Diagnostics

16 pages, 2460 KiB

Open AccessArticle

Hybridization of Deep Learning Pre-Trained Models with Machine Learning Classifiers and Fuzzy Min–Max Neural Network for Cervical Cancer Diagnosis

by Madhura Kalbhor, Swati Shinde, Daniela Elena Popescu and D. Jude Hemanth

Diagnostics 2023, 13(7), 1363; https://doi.org/10.3390/diagnostics13071363 - 6 Apr 2023

Cited by 22 | Viewed by 3328

Abstract

Medical image analysis and classification is an important application of computer vision wherein disease prediction based on an input image is provided to assist healthcare professionals. There are many deep learning architectures that accept the different medical image modalities and provide the decisions [...] Read more.

Medical image analysis and classification is an important application of computer vision wherein disease prediction based on an input image is provided to assist healthcare professionals. There are many deep learning architectures that accept the different medical image modalities and provide the decisions about the diagnosis of various cancers, including breast cancer, cervical cancer, etc. The Pap-smear test is the commonly used diagnostic procedure for early identification of cervical cancer, but it has a high rate of false-positive results due to human error. Therefore, computer-aided diagnostic systems based on deep learning need to be further researched to classify the pap-smear images accurately. A fuzzy min–max neural network is a neuro fuzzy architecture that has many advantages, such as training with a minimum number of passes, handling overlapping class classification, supporting online training and adaptation, etc. This paper has proposed a novel hybrid technique that combines the deep learning architectures with machine learning classifiers and fuzzy min–max neural network for feature extraction and Pap-smear image classification, respectively. The deep learning pretrained models used are Alexnet, ResNet-18, ResNet-50, and GoogleNet. Benchmark datasets used for the experimentation are Herlev and Sipakmed. The highest classification accuracy of 95.33% is obtained using Resnet-50 fine-tuned architecture followed by Alexnet on Sipakmed dataset. In addition to the improved accuracies, the proposed model has utilized the advantages of fuzzy min–max neural network classifiers mentioned in the literature. Full article

(This article belongs to the Special Issue Imaging of Cervical Cancer)

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10 pages, 440 KiB

Open AccessArticle

Chitotriosidase and Neopterin as Two Novel Potential Biomarkers for Advanced Stage and Survival Prediction in Gastric Cancer—A Pilot Study

by Vlad-Ionuţ Nechita, Nadim Al Hajjar, Cristina Drugan, Cristina-Sorina Cătană, Emil Moiş, Mihaela-Ancuţa Nechita and Florin Graur

Diagnostics 2023, 13(7), 1362; https://doi.org/10.3390/diagnostics13071362 - 6 Apr 2023

Cited by 2 | Viewed by 1700

Abstract

Gastric cancer is the fifth type of neoplasia most frequently diagnosed and the fourth cause of death among other cancers. Prevalence is around two times higher for males than females. Chitotriosidase and neopterin are two molecular biomarkers with potential diagnostic and prognostic use [...] Read more.

Gastric cancer is the fifth type of neoplasia most frequently diagnosed and the fourth cause of death among other cancers. Prevalence is around two times higher for males than females. Chitotriosidase and neopterin are two molecular biomarkers with potential diagnostic and prognostic use in malignant pathology. We conducted a longitudinal prospective cohort study on thirty-nine patients with gastric adenocarcinoma, with a male-to-female ratio of 1.78 and an average age of 64.3 ± 9.97 years. No statistically significant differences in biomarker levels at presentation were observed between curative-intent surgery (28 patients) and advanced cases, suited only for palliative procedures (11 patients). Biomarker values were not significantly different for the advanced T stage and the presence of metastasis (p > 0.05—Mann Whitney test). The patients that died in the first 30 days after surgery did not present significantly different values at baseline, in comparison with those that had longer survival times, though a significant cut-off value was observed for chitotriosidase activity at 310 nmol/mL/h [AUC (area under the curve) = 0.78; 95% CI (0.61–0.92)]. The cut-off values corresponding to death after the first year, tumor invasion, and metastasis were not statistically significant. In the COX multivariate model, neopterin did not validate itself as a prognostic biomarker, however, chitotriosidase activity before surgery was significantly associated with overall survival (HR = 1.0038, p = 0.03). We conclude that chitotriosidase may have the potential to improve the prognostic model for gastric adenocarcinoma. Full article

(This article belongs to the Special Issue Evaluating Novel Biomarkers for Personalized Medicine)

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10 pages, 988 KiB

Open AccessArticle

Prognostic Performance of Bedside Lung Ultrasound Score (LUSS) and ROX Index in Hypoxemic Respiratory Failure Due to COVID-19

by Alice Nova, Emanuele Rezoagli, Nilde Eronia, Annalisa Benini, Andrea Scognamiglio, Giuseppe Foti and Giacomo Bellani

Diagnostics 2023, 13(7), 1361; https://doi.org/10.3390/diagnostics13071361 - 6 Apr 2023

Cited by 1 | Viewed by 1994

Abstract

Background: Noninvasive ventilation, mainly helmet CPAP, was widely used during the COVID-19 pandemic, even outside of intensive care units. Both the ROX index and the LUS score (LUSS) have been proposed as tools to predict negative outcomes in patients with hypoxemia treated with [...] Read more.

Background: Noninvasive ventilation, mainly helmet CPAP, was widely used during the COVID-19 pandemic, even outside of intensive care units. Both the ROX index and the LUS score (LUSS) have been proposed as tools to predict negative outcomes in patients with hypoxemia treated with noninvasive ventilation (NIV) outside of ICUs. We aim to evaluate whether the combination of LUSS with the ROX index improves the predictive performance of these indices in patients with hypoxemia due to COVID-19 pneumonia, treated with NIV outside of ICUs. Methods: This is a monocentric prospective observational study conducted at the university teaching hospital Fondazione IRCCS San Gerardo dei Tintori (Monza, Italy) from February to April 2021. LUSS and ROX were collected at the same time in noninvasively ventilated patients outside of the ICU. An LUS exam was performed by 3 emergency medicine attending physicians with at least 5 years’ experience in point-of-care ultrasonography using a 12-zone system. To evaluate the accuracy of the prognostic indices in predicting a composite outcome (endotracheal intubation and mortality), ROC curves were used. A logistic multivariable model was used to explore the predictors of the composite outcome of endotracheal intubation and in-hospital mortality. An unadjusted Kaplan–Meier analysis was used to explore the association with the composite outcome of survival without invasive mechanical ventilation at the 30-day follow-up by stratifying the 3 indices by their best cut-offs. Results: A total of 79 patients were included in the statistical analysis and stratified into 2 groups based on the presence of a negative outcome, which was reported in 24 patients out of 79 (30%). A great proportion of patients (66 patients—84%) were treated with helmet CPAP. All three indices (LUSS, ROX and LUSS/ROX) were independently associated with negative outcomes in the multivariable analyses. Although the comparison between the AUROC of LUSS or ROX versus LUSS/ROX did not reveal a statistically significant difference, we observed a trend toward a higher accuracy for predicting negative outcomes using the LUSS/ROX index as compared to using LUSS. With the Kaplan–Maier approach, all three indices stratified by the best cut-off reported a significant association with the outcome of 30-day survival without mechanical ventilation. Conclusions: A multimodal noninvasive approach that combines ultrasound (i.e., LUSS) and a bedside clinical evaluation (i.e., the ROX index) may help clinicians to predict outcomes and to identify patients who would benefit the most from invasive respiratory support. Full article

(This article belongs to the Special Issue Critical Care Imaging)

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14 pages, 1640 KiB

Open AccessReview

Primary Lymphoproliferative Lung Diseases: Imaging and Multidisciplinary Approach

by Luca Gozzi, Diletta Cozzi, Edoardo Cavigli, Chiara Moroni, Caterina Giannessi, Giulia Zantonelli, Olga Smorchkova, Ron Ruzga, Ginevra Danti, Elena Bertelli, Valentina Luzzi, Valeria Pasini and Vittorio Miele

Diagnostics 2023, 13(7), 1360; https://doi.org/10.3390/diagnostics13071360 - 6 Apr 2023

Cited by 2 | Viewed by 5671

Abstract

Lymphoproliferative lung diseases are a heterogeneous group of disorders characterized by primary or secondary involvement of the lung. Primary pulmonary lymphomas are the most common type, representing 0.5–1% of all primary malignancies of the lung. The radiological presentation is often heterogeneous and non-specific: [...] Read more.

Lymphoproliferative lung diseases are a heterogeneous group of disorders characterized by primary or secondary involvement of the lung. Primary pulmonary lymphomas are the most common type, representing 0.5–1% of all primary malignancies of the lung. The radiological presentation is often heterogeneous and non-specific: consolidations, masses, and nodules are the most common findings, followed by ground-glass opacities and interstitial involvement, more common in secondary lung lymphomas. These findings usually show a prevalent perilymphatic spread along bronchovascular bundles, without a prevalence in the upper or lower lung lobes. An ancillary sign, such as a “halo sign”, “reverse halo sign”, air bronchogram, or CT angiogram sign, may be present and can help rule out a differential diagnosis. Since a wide spectrum of pulmonary parenchymal diseases may mimic lymphoma, a correct clinical evaluation and a multidisciplinary approach are mandatory. In this sense, despite High-Resolution Computer Tomography (HRCT) representing the gold standard, a tissue sample is needed for a certain and definitive diagnosis. Cryobiopsy is a relatively new technique that permits the obtaining of a larger amount of tissue without significant artifacts, and is less invasive and more precise than surgical biopsy. Full article

(This article belongs to the Special Issue Cardiothoracic Imaging: Recent Techniques and Applications in Diagnostics)

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16 pages, 8234 KiB

Open AccessViewpoint

Valid and Reproducible Quantitative Assessment of Cardiac Volumes by Echocardiography in Patients with Valvular Heart Diseases—Possible or Wishful Thinking?

by Andreas Hagendorff, Joscha Kandels, Michael Metze, Bhupendar Tayal and Stephan Stöbe

Diagnostics 2023, 13(7), 1359; https://doi.org/10.3390/diagnostics13071359 - 6 Apr 2023

Cited by 3 | Viewed by 2580

Abstract

The analysis of left ventricular function is predominantly based on left ventricular volume assessment. Especially in valvular heart diseases, the quantitative assessment of total and effective stroke volumes as well as regurgitant volumes is necessary for a quantitative approach to determine regurgitant volumes [...] Read more.

The analysis of left ventricular function is predominantly based on left ventricular volume assessment. Especially in valvular heart diseases, the quantitative assessment of total and effective stroke volumes as well as regurgitant volumes is necessary for a quantitative approach to determine regurgitant volumes and regurgitant fraction. In the literature, there is an ongoing discussion about differences between cardiac volumes estimated by echocardiography and cardiac magnetic resonance tomography. This viewpoint focuses on the feasibility to assess comparable cardiac volumes with both modalities. The former underestimation of cardiac volumes determined by 2D and 3D echocardiography is presumably explained by methodological and technical limitations. Thus, this viewpoint aims to stimulate an urgent and critical rethinking of the echocardiographic assessment of patients with valvular heart diseases, especially valvular regurgitations, because the actual integrative approach might be too error prone to be continued in this form. It should be replaced or supplemented by a definitive quantitative approach. Valid quantitative assessment by echocardiography is feasible once echocardiography and data analysis are performed with methodological and technical considerations in mind. Unfortunately, implementation of this approach cannot generally be considered for real-world conditions. Full article

(This article belongs to the Special Issue Structural Heart Disease: Diagnosis & Treatment)

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12 pages, 2466 KiB

Open AccessArticle

Automatic Kidney Segmentation Method Based on an Enhanced Generative Adversarial Network

by Tian Shan, Yuhan Ying and Guoli Song

Diagnostics 2023, 13(7), 1358; https://doi.org/10.3390/diagnostics13071358 - 6 Apr 2023

Cited by 4 | Viewed by 1692

Abstract

When deciding on a kidney tumor’s diagnosis and treatment, it is critical to take its morphometry into account. It is challenging to undertake a quantitative analysis of the association between kidney tumor morphology and clinical outcomes due to a paucity of data and [...] Read more.

When deciding on a kidney tumor’s diagnosis and treatment, it is critical to take its morphometry into account. It is challenging to undertake a quantitative analysis of the association between kidney tumor morphology and clinical outcomes due to a paucity of data and the need for the time-consuming manual measurement of imaging variables. To address this issue, an autonomous kidney segmentation technique, namely SegTGAN, is proposed in this paper, which is based on a conventional generative adversarial network model. Its core framework includes a discriminator network with multi-scale feature extraction and a fully convolutional generator network made up of densely linked blocks. For qualitative and quantitative comparisons with the SegTGAN technique, the widely used and related medical image segmentation networks U-Net, FCN, and SegAN are used. The experimental results show that the Dice similarity coefficient (DSC), volumetric overlap error (VOE), accuracy (ACC), and average surface distance (ASD) of SegTGAN on the Kits19 dataset reach 92.28%, 16.17%, 97.28%, and 0.61 mm, respectively. SegTGAN outscores all the other neural networks, which indicates that our proposed model has the potential to improve the accuracy of CT-based kidney segmentation. Full article

(This article belongs to the Special Issue Whole Body MRI: Major Advances and Future Perspective-Volume 2)

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11 pages, 1544 KiB

Open AccessArticle

Prognostic Impact of the Get-with-the-Guidelines Heart-Failure Risk Score (GWTG-HF) after Transcatheter Aortic Valve Replacement in Patients with Low-Flow–Low-Gradient Aortic Valve Stenosis

by Clemens Eckel, Johannes Blumenstein, Oliver Husser, Dagmar Sötemann, Christina Grothusen, Judith Schlüter, Marc Becher, Holger Nef, Albrecht Elsässer, Georg Nickenig, Helge Möllmann and Vedat Tiyerili

Diagnostics 2023, 13(7), 1357; https://doi.org/10.3390/diagnostics13071357 - 6 Apr 2023

Viewed by 2037

Abstract

Objectives: This study examined the prognostic value of the get-with-the-guidelines heart-failure risk score (GWTG-HF) on mortality in patients with low-flow–low-gradient aortic valve stenosis (LFLG-AS) after transcatheter aortic valve implantation (TAVI). Background: Data on feasibility of TAVI and mortality prediction in the LFLG-AS population [...] Read more.

Objectives: This study examined the prognostic value of the get-with-the-guidelines heart-failure risk score (GWTG-HF) on mortality in patients with low-flow–low-gradient aortic valve stenosis (LFLG-AS) after transcatheter aortic valve implantation (TAVI). Background: Data on feasibility of TAVI and mortality prediction in the LFLG-AS population are scarce. Clinical risk assessment in this particular population is difficult, and a score has not yet been established for this purpose. Methods: A total of 212 heart failure (HF) patients with real LFLG-AS were enrolled. Patients were classified into low-risk (n = 108), intermediate-risk (n = 90) and high-risk (n = 14) groups calculated by the GWTG-HF score. Clinical outcomes of cardiovascular events according to Valve Academic Research Consortium (VARC-2) recommendations and composite endpoint of death and hospitalization for heart failure (HHF) were assessed at discharge and 1 year of follow-up. Results: Baseline parameters of the groups showed a median age of 81.0 years [77.0; 84.0] (79.0 vs. 82.0 vs. 86.0, respectively p < 0.001), median EuroSCORE II of 6.6 [4.3; 10.7] (5.5 vs. 7.2 vs. 9.1, p = 0.004) and median indexed stroke volume of 26.7 mL/m² [22.0; 31.0] (28.2 vs. 25.8 vs. 25.0, p = 0.004). The groups significantly differed at follow-up in terms of all-cause mortality (10.2 vs. 21.1 vs. 28.6%; p < 0.035). There was no difference in intrahospital event rate (VARC). Postprocedural mean gradients were lower in high-risk group (7.0 vs. 7.0 vs. 5.0 mmHg, p = 0.011). No differences in postprocedural aortic valve area (1.9 vs. 1.7 vs. 1.9 cm², p = 0.518) or rate of device failure (5.6 vs. 6.8 vs. 7.7%, p = 0.731) could be observed. After adjustment for known predictors, the GWTG score (HR 1.07 [1.01–1.14], p = 0.030) as well as pacemaker implantation (HR 3.97 [1.34–11.75], p = 0.013) turned out to be possible predictors for mortality. An increase in stroke volume index (SVI) was, in contrast, protective (HR 0.90 [0.83–0.97]; p = 0.006). Conclusions: The GWTG score may predict mortality after TAVI in LFLG-AS HF patients. Interestingly, all groups showed similar intrahospital event and mortality rates, independent of calculated mortality risk. Low SVI and new conduction disturbances associated with PPI after THV implantation had negative impact on mid-term outcome in post-TAVI HF-patients. Full article

(This article belongs to the Special Issue New Techniques in Interventional Cardiology)

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11 pages, 3699 KiB

Open AccessTechnical Note

Extravascular Ultrasound (EVUS) to Assess the Results of Peripheral Endovascular Procedures

by Stefano Fazzini, Federico Francisco Pennetta, Valerio Turriziani, Simona Vona, Andrea Ascoli Marchetti and Arnaldo Ippoliti

Diagnostics 2023, 13(7), 1356; https://doi.org/10.3390/diagnostics13071356 - 6 Apr 2023

Cited by 4 | Viewed by 1828

Abstract

Contrast arteriography (CA) is considered the gold standard to evaluate any phase in peripheral arterial disease (PAD) interventions, from diagnostics to final results. Nevertheless, duplex ultrasonography (DUS) mostly used for the pre/postoperative phase and follow-up control, could be a potential intraoperative adjunctive imaging [...] Read more.

Contrast arteriography (CA) is considered the gold standard to evaluate any phase in peripheral arterial disease (PAD) interventions, from diagnostics to final results. Nevertheless, duplex ultrasonography (DUS) mostly used for the pre/postoperative phase and follow-up control, could be a potential intraoperative adjunctive imaging tool to assess the effects of endovascular revascularization in patients with iliac and femoropopliteal lesions. The PAD “duplex-assisted” protocol includes a preoperative DUS control followed by an intraoperative and a postoperative control. The most important parameters are pulsed doppler spectral analysis and waveform changes, which are impossible to detect with intravascular ultrasound (IVUS). By using a similar acronym, the intraoperative DUS has been previously described as extravascular ultrasound (EVUS). B-mode imaging, color flow, and peak systolic velocity (PSV) are considered. EVUS could be very useful to evaluate the effects of endovascular treatment, mainly in cases of unclear CAs, severe calcifications and/or dissections. In the context of the “leaving nothing behind” strategy, EVUS can drive the physician to evaluate the absence of flow-limiting dissections and decide which target lesion should be treated with antirestenotic therapy, further vessel preparation, or stenting. The EVUS protocol could be a safe and feasible option to improve the completion assessment of endovascular PAD treatment. A better ultrasound waveform is a sign of improved luminal gain and compliance, which is extremely important to finalize the results of new peripheral device technology, such as intravascular lithotripsy. Full article

(This article belongs to the Special Issue Critical Limb Threatening Ischemia in the COVID Era)

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15 pages, 2195 KiB

Open AccessArticle

Clinical Validation of a Colorimetric Loop-Mediated Isothermal Amplification Using a Portable Device for the Rapid Detection of SARS-CoV-2

by Bruna W. Raddatz, Felipe J. Rabello, Rafael Benedetti, Gisleine J. Steil, Louise M. Imamura, Edson Y. S. Kim, Erika B. Santiago, Luís F. Hartmann, João V. Predebon, Bruna M. Delfino, Meri B. Nogueira, Jucélia S. dos Santos, Breno G. da Silva, Diego R. P. Nicollete, Bernardo M. M. de Almeida, Sergio R. Rogal, Jr. and Marcus V. M. Figueredo

Diagnostics 2023, 13(7), 1355; https://doi.org/10.3390/diagnostics13071355 - 6 Apr 2023

Cited by 4 | Viewed by 2785

Abstract

Quick and reliable mass testing of infected people is an effective tool for the contingency of SARS-CoV-2. During the COVID-19 pandemic, Point-of-Care (POC) tests using Loop-Mediated Isothermal Amplification (LAMP) arose as a useful diagnostic tool. LAMP tests are a robust and fast alternative [...] Read more.

Quick and reliable mass testing of infected people is an effective tool for the contingency of SARS-CoV-2. During the COVID-19 pandemic, Point-of-Care (POC) tests using Loop-Mediated Isothermal Amplification (LAMP) arose as a useful diagnostic tool. LAMP tests are a robust and fast alternative to Polymerase Chain Reaction (PCR), and their isothermal property allows easy incorporation into POC platforms. The main drawback of using colorimetric LAMP is the reported short-term stability of the pre-mixed reagents, as well as the relatively high rate of false-positive results. Also, low-magnitude amplification can produce a subtle color change, making it difficult to discern a positive reaction. This paper presents Hilab Molecular, a portable device that uses the Internet of Things and Artificial Intelligence to pre-analyze colorimetric data. In addition, we established manufacturing procedures to increase the stability of colorimetric RT-LAMP tests. We show that ready-to-use reactions can be stored for up to 120 days at −20 °C. Furthermore, we validated both the Hilab Molecular device and the Hilab RT-LAMP test for SARS-CoV-2 using 581 patient samples without any purification steps. We achieved a sensitivity of 92.93% and specificity of 99.42% (samples with CT ≤ 30) when compared to RT-qPCR. Full article

(This article belongs to the Special Issue Point-of-Care Testing for Infectious Disease)

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11 pages, 2310 KiB

Open AccessArticle

Effect of Systemic Prednisone Treatment on Changes of Inflammation Markers in Chronic Rhinosinusitis

by Malgorzata Wierzchowska, Paulina Kalińczak-Górna, Magdalena Zwolińska, Joanna Ligmanowska, Justyna Durślewicz, Aleksander Zwierz, Bartosz Malinowski, Michał Wiciński and Paweł Burduk

Diagnostics 2023, 13(7), 1354; https://doi.org/10.3390/diagnostics13071354 - 5 Apr 2023

Viewed by 1984

Abstract

(1) Objective: We aimed to evaluate the effect of treatment with prednisone on nasal and systemic periostin and eotaxin expression, IgE in plasma and eosinophils in tissue. (2) Methods: We compared the values of nasal and systemic periostin, eotaxin, IgE and eosinophils in [...] Read more.

(1) Objective: We aimed to evaluate the effect of treatment with prednisone on nasal and systemic periostin and eotaxin expression, IgE in plasma and eosinophils in tissue. (2) Methods: We compared the values of nasal and systemic periostin, eotaxin, IgE and eosinophils in tissue in patients treated with only nasal steroids before FESS, group 1, with those treated with an oral steroid–prednisone, group 2. (3) Results: A statistically significant decrease in the level of periostin, eotaxin and IgE in plasma was achieved in patients treated with prednisone one week before and after surgery (in sequence: p < 0.0476, p < 0.0006, p < 0.0031). In patients treated with steroids, we also observed a lower level of periostin in the epithelium (p < 0.044), eotaxin in the stroma (p limit value < 0.075) and eosinophils (p < 0.031) in the tissues collected during the operation. (4) Conclusions: Systemic steroid treatment with prednisone distinctly decreases periostin, eotaxin and IgE expression in plasma. We also observed a lower level of periostin in the epithelium, eotaxin in the stroma and eosinophils in the tissues. We need more attempts to find inflammatory markers associated with chronic rhinosinusitis. Identifying drugs that decrease inflammatory parameters would allow for more targeted therapy. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

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46 pages, 3603 KiB

Open AccessReview

A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions

by Shriniket Dixit, Anant Kumar and Kathiravan Srinivasan

Diagnostics 2023, 13(7), 1353; https://doi.org/10.3390/diagnostics13071353 - 5 Apr 2023

Cited by 29 | Viewed by 8812

Abstract

Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise [...] Read more.

Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people’s lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI’s drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease. Full article

(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)

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4 pages, 1469 KiB

Open AccessInteresting Images

Histologically Confirmed Testicular Metastasis Revealed by [⁸⁹Zr]Zr-PSMA-617 PET/CT in a Patient with Biochemical Recurrence of Prostate Cancer and Negative Conventional PSMA PET/CT Imaging

by Florian Rosar, Caroline Burgard, Johannes Linxweiler, Mathias Wagner and Samer Ezziddin

Diagnostics 2023, 13(7), 1352; https://doi.org/10.3390/diagnostics13071352 - 5 Apr 2023

Cited by 2 | Viewed by 1788

Abstract

We present an interesting image of a testicular metastasis from prostate cancer revealed by [⁸⁹Zr]Zr-PSMA-617 PET/CT imaging in a 70-year-old man with biochemical recurrence and negative conventional [⁶⁸Ga]Ga-PSMA-11 PET/CT imaging. This case should encourage the consideration of [⁸⁹ [...] Read more.

We present an interesting image of a testicular metastasis from prostate cancer revealed by [⁸⁹Zr]Zr-PSMA-617 PET/CT imaging in a 70-year-old man with biochemical recurrence and negative conventional [⁶⁸Ga]Ga-PSMA-11 PET/CT imaging. This case should encourage the consideration of [⁸⁹Zr]Zr-PSMA-617 PET/CT if conventional PSMA PET/CT imaging had failed to localize biochemical recurrence, and may remind colleagues of this rare but potential metastatic localization in this setting. Full article

(This article belongs to the Special Issue Future Trends in Radioisotope-Based Imaging 2.0)

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13 pages, 1406 KiB

Open AccessArticle

Comparison of the Mesiodistal Angulations of Canine and Molar Teeth in Different Types of Orthodontic Malocclusions: A Retrospective Study

by Orhan Cicek, Hakan Yilmaz and Busra Demir Cicek

Diagnostics 2023, 13(7), 1351; https://doi.org/10.3390/diagnostics13071351 - 5 Apr 2023

Cited by 5 | Viewed by 2546

Abstract

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of [...] Read more.

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower–upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t-test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t-test and one-way ANOVA were used for normally distributed data, while the Mann–Whitney U and Kruskal–Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula. Full article

(This article belongs to the Special Issue New Insights into Diagnosis of Orthodontics)

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10 pages, 996 KiB

Open AccessArticle

Dipeptidyl Amino-Peptidase 3 (DPP3) as an Early Marker of Severity in a Patient Population with Cardiogenic Shock

by Pasquale Innelli, Teresa Lopizzo, Giovanni Paternò, Noemi Bruno, Rosa Paola Radice, Pietro Bertini, Alberto Marabotti, Giampaolo Luzi, Eugenio Stabile, Aldo Di Fazio, Giuseppe Pittella and Gianluca Paternoster

Diagnostics 2023, 13(7), 1350; https://doi.org/10.3390/diagnostics13071350 - 4 Apr 2023

Cited by 4 | Viewed by 2035

Abstract

Dipeptidyl amino-peptidase 3 (DPP3) is an aminopeptidase that is released into circulation upon cell death. DPP3 is involved in the degradation of angiotensins, enkephalines, and endomorphines. It has been shown that circulating DPP3 (cDPP3) plasma concentration increases in cardiogenic shock (CS) patients and [...] Read more.

Dipeptidyl amino-peptidase 3 (DPP3) is an aminopeptidase that is released into circulation upon cell death. DPP3 is involved in the degradation of angiotensins, enkephalines, and endomorphines. It has been shown that circulating DPP3 (cDPP3) plasma concentration increases in cardiogenic shock (CS) patients and correlates with high mortality risk. Cardiogenic shock is a life-threatening syndrome associated with organ hypoperfusion. One of the common causes of CS is acute myocardial infarction (AMI). This study aimed to investigate if cDPP3 levels are associated with CS severity and the need for ventilation in patients suffering from CS. Fifteen patients with CS were included in this study. Six patients were invasively ventilated. The values of cDPP3 were higher in ventilated patients than in non-ventilated patients at admission, 3 h, and 24 h after admission in the intensive care unit. Patients with pulmonary hypertension at admission also showed high cDPP3 values at all time points. Furthermore, high cDPP3 levels were associated with reduced stroke volume. Our results suggest that cDPP3 could predict CS progression and guide therapy escalation. Full article

(This article belongs to the Special Issue Predictive and Prognostic Markers in Critically Ill Patients)

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8 pages, 1116 KiB

Open AccessBrief Report

Evaluation of a ddPCR Commercial Assay for the Absolute Quantification of the Monkeypox Virus West Africa in Clinical Samples

by Elena Pomari, Antonio Mori, Silvia Accordini, Annalisa Donini, Maddalena Cordioli, Evelina Tacconelli and Concetta Castilletti

Diagnostics 2023, 13(7), 1349; https://doi.org/10.3390/diagnostics13071349 - 4 Apr 2023

Cited by 3 | Viewed by 1968

Abstract

Background: Monkeypox virus (MPXV) is a double-stranded DNA virus belonging to the orthopoxvirus genus in the family Poxviridae. Distinct clades are identified: the clade I belonging to the Central African (or Congo Basin) clade and the subclades IIa and IIb belonging to [...] Read more.

Background: Monkeypox virus (MPXV) is a double-stranded DNA virus belonging to the orthopoxvirus genus in the family Poxviridae. Distinct clades are identified: the clade I belonging to the Central African (or Congo Basin) clade and the subclades IIa and IIb belonging to the West African clade. Here, a commercial droplet digital PCR (ddPCR) assay was evaluated for the quantification of the MPXV West Africa clade in clinical samples. Methods: The ddPCR reaction was assessed as a duplex assay using RPP30 as an internal amplification control. A total of 60 clinical specimens were tested, 40 positives (skin lesions, n=10; rectal swabs, n = 10; pharyngeal swabs, n = 10; and whole blood, n = 10), and 20 negatives (n = 5 for each biological matrix) were found at the routine molecular diagnostics (orthopoxvirus qPCR followed by confirmation with Sanger sequencing). To evaluate the analytical sensitivity, the ddPCR reaction was first analyzed on serial dilutions of synthetic DNA spiked in water and in negative biological matrices, achieving a limit of detection of 3.5 copy/µL. Results: Regarding the clinical samples, compared to routine molecular diagnostics, the ddPCR duplex assay showed 100% of specificity for all biological matrices and 100% sensitivity (10/10) for lesions, 100% (10/10) for rectal swabs, 90% (9/10) for pharyngeal swabs, and 60% (6/10) for whole blood. Conclusion: Overall, our data showed that the commercial ddPCR assay allowed the DNA detection of MPXV in 87.5% (35/40) of our cohort, highlighting useful technical indications for the different specimens with a potential greatest performance for skin lesions and rectal swabs. Full article

(This article belongs to the Special Issue Molecular Diagnostics of Infectious Diseases)

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6 pages, 913 KiB

Open AccessCommunication

Choroidal Hyperreflective Nodules Detected by Infrared Reflectance Images Are a Diagnostic Criterion for Neurofibromatosis Type 1 Patients Excluding Those with High Myopia

by Marta Orejudo de Rivas, Javier Mateo Gabás, Miguel Ángel Torralba Cabeza, Olivia Esteban Floría, Raquel Herrero Latorre, Eva Núñez Moscarda, Julia Aramburu Clavería, Guillermo Pérez Rivasés and Javier Ascaso Puyuelo

Diagnostics 2023, 13(7), 1348; https://doi.org/10.3390/diagnostics13071348 - 4 Apr 2023

Cited by 1 | Viewed by 1830

Abstract

Neurofibromatosis type 1 (NF1) is one of the central nervous system’s most common autosomal dominant conditions. The diagnosis is based on the clinical diagnostic criteria and/or a molecularly confirmed mutation in the NF1 gene. This study investigated the possibility of substantiating choroidal nodules [...] Read more.

Neurofibromatosis type 1 (NF1) is one of the central nervous system’s most common autosomal dominant conditions. The diagnosis is based on the clinical diagnostic criteria and/or a molecularly confirmed mutation in the NF1 gene. This study investigated the possibility of substantiating choroidal nodules as a diagnostic criterion for the disease, including patients affected with and without high myopia. A cross-sectional study was carried out in 60 eyes of 30 adult patients diagnosed with NF1. A total of 30 healthy individuals of equivalent age and sex served as control. The Spectralis HRA+OCT MultiColor (Heidelberg Engineering GmbH, Heidelberg, Germany) evaluated the presence of choroidal abnormalities with near-infrared reflectance imaging. Secondly, the presence of iridian Lisch nodules was evaluated by slit lamp examination. Near-infrared reflectance imaging showed the presence of choroidal hyperreflective nodules in 83% of the patients diagnosed with NF1, while these choroidal abnormalities were not observed in any control subject. The patients diagnosed with NF1 associated with high myopia were the only ones who did not present the characteristic choroidal disorders. Therefore, when excluding patients diagnosed with high myopia, choroidal nodules were more frequent than Lisch nodules in a statistically significant proportion. Hyperreflective nodules detected by near-infrared reflectance imaging are as regular as Lisch nodules or even significantly more frequent when excluding high myope patients. Our observation of the mutual exclusion of choroidal hyperreflective nodules and high myopia in the NF1 patients seems a novel and interesting remark. Full article

(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)

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17 pages, 21884 KiB

Open AccessReview

Non-Operative Management of Polytraumatized Patients: Body Imaging beyond CT

by Francesca Iacobellis, Marco Di Serafino, Martina Caruso, Giuseppina Dell’Aversano Orabona, Chiara Rinaldo, Dario Grimaldi, Francesco Verde, Vittorio Sabatino, Maria Laura Schillirò, Giuliana Giacobbe, Gianluca Ponticiello, Mariano Scaglione and Luigia Romano

Diagnostics 2023, 13(7), 1347; https://doi.org/10.3390/diagnostics13071347 - 4 Apr 2023

Cited by 3 | Viewed by 2301

Abstract

In the transition from the operative to the conservative approach for the polytraumatized patients who undergo blunt trauma, diagnostic imaging has assumed a pivotal role, currently offering various opportunities, particularly in the follow-up of these patients. The choice of the most suitable imaging [...] Read more.

In the transition from the operative to the conservative approach for the polytraumatized patients who undergo blunt trauma, diagnostic imaging has assumed a pivotal role, currently offering various opportunities, particularly in the follow-up of these patients. The choice of the most suitable imaging method in this setting mainly depends on the injury complications we are looking for, the patient conditions (mobilization, cooperation, medications, allergies and age), the biological invasiveness, and the availability of each imaging method. Computed Tomography (CT) represents the “standard” imaging technique in the polytraumatized patient due to the high diagnostic performance when a correct imaging protocol is adopted, despite suffering from invasiveness due to radiation dose and intravenous contrast agent administration. Ultrasound (US) is a readily available technology, cheap, bedside performable and integrable with intravenous contrast agent (Contrast enhanced US—CEUS) to enhance the diagnostic performance, but it may suffer particularly from limited panoramicity and operator dependance. Magnetic Resonance (MR), until now, has been adopted in specific contexts, such as biliopancreatic injuries, but in recent experiences, it showed a great potential in the follow-up of polytraumatized patients; however, its availability may be limited in some context, and there are specific contraindications, such as as claustrophobia and the presence non-MR compatible devices. In this article, the role of each imaging method in the body-imaging follow-up of adult polytraumatized patients will be reviewed, enhancing the value of integrated imaging, as shown in several cases from our experience. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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6 pages, 2322 KiB

Open AccessInteresting Images

Chronic Complete Distal Aortic Occlusion and Pulmonary Embolism—Atypical Antiphospholipid Syndrome?

by Simona Caraiola, Laura Voicu, Dragoș Cașu, Elena Armășoiu, Claudia Oana Cobilinschi, Emilian Mihai and Răzvan Adrian Ionescu

Diagnostics 2023, 13(7), 1346; https://doi.org/10.3390/diagnostics13071346 - 4 Apr 2023

Cited by 1 | Viewed by 1613

Abstract

Complete aortic occlusion is a rare pathology with various possible etiologies. According to current data, it is most frequently caused by atherosclerosis. However, thrombosis or vasculitis could also be involved. We present the case of a 42-year-old female with chronic complete distal aortic [...] Read more.

Complete aortic occlusion is a rare pathology with various possible etiologies. According to current data, it is most frequently caused by atherosclerosis. However, thrombosis or vasculitis could also be involved. We present the case of a 42-year-old female with chronic complete distal aortic occlusion, associated pulmonary embolism and positive antiphospholipid antibodies. The patient had an obstetric history suggestive of antiphospholipid syndrome (APS). She presented with typical intermittent claudication symptoms persisting for approximately five years at the time of admission. Arteriography revealed complete infrarenal aortic occlusion and the presence of collateral arteries. Aortoiliac bypass surgery was performed. This case emphasizes an unusual, yet possible, etiology of chronic aortic occlusion—most probably, combining atherosclerosis and chronic thrombosis—in a relatively young patient, in which the diagnosis was significantly delayed due to the peculiar association of traits. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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13 pages, 1706 KiB

Open AccessArticle

Pregnancy Outcomes, Immunophenotyping and Immunohistochemical Findings in a Cohort of Pregnant Patients with COVID-19—A Prospective Study

by Ana-Maria Adam, Radu-Florin Popa, Cristian Vaduva, Costinela Valerica Georgescu, Gigi Adam, Alina-Sinziana Melinte-Popescu, Cristina Popa, Demetra Socolov, Aurel Nechita, Ingrid-Andrada Vasilache, Elena Mihalceanu, AnaMaria Harabor, Marian Melinte-Popescu, Valeriu Harabor, Anca Neagu and Razvan Socolov

Diagnostics 2023, 13(7), 1345; https://doi.org/10.3390/diagnostics13071345 - 4 Apr 2023

Cited by 8 | Viewed by 3006

Abstract

(1) Background: SARS-CoV-2 infection during pregnancy could determine important maternal and fetal complications. We aimed to prospectively assess placental immunohistochemical changes, immunophenotyping alterations, and pregnancy outcomes in a cohort of patients with COVID-19; (2) Methods: 52 pregnant patients admitted to a tertiary maternity [...] Read more.

(1) Background: SARS-CoV-2 infection during pregnancy could determine important maternal and fetal complications. We aimed to prospectively assess placental immunohistochemical changes, immunophenotyping alterations, and pregnancy outcomes in a cohort of patients with COVID-19; (2) Methods: 52 pregnant patients admitted to a tertiary maternity center between October 2020 and November 2021 were segregated into two equal groups, depending on the presence of SARS-CoV-2 infection. Blood samples, fragments of umbilical cord, amniotic membranes, and placental along with clinical data were collected. Descriptive statistics and a conditional logistic regression model were used for data analysis; (3) Results: Adverse pregnancy outcomes such as preterm labor and neonatal intensive care unit admission did not significantly differ between groups. The immunophenotyping analysis indicated that patients with moderate–severe forms of COVID-19 had a significantly reduced population of T lymphocytes, CD4+ T cells, CD8+ T cells (only numeric), CD4+/CD8+ index, B lymphocytes, and natural killer (NK) cells. Our immunohistochemistry analysis of tissue samples failed to demonstrate positivity for CD19, CD3, CD4, CD8, and CD56 markers; (4) Conclusions: Immunophenotyping analysis could be useful for risk stratification of pregnant patients, while further studies are needed to determine the extent of immunological decidual response in patients with various forms of COVID-19. Full article

(This article belongs to the Special Issue Infectious Disease in Pregnancy)

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14 pages, 3070 KiB

Open AccessArticle

The Role of Multidimensional Indices for Mortality Prediction in Chronic Obstructive Pulmonary Disease

by Stanislav Kotlyarov

Diagnostics 2023, 13(7), 1344; https://doi.org/10.3390/diagnostics13071344 - 4 Apr 2023

Cited by 4 | Viewed by 1773

Abstract

(1) Background: Chronic obstructive pulmonary disease (COPD) is one of the most important respiratory diseases. It is characterised by a progressive course with individual differences in clinical presentation and prognosis. The use of multidimensional indices such as the BODE, eBODE, BODEX, CODEX, ADO, [...] Read more.

(1) Background: Chronic obstructive pulmonary disease (COPD) is one of the most important respiratory diseases. It is characterised by a progressive course with individual differences in clinical presentation and prognosis. The use of multidimensional indices such as the BODE, eBODE, BODEX, CODEX, ADO, and Charlson Comorbidity Index has been proposed to predict the survival rate of COPD patients. However, there is limited research on the prognostic significance of these indices in predicting long-term survival rates in patients with COPD. The aim of this prospective cohort study was to investigate the prognostic value of the BODE, eBODE, BODEX, CODEX, ADO, COTE and Charlson Comorbidity Index in predicting 5- and 10-year survival in patients with COPD. (2) Methods: A total of 170 patients were included in the study and their clinical and functional characteristics of COPD progression, such as dyspnoea, body mass index and spirometry data, were evaluated. A Kaplan–Meier survival analysis was used to calculate 5- and 10-year survival rates. The predictive value of each index was assessed using Cox proportional hazards regression models. (3) Results: The 5-year survival rate was 62.35% and the 10-year survival rate was 34.70%. The BODE, eBODE, BODEX, CODEX, ADO, COTE and Charlson Comorbidity Index were all significantly associated with the 10-year survival rate of COPD patients (p < 0.05). The hazard ratios (HRs) for these indices were as follows: BODE (HR = 1.30, 95% confidence interval [CI] 1.21–1.39); eBODE (HR = 1.29, 95% CI 1.21–1.37); BODEX (HR = 1.48, 95% CI 1.35–1.63); CODEX (HR = 1.42, 95% CI 1.31–1.54); COTE (HR = 1.55, 95% CI 1.36–1.75); ADO (HR = 1.41, 95% CI 1.29–1.54); and Charlson Comorbidity Index (HR = 1.35, 95% CI 1.22–1.48). (4) Conclusions: The multidimensional indices are a useful clinical tool for assessing the course and prognosis of COPD. These indices can be used to identify patients at a high risk of mortality and guide the management of COPD patients. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma: Advances in the 21st Century)

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13 pages, 1963 KiB

Open AccessReview

Pediatric Echinococcosis of the Liver in Austria: Clinical and Therapeutical Considerations

by Josef Hager and Consolato M. Sergi

Diagnostics 2023, 13(7), 1343; https://doi.org/10.3390/diagnostics13071343 - 4 Apr 2023

Cited by 1 | Viewed by 2563

Abstract

Echinococcosis is considered a neglected disease in most European countries. However, migratory flows of populations, long-term stays in endemic areas, uninterrupted tourism (travel to Echinococcus-endemic countries), traveling dogs and dog translocations from endemic areas, and inappropriate hygiene practices are potential factors that [...] Read more.

Echinococcosis is considered a neglected disease in most European countries. However, migratory flows of populations, long-term stays in endemic areas, uninterrupted tourism (travel to Echinococcus-endemic countries), traveling dogs and dog translocations from endemic areas, and inappropriate hygiene practices are potential factors that alarm public health officials. Identifying a cyst-like mass in the liver or lung of an individual with a travel history of likely exposure to sheepdogs in an area where the parasite Echinococcus (E.) granulosus (sive cysticus) is endemic advocates for a prompt preliminary diagnosis of cystic echinococcosis (CE), no matter the age of the affected individuals. Routine imaging techniques, including ultrasonography, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans, are used to detect cysts. After a cyst has been discovered, serologic investigations are used to confirm the diagnosis. Typically, alveolar echinococcosis (AE) is found in older individuals. Yet young people are also affected because frequent oral exploration of the environment is a regular behavior for infants and toddlers. In this review, therapeutic considerations for pediatric echinococcosis—drug-based benzimidazole therapy; AE: atypical liver resection, the resection of individual or multiple segments, a right or left hemi-hepatectomy, or an extended hemi-hepatectomy; CE: PAIR-technique, cyst excision, liver segment(s) resection (laparoscopically or conventionally)—are revised following experience in one of the most affected regions of Europe. In addition, we performed a systematic review using three databases (i.e., PubMed, EMBASE, and Scopus) to evaluate the quality of evidence in published studies on pediatric echinococcosis. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

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27 pages, 1864 KiB

Open AccessReview

MRI Findings in Axial Psoriatic Spondylarthritis

by Loredana Sabina Pascu, Nicolae Sârbu, Andrei Vlad Brădeanu, Daniela Jicman (Stan), Madalina Nicoleta Matei, Mihaela Ionela Sârbu, Doina Carina Voinescu, Aurel Nechita and Alin Laurențiu Tatu

Diagnostics 2023, 13(7), 1342; https://doi.org/10.3390/diagnostics13071342 - 4 Apr 2023

Cited by 3 | Viewed by 2799

Abstract

Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy [...] Read more.

Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies. Full article

(This article belongs to the Special Issue Diagnosis and Management of Skin Diseases, Related Disorders and Their Comorbidities)

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11 pages, 910 KiB

Open AccessArticle

The Association of Circulating L-Carnitine, γ-Butyrobetaine and Trimethylamine N-Oxide Levels with Gastric Cancer

by Ilmārs Stonāns, Jelizaveta Kuzmina, Inese Poļaka, Solveiga Grīnberga, Eduards Sevostjanovs, Edgars Liepiņš, Ilona Aleksandraviča, Daiga Šantare, Arnis Kiršners, Roberts Škapars, Andrejs Pčolkins, Ivars Tolmanis, Armands Sīviņš, Mārcis Leja and Maija Dambrova

Diagnostics 2023, 13(7), 1341; https://doi.org/10.3390/diagnostics13071341 - 4 Apr 2023

Cited by 5 | Viewed by 3049

Abstract

Our study aimed to evaluate the association between gastric cancer (GC) and higher concentrations of the metabolites L-carnitine, γ-butyrobetaine (GBB) and gut microbiota-mediated trimethylamine N-oxide (TMAO) in the circulation. There is evidence suggesting that higher levels of TMAO and its precursors in blood [...] Read more.

Our study aimed to evaluate the association between gastric cancer (GC) and higher concentrations of the metabolites L-carnitine, γ-butyrobetaine (GBB) and gut microbiota-mediated trimethylamine N-oxide (TMAO) in the circulation. There is evidence suggesting that higher levels of TMAO and its precursors in blood can be indicative of either a higher risk of malignancy or indeed its presence; however, GC has not been studied in this regard until now. Our study included 83 controls without high-risk stomach lesions and 105 GC cases. Blood serum L-carnitine, GBB and TMAO levels were measured by ultra-high-performance liquid chromatography–mass spectrometry (UPLC/MS/MS). Although there were no significant differences between female control and GC groups, we found a significant difference in circulating levels of metabolites between the male control group and the male GC group, with median levels of L-carnitine reaching 30.22 (25.78–37.57) nmol/mL vs. 37.38 (32.73–42.61) nmol/mL (p < 0.001), GBB–0.79 (0.73–0.97) nmol/mL vs. 0.97 (0.78–1.16) nmol/mL (p < 0.05) and TMAO–2.49 (2.00–2.97) nmol/mL vs. 3.12 (2.08–5.83) nmol/mL (p < 0.05). Thus, our study demonstrated the association between higher blood levels of L-carnitine, GBB, TMAO and GC in males, but not in females. Furthermore, correlations of any two investigated metabolites were stronger in the GC groups of both genders in comparison to the control groups. Our findings reveal the potential role of L-carnitine, GBB and TMAO in GC and suggest metabolic differences between genders. In addition, the logistic regression analysis revealed that the only significant factor in terms of predicting whether the patient belonged to the control or to the GC group was the blood level of L-carnitine in males only. Hence, carnitine might be important as a biomarker or a risk factor for GC, especially in males. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

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15 pages, 6024 KiB

Open AccessArticle

MDCT Diagnosis and Staging of Xanthogranulomatous Pyelonephritis

by Stefania Tamburrini, Rosita Comune, Giulia Lassandro, Filomena Pezzullo, Carlo Liguori, Valeria Fiorini, Stefano Giusto Picchi, Marina Lugarà, Dario Del Biondo, Salvatore Masala, Fabio Tamburro and Mariano Scaglione

Diagnostics 2023, 13(7), 1340; https://doi.org/10.3390/diagnostics13071340 - 4 Apr 2023

Cited by 5 | Viewed by 3519

Abstract

Background: Benign nephrectomy to treat patients with renal inflammatory disease in cases of severe urinary infection represents a diagnostic and management challenge because of significant inflammatory, fibrotic, and infectious components. Among renal inflammatory diseases, fistulization and invasiveness to adjacent structures are some [...] Read more.

Background: Benign nephrectomy to treat patients with renal inflammatory disease in cases of severe urinary infection represents a diagnostic and management challenge because of significant inflammatory, fibrotic, and infectious components. Among renal inflammatory diseases, fistulization and invasiveness to adjacent structures are some of the hallmarks of xanthogranulomatous pyelonephritis (XGP). The aims of this study were as follows 1. to retrospectively determine key demographic and clinical features of XGP among benign nephrectomies; 2. to assess the CT preoperative diagnostic accuracy; and 3. to define the imaging characteristics of the CT stage. Material and Methods: A retrospective review of clinical, laboratory, and radiological features and operative methods of patients who underwent benign nephrectomy with histologically proven XGP was performed. Results: XPG was diagnosed in 18 patients over a 4-year (2018–2022) period. XGP represented 43.90% among benign nephrectomies. The mean age of the patients was 63 years, and the sex prevalence was higher in women (72.22%). Symptoms were vague and not specifically referrable to urinary tract disorders and unilateral (100%), with the left kidney affected in 61.11% of cases. Staghorn calculi and stone disease were the most common underlying cause (72.22%). All patients underwent CT. The preoperative CT imaging accuracy for renal inflammatory disease was 94.44% and indeterminate in 5.56%. A suspected diagnosis of XGP was formulated in 66.67% (12/18; 2 stage II/10 stage III), meanwhile, in 33.33% (6 patients with stage I), a non-specific diagnosis of renal inflammatory disease was formulated. CT was reported according to the Malek and Elder classification and staged in the stage I nephric form (33.33%), stage II perinephric form (11.11%), stage III paranephric form (55.56%). Conclusions: The CT diagnostic accuracy for kidney inflammatory disease was extremely high, whereas the suspected diagnosis of XGP was formulated preoperatively in only 66.67% of high-stage disease, where the hallmarks of invasiveness and fistulization of the pathology increased the diagnostic confidence. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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11 pages, 3295 KiB

Open AccessCase Report

Detection of Fatal Potassium Overdose: A Case Report and Review of the Literature

by Gábor Simon

Diagnostics 2023, 13(7), 1339; https://doi.org/10.3390/diagnostics13071339 - 4 Apr 2023

Cited by 2 | Viewed by 28162

Abstract

Potassium overdose usually occurs accidentally, but potassium is also used for judicial executions, assisted death, and, rarely, suicides. In addition to exogenous overdose, various drugs, and renal failure, diabetic ketoacidosis can cause hyperkalemia. Potassium tablets are used in most cases of suicidal potassium [...] Read more.

Potassium overdose usually occurs accidentally, but potassium is also used for judicial executions, assisted death, and, rarely, suicides. In addition to exogenous overdose, various drugs, and renal failure, diabetic ketoacidosis can cause hyperkalemia. Potassium tablets are used in most cases of suicidal potassium overdose. Suicide by intravenous administration of potassium is rare but usually fatal. The author reports a rare case of suicide with potassium infusion. Autopsy and histology findings, along with post-mortem biochemical analysis of different body fluids and fluid from the infusion set, are reported. Previously published reports of potassium overdose were reviewed, and the detection possibilities of potassium overdose are discussed. The detection possibilities of lethal hyperkalemia are very limited since hyperkalemia produces only nonspecific autopsy and histology findings. Post-mortem potassium concentrations are not indicative of ante-mortem potassium concentrations; therefore, post-mortem biochemical analysis has limited value in determining potassium overdose. The best way to prove potassium overdose is via the collection and analysis of circumstantial evidence. Full article

(This article belongs to the Special Issue Diagnostic Methods in Forensic Pathology)

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10 pages, 515 KiB

Open AccessArticle

Blood Type Associated with the Risk of COVID-19 Infection in Pregnant Women

by Rosalba Sevilla-Montoya, Addy C. Helguera-Reppeto, Irma E. Monroy-Muñoz, Tania A. Vargas-Pavia, Elías I. Valdés-Montoya, Mario Solis-Paredes, Johnatan Torres-Torres, Rafael Velazquez-Cruz, José Esteban Muñoz-Medina, Claudia Martinez-Cordero and Alberto Hidalgo-Bravo

Diagnostics 2023, 13(7), 1338; https://doi.org/10.3390/diagnostics13071338 - 4 Apr 2023

Cited by 1 | Viewed by 2008

Abstract

COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the [...] Read more.

COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the association of blood groups with the risk of infection and complications in pregnant women and newborns from the Mexican-Mestizo population. We studied 1906 individuals. Quantitative variables were analyzed through the Student’s t-test. Categorical variables were analyzed through Pearson’s chi-square test, and logistic regression was used to analyze the association between categorical variables and outcomes. No significant association was observed between blood groups and infection risk. Individuals with the AB blood type are at higher risk for developing severe disease, although blood groups do not seem to be involved in the risk of SARS-CoV-2 infection. However, the AB blood group could be considered a risk factor for developing severe COVID-19 in the Mexican population. Full article

(This article belongs to the Special Issue Diagnosis and Management in COVID-19 Patient)

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17 pages, 4349 KiB

Open AccessArticle

Contrast-Enhanced Imaging Features and Clinicopathological Investigation of Steatohepatitic Hepatocellular Carcinoma

by Kailing Chen, Yadan Xu, Yi Dong, Hong Han, Feng Mao, Hantao Wang, Xuhao Song, Rongkui Luo and Wen-Ping Wang

Diagnostics 2023, 13(7), 1337; https://doi.org/10.3390/diagnostics13071337 - 3 Apr 2023

Cited by 3 | Viewed by 1948

Abstract

Steatohepatitic hepatocellular carcinoma (SH-HCC) is a distinctive histologic variant of HCC for the presence of steatohepatitis. This study intended to evaluate the contrast-enhanced imaging features and clinicopathological characteristics of 26 SH-HCCs in comparison with 26 age-and-sex-matched non-SH-HCCs. The frequency of obesity (34.6%, p [...] Read more.

Steatohepatitic hepatocellular carcinoma (SH-HCC) is a distinctive histologic variant of HCC for the presence of steatohepatitis. This study intended to evaluate the contrast-enhanced imaging features and clinicopathological characteristics of 26 SH-HCCs in comparison with 26 age-and-sex-matched non-SH-HCCs. The frequency of obesity (34.6%, p = 0.048) and type 2 diabetes mellitus (23.1%, p = 0.042) were significantly higher in SH-HCC patients. As seen via B-mode ultrasound (BMUS), SH-HCCs were predominantly hyperechoic (65.4%, p = 0.002) lesions, while non-SH-HCCs were mainly hypo-echoic. As seen via contrast-enhanced ultrasound (CEUS), 96.2% of SH-HCCs exhibited hyperenhancement in the arterial phase. During the portal venous and late phase, 88.5% of SH-HCCs showed late and mild washout. Consequently, most SH-HCCs and all non-SH-HCCs were categorized as LR-4 or LR-5. As seen via magnetic resonance imaging (MRI), a signal drop in the T1WI opposed-phase was observed in 84.6% of SH-HCCs (p = 0.000). Notably, diffuse fat in mass was detected in 57.7% (15/26) SH-HCCs (p < 0.001). As seen via contrast-enhanced MRI (CEMRI), most of the SH-HCCs and non-SH-HCCs exhibited heterogeneous hyperenhancement in the arterial phase (80.8% versus 69.2%, p = 0.337). During the delayed phase, 76.9% SH-HCCs and 88.5% non-SH-HCCs exhibited hypo-enhancement. Histopathologically, the rate of microvascular invasion (MVI) was significantly lower in SH-HCCs than non-SH-HCCs (42.3% versus 73.1%, p = 0.025). The frequency of hepatic steatosis >5% in non-tumoral liver parenchyma of SH-HCCs was significantly higher than in non-SH-HCCs (88.5% versus 26.9%, p = 0.000). Additionally, the fibrotic stages of S0, S1 and S2 in SH-HCCs were significantly higher than in non-SH-HCCs (p = 0.044). During follow-up, although the PFS of SH-HCC patients was significantly longer than non-SH-HCC patients (p = 0.046), for the overall survival rate of SH-HCC and non-SH-HCC patients there was no significant difference (p = 0.162). In conclusion, the frequency of metabolism-related diseases in SH-HCC patients was significantly higher than in non-SH-HCC patients. The imaging features of SH-HCCs combined the fatty change and typical enhancement performance of standard HCC as seen via CEUS/CEMRI. Full article

(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging in 2023)

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12 pages, 885 KiB

Open AccessArticle

Physical Activity Effects on Muscle Fatigue in Sport in Active Adults with Long COVID-19: An Observational Study

by Francesco Coscia, Rosa Mancinelli, Paola Virginia Gigliotti, Franco Checcaglini and Giorgio Fanò-Illic

Diagnostics 2023, 13(7), 1336; https://doi.org/10.3390/diagnostics13071336 - 3 Apr 2023

Cited by 7 | Viewed by 3527

Abstract

Long COVID-19-related changes in physiology includes alterations in performing muscle work as fatigue. Data available do not allow us to define the usefulness of physical activity to attenuate long COVID-19 functional modifications. The present observational study investigates the effects of physical activity on [...] Read more.

Long COVID-19-related changes in physiology includes alterations in performing muscle work as fatigue. Data available do not allow us to define the usefulness of physical activity to attenuate long COVID-19 functional modifications. The present observational study investigates the effects of physical activity on the perception of fatigue, maximum power output, sleep, and cognitive modifications in subjects affected by long COVID-19, distinguishing between active and sedentary subjects. The data demonstrated the following: the perception of fatigue 1 year after the end of virus positivity was significantly reduced with respect to that observed after 6 months by more than 50% more in active subjects compared to sedentary ones; 6 months after the end of virus positivity, the force developed by active subjects was reduced (RM factor: p < 0.001, η2p = 0.527, post hoc: p < 0.001), but the reduction was more pronounced in sedentary ones (mean difference = 38.499 W); poor sleep quality and mild cognitive impairment were assessed in both active and sedentary subjects. In conclusion, the study suggests that the long COVID-19 fatigue was lower in active subjects respect to sedentary ones. A comparative analysis performed due to the overlap of functional alterations between long COVID-19 and ME/CFS showed that in a small percentage of the enrolled subjects (8%), the symptomatology reflected that of ME/CFS and was independent of the individual physical capacities. Full article

(This article belongs to the Special Issue 2022 Padua Days on Muscle and Mobility Medicine – On-Site)

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11 pages, 570 KiB

Open AccessArticle

Salivary Protein and Electrolyte Profiles during Primary Teeth Eruption: A Cross-Sectional Study

by Mina Ahmadian, Sara Maleki Kambakhsh, Nahid Einollahi, Saber Babazadeh, Maryam Tofangchiha, Giuseppe D’Amato and Romeo Patini

Diagnostics 2023, 13(7), 1335; https://doi.org/10.3390/diagnostics13071335 - 3 Apr 2023

Viewed by 1726

Abstract

This study aimed to assess the qualitative changes in the saliva during the process of primary teeth eruption. This cross-sectional study was conducted on 147 children from 2 to 48 months, of which 49 were in group A (no erupted primary teeth), 53 [...] Read more.

This study aimed to assess the qualitative changes in the saliva during the process of primary teeth eruption. This cross-sectional study was conducted on 147 children from 2 to 48 months, of which 49 were in group A (no erupted primary teeth), 53 were in group B (at least one active erupting primary tooth), and 45 were in group C (eruption of all 20 primary teeth was completed). Salivary proteins were evaluated by sodium dodecyl sulfate electrophoresis with polyacrylamide gel, while the concentrations of salivary sodium, potassium, chloride, and calcium ions were evaluated by ion selective electrodes. The data were analyzed using ANOVA and Bonferroni tests (alpha = 0.05). The concentration of proteins with molecular weights of 20–30 KDa was significantly higher in group A, and it gradually decreased with age. The concentration of proteins with molecular weights of 50–60 KDa in group B was significantly lower than those of groups A and C. The calcium ion concentration in group A was significantly higher than that of the other groups. The concentration of potassium ions was minimal in group C. The proteins and electrolyte profiles of the subjects’ saliva changed in the process of primary tooth eruption. The highest concentrations of proteins such as statherin, histatin, P-B peptide, and cystatin and the lowest concentrations of proteins such as amylase were present in group B. Full article

(This article belongs to the Special Issue Diagnosis of Dental Diseases)

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4 pages, 933 KiB

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Bing–Neel Syndrome and Coexisting Pituitary Macroadenoma in a Patient with Waldenström Macroglobulinemia Revealed by ¹⁸F-FDG and ⁶⁸Ga-Pentixafor PET/CT

by Qingqing Pan, Yaping Luo, Xinxin Cao, Jian Li and Jun Feng

Diagnostics 2023, 13(7), 1334; https://doi.org/10.3390/diagnostics13071334 - 3 Apr 2023

Viewed by 1458

Abstract

A 63-year-old man presenting with peripheral neuropathies was diagnosed of Waldenström’s macroglobulinemia, and Bing–Neel syndrome was subsequently confirmed via cerebrospinal fluid examinations. Besides involvement in bone marrow, lymph nodes, as well as the thoracic and sacral nerve root,⁶⁸Ga-Pentixafor PET/CT detected active [...] Read more.

A 63-year-old man presenting with peripheral neuropathies was diagnosed of Waldenström’s macroglobulinemia, and Bing–Neel syndrome was subsequently confirmed via cerebrospinal fluid examinations. Besides involvement in bone marrow, lymph nodes, as well as the thoracic and sacral nerve root,⁶⁸Ga-Pentixafor PET/CT detected active tracer uptake in bilateral choroid plexus, which was negative in ¹⁸F-FDG PET/CT, possibly suggesting the involvement of Bing–Neel syndrome. The coexisting pituitary macroadenoma was FDG-avid but negative in ⁶⁸Ga-Pentixafor PET/CT. After six cycles of chemotherapy, the follow-up PET/CT showed complete remission of the previous disease, including the high uptake of ⁶⁸Ga-Pentixafor in choroid plexus. However, the hypermetabolic pituitary macroadenoma remained unchanged. Full article

(This article belongs to the Special Issue Advances in PET/CT Imaging)

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