A fuzzy approach for feature extraction of brain tissues in Non-Contrast CT

In neuroimaging, brain tissue segmentation is a fundamental part of the techniques that seek to automate the detection of pathologies, the quantification of tissues or the evaluation of the progress of a treatment. Because of its wide availability, lower cost than other imaging techniques, fast execution and proven efficacy, Non-contrast Cerebral Computerized Tomography (NCCT) is the most used technique in emergency room for neuroradiology examination, however, most research on brain segmentation focuses on MRI due to the inherent difficulty of brain tissue segmentation in NCCT. In this work, three brain tissues were characterized: white matter, gray matter and cerebrospinal fluid in NCCT images. Feature extraction of these structures was made based on the radiological attenuation index denoted by the Hounsfield Units using fuzzy logic techniques. We evaluated the classification of each tissue in NCCT images and quantified the feature extraction technique in images from real tissues with a sensitivity of 92% and a specificity of 96% for images from cases with slice thickness of 1 mm, and 96% and 98% respectively for those of 1.5 mm, demonstrating the ability of the method as feature extractor of brain tissues.Postprint (published version

Automated detection of parenchymal changes of ischemic stroke in non-contrast computer tomography: a fuzzy approach

The detection of ischemic changes is a primary task in the interpretation of brain Computer Tomography (CT) of patients suffering from neurological disorders. Although CT can easily show these lesions, their interpretation may be difficult when the lesion is not easily recognizable. The gold standard for the detection of acute stroke is highly variable and depends on the experience of physicians. This research proposes a new method of automatic detection of parenchymal changes of ischemic stroke in Non-Contrast CT. The method identifies non-pathological cases (94 cases, 40 training, 54 test) based on the analysis of cerebral symmetry. Parenchymal changes in cases with abnormalities (20 cases) are detected by means of a contralateral analysis of brain regions. In order to facilitate the evaluation of abnormal regions, non-pathological tissues in Hounsfield Units were characterized using fuzzy logic techniques. Cases of non-pathological and stroke patients were used to discard/confirm abnormality with a sensitivity (TPR) of 91% and specificity (SPC) of 100%. Abnormal regions were evaluated and the presence of parenchymal changes was detected with a TPR of 96% and SPC of 100%. The presence of parenchymal changes of ischemic stroke was detected by the identification of tissues using fuzzy logic techniques. Because of abnormal regions are identified, the expert can prioritize the examination to a previously delimited region, decreasing the diagnostic time. The identification of tissues allows a better visualization of the region to be evaluated, helping to discard or confirm a stroke.Peer ReviewedPostprint (author's final draft

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

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

SCINTIGRAPHIC EVALUATION OF THE CHEEK TEETH IN CLINICALLY SOUND HORSES

In dieser prospektiven, deskriptiven Querschnitts- und Pilotstudie sollten die Radioisotopen-Aufnahmemuster (radioisotope uptake - RU) der Reservekrone und des parodontalen Knochens der Ober- und Unterkieferbackenzähne (CT) bei klinisch gesunden Pferden beschrieben und die Auswirkungen des Alters auf die RU bewertet werden.:Table of Contents Abbreviations: .......................................................................................................... VI 1. Introduction ........................................................................................................ 1 2. Literature overview ............................................................................................ 3 2.1. Evolution of equine dentistry ......................................................................... 3 2.2. Epidemiology of equine dental pathology ..................................................... 5 2.3. Diagnostic imaging modality and equine dental disorders ............................ 5 2.4. Bone scintigraphy as diagnostic tool of equine dental disorders .................. 6 2.5. Literature review of equine dental scintigraphy ............................................ 8 3. Publication ........................................................................................................ 10 Scintigraphic evaluation of the cheek teeth in clinically sound horses ............ 10 3.1. Author contributions .................................................................................... 11 3.2. Abstract ....................................................................................................... 12 3.3. Introduction ................................................................................................. 12 3.4. Material and methods ................................................................................. 14 3.4.1. Subject selection ...................................................................................... 14 3.4.2. Scintigraphic examination ........................................................................ 14 3.4.3. Pilot study ................................................................................................ 15 3.4.4. Image processing and analysis ................................................................ 16 3.4.5. Statistical analysis .................................................................................... 16 3.5. Results ........................................................................................................ 17 3.6. Discussion .................................................................................................. 18 3.7. References ................................................................................................. 22 4. Discussion ........................................................................................................ 31 4.1. Animals ....................................................................................................... 31 4.2. Methodology ............................................................................................... 31 4.3. Results ........................................................................................................ 33 4.4. Study limitation ........................................................................................... 38 4.5. Clinical relevance ........................................................................................ 38 5. Zusammenfassung .......................................................................................... 40 6. Summary ........................................................................................................... 42 7. References ........................................................................................................ 44 8. Acknowledgements ......................................................................................... 51This prospective, cross-sectional, descriptive and pilot-designed study aimed to describe the radioisotope uptake (RU) patterns of the reserved crown and periodontal bone of the maxillary and mandibular cheek teeth (CT) in clinically sound horses and to evaluate the age effect on RU. For this purpose, 60 horses that underwent a bone scintigraphy for reason unrelated to head were included and divided equally into four age groups.:Table of Contents Abbreviations: .......................................................................................................... VI 1. Introduction ........................................................................................................ 1 2. Literature overview ............................................................................................ 3 2.1. Evolution of equine dentistry ......................................................................... 3 2.2. Epidemiology of equine dental pathology ..................................................... 5 2.3. Diagnostic imaging modality and equine dental disorders ............................ 5 2.4. Bone scintigraphy as diagnostic tool of equine dental disorders .................. 6 2.5. Literature review of equine dental scintigraphy ............................................ 8 3. Publication ........................................................................................................ 10 Scintigraphic evaluation of the cheek teeth in clinically sound horses ............ 10 3.1. Author contributions .................................................................................... 11 3.2. Abstract ....................................................................................................... 12 3.3. Introduction ................................................................................................. 12 3.4. Material and methods ................................................................................. 14 3.4.1. Subject selection ...................................................................................... 14 3.4.2. Scintigraphic examination ........................................................................ 14 3.4.3. Pilot study ................................................................................................ 15 3.4.4. Image processing and analysis ................................................................ 16 3.4.5. Statistical analysis .................................................................................... 16 3.5. Results ........................................................................................................ 17 3.6. Discussion .................................................................................................. 18 3.7. References ................................................................................................. 22 4. Discussion ........................................................................................................ 31 4.1. Animals ....................................................................................................... 31 4.2. Methodology ............................................................................................... 31 4.3. Results ........................................................................................................ 33 4.4. Study limitation ........................................................................................... 38 4.5. Clinical relevance ........................................................................................ 38 5. Zusammenfassung .......................................................................................... 40 6. Summary ........................................................................................................... 42 7. References ........................................................................................................ 44 8. Acknowledgements ......................................................................................... 5

Detailed structure of the venous drainage of the brain: relevance to accidental and non-accidental traumatic head injuries

This project aimed to prove the existence of fine subdural veins hypothesised to be the source of intracranial bleeding seen in cases of accidental and non-accidental traumatic head injuries, and consequently illustrate their anatomical structure. This was important in contributing towards establishing the causal mechanism for traumatic intracranial bleeding, and was particularly applicable in unexplained traumatic head injuries in cases of possible child abuse. These issues are on-going, worldwide concerns that have been of public as well as scientific concern for many years. To illustrate the fine cerebral vessels, a unique modelling technique was recently developed involving polyurethane resin casting of the brain vasculature. Rat, marmoset, rhesus macaque and human brain tissue were all used. Tissue surrounding the resin perfused vessels were then either macerated to reveal the whole cast, or dissected to illustrate the cast as it would appear in situ. To allow analysis of these fine subdural vessels, various imaging techniques including fluorescence microscopy, light microscopy, confocal microscopy, scanning electron microscopy, transmission electron microscopy, magnetic resonance imaging, micro-computed tomography and 3D X-ray microscopy were used. The existence of subdural vessels was clearly illustrated via gross dissection of both primate and cadaveric material. Fluorescence imaging of resin-filled rat brain histological sections also showed orientation of fine vessels within the subdural space. Magnetic resonance imaging of the human head in vivo, as well as cadaveric material have shown signs of small calibre vessels that have never been previously documented, that are too fine to be bridging veins, yet seem to drain into the superior sagittal sinus. These results prove the existence of subdural vessels, present in a range of different species. Future work will further illustrate the exact morphological structure of these vessels, and biomechanical modelling will be applied to determine the exact forces required to cause them to rupture