Search Results (282)

Background and Objective: High-flow pancreaticoduodenal artery (PDA) aneurysms secondary to celiac trunk occlusion or stenosis have a high risk of rupture. Embolization offers a less invasive alternative to surgery. We evaluated the effectiveness and safety of retrograde embolization via the superior mesenteric artery of high-flow PDA aneurysms without celiac trunk revascularization. Methods: This retrospective bicentric study included patients who underwent embolization of high-flow PDA aneurysms due to significant celiac trunk stenosis or occlusion. All patients underwent pre-interventional dynamic contrast-enhanced computed tomography. Retrograde embolization was performed using microcoils and/or liquid agents without celiac trunk revascularization. Follow up involved clinical and radiological assessment at one month. Technical and clinical success were evaluated, and complications were categorized as minor or major. Results: Twenty-three patients (mean age 65 ± 14 years; 52% male) were included. Emergency embolization was required in 12 patients (52%). The technical success rate was 100%. Patients were monitored for a median of 16 months. Clinical success was 87%. No hemorrhagic recurrences were observed. Minor complications occurred in two cases. One major complication involved splenic infarction due to glue migration, requiring splenectomy and intensive unit care admission. Conclusions: Retrograde embolization of high-flow PDA aneurysms is effective and safe without needing celiac trunk revascularization. Full article

Background/Objectives: Enfortumab vedotin (EV) is an antibody-drug conjugate (ADC) that combines monomethyl auristatin E (MMAE), a potent cytotoxic agent, with a monoclonal antibody targeting Nectin-4. It has emerged as a promising therapy for metastatic urothelial carcinoma (mUC), either as monotherapy or in combination with pembrolizumab, improving significantly the overall survival of these patients. EV is associated with common adverse events, including skin reactions, glucose imbalance, and peripheral neuropathy, which are usually mild in severity and easily manageable. Methods: Following an initial case of pleuro-pneumopathy occurring in a patient treated with EV, we conducted a retrospective analysis of EV effects on pulmonary imaging. Results: In a cohort of 20 all-comers mUC patients, we identified three cases of potentially EV-related lung toxicity, resulting in a pleuro-pneumopathy rate of 15%. Two of these cases appeared highly symptomatic and required high steroid doses, with a rapid resolution of symptoms and normalization of radiological findings. In one patient, rechallenge of EV was associated with reoccurrence of pneumopathy. We described the clinical and radiological features of these cases, as well as their evolution after EV discontinuation and rechallenge. Conclusions: This case series underscores the importance of close pulmonary monitoring during EV treatment. Full article

Background: Cemento-osseous dysplasias (CODs) are rare lesions of the jawbone. Their occurrence, localization, type, size, and shape can vary between cases. This fibro-osseous lesion is typically found in the jaw near tooth-bearing areas and is often asymptomatic, discovered incidentally, and may be associated with the periapical region of the teeth. In rare cases, COD can lead to secondary bone osteomyelitis. Currently, there is limited information in the literature on the occurrence and characteristics of COD. This paper’s main aim was to focus on the authors’ COD experience in the lower Silesian area. Methods: A retrospective evaluation of radiographies (RTG-Panx, cone-beam computed tomography (CBCT)) was conducted on patients treated, diagnosed, or consulted by the authors. A statistical correlation analysis was made to establish any relationship within the gathered data. Results: COD is predominantly an incidental finding in the mandibular bone near tooth apices. It is most commonly diagnosed in females. Both CBCT and panoramic radiographies are generally sufficient for diagnosing the lesion. COD rarely requires treatment. Conclusions: COD lesions are mostly discovered incidentally during routine radiographies or cone-beam computed tomography (CBCT) scans. In most cases, clinical and radiological monitoring is sufficient, along with evaluating the teeth’s response to cold stimuli and assessing the surrounding bone structures. Biopsies or tooth extractions are seldom necessary. When oral hygiene is well-maintained and no periapical inflammation is present, COD lesions typically remain asymptomatic. Full article

Due to the consequences of nuclear and/or radiological accidents in the past (Chernobyl, Fukushima, etc.), and potential future events of that kind, the constant monitoring of environmental radioactivity is important. There are different pathways of the transfer of radionuclides from environment to humans (ingestion, inhalation and external). Food ingestion greatly contributes to the total effective dose; hence, it is of great importance to investigate exposure to radionuclides through food. This paper presents the results of a long-term investigation of ¹³⁷Cs activity concentration in apples in northwestern Croatia for the period 1968–2023. The highest ¹³⁷Cs activity concentration in apples was measured in 1986, decreasing exponentially ever since. The Fukushima-Daiichi accident in 2011 did not cause a significant increase in ¹³⁷Cs activity concentration, although the presence of the consequent fallout was detected via the appearance of ¹³⁴Cs in some parts of the environment. The observed residence time for ¹³⁷Cs in apples was estimated to be 4.5 and 3.9 years for the pre-Chernobyl and post-Chernobyl periods, respectively. The correlation between ¹³⁷Cs in fallout and apples is very good, the correlation coefficients being 0.99, which indicates that fallout is the main source of contamination. The estimated effective dose received by adult members of the Croatian public due to intake of radiocaesium from apples over the overall observed period is 6.4 µSv. Therefore, the consumption of apples was not a critical pathway for the transfer of radiocaesium to humans. Full article

Introduction: Quantitative spinal cord imaging has facilitated the objective appraisal of spinal cord pathology in a range of neurological conditions both in the academic and clinical setting. Diverse methodological approaches have been implemented, encompassing a range of morphometric, diffusivity, susceptibility, magnetization transfer, and spectroscopy techniques. Advances have been fueled both by new MRI platforms and acquisition protocols as well as novel analysis pipelines. The quantitative evaluation of specific spinal tracts and grey matter indices has the potential to be used in diagnostic and monitoring applications. The comprehensive characterization of spinal disease burden in pre-symptomatic cohorts, in carriers of specific genetic mutations, and in conditions primarily associated with cerebral disease, has contributed important academic insights. Methods: A narrative review was conducted to examine the clinical and academic role of quantitative spinal cord imaging in a range of neurodegenerative and acquired spinal cord disorders, including hereditary spastic paraparesis, hereditary ataxias, motor neuron diseases, Huntington’s disease, and post-infectious or vascular disorders. Results: The clinical utility of specific methods, sample size considerations, academic role of spinal imaging, key radiological findings, and relevant clinical correlates are presented in each disease group. Conclusions: Quantitative spinal cord imaging studies have demonstrated the feasibility to reliably appraise structural, microstructural, diffusivity, and metabolic spinal cord alterations. Despite the notable academic advances, novel acquisition protocols and analysis pipelines are yet to be implemented in the clinical setting. Full article

A tetracalcium phosphate/monetite/calcium sulfate hemihydrate powder cement mixture (CAS) in the form of a paste was used as a socket preservative to prevent alveolar ridge resorption after the extraction of the second premolar tooth in the mandible of a pig model. During the post-surgery period, the animals were monitored daily. No signs of inflammation, infection, or other complications were observed in the defect site for six months. Six months after surgery, the mandible defects in pigs were evaluated using macroscopic, histological, and radiological techniques. Treatment of the extraction sites with CAS biocement resulted in the uniform filling of the defects with alveolar bone tissue, characterized by a relatively smooth and homogeneous gum surface with no visible biocement residues. The formation of new bone tissue with osteoblasts, osteocytes, and mineralized matrices was confirmed. The results showed the similar morphology, thickness, and complete integration of the newly formed bone with the surrounding tissue. CAS biocement could be an effective material to prevent alveolar bone reduction as well as soft tissue loss and could support dental implant placement with long-term functionality. Full article

The present study characterizes gamma dose rate (GDR) concentrations in Bilbao, located in the northern Iberian Peninsula, utilizing a comprehensive 10-min interval database spanning from 2009 to 2018. This station belongs to the radiological environmental monitoring of the Basque Country network. The daily average GDR was found to be 0.07624 ± 0.00004 µSv/h, with the daily 95th percentile averaging 0.08026 ± 0.00007 µSv/h throughout the entire period. Our analysis specifically addresses the impact of precipitation on GDR, revealing a higher correlation coefficient for daily 95th percentile values compared to daily averages. Additionally, the influence of the Galerna (GL) event, a natural meteorological phenomenon in this region, on GDR was investigated, noting that it can develop both with and without precipitation. Understanding the interaction between GDR and this meteorological scenario is vital for the development of more reliable radiological monitoring strategies and for safeguarding public health. For this purpose, 40 GL events were analyzed. The present results indicate that GDR values frequently exceed alarm levels when a GL is formed. These GDR peaks should be considered natural radiological events, necessitating the classification of such GDR peaks as false alarms within the radiological monitoring network. To explain them in detail, 10-min time series of precipitation and radon outdoor concentrations were analyzed. The results demonstrate that the GL event with precipitation is a meteorological scenario that can be associated with false alarms. The present analysis provides a distinct contrast in radon behavior under the same meteorological event in case of being developed with precipitation or without precipitation. The findings from this analysis are crucial for avoiding and understanding false radiological alarms triggered in the monitoring network, thereby enhancing the accuracy of radiological data interpretation and improving public safety measures. Full article

Thoracostomy and chest tube placement are key procedures in treating pleural diseases involving the accumulation of fluids (e.g., malignant effusions, serous fluid, pus, or blood) or air (pneumothorax) in the pleural cavity. Initially described by Hippocrates and refined through the centuries, chest drainage achieved a historical milestone in the 19th century with the creation of closed drainage systems to prevent the entry of air into the pleural space and reduce infection risk. The introduction of plastic materials and the Heimlich valve further revolutionized chest tube design and function. Technological advancements led to the availability of various chest tube designs (straight, angled, and pig-tail) and drainage systems, including PVC and silicone tubes with radiopaque stripes for better radiological visualization. Modern chest drainage units can incorporate smart digital systems that monitor and graphically report pleural pressure and evacuated fluid/air, improving patient outcomes. Suction application via wall systems or portable digital devices enhances drainage efficacy, although careful regulation is needed to avoid complications such as re-expansion pulmonary edema or prolonged air leak. To prevent recurrent effusion, particularly due to malignancy, pleurodesis agents can be applied through the chest tube. In cases of non-expandable lung, maintaining a long-term chest drain may be the most appropriate approach and procedures such as the placement of an indwelling pleural catheter can significantly improve quality of life. Continued innovations and rigorous training ensure that chest tube insertion remains a cornerstone of effective pleural disease management. This review provides a comprehensive overview of the historical evolution and modern advancements in pleural drainage. By addressing both current technologies and procedural outcomes, it serves as a valuable resource for healthcare professionals aiming to optimize pleural disease management and patient care. Full article

Background: Multinodular Vacuolating Neuronal Tumors (MVNTs) are mixed glial–neuronal brain lesions classified as World Health Organization (WHO) CNS grade 1 tumors, often associated with long-term epilepsy. First described by Huse et al. in 2013 and included in the WHO CNS classification in 2016, MVNTs present a range of clinical manifestations, from symptomatic to asymptomatic. They typically affect young to middle-aged adults and exhibit diverse presentations. Radiologically, MVNTs are usually supratentorial, frequently located in the temporal lobe but also observed in the frontal and parietal lobes. MRI is essential for diagnosis, revealing multiple coalescing subcortical or cortical nodules with hyperintense signals on T2-weighted/FLAIR sequences, often without peripheral edema or mass effects. Case Reports: This paper presents two cases: one symptomatic MVNT with significant clinical manifestations, and the other documenting an incidental finding of MVNT in an asymptomatic patient. One case shows typical temporal lobe localization, while the other highlights a rare frontal lobe localization, with clear radiological findings on T2/FLAIR sequences. Conclusions: These cases illustrate the varied clinical presentations of MVNTs and emphasize MRI’s critical role in diagnosis and management. Asymptomatic cases often require conservative management, stressing the avoidance of unnecessary invasive procedures and the importance of regular monitoring. Full article

The integration of deep learning into radiology has the potential to enhance diagnostic processes, yet its acceptance in clinical practice remains limited due to various challenges. This study aimed to develop and evaluate a fine-tuned large language model (LLM), based on Llama 3-8B, to automate the generation of accurate and concise conclusions in magnetic resonance imaging (MRI) and computed tomography (CT) radiology reports, thereby assisting radiologists and improving reporting efficiency. A dataset comprising 15,000 radiology reports was collected from the University of Medicine and Pharmacy of Craiova’s Imaging Center, covering a diverse range of MRI and CT examinations made by four experienced radiologists. The Llama 3-8B model was fine-tuned using transfer-learning techniques, incorporating parameter quantization to 4-bit precision and low-rank adaptation (LoRA) with a rank of 16 to optimize computational efficiency on consumer-grade GPUs. The model was trained over five epochs using an NVIDIA RTX 3090 GPU, with intermediary checkpoints saved for monitoring. Performance was evaluated quantitatively using Bidirectional Encoder Representations from Transformers Score (BERTScore), Recall-Oriented Understudy for Gisting Evaluation (ROUGE), Bilingual Evaluation Understudy (BLEU), and Metric for Evaluation of Translation with Explicit Ordering (METEOR) metrics on a held-out test set. Additionally, a qualitative assessment was conducted, involving 13 independent radiologists who participated in a Turing-like test and provided ratings for the AI-generated conclusions. The fine-tuned model demonstrated strong quantitative performance, achieving a BERTScore F1 of 0.8054, a ROUGE-1 F1 of 0.4998, a ROUGE-L F1 of 0.4628, and a METEOR score of 0.4282. In the human evaluation, the artificial intelligence (AI)-generated conclusions were preferred over human-written ones in approximately 21.8% of cases, indicating that the model’s outputs were competitive with those of experienced radiologists. The average rating of the AI-generated conclusions was 3.65 out of 5, reflecting a generally favorable assessment. Notably, the model maintained its consistency across various types of reports and demonstrated the ability to generalize to unseen data. The fine-tuned Llama 3-8B model effectively generates accurate and coherent conclusions for MRI and CT radiology reports. By automating the conclusion-writing process, this approach can assist radiologists in reducing their workload and enhancing report consistency, potentially addressing some barriers to the adoption of deep learning in clinical practice. The positive evaluations from independent radiologists underscore the model’s potential utility. While the model demonstrated strong performance, limitations such as dataset bias, limited sample diversity, a lack of clinical judgment, and the need for large computational resources require further refinement and real-world validation. Future work should explore the integration of such models into clinical workflows, address ethical and legal considerations, and extend this approach to generate complete radiology reports. Full article

Parkinson’s disease and Alzheimer’s disease are among the most common neurodegenerative disorders. These diseases are correlated with advancing age and are hence increasingly becoming prevalent in developed countries due to an increasingly aging demographic. Several tools are used to predict and diagnose these diseases, including pathological and genetic tests, radiological scans, and clinical examinations. Artificial intelligence is evolving to artificial general intelligence, which mimics the human learning process. Large language models can use an enormous volume of online and offline resources to gain knowledge and use it to perform different types of tasks. This work presents an understanding of two major neurodegenerative disorders, artificial general intelligence, and the efficacy of using artificial general intelligence in detecting and predicting these neurodegenerative disorders. A detailed discussion on detecting these neurodegenerative diseases using artificial general intelligence by analyzing diagnostic data is presented. An Internet of Things-based ubiquitous monitoring and treatment framework is presented. An outline for future research opportunities based on the challenges in this area is also presented. Full article

This study analyzes the concentration of radioactive material in the soil near the Maanshan nuclear power plant (NPP). Out of the thirty samples, only one sample was found to have ¹³⁷Cs radioactivity measuring 2.58 Bq/kg. The activity concentrations were 77.2–517.7 Bq/kg, 3.9–31.6 Bq/Kg, and 5.3–39.1 Bq/kg, respectively, with mean values of 344.4 Bq/kg, 18.6 Bq/kg, and 26.5 Bq/kg for ⁴⁰K, ²²⁶Ra, and ²³²Th, respectively. These levels are lower than the global average of soil activity concentrations. The activity concentrations varied, with the highest levels being 7–8 times greater than the lowest levels. Clay content had a positive correlation and sand content had a negative correlation with ⁴⁰K, ²²⁶Ra, and ²³²Th activity concentrations. The activity concentrations followed a normal distribution for ⁴⁰K, ²²⁶Ra, and ²³²Th. The activity ratios for ²³²Th/²²⁶Ra, ⁴⁰K/²³²Th, and ⁴⁰K/²²⁶Ra were 1.43 ± 0.22, 13.1 ± 1.9, and 18.8 ± 4.1, respectively, and ratios show light minerals in the soils. The average values for external hazard indices (H_ex) and radium equivalent activity (Ra_eq) were 0.22 Bq/kg and 83.0 Bq/kg, respectively, both of which are below the recommended limit values of 1.0 Bq/kg and 370 Bq/kg, respectively. The outdoor absorbed dose rate (D_Rex) and annual effective dose equivalent (AED_ex) were 39.0 nGy/h and 47.8 μSv/y, respectively, both of which are lower than the global soil average of 59 nGy/h and 70 μSv/y, respectively. These results indicate that local residents and tourists are not at significant risk of radiological hazards from the soil. The soil activity concentrations can serve as a baseline for continuous monitoring, even after the Maanshan NPP is decommissioned in 2025. Full article

The measurement performance and characteristics of electronic radon monitors with respect to radiological and environmental parameters are investigated. The study includes a sample of 14 different types of devices from nine manufacturers. The devices are currently available on the market with acquisition costs in the low or medium range. For comparison purposes, a high-end AlphaGUARD device is included in the study as a benchmark for measurement performance of radon monitors. Significant differences in the measurement performance are found between the tested instrument types. Overall, however, it can be concluded that most radon monitors perform acceptably and provide reliable information on radon activity concentrations in homes or workplaces, allowing residents and employers to make decisions about the need for radon protection measures. But it turns out that many radon monitors are supplied by the manufacturer with inadequate calibration, so that the instruments must be additionally calibrated in a reference atmosphere before they can be used. Among the tested radon monitors, there are also types with sufficiently good measuring performance, which represent an inexpensive alternative to high-end devices for radon professionals. Full article

Vertebral compression fractures (VCFs) affect 1.4 million patients every year, especially among the globally aging population, leading to increased morbidity and mortality. Often characterized with symptoms of sudden onset back pain, decreased vertebral height, progressive kyphosis, and limited mobility, VCFs can significantly impact a patient’s quality of life and are a significant public health concern. Imaging modalities in radiology, including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) studies and bone scans, play crucial and evolving roles in the diagnosis, assessment, and management of VCFs. An understanding of anatomy, and the extent to which each imaging modality serves to elucidate that anatomy, is crucial in understanding and providing guidance on fracture severity, classification, associated soft tissue injuries, underlying pathologies, and bone mineral density, ultimately guiding treatment decisions, monitoring treatment response, and predicting prognosis and long-term outcomes. This article thus explores the important role of radiology in illuminating the underlying anatomy and pathophysiology, classification, diagnosis, treatment, and management of patients with VCFs. Continued research and advancements in imaging technologies will further enhance our understanding of VCFs and pave the way for personalized and effective management strategies. Full article

Background: Patients with scoliosis often require multiple imaging modalities. The aim of this study was to find out whether primary diagnosis, including surgical planning, could be carried out entirely without computed tomography (CT) scans and whether follow-up could be replaced with alternative methods without the use of X-rays. In order to reduce the radiation exposure in the diagnosis and treatment of severe scoliosis, we expect to replace X-rays with radiation-free or less-intensive radiation examinations. This study protocol is interdisciplinary. Methods: A total of 50 male and female patients (children and adolescents, aged 7–18 years) treated for scoliosis will be analyzed. In addition to routine projection radiographs, preoperative CT, and/or X-ray stereoradiography (EOS) examinations, thin-slice 3D magnetic resonance imaging (MRI) sequences will be retrospectively reformatted during the preoperative MRI examination. A three-dimensional back scan (video-raster stereography) and an intraoral scan will also be obtained. The following questions should be answered at the end of the project: (1) Can MRI examination with additional thin-slice 3D reconstruction answer all relevant questions for preoperative planning instead of CT? (2) Are EOS or whole-spine X-ray examinations in combination with MRI data sufficient for the evaluation of the pedicles and spinal deformity? (3) Does the Cobb angle in the radiograph correlate with the calculations from the back scanner image and can follow-up checks be replaced? (4) Are there any correlations between dental anomalies and scoliosis? Conclusions: Until now, pediatric patients with scoliosis have been diagnosed, monitored, and treated with numerous independent specialist disciplines, such as pediatricians, orthopedic surgeons, neurosurgeons, and general practitioners with different radiological issues. The aim of this project is to reduce radiation and lower perioperative risks by creating a preoperative and follow-up-related standard protocol in close interdisciplinary and targeted cooperation between all the specialist disciplines involved. In line with the holistic examination approach, the associated accompanying diseases and developmental disorders such as dental and neuronal malformations will also be examined. On the one hand, CT-based questions could be replaced with the reconstruction of thin-slice MRI sequences. In addition, it may be possible to use the three-dimensional back scan as an intermediate diagnostic procedure instead of X-rays in the monitoring of severe scoliosis. Insofar as correlations or causalities between scoliosis and occlusal anomalies, early orthodontic intervention could positively benefit the duration of therapy at a later stage. Full article