Clinically applicable artificial intelligence system for dental diagnosis with CBCT

Abstract In this study, a novel AI system based on deep learning methods was evaluated to determine its real-time performance of CBCT imaging diagnosis of anatomical landmarks, pathologies, clinical effectiveness, and safety when used by dentists in a clinical setting. The system consists of 5 modules: ROI-localization-module (segmentation of teeth and jaws), tooth-localization and numeration-module, periodontitis-module, caries-localization-module, and periapical-lesion-localization-module. These modules use CNN based on state-of-the-art architectures. In total, 1346 CBCT scans were used to train the modules. After annotation and model development, the AI system was tested for diagnostic capabilities of the Diagnocat AI system. 24 dentists participated in the clinical evaluation of the system. 30 CBCT scans were examined by two groups of dentists, where one group was aided by Diagnocat and the other was unaided. The results for the overall sensitivity and specificity for aided and unaided groups were calculated as an aggregate of all conditions. The sensitivity values for aided and unaided groups were 0.8537 and 0.7672 while specificity was 0.9672 and 0.9616 respectively. There was a statistically significant difference between the groups (p = 0.032). This study showed that the proposed AI system significantly improved the diagnostic capabilities of dentists

Multidisciplinary oncology care pathways, evaluation of organisational interventions

In het proefschrift van Van Huizen worden de reorganisatie van multidisciplinaire medische overleggen (MDO’s) en video-confereren (VC) geëvalueerd. Het bleek dat door de invoering van een multidisciplinair eerste-dag spreekuur voor hoofd-hals-kanker en de reorganisatie van het gastro-intestinale oncologische MDO, de efficiëntie van de zorgtrajecten, vooral de wachttijd tot behandeling, verbeterde. Daarnaast bleek dat bij multidisciplinaire behandelingen het informeren van de patiënt extra aandacht verdient en wensen steeds moeten worden meegewogen.Zes verschillende vormen van VC in oncologische netwerken werden geïdentificeerd. De toepassingen van VC varieerde van ad hoc overleg met experts over behandeling van complexe casussen of zeer zeldzame tumoren, tot regulier overleg tussen zorgprofessionals, bijvoorbeeld in de palliatieve zorg. Voordelen van VC voor patiënten waren minder reizen voor diagnostisch onderzoek, betere coördinatie van zorg, betere toegang tot schaarse voorzieningen en behandeling in de eigen regio. Voordelen voor zorgmedewerkers waren optimalisatie van behandelplannen door multidisciplinaire discussies van complexe cases, tegelijkertijd informeren van zorgmedewerkers over wijzigingen in het zorgplan voor individuele patiënten en medische ontwikkelingen, verbeterde zorgcoördinatie en minder reizen.Het reguliere VC-MDO Hoofd-Hals Oncologie tussen een Universitair Medisch Centrum Groningen en haar partner Medisch Centrum Leeuwarden bleek vooral van waarde voor het bespreken van complexe casussen, omdat het andere team er met een ‘frisse blik’ naar keek, en voor het afstemmen van medisch beleid. Voor de aansturing van een zorgtraject bleek er behoefte te zijn aan een ‘real-time dashboard’ betreffende diagnostische procedures en behandelplannen. De meerwaarde van zo’n dashboard zou in toekomstig onderzoek geëvalueerd moeten worden.Van Huizen's dissertation evaluates the reorganisation of multidisciplinary meetings (MDTMs) and video-conferencing (VC). It turned out that introduction of a multidisciplinary first-day consultation for head-and-neck cancer and reorganisation of the gastrointestinal oncological MDTM improved the efficiency of the care pathway, particularly waiting times to start treatment. It was shown that in case of multidisciplinary treatment, extra attention should be paid to informing the patient and that wishes should always be taken into consideration.Six different types of VC in oncology networks were identified. Applications ranged from ad hoc consultation with experts about complex cases or very rare tumours to regular meetings about e.g. palliative care. Benefits for patients were, less travel, better coordination of care, better access to scarce facilities and treatment in their own community. Benefits for healthcare professionals involved optimised treatment plans through multidisciplinary discussion of complex cases, the ability to inform all healthcare professionals simultaneously on developments in the care of individual patients, enhanced care coordination, less travel and continued medical education.The regular VC-MDTM Head-and-Neck Oncology between Groningen University Medical Centre and its partner Leeuwarden Medical Centre added value in discussing complex cases, because the other team offered a fresh perspective by hearing it ‘as new’ and in in keeping their medical viewpoints aligned.For management of a care pathway, there was a need for real-time information regarding diagnostic procedures and treatment plans in the form of a ‘real time dashboard’. The added value of such a dashboard should evaluated in future research

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

The promise of digital healthcare technologies

Digital health technologies have been in use for many years in a wide spectrum of healthcare scenarios. This narrative review outlines the current use and the future strategies and significance of digital health technologies in modern healthcare applications. It covers the current state of the scientific field (delineating major strengths, limitations, and applications) and envisions the future impact of relevant emerging key technologies. Furthermore, we attempt to provide recommendations for innovative approaches that would accelerate and benefit the research, translation and utilization of digital health technologies

Tekes projekti SuperMachines loppuraportti

Tutkimuksessa kerättiin best practice aineistoa ja kehitettiin internet alusta kerätyn aineiston tutkimiseen ja hakujen suorittamiseen. Aineisto löytyy internet osoitteesta: http://www.amcase.info/. Rekisteröitymällä kuka vain voi syöttää alustalle lisää aineistoa. Kappaleiden suunnitteluohjeet on julkaistu Suomen pikavalmistusyhdistyksen sivuilla: http://firpa.fi/html/am-tietoa.html. Ohjeesta löytyy mm. suositeltu minimi seinämänvahvuus, suositellun pienimmän yksityiskohdan koko, tyypillinen markkinoilta löytyvä rakennuskammin koko, sekä tyypilliset materiaalit. Valmiiden kokoonpanojen ja mekanismien suunnitteluun muodostettiin Objet 30 ja UPrint SE+ laitteelle ohjeistus josta löytyy pienin radiaalinen välys, aksiaalinen välys, sekä pienin rako riippuen rakennussuunnasta. Tutkimusprojektin aikana seurattiin alan teknologian kehitystä. Kahden vuoden aikana markkinoille ilmaantui noin. 50 uutta laitevalmistajaa, sekä noin 300 erilaista laitetta, sekä lukuisia materiaaleja. Merkittävimmät uudistukset listattiin ja pohdittiin mahdollisia kehityssuuntia. Kaikki uudet toimijat ja laitteet päivitettiin Firpan ylläpitämään tietokantaan: http://firpa.fi/html/am-tietoa.html. Markkinoilla on selvä suuntaus tuotantokomponenttien valmistamiseen, kotitulostimien hintojen laskemiseen, sekä isompien kappaleiden valmistamiseen. Muovilevy komponenttien muovaamista tutkittiin laserin ja alipaineen avulla DDShape laitteella. Laitteella onnistuttiin tekemään testikappaleita ja laitetta saatiin kehitettyä eteenpäin. Laitteiston kehittämiseksi ja kaupallistamisen tueksi Tekes on myöntänyt "Tutkimusideoista uutta tietoa ja liiketoimintaa" (TUTLI) rahoituksen. ISF mini projektissa onnistuttiin kehittämään edullinen pienten kappaleiden painomuovauskone. Samalla kartoitettiin laitteelle soveltuvat parametrit ja rajoitukset. Laseravusteisella muovaamisella päästään kuparilla isompaan seinämän kaltevuuteen ja pinnalaatu pysyy hyvänä. Teräksellä laserista ei ollut juuri hyötyä ja alumiinilla muovattavuus kyllä parani, mutta pinnalaatu huononi. AM kappaleiden viimeistelykoneistuksessa tutkittiin muovisten kappaleiden viimeistely jyrsimällä, sekä metallikappaleiden automaattista hiontaa. Jyrsinnässä vertailtiin eri menetelmillä tehtyjä kappaleita, sekä mitattiin kappaleiden mittatarkkuutta ja geometrisia toleransseja. Huonosta kotitulostimella tehdystä kappaleesta on vaikea saada hyvää kappaletta vaikka se viimeisteltäisiin koneistamalla. Suurimmat ongelmat liittyvät kappaleiden vääntymiseen johtuen lämpöjännityksistä valmistusprosessin aikana. Kappaleiden automaattisessa hionnassa parhaat tulokset saatiin DMLS kappaleille käyttämällä hionta-aineena teräshauleja ja pyörittämällä niitä hiottavat kappaleen kanssa rummussa. Ra arvo parani tällöin noin seitsemästä mikrometristä kolmeen mikrometriin

‘Recommendations for the development of a framework for radiological imaging studies during implant therapy in SA’

Philosophiae Doctor - PhDRadiographic examination is an essential facet of dental implant therapy, and the success of this therapy depends on a suitable treatment based on adequate clinical and radiographic information. International organisational bodies have published guidelines on the use of radiographic imaging during implant therapy, but since the cone beam computed tomography modality became available, a need for the development of comprehensive imaging guidelines to limit the misuse of this modality became necessary. There is a lack of stringency regarding the recommendations and guidelines on radiographic imaging modalities used during implant therapy. This is due to variations in practice, experience, and socioeconomic factors. The most recent published global guidelines and recommendations and their relevance to dental implant therapy are described in this chapter

Case series of breast fillers and how things may go wrong: radiology point of view

INTRODUCTION: Breast augmentation is a procedure opted by women to overcome sagging breast due to breastfeeding or aging as well as small breast size. Recent years have shown the emergence of a variety of injectable materials on market as breast fillers. These injectable breast fillers have swiftly gained popularity among women, considering the minimal invasiveness of the procedure, nullifying the need for terrifying surgery. Little do they know that the procedure may pose detrimental complications, while visualization of breast parenchyma infiltrated by these fillers is also deemed substandard; posing diagnostic challenges. We present a case series of three patients with prior history of hyaluronic acid and collagen breast injections. REPORT: The first patient is a 37-year-old lady who presented to casualty with worsening shortness of breath, non-productive cough, central chest pain; associated with fever and chills for 2-weeks duration. The second patient is a 34-year-old lady who complained of cough, fever and haemoptysis; associated with shortness of breath for 1-week duration. CT in these cases revealed non thrombotic wedge-shaped peripheral air-space densities. The third patient is a 37‐year‐old female with right breast pain, swelling and redness for 2- weeks duration. Previous collagen breast injection performed 1 year ago had impeded sonographic visualization of the breast parenchyma. MRI breasts showed multiple non- enhancing round and oval shaped lesions exhibiting fat intensity. CONCLUSION: Radiologists should be familiar with the potential risks and hazards as well as limitations of imaging posed by breast fillers such that MRI is required as problem-solving tool

Characterization of alar ligament on 3.0T MRI: a cross-sectional study in IIUM Medical Centre, Kuantan

INTRODUCTION: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female. The specific objectives are to assess the prevalence of alar ligament visualized on MRI, to describe its characteristics in term of its course, shape and signal homogeneity and to find differences in alar ligament signal intensity between male and female. This study also aims to determine the association between the heights of respondents with alar ligament signal intensity and dimensions. MATERIALS & METHODS: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. RESULTS: Alar ligament was best depicted in coronal plane, followed by sagittal and axial planes. The orientations were laterally ascending in most of the subjects (60%), predominantly oval in shaped (54%) and 67% showed inhomogenous signal. No significant difference of alar ligament signal intensity between male and female respondents. No significant association was found between the heights of the respondents with alar ligament signal intensity and dimensions. CONCLUSION: Employing a 3.0T MR scanner, the alar ligament is best portrayed on coronal plane, followed by sagittal and axial planes. However, tremendous variability of alar ligament as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury

XXII International Conference on Mechanics in Medicine and Biology - Abstracts Book

This book contain the abstracts presented the XXII ICMMB, held in Bologna in September 2022. The abstracts are divided following the sessions scheduled during the conference