CT diagnosis of early stroke : the initial approach to the new CAD tool based on multiscale estimation of ischemia

Background: Computer aided diagnosis (CAD) becomes one of the most important diagnostic tools for urgent states in cerebral stroke and other life-threatening conditions where time plays a crucial role. Routine CT is still diagnostically insufficient in hyperacute stage of stroke that is in the therapeutic window for thrombolytic therapy. Authors present computer assistant of early ischemic stroke diagnosis that supports the radiologic interpretations. A new semantic-visualization system of ischemic symptoms applied to noncontrast, routine CT examination was based on multiscale image processing and diagnostic content estimation. Material/Methods: Evaluation of 95 sets of examinations in patients admitted to a hospital with symptoms suggesting stroke was undertaken by four radiologists from two medical centers unaware of the final clinical findings. All of the consecutive cases were considered as having no CT direct signs of hyperacute ischemia. At the first test stage only the CTs performed at the admission were evaluated independently by radiologists. Next, the same early scans were evaluated again with additional use of multiscale computer-assistant of stroke (MulCAS). Computerized suggestion with increased sensitivity to the subtle image manifestations of cerebral ischemia was constructed as additional view representing estimated diagnostic content with enhanced stroke symptoms synchronized to routine CT data preview. Follow-up CT examinations and clinical features confirmed or excluded the diagnosis of stroke constituting 'gold standard' to verify stroke detection performance. Results: Higher AUC (area under curve) values were found for MulCAS -aided radiological diagnosis for all readers and the differences were statistically significant for random readers-random cases parametric and non-parametric DBM MRMC analysis. Sensitivity and specificity of acute stroke detection for the readers was increased by 30% and 4%, respectively. Conclusions: Routine CT completed with proposed method of computer assisted diagnosis provided noticeable better diagnosis efficiency of acute stroke according to the rates and opinions of all test readers. Further research includes fully automatic detection of hypodense regions to complete assisted indications and formulate the suggestions of stroke cases more objectively. Planned prospective studies will let evaluate more accurately the impact of this CAD tool on diagnosis and further treatment in patients suffered from stroke. It is necessary to determine whether this method is possible to be applied widely

A glance at imaging bladder cancer.

Purpose: Early and accurate diagnosis of Bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons. Methods: Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging . Results: A total of 81 published papers were retrieved and are included in the review. For patients with hematuria and suspected of BCa, cystoscopy and CT are most commonly recommended. Ultrasonography, MRI, PET/CT using 18F-FDG or 11C-choline and recently PET/MRI using 18F-FDG also play a prominent role in detection of BCa. Conclusion: For initial diagnosis of BCa, cystoscopy is generally performed. However, cystoscopy can not accurately detect carcinoma insitu (CIS) and can not distinguish benign masses from malignant lesions. CT is used in two modes, CT and computed tomographic urography (CTU), both for dignosis and staging of BCa. However, they cannot differentiate T1 and T2 BCa. MRI is performed to diagnose invasive BCa and can differentiate muscle invasive bladder carcinoma (MIBC) from non-muscle invasive bladder carcinoma (NMIBC). However, CT and MRI have low sensitivity for nodal staging. For nodal staging PET/CT is preferred. PET/MRI provides better differentiation of normal and pathologic structures as compared with PET/CT. Nonetheless none of the approaches can address all issues related for the management of BCa. Novel imaging methods that target specific biomarkers, image BCa early and accurately, and stage the disease are warranted

Advances in Microfluidics and Lab-on-a-Chip Technologies

Advances in molecular biology are enabling rapid and efficient analyses for effective intervention in domains such as biology research, infectious disease management, food safety, and biodefense. The emergence of microfluidics and nanotechnologies has enabled both new capabilities and instrument sizes practical for point-of-care. It has also introduced new functionality, enhanced sensitivity, and reduced the time and cost involved in conventional molecular diagnostic techniques. This chapter reviews the application of microfluidics for molecular diagnostics methods such as nucleic acid amplification, next-generation sequencing, high resolution melting analysis, cytogenetics, protein detection and analysis, and cell sorting. We also review microfluidic sample preparation platforms applied to molecular diagnostics and targeted to sample-in, answer-out capabilities

Can high-frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

Aim To determine whether high-frequency ultrasound can predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to identify patients with axillary disease requiring surgery who would not normally, on clinical grounds, have an axillary dissection, so potentially improving outcome and survival rates. Materials and methods The ipsilateral and contralateral axillae of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Power Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, and measurements were also taken to determine the L/S ratio and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results In this study of patients with invasive breast cancer, ipsilateral lymph nodes with a cortical bulge ≥3 mm and/or at least two lymph nodes with absent echogenic centres indicated the presence of metastatic axillary lymph nodes (10 patients). The sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P value was 0.001 and the Kappa score was 0.55.\ud Conclusion This would indicate that high-frequency ultrasound can be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management

Phenotype-based and Self-learning Inter-individual Sleep Apnea Screening with a Level IV Monitoring System

Purpose: We propose a phenotype-based artificial intelligence system that can self-learn and is accurate for screening purposes, and test it on a Level IV monitoring system. Methods: Based on the physiological knowledge, we hypothesize that the phenotype information will allow us to find subjects from a well-annotated database that share similar sleep apnea patterns. Therefore, for a new-arriving subject, we can establish a prediction model from the existing database that is adaptive to the subject. We test the proposed algorithm on a database consisting of 62 subjects with the signals recorded from a Level IV wearable device measuring the thoracic and abdominal movements and the SpO2. Results: With the leave-one cross validation, the accuracy of the proposed algorithm to screen subjects with an apnea-hypopnea index greater or equal to 15 is 93.6%, the positive likelihood ratio is 6.8, and the negative likelihood ratio is 0.03. Conclusion: The results confirm the hypothesis and show that the proposed algorithm has great potential to screen patients with SAS

The future of laboratory medicine - A 2014 perspective.

Predicting the future is a difficult task. Not surprisingly, there are many examples and assumptions that have proved to be wrong. This review surveys the many predictions, beginning in 1887, about the future of laboratory medicine and its sub-specialties such as clinical chemistry and molecular pathology. It provides a commentary on the accuracy of the predictions and offers opinions on emerging technologies, economic factors and social developments that may play a role in shaping the future of laboratory medicine