Machine Learning Framework to Identify Individuals at Risk of Rapid Progression of Coronary Atherosclerosis: From the PARADIGM Registry.

Background Rapid coronary plaque progression (RPP) is associated with incident cardiovascular events. To date, no method exists for the identification of individuals at risk of RPP at a single point in time. This study integrated coronary computed tomography angiography-determined qualitative and quantitative plaque features within a machine learning (ML) framework to determine its performance for predicting RPP. Methods and Results Qualitative and quantitative coronary computed tomography angiography plaque characterization was performed in 1083 patients who underwent serial coronary computed tomography angiography from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) registry. RPP was defined as an annual progression of percentage atheroma volume ≥1.0%. We employed the following ML models: model 1, clinical variables; model 2, model 1 plus qualitative plaque features; model 3, model 2 plus quantitative plaque features. ML models were compared with the atherosclerotic cardiovascular disease risk score, Duke coronary artery disease score, and a logistic regression statistical model. 224 patients (21%) were identified as RPP. Feature selection in ML identifies that quantitative computed tomography variables were higher-ranking features, followed by qualitative computed tomography variables and clinical/laboratory variables. ML model 3 exhibited the highest discriminatory performance to identify individuals who would experience RPP when compared with atherosclerotic cardiovascular disease risk score, the other ML models, and the statistical model (area under the receiver operating characteristic curve in ML model 3, 0.83 [95% CI 0.78-0.89], versus atherosclerotic cardiovascular disease risk score, 0.60 [0.52-0.67]; Duke coronary artery disease score, 0.74 [0.68-0.79]; ML model 1, 0.62 [0.55-0.69]; ML model 2, 0.73 [0.67-0.80]; all P<0.001; statistical model, 0.81 [0.75-0.87], P=0.128). Conclusions Based on a ML framework, quantitative atherosclerosis characterization has been shown to be the most important feature when compared with clinical, laboratory, and qualitative measures in identifying patients at risk of RPP

Radiogenomics in clear cell renal cell carcinoma: correlations between advanced CT imaging (texture analysis) and microRNAs expression

Purpose: A relevant challenge for the improvement of clear cell renal cell carcinoma management could derive from the identification of novel molecular biomarkers that could greatly improve the diagnosis, prognosis, and treatment choice of these neoplasms. In this study, we investigate whether quantitative parameters obtained from computed tomography texture analysis may correlate with the expression of selected oncogenic microRNAs. Methods: In a retrospective single-center study, multiphasic computed tomography examination (with arterial, portal, and urographic phases) was performed on 20 patients with clear cell renal cell carcinoma and computed tomography texture analysis parameters such as entropy, kurtosis, skewness, mean, and standard deviation of pixel distribution were measured using multiple filter settings. These quantitative data were correlated with the expression of selected microRNAs (miR-21-5p, miR-210-3p, miR-185-5p, miR-221-3p, miR-145-5p). Both the evaluations (microRNAs and computed tomography texture analysis) were performed on matched tumor and normal corticomedullar tissues of the same patients cohort. Results: In this pilot study, we evidenced that computed tomography texture analysis has robust parameters (eg, entropy, mean, standard deviation) to distinguish normal from pathological tissues. Moreover, a higher coefficient of determination between entropy and miR-21-5p expression was evidenced in tumor versus normal tissue. Interestingly, entropy and miR-21-5p show promising correlation in clear cell renal cell carcinoma opening to a radiogenomic strategy to improve clear cell renal cell carcinoma management. Conclusion: In this pilot study, a promising correlation between microRNAs and computed tomography texture analysis has been found in clear cell renal cell carcinoma. A clear cell renal cell carcinoma can benefit from noninvasive evaluation of texture parameters in adjunction to biopsy results. In particular, a promising correlation between entropy and miR-21-5p was found

Role of peripheral quantitative computed tomography in identifying disuse osteoporosis in paraplegia

Objective: Disuse osteoporosis is a major long-term health consequence of spinal cord injury (SCI) that still needs to be addressed. Its management in SCI should begin with accurate diagnosis, followed by targeted treatments in the most vulnerable subgroups. We present data quantifying disuse osteoporosis in a cross-section of the Scottish paraplegic population to identify subgroups with lowest bone mineral density (BMD). Materials and Methods: Forty-seven people with chronic SCI at levels T2-L2 were scanned using peripheral Quantitative Computed Tomography (pQCT) at four tibial sites and two femoral sites, at the Queen Elizabeth National Spinal Injuries Unit, Glasgow (U.K.). At the distal epiphyses, trabecular BMD (BMDtrab), total BMD, total bone cross-sectional area (CSA), and bone mineral content (BMC) were determined. In the diaphyses, cortical BMD, total bone CSA, cortical CSA, and BMC were calculated. Bone, muscle and fat CSAs were estimated in the lower leg and thigh. Results: BMDtrab decreased exponentially with time since injury, at different rates in the tibia and femur. At most sites, female paraplegics had significantly lower BMC, total bone CSA and muscle CSA than male paraplegics. Subjects with lumbar SCI tended to have lower bone values and smaller muscle CSAs than in thoracic SCI. Conclusion: At the distal epiphyses of the tibia and femur, there is generally a rapid and extensive reduction in BMDtrab after SCI. Female subjects, and those with lumbar SCI, tend to have lower bone values than males or those with thoracic SCI, respectively. Keywords: Bone loss, osteoporosis, paraplegia, peripheral Quantitative Computed Tomography, spinal cord injur

X-ray tomography as a tool for detailed anatomical analysis

Wood identification, anatomical examination and retrieval of quantitative information arc important aspects of many research disciplines. Conventional light microscopy with a camera and (semi)automatic image analysis software is an often used methodology for these purposes. Morc advanced techniques such as fluorescence, scanning electron, transmission electron, confocal laser scanning and atomic force microscopy arc also part of the toolset answering to the need for detailed imaging. Fast, non-destructive visualization in three dimensions with high resolution combined with a broad field of view is sought-after, especially in combination with flexible software. A highly advanced supplement to the existing techniques, namely X-ray sub-micron tomography, meets these requirements. It enables the researcher to visualize the material with a voxel size approaching <1 mu m for small samples (<1 mm). Furthermore, with tailor-made processing software quantitative data about the wood in two and three dimensions can be obtained. Examples of visualization and analysis of four wood species arc given in this paper, focusing on the opportunities of tomography at micron and sub-micron resolution. X-ray computed tomography offers many possibilities for material research in general and wood science in specific, as a qualitative as well as a quantitative technique

Contributions of X-ray CT to the characterization of natural building stones and their disintegration

This paper highlights the use of the high resolution scanner at the Centre for X-ray Tomography in Ghent, Belgium (UGCT), for the 3D quantitative evaluation of the disintegration of some French natural building stones. Rocks deteriorate when they are exposed to extreme weathering factors such as a combination of water and freeze-thaw cycles or high pressure. The results of those processes can be very diverse: from element migration to crust formation to the origination of micro-cracks. Thanks to its non-destructive character, high resolution computed tomography (CT) turned out to be an excellent monitoring tool as it contributes to the characterization of the internal structure of the natural building stone. X-ray CT also provides a better insight into the micro-structural durability properties of the building stone

3D imaging of clay minerals inside sandstone: pushing the spatial resolution limits using ptychographic tomography

Characterization of microporous, clay-sized particles in natural stone is essential for the understanding of their dynamics. These processes are importand in the fields of oil and gas, groundwater, building stone weathering and soil science. Methods such as X-ray micro-computed tomography is an excellent tool to study features larger than or just under 1 μm, but below the 400 nm limit, the technique falls short. Although destructive methods exists (e.g. FIB/SEM), non-destructive imaging at these very high resolutions has been impossible, until recent developments at synchrotron beam lines. In this study, we use ptychographic tomography at the cSAXS beam line of the PSI in Switzerland, for imaging of clay microstructure at resolutions down to 45 nm, which is the first application of ptychographic tomography for geological samples to our knowledge. During these experiments, relative humidity of the sample’s environment was controlled, in order to asses the influence of R.H. on the analyzed clay minerals. Based on these images, quantitative data on mineral content, porosity, connectivity and behavior under changing environmental conditions of clay mineral clusters was acquired

In vivo assessment of the mechanical properties of the child cortical bone using quantitative computed tomography

The mechanical properties of the rib cortical bone are extremely rare on children due to difficulties to obtain specimens to perform conventional tests. Some recent studies used cadaveric bones or bone tissues collected during surgery but are limited by the number of samples that could be collected. A non-invasive technique could be extremely valuable to overcome this limitation. It has been shown that a relationship exists between the mechanical properties (apparent Young’s modulus and ultimate strength) and the bone mineral density (assessed using Quantitative Computed Tomography, QCT), for the femur and recently by our group for the adult ribs ex vivo. Thus the aim of this study was to assess the mechanical properties of the child rib cortical bone using both QCT images in vivo and the previous relationship between bone mineral density and mechanical properties of the rib cortical bone. Twenty-eight children were included in this study. Seven age-groups have been considered (1, 1.5, 3, 6, 10, 15, 18 years old). The QCT images were prescribed for various thoracic pathologies at the pediatric hospital in Lyon. A calibration phantom was added to the clinical protocol without any modifications for the patient. The protocol was approved by the ethical committee. A 3D reconstruction of each thorax was performed using the QCT images. A custom software was then used to obtain cross-sections to the rib midline. The mean bone mineral density was then computed by averaging the Hounsfield Units in a specific cross-section and by converting the mean value (Hounsfield Units) in bone mineral density using the calibration phantom. This bone mineral density was assessed for the 6th rib of each subject. Our relationship between the bone mineral density and the mechanical properties of the rib cortical bone was used to derive the mechanical properties of the child ribs in vivo. The results give values for the apparent Young’s modulus and the ultimate strength. The mechanical properties increase along growth. As an example the apparent Young’s modulus in the lateral region ranges from 7 GPa +/-3 at 1 year old up to 13 GPa +/- 2 at 18 years old. These data are in agreement with the few previous values obtained from child tissues. This methodology opens the way to in vivo measurement of the mechanical properties of the child cortical bone based on calibrated QCT images

Radiation exposure awareness from patients undergoing nuclear medicine diagnostic 99mTc-MDP bone scans and 2-deoxy-2-(18F) fluoro-D-glucose PET/computed tomography scans

INTRODUCTION: Medical imaging is on average the largest source of artificial radiation exposure worldwide. This study seeks to understand patient's awareness of radiation exposure derived from nuclear medicine diagnostic scans and assess if current information provided by leaflets is adequate. METHODS: Single-centre cross-sectional questionnaire study applied to bone scan and FDG PET/computed tomography patients, at a nuclear medicine and PET/computed tomography department over a 15-week period in 2018. Questionnaires on dose comparators were designed in collaboration with patients, public, and experts in radiation exposure. Qualitative data were analysed using thematic analysis and quantitative data using SPSS (V. 24). RESULTS: A total of 102 questionnaires were completed (bone scan = 50; FDG PET/computed tomography = 52). Across both groups, 33/102 (32.4%) patients reported having a reasonable understanding of nuclear medicine and 21/102 (20.6%) reported a reasonable knowledge of ionising radiations. When asked to compare the exposure dose of respective scans with common comparators 8/50 (16%) of bone scan patients and 11/52 (21.2%) FDG PET/computed tomography answered correctly. On leaflet information, 15/85 (17.6%) patients reported the leaflets do not provide enough information on radiation exposure and of these 10/15 (66.7%) commented the leaflets should incorporate more information on radiation exposure dose. CONCLUSION: More observational and qualitative studies in collaboration with patients are warranted to evaluate patients' understanding and preferences in communication of radiation exposure from nuclear medicine imaging. This will ensure communication tools and guidelines developed to comply with ionising radiation (medical exposure) regulation 2017 are according to patients needs and preferences

Vessel tractography using an intensity based tensor model

In this paper, we propose a novel tubular structure segmen- tation method, which is based on an intensity-based tensor that fits to a vessel. Our model is initialized with a single seed point and it is ca- pable of capturing whole vessel tree by an automatic branch detection algorithm. The centerline of the vessel as well as its thickness is extracted. We demonstrated the performance of our algorithm on 3 complex contrast varying tubular structured synthetic datasets for quantitative validation. Additionally, extracted arteries from 10 CTA (Computed Tomography An- giography) volumes are qualitatively evaluated by a cardiologist expert’s visual scores

Alkenylation and Allylation of Aldehydes by Using an Ni/Cr/TDAE Redox System

In 360 females, Bone mineral density (BMD) in lumbar vertebrae (L2-L4) was assessed by quantitative computed tomography (QCT), and the values obtained were compared with the frequency of vertebral transformation or fracture as assessed by lateral scan image (scanogram) by X-ray CT. A correlation was observed between the frequency of vertebral transformation (or fracture) and lumbar BMD values : BMD under 125 mg/cm(3) was observed over 90% of women with vertebral transformation, and BMD under 70mg/cm(3) was found about 50% of them. These results suggest that decrease in BMD in lumbar vertebrae leads to vertebral transformation or fracture. Thus, measurement of BMD by QCT would be very useful in predicting vertebral transformation or fractures