Neuroimaging of Tuberculosis- Modalities, Imaging Protocols and Radiomics: A Review

Background and objective: A large number of review and research articles exists in literature which describe the radiological appearance of various manifestations of nervous system tuberculosis, however there is paucity of text which describes the application of each and every imaging modality in the workup of the entire spectrum of this pathology. The intent of this article is to review the existing literature on the role of different radiological modalities in the stepwise work up of CNS TB. The article focuses on the role of plain radiograph, fluoroscopy, computed tomography, magnetic resonance imaging along with its advanced sequences and nuclear medicine in imaging of the many faces of tuberculosis in CNS. The article also aims to review the existing literature on the role of MR based textural analysis (Radiomics) as a problem-solving tool in various nervous system pathologies. Methods: We searched PubMed central databases for articles published in English from January 1 2000 to February 28 2021 along with references from the relevant articles. The search terms included “imaging in central nervous system tuberculosis” “Radiomics in tuberculosis “, “Radomics in central nervous system ”. In total 95 articles including case reports, case series, original articles and review articles were included in this review. Results: Conventional imaging modalities including radiograph and fluoroscopy are becoming extinct in work up of tuberculosis in the nervous system itself, however a plain radiograph still holds a key position in screening the chest for presence of subclinical respiratory tract infection in patients presenting with brain tuberculosis. In addition, it is a sensitive tool as baseline investigation in workup of spinal tuberculosis (T.B). Fluoroscopy is a useful tool in image guided procedures for collection of samples for histopathology and CSF analysis. Cross sectional imaging modalities including computed tomography and magnetic resonance imaging have revolutionized imaging of central nervous system pathologies in particular tuberculosis. Computed tomography acts as a screening tool to identify the presence of intracranial tuberculosis and recognize its complications. In addition it is an important tool to determine the extent of spinal T.B. Magnetic Resonance Imaging (MRI) along with its advanced sequences including spectroscopy, Magnetization transfer T1 sequence (MT T1), perfusion imaging, and magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) is an ideal imaging method to work up CNS TB. It can identify numerous manifestations of tuberculosis in the brain, work up its associated complication, and explain the extent of neurological symptoms. Moreover, it has the capability to differentiate TB from other nervous system infections. Furthermore, it can differentiate neoplastic and inflammatory brain disorders from CNS TB. Radiomics, particularly the textural features based on MR imaging is the future of neuroimaging. Its role is getting established in the work up of several intracranial pathologies including brain tumors and neurodegenerative disorders. Certainly, it has significant potential in the imaging work up of CNS tuberculosis, which is underexplored and therefore requires the central attention of upcoming researchers focusing on this topic. Conclusion: Cross sectional imaging is the mainstay of imaging workup. Nuclear imaging is becoming an essential adjuvant to determine the burden of the disease. Role of radiomics is evolving in intracranial pathologies and certainly needs the central attention of future researches to establish its role in CNS TB imaging

Mr Textural Features (Radiomics) For Predicting Response to Treatment in Patients with Intracranial Tuberculoma: A Retrospective Cross-Sectional Study

Background and objective: MR based radiomics can potentially response to treatment in intracranial tuberculoma, but very scarce literature is available in this regard. The purpose of this study was to determine whether MR based radiomic features can be used to predict response to antituberculosis (AT) treatment. Methods: Data of patients with intracranial tuberculomas who underwent MR imaging and AT treatment at our institution during the last 10 years was analyzed. In each case follow-up imaging performed at 6 months post initiation of treatment was reviewed to establish response to treatment. The textural analysis was performed by two consultant neuroradiologists, using open-source software (Lifex) with FLAIR coronal image after contrast administration from pretreatment MRI study radiomic analysis. Results: Twenty-four patients with mean age 33.8 years were included in the study. Sixteen patients were in the treatment responsive group while eight patients were in the treatment resistant group. Thirty-eight radiomic parameters were extracted for each patient. There was a significant difference in three out of 38 parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) in patients amongst the two groups. Logistic regression model was developed using these parameters which accurately predicted 83.3% of the cases according to the response to the AT treatment (χ2=11.517, p=0.003). ROC curve analysis was performed using histogram skewness which showed acceptable discrimination (p=0.037 and 95% CI =0.577-0.954) for predicting the response to treatment. Conclusion: MR textural parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) may be used as imaging biomarkers to predict response to treatment in patients with intracranial tuberculoma

Selective and Effective Strategic Collection Development Approach in Universities Libraries

Purpose: University libraries playing pivotal role in developing and delivering education among university community by providing authentic information resources in terms of books, magazines, academic research journals etc. Collection development policies adopted to select and purchase the library print and electronic resources which worked as a guide for decision making. The purpose of this study is to propose the collection development policy which will help the acquisition librarians in selecting, evaluating and purchasing the materials for academic/universities libraries. Methodology: The trends of collection development practices were identified through the intensive literature review. Then, the university libraries of Lahore were personally visited to understand their collection development policies and practices. Moreover, the acquisition librarians from outside of Lahore were contacted via phone call to understand and discuss the collection development process in their libraries. Findings: The study findings revealed that there is no systematic written policy for assessment, selection, evaluation and deselection of library material at the universities libraries of Pakistan. Even, the acquisition process of books in universities libraries vary from university to university and even province to province. However, the proposed collection development policy revealed that the automatic receiving of books and other library materials via gifts, donations, exchanging library materials, resource sharing, and subscribing memberships of other organizations will be helpful to enhance the library collection and also reduce the cost to purchase the library materials. The proposed steps for collection development will act as a segment of complete collection development policy and may work as a guide line of collection development procedure to the universities libraries. Originality/Value: The study is first attempt to draw holistic approach of collection development at national level and it will also provide guideline to select user centered resources and also beneficial in terms of saving finances by practicing the proposed steps for developing academic libraries collection

Reservoir Potential Evaluation of the Middle Paleocene Lockhart Limestone of the Kohat Basin, Pakistan: Petrophysical Analyses

The Lockhart Limestone is evaluated for its reservoir potential by utilizing wireline logs of Shakardara-01 well from Kohat Basin, Pakistan. The analyses showed 28.03% average volume of shale (Vsh), 25.57% average neutron porosity (NPHI), 3.31% average effective porosity (PHIE), 76% average water saturation (Sw), and 24.10% average hydrocarbon saturation (Sh) of the Lockhart Limestone in Shakardara-01 well. Based on variation in petrophysical character, the reservoir units of the Lockhart Limestone are divided into three zones i.e., zone-1, zone-2 and zone-3. Out of these zones, zone-1 and zone-2 possess a poor reservoir potential for hydrocarbons as reflected by very low effective porosity (1.40 and 2.02% respectively) and hydrocarbon saturation (15 and 5.20%), while zone-3 has a moderate reservoir potential due to its moderate effective porosity (6.50%) and hydrocarbon saturation (52%) respectively. Overall, the average effective porosity of 3.31% and hydrocarbon saturation of 24.10% as well as 28.03% volume of shale indicated poor reservoir potential of the Lockhart Limestone. Lithologically, this formation is dominated by limestone and shale interbeds in the Shakardara-01 well. Cross-plots of the petrophysical parameters versus depth showed that the Lockhart Limestone is a poor to tight reservoir in Shakardara-01 well and can hardly produce hydrocarbons under conventional drilling conditions

Price and Income Elasticities of Crude Oil Demand: Cross Country Analysis

Volatility in crude oil price is the main issue in this era. Great volatility in price of crude oil affects the demand of oil directly and indirectly in developing countries because these countries are oil importing countries especially Pakistan, India and China. Crude oil therefore contributes to and thereby influences the GDP of the country as a source of energy. It is very critical and essential for any country to explore and produce gas to improve energy shortage, for some deliberate importance of gas because natural gas is very clean, cheap and sustainable source to produce energy within a country. This study aimed to analyze the price and income elasticities of crude oil demand in developing countries time series data used from the period of 1971-2014. ADF test was used to check the stationary of variables and it is seem that all variable are not stationary at level. ARDL used for co integration and all variables of the models have long run relation with dependent and explanatory variables. Price and income elasticities of crude oil demand were measured in short and long run for developing countries and it was concluded that long run elasticities of price and income were less inelastic or some cases like China was elastic than short run elasticities of price and income of crude oil demand. It was suggested that oil importer countries should explore the alternatives of oil within a country to fulfill the domestic demand