The indicators of optical density of the alveolar bone of patients with chronic generalized parodontitis and bruxism

The article is devoted to the study of optical density of patients with paradentium diseases. The aim of the study was the evaluation of indicators of optical density of bone tissue of jaws using dental computerized tomography in patients with chronic generalized parodontitis. Materials and methods: in the research following methods were used: dental computerized tomography, densitometry, index estimation of paradentium tissues. The characteristics of clinical, functional features of patients were given. The method of treatment was developed. The effectiveness of this method was evaluated. The positive dynamics of clinical symptoms is more pronounced in patients that received the offered method of treatment, than in patients that received basic therapy. This revealed in the reduction of time of the treatment on 10 days in average. The disappearance of edema, hyperemia of the gingiva, pain and bleeding during the probing and during eating, the restoration of densely elastic consistency of the gingiva, correct configuration of marginal papillae and full gingival edge are clinically revealed. Complex use of basic therapy, laserphoresis with Kanalgat gel in patients with chronic generalized parodontitis of mild severity caused to significant increase in the clinical effectiveness of treatment.Целью работы явилось определение показателей оптической плотности костной ткани челюстей с помощью метода дентальной компьютерной томографии у пациентов с хроническим генерализованным пародонтитом. Материалы и методы: в исследовании использовались следующие методы диагностики: дентальная компьютерная томография, денситометрия, индексная оценка тканей пародонта. Проводилось лечение с использованием лазерофореза с гелем канальгат. Представлены результаты комплексного обследования, диагностики и лечения 95 пациентов с хроническим генерализованным пародонтитом легкой степени тяжести. Дана характеристика клиническим, функциональным особенностям этих больных. Разработан метод лечения. Определена его эффективность. Положительная динамика клинической симптоматики имела более выраженный характер у пациентов, получавших предложенный метод лечения, чем у пациентов, получавших базовую терапию. Это проявлялось в сокращении сроков лечения в среднем на 10 дней. Клинически проявлялось исчезновением отека, гиперемии десны, боли и кровоточивости при зондировании и при приеме пищи, восстановлением плотноэластической консистенции десны, правильной конфигурации маргинальных сосочков и всего десневого края. Комплексное применение базовой терапии, лазерофореза с гелем канальгат у пациентов с хроническим генерализованным пародонтитом легкой степени тяжести, вызвало достоверное повышение клинической эффективности лечения

Detection of liver cirrhosis in standard T2-weighted MRI using deep transfer learning

Objectives!#!To investigate the diagnostic performance of deep transfer learning (DTL) to detect liver cirrhosis from clinical MRI.!##!Methods!#!The dataset for this retrospective analysis consisted of 713 (343 female) patients who underwent liver MRI between 2017 and 2019. In total, 553 of these subjects had a confirmed diagnosis of liver cirrhosis, while the remainder had no history of liver disease. T2-weighted MRI slices at the level of the caudate lobe were manually exported for DTL analysis. Data were randomly split into training, validation, and test sets (70%/15%/15%). A ResNet50 convolutional neural network (CNN) pre-trained on the ImageNet archive was used for cirrhosis detection with and without upstream liver segmentation. Classification performance for detection of liver cirrhosis was compared to two radiologists with different levels of experience (4!##!Results!#!Dice coefficients for automatic segmentation were above 0.98 for both validation and test data. The classification accuracy of liver cirrhosis on validation (vACC) and test (tACC) data for the DTL pipeline with upstream liver segmentation (vACC = 0.99, tACC = 0.96) was significantly higher compared to the resident (vACC = 0.88, p < 0.01; tACC = 0.91, p = 0.01) and to the board-certified radiologist (vACC = 0.96, p < 0.01; tACC = 0.90, p < 0.01).!##!Conclusion!#!This proof-of-principle study demonstrates the potential of DTL for detecting cirrhosis based on standard T2-weighted MRI. The presented method for image-based diagnosis of liver cirrhosis demonstrated expert-level classification accuracy.!##!Key points!#!• A pipeline consisting of two convolutional neural networks (CNNs) pre-trained on an extensive natural image database (ImageNet archive) enables detection of liver cirrhosis on standard T2-weighted MRI. • High classification accuracy can be achieved even without altering the pre-trained parameters of the convolutional neural networks. • Other abdominal structures apart from the liver were relevant for detection when the network was trained on unsegmented images

Combining iterative metal artifact reduction and virtual monoenergetic images severely reduces hip prosthesis-associated artifacts in photon-counting detector CT

Abstract Aim of this study was to assess the impact of virtual monoenergetic images (VMI) in combination and comparison with iterative metal artifact reduction (IMAR) on hip prosthesis-associated artifacts in photon-counting detector CT (PCD-CT). Retrospectively, 33 scans with hip prosthesis-associated artifacts acquired during clinical routine on a PCD-CT between 08/2022 and 09/2022 were analyzed. VMI were reconstructed for 100–190 keV with and without IMAR, and compared to polychromatic images. Qualitatively, artifact extent and assessment of adjacent soft tissue were rated by two radiologists using 5-point Likert items. Quantitative assessment was performed measuring attenuation and standard deviation in most pronounced hypodense and hyperdense artifacts, artifact-impaired bone, muscle, vessels, bladder and artifact-free corresponding tissue. To quantify artifacts, an adjusted attenuation was calculated as the difference between artifact-impaired tissue and corresponding tissue without artifacts. Qualitative assessment improved for all investigated image reconstructions compared to polychromatic images (PI). VMI100keV in combination with IMAR achieved best results (e.g. diagnostic quality of the bladder: median PI: 1.5 (range 1–4); VMI100keV+IMAR: 5 (3–5); p < 0.0001). In quantitative assessment VMI100keV with IMAR provided best artifact reduction with an adjusted attenuation closest to 0 (e.g. bone: PI: 302.78; VMI100keV+IMAR: 51.18; p < 0.0001). The combination of VMI and IMAR significantly reduces hip prosthesis-associated artifacts in PCD-CT and improves the diagnostic quality of surrounding tissue

Free-breathing high resolution modified Dixon steady-state angiography with compressed sensing for the assessment of the thoracic vasculature in pediatric patients with congenital heart disease

Background!#!Cardiovascular magnetic resonance angiography (CMRA) is a non-invasive imaging modality of choice in pediatric patients with congenital heart disease (CHD). This study was aimed to evaluate the diagnostic utility of a respiratory- and electrocardiogram-gated steady-state CMRA with modified Dixon (mDixon) fat suppression technique and compressed sensing in comparison to standard first-pass CMRA in pediatric patients with CHD at 3 T.!##!Methods!#!In this retrospective single center study, pediatric CHD patients who underwent CMR with first-pass CMRA followed by mDixon steady-state CMRA at 3 T were analyzed. Image quality using a Likert scale from 5 (excellent) to 1 (non-diagnostic) and quality of fat suppression were assessed in consensus by two readers. Blood-to-tissue contrast and quantitative measurements of the thoracic vasculature were assessed separately by two readers. CMRA images were reevaluated by two readers for additional findings, which could be identified only on either one of the CMRA types. Paired Student t test, Wilcoxon test, and intraclass correlation coefficients (ICCs) were used for statistical analysis.!##!Results!#!32 patients with CHD (3.3 ± 1.7 years, 13 female) were included. Overall image quality of steady-state mDixon CMRA was higher compared to first-pass CMRA (4.5 ± 0.5 vs. 3.3 ± 0.5; P &amp;lt; 0.001). Blood-to-tissue contrast ratio of steady-state mDixon CMRA was comparable to first-pass CMRA (7.85 ± 4.75 vs. 6.35 ± 2.23; P = 0.133). Fat suppression of steady-state mDixon CMRA was perfect in 30/32 (94%) cases. Vessel diameters were greater in first-pass CMRA compared to steady-state mDixon CMRA with the greatest differences at the level of pulmonary arteries and veins (e.g., right pulmonary artery for reader 1: 10.4 ± 2.4 vs. 9.9 ± 2.3 mm, P &amp;lt; 0.001). Interobserver agreement was higher for steady-state mDixon CMRA for all measurements compared to first-pass CMRA (ICCs &amp;gt; 0.92). In 9/32 (28%) patients, 10 additional findings were identified on mDixon steady-state CMRA (e.g., partial anomalous venous return, abnormalities of coronary arteries, subclavian artery stenosis), which were not depicted using first-pass CMRA.!##!Conclusions!#!Steady-state mDixon CMRA offers a robust fat suppression, a high image quality, and diagnostic utility for the assessment of the thoracic vasculature in pediatric CHD patients

Diagnostic value of magnetic resonance parametric mapping for non-invasive assessment of liver fibrosis in patients with primary sclerosing cholangitis

Background!#!Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease, characterized by bile duct inflammation and destruction, leading to biliary fibrosis and cirrhosis. The purpose of this study was to investigate the utility of T1 and T2 mapping parameters, including extracellular volume fraction (ECV) for non-invasive assessment of fibrosis severity in patients with PSC.!##!Methods!#!In this prospective study, patients with PSC diagnosis were consecutively enrolled from January 2019 to July 2020 and underwent liver MRI. Besides morphological sequences, MR elastography (MRE), and T1 and T2 mapping were performed. ECV was calculated from T1 relaxation times. The presence of significant fibrosis (≥ F2) was defined as MRE-derived liver stiffness ≥ 3.66 kPa and used as the reference standard, against which the diagnostic performance of MRI mapping parameters was tested. Student t test, ROC analysis and Pearson correlation were used for statistical analysis.!##!Results!#!32 patients with PSC (age range 19-77 years) were analyzed. Both, hepatic native T1 (r = 0.66; P &amp;lt; 0.001) and ECV (r = 0.69; P &amp;lt; 0.001) correlated with MRE-derived liver stiffness. To diagnose significant fibrosis (≥ F2), ECV revealed a sensitivity of 84.2% (95% confidence interval (CI) 62.4-94.5%) and a specificity of 84.6% (CI 57.8-95.7%); hepatic native T1 revealed a sensitivity of 52.6% (CI 31.7-72.7%) and a specificity of 100.0% (CI 77.2-100.0%). Hepatic ECV (area under the curve (AUC) 0.858) and native T1 (AUC 0.711) had an equal or higher diagnostic performance for the assessment of significant fibrosis compared to serologic fibrosis scores (APRI (AUC 0.787), FIB-4 (AUC 0.588), AAR (0.570)).!##!Conclusions!#!Hepatic T1 and ECV can diagnose significant fibrosis in patients with PSC. Quantitative mapping has the potential to be a new non-invasive biomarker for liver fibrosis assessment and quantification in PSC patients