradient-echo (GE) dynamic susceptibility contrast (DSC) MR images, which are acquired during the early passes of a contrast agent. Alternatively, spin-echo (SE) DSC can be used to achieve specific sensitivity to the capillary
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Perfusion measures of the total vasculature are commonly derived with gradient-echo (GE) dynamic susceptibility contrast (DSC) MR images, which are acquired during the early passes of a contrast agent. Alternatively, spin-echo (SE) DSC can be used to achieve specific sensitivity to the capillary signal. For an improved contrast-to-noise ratio, ultra-high-field MRI makes this technique more appealing to study cerebral microvascular physiology. Therefore, this study assessed the applicability of SE-DSC MRI at 7 T. Forty-one elderly adults underwent 7 T MRI using a multi-slice SE-EPI DSC sequence. The cerebral blood volume (CBV) and cerebral blood flow (CBF) were determined in the cortical grey matter (CGM) and white matter (WM) and compared to values from the literature. The relation of CBV and CBF with age and sex was investigated. Higher CBV and CBF values were found in CGM compared to WM, whereby the CGM-to-WM ratios depended on the amount of largest vessels excluded from the analysis. CBF was negatively associated with age in the CGM, while no significant association was found with CBV. Both CBV and CBF were higher in women compared to men in both CGM and WM. The current study verifies the possibility of quantifying cerebral microvascular perfusion with SE-DSC MRI at 7 T.
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Open AccessArticle
Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors
by
Alonso La Rosa, Kathryn E. Mittauer, Nema Bassiri, Amy E. Rzepczynski, Michael D. Chuong, Sreenija Yarlagadda, Tugce Kutuk, Nicole C. McAllister, Matthew D. Hall, Alonso N. Gutierrez, Ranjini Tolakanahalli, Minesh P. Mehta and Rupesh Kotecha
Tomography 2024, 10(1), 169-180; https://doi.org/10.3390/tomography10010013 - 17 Jan 2024
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Radiotherapy for ultracentral lung tumors represents a treatment challenge, considering the high rates of high-grade treatment-related toxicities with stereotactic body radiation therapy (SBRT) or hypofractionated schedules. Accelerated hypofractionated magnetic resonance-guided adaptive radiation therapy (MRgART) emerged as a potential game-changer for tumors in these
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Radiotherapy for ultracentral lung tumors represents a treatment challenge, considering the high rates of high-grade treatment-related toxicities with stereotactic body radiation therapy (SBRT) or hypofractionated schedules. Accelerated hypofractionated magnetic resonance-guided adaptive radiation therapy (MRgART) emerged as a potential game-changer for tumors in these challenging locations, in close proximity to central organs at risk, such as the trachea, proximal bronchial tree, and esophagus. In this series, 13 consecutive patients, predominantly male (n = 9), with a median age of 71 (range (R): 46–85), underwent 195 MRgART fractions (all 60 Gy in 15 fractions) to metastatic (n = 12) or primary ultra-central lung tumors (n = 1). The median gross tumor volumes (GTVs) and planning target volumes (PTVs) were 20.72 cc (R: 0.54–121.65 cc) and 61.53 cc (R: 3.87–211.81 cc), respectively. The median beam-on time per fraction was 14 min. Adapted treatment plans were generated for all fractions, and indications included GTV/PTV undercoverage, OARs exceeding tolerance doses, or both indications in 46%, 18%, and 36% of fractions, respectively. Eight patients received concurrent systemic therapies, including immunotherapy (four), chemotherapy (two), and targeted therapy (two). The crude in-field loco-regional control rate was 92.3%. No CTCAE grade 3+ toxicities were observed. Our results offer promising insights, suggesting that MRgART has the potential to mitigate toxicities, enhance treatment precision, and improve overall patient care in the context of ultracentral lung tumors.
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