| 1. |
- Arnoldussen, Ilse A. C., et al.
(author)
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Adiposity is related to cerebrovascular and brain volumetry outcomes in the RUN DMC study
- 2019
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In: Neurology. - : Wolters Kluwer. - 0028-3878 .- 1526-632X. ; 93:9, s. e864-e878
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Adiposity predictors, body mass index (BMI), waist circumference (WC), and blood leptin and total adiponectin levels were associated with components of cerebral small vessel disease (CSVD) and brain volumetry in 503 adults with CSVD who were ≥50 years of age and enrolled in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC).METHODS: RUN DMC participants were followed up for 9 years (2006-2015). BMI, WC, brain imaging, and dementia diagnoses were evaluated at baseline and follow-up. Adipokines were measured at baseline. Brain imaging outcomes included CSVD components, white matter hyperintensities, lacunes, microbleeds, gray and white matter, hippocampal, total brain, and intracranial volumes.RESULTS: Cross-sectionally among men at baseline, higher BMI, WC, and leptin were associated with lower gray matter and total brain volumes, and higher BMI and WC were associated with lower hippocampal volume. At follow-up 9 years later, higher BMI was cross-sectionally associated with lower gray matter volume, and an obese WC (>102 cm) was protective for ≥1 lacune or ≥1 microbleed in men. In women, increasing BMI and overweight or obesity (BMI ≥25 kg/m2 or WC >88 cm) were associated with ≥1 lacune. Longitudinally, over 9 years, a baseline obese WC was associated with decreasing hippocampal volume, particularly in men, and increasing white matter hyperintensity volume in women and men.CONCLUSIONS: Anthropometric and metabolic adiposity predictors were differentially associated with CSVD components and brain volumetry outcomes by sex. Higher adiposity is associated with a vascular-neurodegenerative spectrum among adults at risk for vascular forms of cognitive impairment and dementias.
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| 2. |
- Dallora Moraes, Ana Luiza, et al.
(author)
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Age assessment of youth and young adults using magnetic resonance imaging of the knee : A deep learning approach
- 2019
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In: JMIR Medical Informatics. - : JMIR PUBLICATIONS. - 2291-9694. ; 7:4, s. 419-436
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Journal article (peer-reviewed)abstract
- Background: Bone age assessment (BAA) is an important tool for diagnosis and in determining the time of treatment in a number of pediatric clinical scenarios, as well as in legal settings where it is used to estimate the chronological age of an individual where valid documents are lacking. Traditional methods for BAA suffer from drawbacks, such as exposing juveniles to radiation, intra- and interrater variability, and the time spent on the assessment. The employment of automated methods such as deep learning and the use of magnetic resonance imaging (MRI) can address these drawbacks and improve the assessment of age. Objective: The aim of this paper is to propose an automated approach for age assessment of youth and young adults in the age range when the length growth ceases and growth zones are closed (14-21 years of age) by employing deep learning using MRI of the knee. Methods: This study carried out MRI examinations of the knee of 402 volunteer subjects-221 males (55.0%) and 181 (45.0%) females-aged 14-21 years. The method comprised two convolutional neural network (CNN) models: the first one selected the most informative images of an MRI sequence, concerning age-assessment purposes; these were then used in the second module, which was responsible for the age estimation. Different CNN architectures were tested, both training from scratch and employing transfer learning. Results: The CNN architecture that provided the best results was GoogLeNet pretrained on the ImageNet database. The proposed method was able to assess the age of male subjects in the range of 14-20.5 years, with a mean absolute error (MAE) of 0.793 years, and of female subjects in the range of 14-19.5 years, with an MAE of 0.988 years. Regarding the classification of minors-with the threshold of 18 years of age-an accuracy of 98.1% for male subjects and 95.0% for female subjects was achieved. Conclusions: The proposed method was able to assess the age of youth and young adults from 14 to 20.5 years of age for male subjects and 14 to 19.5 years of age for female subjects in a fully automated manner, without the use of ionizing radiation, addressing the drawbacks of traditional methods. © 2019 Journal of Medical Internet Research. All rights reserved.
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| 3. |
- Kvist, Ola, et al.
(author)
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A cross-sectional magnetic resonance imaging study of factors influencing growth plate closure in adolescents and young adults
- 2021
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:4, s. 1249-1256
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Journal article (peer-reviewed)abstract
- Aim To assess growth plate fusion by magnetic resonance imaging (MRI) and evaluate the correlation with sex, age, pubertal development, physical activity and BMI. Methods Wrist, knee and ankle of 958 healthy subjects aged 14.0-21.5 years old were examined using MRI and graded by two radiologists. Correlations of growth plate fusion score with age, pubertal development, physical activity and BMI were assessed. Results Complete growth plate fusion occurred in 75%, 85%, 97%, 98%, 98% and 90%, 97%, 95%, 97%, 98% (radius, femur, proximal- and distal tibia and calcaneus) in 17-year-old females and 19-year-old males, respectively. Complete fusion occurs approximately 2 years earlier in girls than in boys. Pubertal development correlated with growth plate fusion score (rho = 0.514-0.598 for the different growth plate sites) but regular physical activity did not. BMI also correlated with growth plate fusion (rho = 0.186-0.384). Stratified logistic regression showed increased odds ratio (OR F: 2.65-8.71; M: 1.71-4.03) for growth plate fusion of obese or overweight subects versus normal-weight subjects. Inter-observer agreement was high (Kappa = 0.87-0.94). Conclusion Growth plate fusion can be assessed by MRI; occurs in an ascending order, from the foot to the wrist; and is significantly influenced by sex, pubertal development and BMI, but not by physical activity.
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| 4. |
- Toffaha, Ali, et al.
(author)
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What you see might not be what you get : Discrepancies between intraoperative findings and preoperative diagnosis of ovarian tumors. Appendicular mucocele presenting as an adnexal mass - Case report and review of literature
- 2020
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In: International Journal of Surgery Case Reports. - : Elsevier. - 2210-2612. ; 75, s. 543-549
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Journal article (peer-reviewed)abstract
- Introduction: Adnexal masses include those affecting the ovary or fallopian tubes. We report a unique case with discrepancy between the pre-operative diagnosis (adnexal mass) and the post-operative definitive findings (appendicular tumor invading ovary). We also employ a literature review to provide four scenarios of uncertainty that are encountered between appendiceal and adnexal masses. Presentation of case: A 58 year old female with history of treated left colon cancer, referred to the gynecology clinic with intermittent vaginal bleeding for 5 days. Examination showed lower abdominal midline mobile non-tender mass, bulky uterus and right adnexal fullness. Other history, physical examination and laboratory tests were unremarkable. US and MRI suggested a right ovarian mass and uterine fibroids. Intraoperatively, she had a right ovarian large mobile multi-locular mass. The appendix was adherent to the ovary, with mucus extruding through its tip. Appendectomy was undertaken alongside hysterectomy and bilateral salpingo-oophorectomy. Histopathology showed right ovarian mucinous neoplasm, but the origin was a low-grade appendiceal mucinous neoplasm (pT4aNxMx). The patient was recurrence free across 3 years of follow up. Discussion: Appendicular mucocele can present as adnexal mass. Pre-operative diagnosis and differentiation is sometimes difficult. Conclusion: Adnexal masses need careful pre-operative diagnoses. The definitive management is based on the final intra- and post-operative findings. As a variety of scenarios could be encountered, there could be a need to involve general/colorectal surgeons in case of appendicular tumors. Patients should be counselled regarding the possible change in intra-operative plan, and are better operated upon in facilities with appropriate teams and equipment.
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| 5. |
- Al Hassan, Mohamed S., et al.
(author)
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Choroidal metastasis as initial presentation of aggressive medullary thyroid carcinoma with widespread mediastinal, brain, pituitary, bone, lung, and liver metastasis : Case report and literature review
- 2021
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In: International Journal of Surgery Case Reports. - : Elsevier. - 2210-2612. ; 87:October 2021
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Journal article (peer-reviewed)abstract
- Introduction: Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that originates from the parafollicular C cells of the thyroid gland. MTC can be due to sporadic or hereditary causes due to gain of function germ line mutations in the RET proto-oncogene. MTC presenting as ocular symptoms due to choroidal mass is rare with bad prognosis. Presentation of case: A 38-year-old Sudanese male presented to Hamad General Hospital, complaining of sudden painless decrease of vision of the right eye of 3 weeks duration. After investigations using imaging methods, the patient was discovered to have metastatic MTC that presented as choroidal mass and metastasized to his lung, bone, brain, pituitary, liver and mediastinum. Discussion: In terms of investigations, serum levels of calcitonin have superior diagnostic accuracy. Our patient undertook diagnostic imaging including ultrasonography, fine needle aspiration and computerized tomography (CT) scan and/or MRI imaging. He undertook total thyroidectomy and left neck dissection followed by stereotactic radiosurgery for the right orbit and pituitary. He then received systemic anti-RET therapy (Selpercatinib). At 5 months follow up there was dramatic drop in CEA from 888 μg/L to 164 μg/L, and calcitonin from >585.2 pmol/L to 354 pmol/L. Conclusion: Choroidal metastasis as initial presentation of MTC is extremely rare and challenging to diagnose. Surgeons need a high index of suspicion when ocular symptoms accompany a neck mass or thyroid-related symptoms. MTC has a progressive course with involvement of blood vessels and neck lymph nodes. Choroidal metastasis of MTC is challenging to manage.
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| 6. |
- Björkman, Berit, et al.
(author)
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Children's experience of going through an acute radiographic examination
- 2012
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In: Radiography. - : Elsevier. - 1078-8174 .- 1532-2831. ; 18:2, s. 84-89
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Journal article (peer-reviewed)abstract
- Children’s experience of radiographic examinations remains largely unexplored, although most radiographers examine children on a daily basis. In order to provide the high quality care that meets the needs of patients it was considered important to undertake research focused upon the patients’ experience of radiographic practice.The aim of the study was to investigate children’s experiences undergoing a radiographic examination for a suspected fracture.Inclusion criteria were Swedish-speaking children between 3 and 15 years of age who were submitted for a radiographic examination with an acute condition of the upper or lower extremity. Patients were informed of the study and together with the escorting parent or relative asked for consent to participate.During the examination the child was videotaped and immediately after, the child was interviewed in a nearby facility. The interview contained open-ended questions and was conducted while watching the videotape together with the child and their parent or relative and the researcher.Qualitative content analysis was used in analyzing the collected data. The analysis resulted in two categories - “feeling uncomfortable” and “feeling confident”. The subcategories contained in these categories were “pain in relation to injury and examination”, “the waiting time is strenuous”, “worries for the future and consequences of the injury”, “confidence in parental presence”, “confidence in radiographic staff and examination procedure”, and finally “recognition entails familiarity”.The results revealed that for the younger children, the experience of undergoing an acute radiographic examination was associated with pain and anxiety, but for the older children, the anxiety was more connected to whether the injury had caused a fracture and any anticipated future consequences or complications.
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| 7. |
- Kvist, Ola F. T., et al.
(author)
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Comparison of reliability of magnetic resonance imaging using cartilage and T1-weighted sequences in the assessment of the closure of the growth plates at the knee
- 2020
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In: Acta Radiologica Open. - London : Sage Publications. - 2058-4601. ; 9:9, s. 1-9
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Journal article (peer-reviewed)abstract
- Background: Growth development is traditionally evaluated with plain radiographs of the hand and wrist to visualize bone structures using ionizing radiation. Meanwhile, MRI visualizes bone and cartilaginous tissue without radiation exposure. Purpose: To determine the state of growth plate closure of the knee in healthy adolescents and young adults and compare the reliability of staging using cartilage sequences and T1-weighted (T1W) sequence between pediatric and general radiologists. Material and Methods: A prospective, cross-sectional study of MRI of the knee with both cartilage and T1W sequences was performed in 395 male and female healthy subjects aged between 14.0 and 21.5 years old. The growth plate of the femur and the tibia were graded using a modified staging scale by two pediatric and two general radiologists. Femur and tibia were graded separately with both sequences. Results: The intraclass correlation was overall excellent. The inter- and intra-observer agreement for pediatric radiologists on T1W was 82% (kappa = 0.73) and 77% (kappa = 0.65) for the femur and 90% (kappa = 0.82) and 87% (kappa = 0.75) for the tibia. The inter-observer agreement for general radiologists on T1W was 69% (kappa = 0.56) for the femur and 56% (kappa = 0.34) for the tibia. Cohen's kappa coefficient showed a higher inter- and intra-observer agreement for cartilage sequences than for T1W: 93% (kappa = 0.86) and 89% (kappa = 0.79) for the femur and 95% (kappa = 0.90) and 91% (kappa = 0.81) for the tibia. Conclusion: Cartilage sequences are more reliable than T1W sequence in the assessment of the growth plate in adolescents and young adults. Pediatric radiology experience is preferable.
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