Assessment of Bone Mineral Density in Male Patients with Chronic Obstructive Pulmonary Disease by DXA and Quantitative Computed Tomography

The purpose of this study is to identify the prevalence of osteoporosis in male patients with chronic obstructive pulmonary disease (COPD) by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and to compare the diagnostic abilities of the above methods. Thirty-seven male patients with established COPD were examined with DXA and standard QCT in lumbar spine, including L1, L2, and L3 vertebrae. T-scores and bone mineral density values were calculated by DXA and QCT method, respectively. Comparative assessment of the findings was performed and statistical analysis was applied. QCT measurements found more COPD patients with impaired bone mineral density compared to DXA, namely, 13 (35.1%) versus 12 (32.4%) patients with osteopenia and 16 (43.2%) versus 9 (16.2%) patients with osteoporosis (p=0.04). More vertebrae were found with osteoporosis by QCT compared to DXA (p=0.03). The prevalence of osteoporosis among male patients with COPD is increased and DXA may underestimate this risk. QCT measurements have an improved discriminating ability to identify low BMD compared to DXA measurements because QCT is able to overcome diagnostic pitfalls including aortic calcifications and degenerative spinal osteophytes

Incidental Non-Cardiac Findings of a Coronary Angiography with a 128-Slice Multi-Detector CT Scanner: Should We Only Concentrate on the Heart?

Objective: To evaluate the spectrum, prevalence, and significance of incidental non-cardiac findings (INCF) in patients referred for a non-invasive coronary angiography using a 128-slice multi-detector CT (MDCT). Materials and Methods: The study subjects included 1,044 patients; 774 males (mean age, 59.9 years) and 270 females (mean age, 63 years), referred for a coronary CT angiography on a 128-slice MDCT scanner. The scans were acquired from the level of the carina to just below the diaphragm. To evaluate INCFs, images were reconstructed with a large field of view (> 300 mm) covering the entire thorax. Images were reviewed in the axial, coronal, and sagittal planes, using the mediastinal, lung, and bone windows. The INCFs were classified as severe, indeterminate, and mild, based on their clinical importance, and as thoracic or abdominal based on their locations. Results: Incidental non-cardiac findings were detected in 56% of patients (588 of 1,044), including 435 males (mean age, 65.6 years) and 153 females (mean age, 67.9 years). A total of 729 INCFs were observed: 459 (63%) mild (58% thoracic, 43% abdominal), 96 (13%) indeterminate (95% thoracic, 5% abdominal), and 174 (24%) severe (87% thoracic, 13% abdominal). The prevalence of severe INCFs was 15%. Two severe INCFs were histologically verified as lung cancers. Conclusion: The 128-slice MDCT coronary angiography, in addition to cardiac imaging, can provide important information on the pathology of the chest and upper abdomen. The presence of severe INCFs is not rare, especially in the thorax. Therefore, all organs in the scan should be thoroughly evaluated in daily clinical practice

New imaging methods in the detection of vesicoureteral reflux

PURPOSE: attempt to find out an effective and reliable alternative method for the diagnosis of vesicoureteral reflux (VUR), without irradiation, in children, and the comparison of its results with those of voiding cystourethrography (VCUG).METHODS: in a prospective comparative study we examined 88 children (176 units) sonographically and with VCUG, in order to detect VUR. First we examined sonographically the kidney’s morphology on an empty bladder. Then we examined them sonographically after filling the urinary bladder with fluid (fluid cystorenography, fluid-CRG) and after filling it with air (air cystorenography, air-CRG). Within the following 2-5 days the standard VCUG was performed. We compared the results of these three methods.RESULTS: fluid-CRG showed fluid reflux to the pelvicalyceal system in 25/176 kidneys (sensitivity 94,4%, specificity 94,9%, accuracy 94,9%). Air-CRG showed air reflux in 19/176 kidneys (sensitivity 83,3%, specificity 96,8%, accuracy 95,4%). VCUG showed VUR in 18/176 pelvicalyceal systems and/or ureters.CONCLUSION: fluid-CRG and/or air-CRG can be used as complimentary methods to the VCUG, or during the follow up of patients with known VUR. VCUG cannot be replaced completely by fluid-CRG or air-CRG, especially the first and the last one, because of the false negative results of these methods and because none of them can show the renal collecting system, the urinary bladder and the urethra on the standard way.ΣΚΟΠΟΣ: η προσπάθεια ανεύρεσης αποτελεσματικής εναλλακτικής μεθόδου διάγνωσης της κυστεοουρητηρικής παλινδρόμησης (ΚΟΠ) σε παιδιά χωρίς τη χρήση ακτινοβολίας και η σύγκριση των αποτελεσμάτων μας με τη μέθοδο της ανιούσας κυστεογραφίαςΥΛΙΚΟ: σε μια προοπτική μελέτη εξετάστηκαν 88 παιδιά (176 νεφρικές μονάδες) με ανιούσα κυστεογραφία και υπερηχοτομογραφία με σκοπό την ανάδειξη ΚΟΠ. Αρχικά ο έλεγχος έγινε με άδεια ουροδόχο κύστη. Ακολούθησε υπερηχογραφικός έλεγχος κατόπιν πλήρωσης της ουροδόχου κύστης διαδοχικά με υγρό (υγροκυστεογραφία) και με αέρα (αεροκυστεογραφία). Στις επόμενες 2-5 ημέρες πραγματοποιήθηκε ο έλεγχος με ανιούσα κυστεοουρηθρογραφία. Συγκρίναμε τα αποτελέσματα των τριών μεθόδων.ΑΠΟΤΕΛΕΣΜΑΤΑ: η υγροκυστεογραφία ανέδειξε παλινδρόμηση υγρού σε 25/176 νεφρούς (ευαισθησία 94,4%, ειδικότητα 94,9%, ακρίβεια 94,9%). Η αεροκυστεογραφία ανέδειξε παλινδρόμηση αέρα σε 19/176 νεφρούς (ευαισθησία 83,3%, ειδικότητα 96,8%, ακρίβεια 95,4%). Η ανιούσα κυστεοουρηθρογραφία ανέδειξε ΚΟΠ στους 18/176 νεφρούς.ΣΥΜΠΕΡΑΣΜΑ: η υγροκυστεογραφία και η αεροκυστεογραφία μπορούν να χρησιμοποιηθούν ως εναλλακτικές μέθοδοι της ανιούσας κυστεοουρηθρογραφίας, ή ως μόνες μέθοδοι στον επανέλεγχο παιδιών με γνωστή ΚΟΠ. Η ανιούσα κυστεοουρηθρογραφία δεν μπορεί να αντικατασταθεί πλήρως από την υγροκυστεογραφία και την αεροκυστεογραφία, ιδιαίτερα στον πρώτο και στον τελευταίο έλεγχο του παιδιού, λόγω των ψευδώς αρνητικών αποτελεσμάτων που παρουσιάζουν και καθώς καμία από αυτές δεν αναδεικνύει την ανατομία του αποχετευτικού νεφρικού συστήματος, της ουροδόχου κύστεως και της ουρήθρας

Application of Radiomics and Decision Support Systems for Breast MR Differential Diagnosis

Over the years, MR systems have evolved from imaging modalities to advanced computational systems producing a variety of numerical parameters that can be used for the noninvasive preoperative assessment of breast pathology. Furthermore, the combination with state-of-the-art image analysis methods provides a plethora of quantifiable imaging features, termed radiomics that increases diagnostic accuracy towards individualized therapy planning. More importantly, radiomics can now be complemented by the emerging deep learning techniques for further process automation and correlation with other clinical data which facilitate the monitoring of treatment response, as well as the prediction of patient’s outcome, by means of unravelling of the complex underlying pathophysiological mechanisms which are reflected in tissue phenotype. The scope of this review is to provide applications and limitations of radiomics towards the development of clinical decision support systems for breast cancer diagnosis and prognosis

Body Composition in Adult Patients with Thalassemia Major

Objective. To assess body composition in adult male and female patients with thalassemia major by dual-energy X-ray absorptiometry (DXA) and to compare the findings with a group of healthy age-matched controls. Methods. Our study group included sixty-two patients (27 males, mean age 36 years, and 35 females, mean age 36.4 years) and fifteen age-matched healthy controls. All patients had an established diagnosis of thalassemia major and followed a regular blood transfusion scheme since childhood and chelation treatment. Fat, lean, and bone mineral density (BMD) were assessed with dual-energy X-ray absorptiometry. Ferritin levels and body mass index of all patients and controls were also recorded. Student t-test and Wilcoxon test were performed and statistical significance was set at p<0.05. Results. BMD and whole body lean mass are lower in both male and female adult patients compared with controls (p<0.01 in both groups), whereas whole body fat mass was found to have no statistically significant difference compared to controls. Regional trunk fat around the abdomen was found to be lower in male patients compared to controls (p=0.02). Conclusion. Severe bone loss and diminished lean mass are expected in adult male and female patients with thalassemia major. Fat changes seem to affect mainly male patients