bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrocardiographic Gating and Cerebral Perfusion Computed Tomography Option-Set Prevalence and Utilization Data From 62 Institutions in the United States
Authors: Rose Sean D. , Lubner Meghan G. , Heil John , Greenwood Gina M. , Szczykutowicz Timothy P. 
Published: February 2023

Objectives
To provide the radiology community with data to address the question: “Compared with peer institutions, is my institution efficiently using its electrocardiographic (ECG) gating and cerebral perfusion-capable computed tomography (CT) scanners?”

Methods
In this retrospective study, we analyze 6 months of scanner utilization data from 62 institutions (299 locations, 507 scanners) to identify scanners capable of performing ECG gating and perfusion CT studies. We report the number of ECG gating/perfusion–capable scanners and locations as a function of the total number of locations and scanners in each institution. We additionally regress the number of ECG-gated and perfusion examinations on (1) the number of locations/scanners capable of performing these examinations and (2) the fraction of the institution's CT examination volume that requires ECG gating or perfusion. We provide look-up tables so an institution can compare its ECG-gated/perfusion examination volume to other institutions with similar ECG-gated/perfusion examination fractions and capable scanners.

Results
We detected an effect of both ECG-gating examination fraction and the number of ECG gating–capable scanners on ECG-gated examination volume (χ
2
1 = 77.5 [P < 0.001] and χ
2
1 = 64.2 [P < 0.001], respectively). Similar results were obtained for perfusion examination fraction and perfusion-capable scanners as they relate to perfusion examination volume (χ
2
1 = 51.6 [P < 0.001] and χ
2
1 = 45.2 [P < 0.001], respectively). The number of ECG gating/perfusion–capable scanners and locations within an institution were found to positively correlate with both the total number of locations and scanners within an institution (P < 0.001 for all hypothesis tests).

Conclusions
The study provides multi-institutional data on ECG gating and perfusion examination volumes that can be used to inform CT purchasing decisions.
Does the Thymus Index Predict COVID-19 Severity?
Authors: Berkan Ocal , Kiziloğlu Ilker , Keles Ercan , Duman Lale , Bozkurt Mehmet , Adıbelli Zehra , Oncel Guray , Berkan Nevsin , Ekemen Keles Yildiz , Jones Jeremy H. , Inan Abdurrahman Hamdi , Solak Cihan , Emiroğlu Mustafa , Yildirim Mehmet , Dursun Ayberk , Ilhan Enver , Camyar Asuman , Inceer Ozge , Nart Ahmet , Yilmaz Mehmet Birhan 
Published: February 2023

Background
The COVID-19 (coronavirus disease 2019) pandemic is a global health emergency that is straining health care resources. Identifying patients likely to experience severe illness would allow more targeted use of resources. This study aimed to investigate the association between the thymus index (TI) on thorax computed tomography (CT) and prognosis in patients with COVID-19.

Methods
A multicenter, cross-sectional, retrospective study was conducted between March 17 and June 30, 2020, in patients with confirmed COVID-19. The patients' clinical history and laboratory data were collected after receiving a signed consent form. Four experienced radiologists who were blinded to each other and patient data performed image evaluation. The appearance of the thymus was assessed in each patient using 2 published systems, including the TI and thymic morphology. Exclusion criteria were lack of initial diagnostic thoracic CT, previous sternotomy, pregnancy, and inappropriate images for thymic evaluation. A total of 2588 patients with confirmed COVID-19 and 1231 of these with appropriate thoracic CT imaging were included. Multivariable analysis was performed to predict the risk of severe disease and mortality.

Results
The median age was 45 (interquartile range, 33–58) years; 52.2% were male. Two hundred forty-nine (20.2%) patients had severe disease, and 60 (4.9%) patients died. Thymus index was significantly associated with mortality and severe disease (odds ratios, 0.289 [95% confidence interval, 0.141–0.588; P = 0.001]; and 0.266 [95% confidence interval, 0.075–0.932; P = 0.038]), respectively. Perithymic lymphadenopathy on CT imaging had a significantly strong association with grades of TI in patients with severe disease and death (V = 0.413 P = 0.017; and V = 0.261 P = 0.002, respectively). A morphologically assessable thymus increased the probability of survival by 17-fold and the absence of severe disease by 12-fold.

Conclusion
Assessment of the thymus in patients with COVID-19 may provide useful prognostic data for both disease severity and mortality.
A Computed Tomography Radiomics Nomogram in Differentiating Chordoma From Giant Cell Tumor in the Axial Skeleton
Authors: Nie Pei , Zhao Xia , Wang Ning , Ma Jinlong , Zuo Panli , Hao Dapeng , Yu Tengbo 
Published: February 2023

Objective
The aim of the study is to develop and validate a computed tomography (CT) radiomics nomogram for preoperatively differentiating chordoma from giant cell tumor (GCT) in the axial skeleton.

Methods
Seventy-three chordomas and 38 GCTs in axial skeleton were retrospectively included and were divided into a training cohort (n = 63) and a test cohort (n = 48). The radiomics features were extracted from CT images. A radiomics signature was developed by using the least absolute shrinkage and selection operator model, and a radiomics score (Rad-score) was acquired. By combining the Rad-score with independent clinical risk factors using multivariate logistic regression model, a radiomics nomogram was established. Calibration and receiver operator characteristic curves were used to assess the performance of the nomogram.

Results
Five features were selected to construct the radiomics signature. The radiomics signature showed favorable discrimination in the training cohort (area under the curve [AUC], 0.860; 95% confidence interval [CI], 0.760–0.960) and the test cohort (AUC, 0.830; 95% CI, 0.710–0.950). Age and location were the independent clinical factors. The radiomics nomogram combining the Rad-score with independent clinical factors showed good discrimination capability in the training cohort (AUC, 0.930; 95% CI, 0.880–0.990) and the test cohort (AUC, 0.980; 95% CI, 0.940–1.000) and outperformed the radiomics signature (z = 2.768, P = 0.006) in the test cohort.

Conclusions
The CT radiomics nomogram shows good predictive efficacy in differentiating chordoma from GCT in the axial skeleton, which might facilitate clinical decision making.
Identification of lncRNA-miRNA-mRNA networks in late-onset pre-eclampsia
Authors: Tang Yao , Liu Zhen-Zhen , Liu Hai-Yan , Wang Cheng-Jie , Pei Jiang-Nan , Chu Nan , Peng Ting , Li Xiao-Tian , Gu Wei-Rong 
Published: February 2023

Objective:
Long non-coding RNAs (lncRNAs) are implicated in multiple pathophysiological processes in placenta-related disorders; however, their expression and function in late-onset pre-eclampsia (LOPE) remain unclear. This study aimed to investigate the expression of lncRNAs in LOPE, construct a competing endogenous RNA (ceRNA) network, and identify the pathways associated with LOPE pathogenesis.

Methods:
We performed lncRNA and mRNAs microarray profiling to identify the differential expression profiles of lncRNAs and mRNAs in LOPE compared to those in normal pregnancy. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to validate differentially expressed genes. Subsequently, we generated an interaction network between lncRNAs, (micro-RNAs) miRNAs, and mRNAs based on the Pearson’s correlation coefficient between lncRNAs and mRNAs. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to understand the functional significance of differentially expressed lncRNAs (DElncRNAs) in LOPE.

Results:
We identified 29 DElncRNAs (25 upregulated and four downregulated) and 212 differentially expressed mRNAs (DEmRNAs; 203 upregulated and nine downregulated) in LOPE placentas. Within them, six lncRNAs and four mRNAs were verified by qRT-PCR. GO and KEGG analyses revealed the potential pathways affected by these mRNAs, such as positive regulation of leukocyte chemotaxis, chemokine signaling pathway, and response to hypoxia. Finally, we constructed a ceRNA network including three DElncRNAs and 124 DEmRNAs, whose competing interactions may be mediated by 17 miRNAs. Two DElncRNAs, ENST00000515376 and ENST00000520544, were found to be hub genes, as they interacted with most miRNAs and mRNAs. ENST00000515376 is most likely related to the metabolic process of arachidonic acid, whereas ENST00000520544 is more likely related to the coagulation system, such as the regulation of blood coagulation and platelet degranulation.

Conclusion:
Differential expression profile of lncRNAs and the lncRNA-miRNA-mRNA network in LOPE provide potential therapeutic targets for this disease.
Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis
Authors: Sieiro Santos Cristiana , Sendino-Tenorio Isabel , Álvarez Castro Carolina , Moriano Morales Clara , Cordero Coma Miguel , Díez Álvarez Elvira 
Published: February 2023

Background
Evaluating the efficacy and refractoriness to treatment and determining factors associated with adverse outcomes in uveitis associated with spondylarthritis (SpA) are complicated by the lack of validated outcome measures.

Objectives
The aims of this study were to develop an outcome score SpA-U in patients with uveitis associated with SpA and to determine factors associated with adverse outcomes in patients with uveitis under systemic treatment.

Methods
The outcome score SpA-U was defined by best-corrected visual acuity, anterior chamber inflammation, macular edema and inflammation of posterior chamber, global assessment, and refractoriness to treatment. Factors associated with adverse outcomes in uveitis were studied using linear regression. For categorical factors, marginal averages and their SEs are displayed together with linear regression coefficients with 95% confidence intervals. For continuous factors, averages and SDs are reported in addition to linear regression coefficients with 95% confidence interval. Two regression coefficients are reported for each variable: unadjusted and adjusted for age at diagnosis and sex.

Results
One hundred ninety-seven uveitis outbreaks were included. Sixty-two uveitis outbreaks (31%) were classified as severe, 42 as moderate (21%), and 93 as mild (47%) based on the definition and construction of outcome score. The results of the linear regression model revealed that the uveitis activity was more severe in patients with smoking history (β = 0.34), axial and peripheral involvement (β = 0.43), Ankylosing Spondylitis Disease Activity Score >2.1 (β = 0.45), positive HLA-B27 (β = 0.29), female sex (β = 0.19), patients with C-reactive protein elevation (β = 0.002), and bilateral ocular involvement (β = 0.32). At the same time, shorter disease evolution (β = −0.02) was associated with less severe uveitis activity.

Conclusion
We have determined factors associated with adverse outcomes in patients with uveitis associated with SpA by developing an outcome score SpA-U that integrates ocular inflammatory activity, visual acuity, global assessment, and refractoriness to treatment.
Clinical Outcomes With and Without Plasma Exchange in the Treatment of Rapidly Progressive Interstitial Lung Disease Associated With Idiopathic Inflammatory Myopathy
Authors: Eggleston Reid H. , Baqir Misbah , Varghese Cyril , Pennington Kelly M. , Bekele Delamo I. , Hartman Thomas E. , Ernste Floranne C. 
Published: February 2023

Abstract

Background/Objective
A subset of patients with idiopathic inflammatory myopathy (IIM) develops highly fatal, rapidly progressive interstitial lung disease (RP-ILD). Treatment strategies consist of glucocorticoid and adjunctive immunosuppressive therapies. Plasma exchange (PE) is an alternative therapy, but its benefit is unclear. In this study, we aimed to determine whether PE benefited outcomes for patients with RP-ILD.

Methods
In this medical records review study, we compared baseline characteristics and clinical outcomes for 2 groups of patients with IIM-related RP-ILD: those who received and did not receive PE.

Results
Our cohort consisted of 15 patients, 9 of whom received PE. Baseline demographic characteristics and severity of lung, skin, and musculoskeletal disease between the 2 groups of patients were not significantly different. Five patients required mechanical ventilation (2, PE; 3, no PE). Plasma exchange was generally a third-line adjunctive treatment option. The PE group had a longer median (interquartile range) hospitalization (27.0 [23.0–36.0] days) than the non-PE group (12.0 [8.0–14.0] days) (p = 0.02). There was a potential benefit in 30-day mortality improvement in those receiving PE (0% vs 33%, p = 0.14), with a statistically significant improvement in 2 important composite end points including 30-day mortality or need for lung transplant (0% vs 50%, p = 0.04) and 1-year mortality or need for lung transplant or hospital readmission for RP-ILD in those receiving PE (22% vs 83%, p = 0.04).

Conclusions
Plasma exchange may be an underutilized, safe salvage therapy for patients with IIM-related RP-ILD when other immunosuppressive therapies fail.
The Effect of Corticosteroids on Temporal Artery Biopsy Positivity in Giant Cell Arteritis
Authors: Papadakos Stavros P. , Papazoglou Andreas S. , Moysidis Dimitrios V. , Tsagkaris Christos , Papadakis Dimitrios L. , Koutsogianni Alexandra , Fragoulis Georgios , Papadakis Marios 
Published: February 2023

Objective
Temporal artery biopsy (TAB) remains the standard criterion for the diagnosis of giant cell arteritis (GCA). Temporal artery biopsy is suggested to be performed within 2 weeks from the initiation of corticosteroids. However, the effects of TAB timing on the sensitivity of its findings still warrant further investigation.

Methods
We reviewed the medical records of patients with GCA from a tertiary medical center in Germany over an 8-year period.

Results
We analyzed data from 109 patients with a median age of 76 years and a median time from glucocorticoid treatment to TAB of 4 days. Approximately 60% of biopsies were positive. Our analysis yielded a nonsignificant trend toward shorter duration of corticosteroid treatment in the TAB(+) group (p = 0.06). A more than 7 days' duration of steroid treatment was independently linked with lower rates of positive TAB (adjusted odds ratio, 0.33; 95% confidence interval, 0.11–1.00).

Conclusion
We conclude that the duration of corticosteroid treatment seems to affect the positivity of TAB in patients with suspected GCA. Further larger studies are required to confirm the generalizability of our findings.
Repeated Contrast-Enhanced Micro-CT Examinations Decrease Animal Welfare and Influence Tumor Physiology
Authors: Baier Jasmin , Rix Anne , Darguzyte Milita , Girbig Renée Michèle , May Jan-Niklas , Palme Rupert , Tolba René , Kiessling Fabian 
Published: February 2023

ObjectivesComputed tomography (CT) imaging is considered relatively safe and is often used in preclinical research to study physiological processes. However, the sum of low-dose radiation, anesthesia, and animal handling might impact animal welfare and physiological parameters. This is particularly relevant for longitudinal studies with repeated CT examinations. Therefore, we investigated the influence of repeated native and contrast-enhanced (CE) CT on animal welfare and tumor physiology in regorafenib-treated and nontreated tumor-bearing mice.Material and MethodsMice bearing 4T1 breast cancer were divided into 5 groups: (1) no imaging, (2) isoflurane anesthesia only, (3) 4 mGy CT, (4) 50 mGy CT, and (5) CE-CT (iomeprol). In addition, half of each group was treated with the multikinase inhibitor regorafenib. Mice were imaged 3 times within 1 week under isoflurane anesthesia. Behavioral alterations were investigated by score sheet evaluation, rotarod test, heart rate measurements, and fecal corticosterone metabolite analysis. Tumor growth was measured daily with a caliper. Tumors were excised at the end of the experiment and histologically examined for blood vessel density, perfusion, and cell proliferation.ResultsAccording to the score sheet, animals showed a higher burden after anesthesia administration and in addition with CT imaging (P< 0.001). Motor coordination was not affected by native CT, but significantly decreased after CE-CT in combination with the tumor therapy (P< 0.001). Whereas tumor growth and blood vessel density were not influenced by anesthesia or imaging, CT-scanned animals had a higher tumor perfusion (P< 0.001) and a lower tumor cell proliferation (P< 0.001) for both radiation doses. The most significant difference was observed between the control and CE-CT groups.ConclusionRepeated (CE-) CT imaging of anesthetized animals can lead to an impairment of animal motor coordination and, thus, welfare. Furthermore, these standard CT protocols seem to be capable of inducing alterations in tumor physiology when applied repetitively. These potential effects of native and CE-CT should be carefully considered in preclinical oncological research.
Standardization and Quantitative Imaging With Photon-Counting Detector CT
Authors: McCollough Cynthia H. , Rajendran Kishore , Leng Shuai 
Published: February 2023

AbstractComputed tomography (CT) images display anatomic structures across 3 dimensions and are highly quantitative; they are the reference standard for 3-dimensional geometric measurements and are used for 3-dimensional printing of anatomic models and custom implants, as well as for radiation therapy treatment planning. The pixel intensity in CT images represents the linear x-ray attenuation coefficient of the imaged materials after linearly scaling the coefficients into a quantity known as CT numbers that is conveyed in Hounsfield units. When measured with the same scanner model, acquisition, and reconstruction parameters, the mean CT number of a material is highly reproducible, and quantitative applications of CT scanning that rely on the measured CT number, such as for assessing bone mineral density or coronary artery calcification, are well established. However, the strong dependence of CT numbers on x-ray beam spectra limits quantitative applications and standardization from achieving robust widespread success. This article reviews several quantitative applications of CT and the challenges they face, and describes the benefits brought by photon-counting detector (PCD) CT technology. The discussed benefits of PCD-CT include that it is inherently multienergy, expands material decomposition capabilities, and improves spatial resolution and geometric quantification. Further, the utility of virtual monoenergetic images to standardize CT numbers is discussed, as virtual monoenergetic images can be the default image type in PCD-CT due to the full-time spectral nature of the technology.
Deep Learning Diagnosis and Classification of Rotator Cuff Tears on Shoulder MRI
Authors: Lin Dana J. , Schwier Michael , Geiger Bernhard , Raithel Esther , von Busch Heinrich , Fritz Jan , Kline Mitchell , Brooks Michael , Dunham Kevin , Shukla Mehool , Alaia Erin F. , Samim Mohammad , Joshi Vivek , Walter William R. , Ellermann Jutta M. , Ilaslan Hakan , Rubin David , Winalski Carl S. , Recht Michael P. 
Published: February 2023

Background
Detection of rotator cuff tears, a common cause of shoulder disability, can be time-consuming and subject to reader variability. Deep learning (DL) has the potential to increase radiologist accuracy and consistency.

Purpose
The aim of this study was to develop a prototype DL model for detection and classification of rotator cuff tears on shoulder magnetic resonance imaging into no tear, partial-thickness tear, or full-thickness tear.

Materials and Methods
This Health Insurance Portability and Accountability Act-compliant, institutional review board–approved study included a total of 11,925 noncontrast shoulder magnetic resonance imaging scans from 2 institutions, with 11,405 for development and 520 dedicated for final testing. A DL ensemble algorithm was developed that used 4 series as input from each examination: fluid-sensitive sequences in 3 planes and a sagittal oblique T1-weighted sequence. Radiology reports served as ground truth for training with categories of no tear, partial tear, or full-thickness tear. A multireader study was conducted for the test set ground truth, which was determined by the majority vote of 3 readers per case. The ensemble comprised 4 parallel 3D ResNet50 convolutional neural network architectures trained via transfer learning and then adapted to the targeted domain. The final tear-type prediction was determined as the class with the highest probability, after averaging the class probabilities of the 4 individual models.

Results
The AUC overall for supraspinatus, infraspinatus, and subscapularis tendon tears was 0.93, 0.89, and 0.90, respectively. The model performed best for full-thickness supraspinatus, infraspinatus, and subscapularis tears with AUCs of 0.98, 0.99, and 0.95, respectively. Multisequence input demonstrated higher AUCs than single-sequence input for infraspinatus and subscapularis tendon tears, whereas coronal oblique fluid-sensitive and multisequence input showed similar AUCs for supraspinatus tendon tears. Model accuracy for tear types and overall accuracy were similar to that of the clinical readers.

Conclusions
Deep learning diagnosis of rotator cuff tears is feasible with excellent diagnostic performance, particularly for full-thickness tears, with model accuracy similar to subspecialty-trained musculoskeletal radiologists.
Single Breath-Hold 3-Dimensional Magnetic Resonance Elastography Depicts Liver Fibrosis and Inflammation in Obese Patients
Authors: Darwish Omar Isam , Gharib Ahmed M. , Jeljeli Sami , Metwalli Nader S. , Feeley Jenna , Rotman Yaron , Brown Rebecca J. , Ouwerkerk Ronald , Kleiner David E. , Stäb Daniel , Speier Peter , Sinkus Ralph , Neji Radhouene 
Published: January 2023

Objectives
Three-dimensional (3D) magnetic resonance elastography (MRE) measures liver fibrosis and inflammation but requires several breath-holds that hamper clinical acceptance. The aim of this study was to evaluate the technical and clinical feasibility of a single breath-hold 3D MRE sequence as a means of measuring liver fibrosis and inflammation in obese patients.

Methods
From November 2020 to December 2021, subjects were prospectively enrolled and divided into 2 groups. Group 1 included healthy volunteers (n = 10) who served as controls to compare the single breath-hold 3D MRE sequence with a multiple–breath-hold 3D MRE sequence. Group 2 included liver patients (n = 10) who served as participants to evaluate the clinical feasibility of the single breath-hold 3D MRE sequence in measuring liver fibrosis and inflammation. Controls and participants were scanned at 60 Hz mechanical excitation with the single breath-hold 3D MRE sequence to retrieve the magnitude of the complex-valued shear modulus (|G*| [kPa]), the shear wave speed (Cs [m/s]), and the loss modulus (G" [kPa]). The controls were also scanned with a multiple–breath-hold 3D MRE sequence for comparison, and the participants had histopathology (Ishak scores) for correlation with Cs and G".

Results
For the 10 controls, 5 were female, and the mean age and body mass index were 33.1 ± 9.5 years and 23.0 ± 2.1 kg/m2, respectively. For the 10 participants, 8 were female, and the mean age and body mass index were 45.1 ± 16.5 years and 33.1 ± 4.0 kg/m2 (obese range), respectively. All participants were suspected of having nonalcoholic fatty liver disease. Bland-Altman analysis of the comparison in controls shows there are nonsignificant differences in |G*|, Cs, and G" below 6.5%, suggesting good consensus between the 2 sequences. For the participants, Cs and G" correlated significantly with Ishak fibrosis and inflammation grades, respectively (ρ = 0.95, P < 0.001, and ρ = 0.84, P = 0.002).

Conclusion
The single breath-hold 3D MRE sequence may be effective in measuring liver fibrosis and inflammation in obese patients.