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Diagnostics, Volume 11, Issue 9 (September 2021) – 216 articles

Cover Story (view full-size image): Neuroinflammation is an essential pathomechanism of Alzheimer’s disease, strictly linked to the amyloid cascade hypothesis. Although classically defined as a CNS-confined process, a central role for the peripheral immune system is well recognized today. In fact, a bidirectional communication is operative, with monocytes and released soluble factors—cytokines and chemokines—shuttling between one compartment and the other. Assessing neuroinflammation-associated biomarkers in periphery represents, then, an exciting window for monitoring AD and, perhaps, for tailoring novel treatments. View this paper.
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Article
A Deep Learning Based Approach for Patient Pulmonary CT Image Screening to Predict Coronavirus (SARS-CoV-2) Infection
Diagnostics 2021, 11(9), 1735; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091735 - 21 Sep 2021
Cited by 1 | Viewed by 574
Abstract
The novel coronavirus (nCoV-2019) is responsible for the acute respiratory disease in humans known as COVID-19. This infection was found in the Wuhan and Hubei provinces of China in the month of December 2019, after which it spread all over the world. By [...] Read more.
The novel coronavirus (nCoV-2019) is responsible for the acute respiratory disease in humans known as COVID-19. This infection was found in the Wuhan and Hubei provinces of China in the month of December 2019, after which it spread all over the world. By March, 2020, this epidemic had spread to about 117 countries and its different variants continue to disturb human life all over the world, causing great damage to the economy. Through this paper, we have attempted to identify and predict the novel coronavirus from influenza-A viral cases and healthy patients without infection through applying deep learning technology over patient pulmonary computed tomography (CT) images, as well as by the model that has been evaluated. The CT image data used under this method has been collected from various radiopedia data from online sources with a total of 548 CT images, of which 232 are from 12 patients infected with COVID-19, 186 from 17 patients with influenza A virus, and 130 are from 15 healthy candidates without infection. From the results of examination of the reference data determined from the point of view of CT imaging cases in general, the accuracy of the proposed model is 79.39%. Thus, this deep learning model will help in establishing early screening of COVID-19 patients and thus prove to be an analytically robust method for clinical experts. Full article
(This article belongs to the Special Issue Machine Learning for Computer-Aided Diagnosis in Biomedical Imaging)
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Article
Hybrid Additive Fabrication of a Transparent Liver with Biosimilar Haptic Response for Preoperative Planning
Diagnostics 2021, 11(9), 1734; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091734 - 21 Sep 2021
Viewed by 483
Abstract
Due to the complexity of liver surgery, the interest in 3D printing is constantly increasing among hepatobiliary surgeons. The aim of this study was to produce a patient-specific transparent life-sized liver model with tissue-like haptic properties by combining additive manufacturing and 3D moulding. [...] Read more.
Due to the complexity of liver surgery, the interest in 3D printing is constantly increasing among hepatobiliary surgeons. The aim of this study was to produce a patient-specific transparent life-sized liver model with tissue-like haptic properties by combining additive manufacturing and 3D moulding. A multistep pipeline was adopted to obtain accurate 3D printable models. Semiautomatic segmentation and registration of routine medical imaging using 3D Slicer software allowed to obtain digital objects representing the structures of interest (liver parenchyma, vasculo-biliary branching, and intrahepatic lesion). The virtual models were used as the source data for a hybrid fabrication process based on additive manufacturing using soft resins and casting of tissue-mimicking silicone-based blend into 3D moulds. The model of the haptic liver reproduced with high fidelity the vasculo-biliary branching and the relationship with the intrahepatic lesion embedded into the transparent parenchyma. It offered high-quality haptic perception and a remarkable degree of surgical and anatomical information. Our 3D transparent model with haptic properties can help surgeons understand the spatial changes of intrahepatic structures during surgical manoeuvres, optimising preoperative surgical planning. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Article
PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia
Diagnostics 2021, 11(9), 1733; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091733 - 21 Sep 2021
Viewed by 397
Abstract
Post-thyroidectomy hypocalcemia is a frequent complication with significant morbidity, and has been shown to increase hospital stay and readmission rates. The evaluation of serum parathyroid hormone (PTH) levels after thyroidectomy represents a reliable method to predict post-thyroidectomy hypocalcemia, but it remains infrequently used. [...] Read more.
Post-thyroidectomy hypocalcemia is a frequent complication with significant morbidity, and has been shown to increase hospital stay and readmission rates. The evaluation of serum parathyroid hormone (PTH) levels after thyroidectomy represents a reliable method to predict post-thyroidectomy hypocalcemia, but it remains infrequently used. This retrospective study investigates serum PTH values 3 h after thyroidectomy as a predictor of hypocalcemia. In this study, we enrolled 141 patients aged between 27 and 71 years eligible for total thyroidectomy who presented with multinodular goiter, suspicious nodule on cytological examination, Graves’ disease, or toxic multinodular goiter. Three hours after total thyroidectomy, 53 patients (37.6%) showed a reduction in serum PTH. Of these patients 75.5% developed hypocalcemia by 24 h after surgery and 100% were hypocalcemic after 48 h (p < 0.001). There was no significant difference attributable to the different thyroid diseases, nor to the age of the patients. PTH at 3 h after total thyroidectomy accurately predicts post-operative hypocalcemia. The early detection of patients at risk of developing post-operative hypocalcemia allows for prompt supplementation of calcium and Vitamin D in order to prevent symptoms and allows for a safe and timely discharge. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Article
Object or Background: An Interpretable Deep Learning Model for COVID-19 Detection from CT-Scan Images
Diagnostics 2021, 11(9), 1732; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091732 - 21 Sep 2021
Viewed by 426
Abstract
The new strains of the pandemic COVID-19 are still looming. It is important to develop multiple approaches for timely and accurate detection of COVID-19 and its variants. Deep learning techniques are well proved for their efficiency in providing solutions to many social and [...] Read more.
The new strains of the pandemic COVID-19 are still looming. It is important to develop multiple approaches for timely and accurate detection of COVID-19 and its variants. Deep learning techniques are well proved for their efficiency in providing solutions to many social and economic problems. However, the transparency of the reasoning process of a deep learning model related to a high stake decision is a necessity. In this work, we propose an interpretable deep learning model Ps-ProtoPNet to detect COVID-19 from the medical images. Ps-ProtoPNet classifies the images by recognizing the objects rather than their background in the images. We demonstrate our model on the dataset of the chest CT-scan images. The highest accuracy that our model achieves is 99.29%. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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Article
The Importance of the Novel Postpartum Uterine Ultrasonographic Scale in Numerical Assessments of Uterine Involution Regarding Perinatal Maternal and Fetal Outcomes
Diagnostics 2021, 11(9), 1731; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091731 - 21 Sep 2021
Viewed by 557
Abstract
Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or [...] Read more.
Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). A total of 131 consecutive patients admitted for delivery in the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, were prospectively evaluated using the PUUS method. The mean age was 27.72 years old, and they were examined during the first 24–48 h after vaginal delivery, or in the first 48–72 h after cesarean delivery. For patients with a PUUS grade greater than 1, re-examination was preformed daily in the following days, until the PUUS grade decreased to 1 or 0. Results: By standardizing uterine involution in a numerical fashion, we precisely demonstrate that uterine involution varied with the method of delivery (vaginal/cesarean) and with the number of vials of oxytocin received intrapartum, but not with the number of vials of ergometrine maleate received, and not with the origin of the parturient (rural/urban). Full article
(This article belongs to the Section Medical Imaging)
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Review
Patient-Reported Outcomes and Preferences for Colon Capsule Endoscopy and Colonoscopy: A Systematic Review with Meta-Analysis
Diagnostics 2021, 11(9), 1730; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091730 - 20 Sep 2021
Cited by 1 | Viewed by 711
Abstract
Colon capsule endoscopy as an alternative to colonoscopy for the diagnosis of colonic disease may serve as a less invasive and more tolerable investigation for patients. Our aim was to examine patient-reported outcomes for colon capsule endoscopy compared to conventional optical colonoscopy including [...] Read more.
Colon capsule endoscopy as an alternative to colonoscopy for the diagnosis of colonic disease may serve as a less invasive and more tolerable investigation for patients. Our aim was to examine patient-reported outcomes for colon capsule endoscopy compared to conventional optical colonoscopy including preference of investigation modality, tolerability and adverse events. A systematic literature search was conducted in Web of Science, PubMed and Embase. Search results were thoroughly screened for in- and exclusion criteria. Included studies underwent assessment of transparency and completeness, after which, data for meta-analysis were extracted. Pooled estimates of patient preference were calculated and heterogeneity was examined including univariate meta-regressions. Patient-reported tolerability and adverse events were reviewed. Out of fourteen included studies, twelve had investigated patient-reported outcomes in patients who had undergone both investigations, whereas in two the patients were randomized between investigations. Pooled patient preferences were estimated to be 52% (CI 95%: 41–63%) for colon capsule endoscopy and 45% (CI 95%: 33–57%) for conventional colonoscopy: not indicating a significant difference. Procedural adverse events were rarely reported by patients for either investigation. The tolerability was high for both colon capsule endoscopy and conventional colonoscopy. Patient preferences for conventional colonoscopy and colon capsule endoscopy were not significantly different. Procedural adverse events were rare and the tolerability for colon capsule endoscopy was consistently reported higher or equal to that of conventional colonoscopy. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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Article
The Impact of Phototherapy on the Accuracy of Transcutaneous Bilirubin Measurements in Neonates: Optimal Measurement Site and Timing
Diagnostics 2021, 11(9), 1729; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091729 - 20 Sep 2021
Viewed by 766
Abstract
Transcutaneous bilirubinometer devices are widely applied to assess neonatal hyperbilirubinemia. However, the optimal skin site and timing of transcutaneous bilirubin (TCB) measurements for the strongest correlation with total serum bilirubin (TSB) levels after phototherapy are still unclear. We conducted a retrospective observational study [...] Read more.
Transcutaneous bilirubinometer devices are widely applied to assess neonatal hyperbilirubinemia. However, the optimal skin site and timing of transcutaneous bilirubin (TCB) measurements for the strongest correlation with total serum bilirubin (TSB) levels after phototherapy are still unclear. We conducted a retrospective observational study evaluating the correlation of TCB and TSB levels in neonates postphototherapy. The TCB measurements on the forehead and mid-sternum at 0 and 30 min postphototherapy were assessed by using a JM-103 bilirubinometer. Paired TCB and TSB measurements were assessed by Pearson correlation and Bland–Altman plots. We analyzed 40 neonates with 96 TSB and 384 TCB measurements. The TSB level correlated moderately with the forehead TCB level at 30 min postphototherapy (r = 0.65) and less strongly with the midsternum TCB level at 0 min postphototherapy (r = 0.52). The forehead at 30 min after cessation of phototherapy was the best time point and location of TCB measurement for the assessment of neonatal jaundice status. The reliability of TCB measurements varied across skin sites and durations after phototherapy. The effectiveness of TCB measurement to assess neonatal hyperbilirubinemia is much better on covered skin areas (foreheads) 30 min postphototherapy. The appropriate application of transcutaneous bilirubinometers could aid in clinical practice and avoid unnecessary management. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics for Low-Resource Settings)
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Article
C-Reactive Protein for the Early Assessment of Non-Malarial Febrile Patients: A Retrospective Diagnostic Study
Diagnostics 2021, 11(9), 1728; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091728 - 20 Sep 2021
Viewed by 653
Abstract
Biomarkers, especially CRP, have demonstrated their relevance to differentiate viral from bacterial infection, even though a reliable threshold is far to being found. In low- and middle-income countries, affordable and user-friendly rapid diagnostic tests based on biomarkers can be widely adopted to help [...] Read more.
Biomarkers, especially CRP, have demonstrated their relevance to differentiate viral from bacterial infection, even though a reliable threshold is far to being found. In low- and middle-income countries, affordable and user-friendly rapid diagnostic tests based on biomarkers can be widely adopted to help health workers in the management of non-malarial fever. The primary objective of this study is to assess the best CRP cut-off to distinguish viral from bacterial infections. Other biomarkers were evaluated for the same purpose, alone or in combination with CRP. We retrospectively collected data from two referral hospital departments for infectious and tropical diseases in Italy. Areas under the ROC curve (AUC) were calculated and then compared using the DeLong test. Overall, we included 1193 febrile cases (viral 20.74% vs. bacterial 79.25%). We also collected malaria (n = 202) and intestinal parasite (n = 186) cases to establish their impact on biomarkers. CRP had the best accuracy in differentiating viral from bacterial infections. The best performance of CRP was a cut-off of 11 mg/L. All other biomarkers studied had significantly lower accuracy. Median CRP values were within the normal ranges in parasitic infections, while they were higher in malaria. None of the combinations of CRP with other biomarkers significantly increased the accuracy of CRP alone. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
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Article
Usability and Clinical Performance Characteristics of the Asante HIV1/2 Test by Trained Users in Two African Sites
Diagnostics 2021, 11(9), 1727; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091727 - 20 Sep 2021
Viewed by 598
Abstract
HIV self-testing (HIVST) devices are acknowledged as having the potential to enable the acceleration of HIV diagnosis and linkage to care. How efficiently professional and trained users engaged with the Asante HIV-1/2 Oral Self-Test (Asante) (Sedia Biosciences, Portland, OR, USA), and the accuracy [...] Read more.
HIV self-testing (HIVST) devices are acknowledged as having the potential to enable the acceleration of HIV diagnosis and linkage to care. How efficiently professional and trained users engaged with the Asante HIV-1/2 Oral Self-Test (Asante) (Sedia Biosciences, Portland, OR, USA), and the accuracy of the device in comparison to other HIV rapid diagnostic tests (RDT), was assessed to be able to guide the development and adoption of the device in Senegal and South Africa. Using convenience sampling, potential participants were recruited from catchment areas where HIV was prevalent. Trained users performed an HIV test on participants using an Oral HIVST. The professional user’s interpretation of results was then measured against the results of various other RDTs. The South African study had 1652 participants and the Senegalese, 500. Most of the participants in each study were 18–35 years old. Senegal had a higher number of females (346/500, 69.2%) compared to South Africa (699/1662, 42.1%). Asante displayed very high sensitivity and specificity when tested against other devices. In the final enzyme-linked immunosorbent assay (ELISA) comparison, in South Africa, the sensitivity: specificity was 99.1:99.9% and in Senegal, 98.4:100.0%. Senegal further identified 53/63 (84.1%) with HIV-1, 8/63 (12.7) with HIV-2 and 2/63 (3.2%) with HIV-1/2 co-infections. Professional or trained users’ interpretations of Asante results correlated strongly to results when using various RDTs, the ELISA assay and Western blot tests, making it a dependable HIV testing instrument. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics for Low-Resource Settings)
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Article
Usefulness of Endoscopic Ultrasound with the Jelly-Filling Method for Esophageal Varices
Diagnostics 2021, 11(9), 1726; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091726 - 20 Sep 2021
Viewed by 531
Abstract
Although the importance of endoscopic ultrasound (EUS) for esophageal varices (EVs) has been demonstrated, it is difficult to obtain sufficient EUS images with the water-filling method because of poor water stagnation in the esophagus. In this study on EVs, we aimed to evaluate [...] Read more.
Although the importance of endoscopic ultrasound (EUS) for esophageal varices (EVs) has been demonstrated, it is difficult to obtain sufficient EUS images with the water-filling method because of poor water stagnation in the esophagus. In this study on EVs, we aimed to evaluate the usefulness of the jelly-filling method for EUS. Consecutive patients who underwent EUS for EVs were included. The quality of EUS images, the diagnostic ability of the presence of blood vessels inside and outside the esophageal wall, and the procedure time were compared between the jelly-filling and water-filling methods. Thirty cases were analyzed (jelly-filling method in 13 and water-filling method in 17). The EUS image quality score was significantly higher in the jelly-filling method (jelly vs. water; three points vs. two points, p < 0.001). Additionally, EUS image quality scores in both nonexperts and experts were significantly higher in the jelly-filling method. The diagnostic ability of the presence of perforation veins was significantly higher in the jelly-filling method (jelly vs. water; 100% vs. 52.9%, p = 0.004). However, the procedure time was significantly longer in the jelly-filling method (p = 0.024). In conclusion, EUS using the jelly-filling method for EVs provided sufficient image quality. Full article
(This article belongs to the Special Issue The Next Generation of Upper Gastrointestinal Endoscopy)
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Article
The TVGH-NYCU Thal-Classifier: Development of a Machine-Learning Classifier for Differentiating Thalassemia and Non-Thalassemia Patients
Diagnostics 2021, 11(9), 1725; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091725 - 20 Sep 2021
Viewed by 766
Abstract
Thalassemia and iron deficiency are the most common etiologies for microcytic anemia and there are indices discriminating both from common laboratory simple automatic counters. In this study a new classifier for discriminating thalassemia and non-thalassemia microcytic anemia was generated via combination of exciting [...] Read more.
Thalassemia and iron deficiency are the most common etiologies for microcytic anemia and there are indices discriminating both from common laboratory simple automatic counters. In this study a new classifier for discriminating thalassemia and non-thalassemia microcytic anemia was generated via combination of exciting indices with machine-learning techniques. A total of 350 Taiwanese adult patients whose anemia diagnosis, complete blood cell counts, and hemoglobin gene profiles were retrospectively reviewed. Thirteen prior established indices were applied to current cohort and the sensitivity, specificity, positive and negative predictive values were calculated. A support vector machine (SVM) with Monte-Carlo cross-validation procedure was adopted to generate the classifier. The performance of our classifier was compared with original indices by calculating the average classification error rate and area under the curve (AUC) for the sampled datasets. The performance of this SVM model showed average AUC of 0.76 and average error rate of 0.26, which surpassed all other indices. In conclusion, we developed a convenient tool for primary-care physicians when deferential diagnosis contains thalassemia for the Taiwanese adult population. This approach needs to be validated in other studies or bigger database. Full article
(This article belongs to the Special Issue Advances in Hematology Laboratory)
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Article
Combination of Bone Marrow Biopsy and Flow Cytometric Analysis: The Prognostically Relevant Central Approach for Detecting Bone Marrow Invasion in Diffuse Large B-Cell Lymphoma
Diagnostics 2021, 11(9), 1724; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091724 - 20 Sep 2021
Viewed by 443
Abstract
Bone marrow (BM) involvement is associated with prognosis in diffuse large B-cell lymphoma (DLBCL), the most prevalent disease subtype of malignant lymphoma. We conducted this multi-institutional retrospective study to investigate the functional association and prognostic values of four BM tests (BM biopsy, BM [...] Read more.
Bone marrow (BM) involvement is associated with prognosis in diffuse large B-cell lymphoma (DLBCL), the most prevalent disease subtype of malignant lymphoma. We conducted this multi-institutional retrospective study to investigate the functional association and prognostic values of four BM tests (BM biopsy, BM clot, flow cytometry (FCM), and BM smear). A total of 221 DLBCL patients were enrolled. BM involvement was detected in 17 (7.7%), 16 (7.2%), 27 (12.2%), and 34 (15.4%) patients by BM biopsy, BM clot, FCM, and BM smear, respectively. The consistency between BM biopsy and clot examination was favorable, with a κ coefficient of 0.705, whereas the consistencies among other modalities were poor. In 184 patients treated with the first-line R-CHOP (-like) regimen, BM involvement was associated with shorter progression-free survival (PFS) irrespective of the type of modality for a positive result. Intriguingly, among various single and combinatory modalities, the combination of BM biopsy and FCM had the highest hazard ratio of 3.33 and a c-index of 0.712. In conclusion, our study suggested that the combination of BM biopsy and FCM is the prognostically relevant central approach for BM involvement detection. The other BM examinations also may provide complementary information in clinical settings. Full article
(This article belongs to the Topic Cancer Biology and Therapy)
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Article
The Assessment of the Usefulness of Prenatal Magnetic Resonance Imaging in the Diagnosis of Central Nervous System Defects
Diagnostics 2021, 11(9), 1723; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091723 - 20 Sep 2021
Viewed by 500
Abstract
Central nervous system (CNS) abnormalities cause about 40% of infant deaths in the first year of life. In case of the detection of abnormalities by ultrasound, a pregnant woman should be offered prenatal magnetic resonance imaging (pMRI). The aims of our study were: [...] Read more.
Central nervous system (CNS) abnormalities cause about 40% of infant deaths in the first year of life. In case of the detection of abnormalities by ultrasound, a pregnant woman should be offered prenatal magnetic resonance imaging (pMRI). The aims of our study were: (1) to evaluate the effectiveness of pMRI in the diagnosis of selected fetal CNS defects; and (2) to assess the possibility of replacing postnatal tests with prenatal magnetic resonance. The prospective and observational study was conducted between 2014 and 2017 at the University Hospital in Krakow. Patients with suspected CNS defects of the fetus were qualified for pMRI in the third trimester of pregnancy. Sixty patients were included in the study group. Prenatal MRI was characterized by low accuracy in the diagnosis of complex brain defects. Cohen’s kappa coefficient κ = 0.21 (95% CI 0.00–0.46). No evidence was found suggesting the replacement of postnatal tests with pMRI. MRI was characterized by low consistency of diagnoses in the case of complex brain defects. The possibility of replacing postnatal studies with pMRI was not supported. Full article
(This article belongs to the Collection Hybrid Imaging in Medicine)
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Review
Artificial Intelligence in Capsule Endoscopy: A Practical Guide to Its Past and Future Challenges
Diagnostics 2021, 11(9), 1722; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091722 - 20 Sep 2021
Viewed by 762
Abstract
Artificial intelligence (AI) has revolutionized the medical diagnostic process of various diseases. Since the manual reading of capsule endoscopy videos is a time-intensive, error-prone process, computerized algorithms have been introduced to automate this process. Over the past decade, the evolution of convolutional neural [...] Read more.
Artificial intelligence (AI) has revolutionized the medical diagnostic process of various diseases. Since the manual reading of capsule endoscopy videos is a time-intensive, error-prone process, computerized algorithms have been introduced to automate this process. Over the past decade, the evolution of convolutional neural network (CNN) enabled AI to detect multiple lesions simultaneously with increasing accuracy and sensitivity. Difficulty in validating CNN performance and unique characteristics of capsule endoscopy images make computer-aided reading systems in capsule endoscopy still on a preclinical level. Although AI technology can be used as an auxiliary second observer in capsule endoscopy, it is expected that in the near future, it will effectively reduce the reading time and ultimately become an independent, integrated reading system. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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Review
Diagnosis of Early Mycosis Fungoides
Diagnostics 2021, 11(9), 1721; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091721 - 19 Sep 2021
Viewed by 754
Abstract
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphomas, generally has a favorable clinical course. Early MF typically presents erythematous patches and/or plaques and lasts for many years without affecting the life expectancy. Only limited cases progress to develop skin tumors, [...] Read more.
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphomas, generally has a favorable clinical course. Early MF typically presents erythematous patches and/or plaques and lasts for many years without affecting the life expectancy. Only limited cases progress to develop skin tumors, with subsequent lymph nodes and rarely visceral organ involvement. One of the clinical problems in early MF is the difficulty in differentiating the disease from benign inflammatory disorders (BIDs), such as atopic dermatitis, chronic eczema, and psoriasis. In some MF cases, clinical and pathological findings are similar to those of BIDs. However, the accurate diagnosis of early MF is quite important, as inappropriate treatment including immunosuppressants can cause unfavorable or even fatal outcomes. This article focuses on general methods and novel tools for diagnosis of early MF. Full article
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Review
MicroRNAs in Hypertrophic, Arrhythmogenic and Dilated Cardiomyopathy
Diagnostics 2021, 11(9), 1720; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091720 - 19 Sep 2021
Cited by 1 | Viewed by 652
Abstract
MicroRNAs (miRNAs) are a class of non-coding RNAs of about 20 nucleotides in length, involved in the regulation of many biochemical pathways in the human body. The level of miRNAs in tissues and circulation can be deregulated because of altered pathophysiological mechanisms; thus, [...] Read more.
MicroRNAs (miRNAs) are a class of non-coding RNAs of about 20 nucleotides in length, involved in the regulation of many biochemical pathways in the human body. The level of miRNAs in tissues and circulation can be deregulated because of altered pathophysiological mechanisms; thus, they can be employed as biomarkers for different pathological conditions, such as cardiac diseases. This review summarizes published findings of these molecular biomarkers in the three most common structural cardiomyopathies: human dilated, arrhythmogenic and hypertrophic cardiomyopathy. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
Review
A New Dawn for the Use of Artificial Intelligence in Gastroenterology, Hepatology and Pancreatology
Diagnostics 2021, 11(9), 1719; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091719 - 19 Sep 2021
Cited by 1 | Viewed by 1170
Abstract
Artificial intelligence (AI) is rapidly becoming an essential tool in the medical field as well as in daily life. Recent developments in deep learning, a subfield of AI, have brought remarkable advances in image recognition, which facilitates improvement in the early detection of [...] Read more.
Artificial intelligence (AI) is rapidly becoming an essential tool in the medical field as well as in daily life. Recent developments in deep learning, a subfield of AI, have brought remarkable advances in image recognition, which facilitates improvement in the early detection of cancer by endoscopy, ultrasonography, and computed tomography. In addition, AI-assisted big data analysis represents a great step forward for precision medicine. This review provides an overview of AI technology, particularly for gastroenterology, hepatology, and pancreatology, to help clinicians utilize AI in the near future. Full article
(This article belongs to the Special Issue The Next Generation of Upper Gastrointestinal Endoscopy)
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Article
Comparison of Different Machine Learning Classifiers for Glaucoma Diagnosis Based on Spectralis OCT
Diagnostics 2021, 11(9), 1718; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091718 - 19 Sep 2021
Viewed by 612
Abstract
Early detection is important in glaucoma management. By using optical coherence tomography (OCT), the subtle structural changes caused by glaucoma can be detected. Though OCT provided abundant parameters for comprehensive information, clinicians may be confused once the results conflict. Machine learning classifiers (MLCs) [...] Read more.
Early detection is important in glaucoma management. By using optical coherence tomography (OCT), the subtle structural changes caused by glaucoma can be detected. Though OCT provided abundant parameters for comprehensive information, clinicians may be confused once the results conflict. Machine learning classifiers (MLCs) are good tools for considering numerous parameters and generating reliable diagnoses in glaucoma practice. Here we aim to compare different MLCs based on Spectralis OCT parameters, including circumpapillary retinal nerve fiber layer (cRNFL) thickness, Bruch’s membrane opening-minimum rim width (BMO-MRW), Early Treatment Diabetes Retinopathy Study (ETDRS) macular thickness, and posterior pole asymmetry analysis (PPAA), in discriminating normal from glaucomatous eyes. Five MLCs were proposed, namely conditional inference trees (CIT), logistic model tree (LMT), C5.0 decision tree, random forest (RF), and extreme gradient boosting (XGBoost). Logistic regression (LGR) was used as a benchmark for comparison. RF was shown to be the best model. Ganglion cell layer measurements were the most important predictors in early glaucoma detection and cRNFL measurements were more important as the glaucoma severity increased. The global, temporal, inferior, superotemporal, and inferotemporal sites were relatively influential locations among all parameters. Clinicians should cautiously integrate the Spectralis OCT results into the entire clinical picture when diagnosing glaucoma. Full article
(This article belongs to the Special Issue High-Tech Devices in the Diagnosis of Eye Diseases)
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Article
Macular Microvascular Modifications in Progressive Lamellar Macular Holes
Diagnostics 2021, 11(9), 1717; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091717 - 19 Sep 2021
Viewed by 432
Abstract
Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography [...] Read more.
Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. Methods: OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. Results: BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. Conclusions: TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs. Full article
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Article
Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension
Diagnostics 2021, 11(9), 1716; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091716 - 19 Sep 2021
Viewed by 652
Abstract
Microalbuminuria is closely associated with the risk of cardiovascular disease and all-cause mortality in the general population. Less is known about its relationship with subclinical atherosclerosis. We aimed to assess the prevalence of microalbuminuria and its relationship with subclinical atherosclerosis in middle-aged, nondiabetic, [...] Read more.
Microalbuminuria is closely associated with the risk of cardiovascular disease and all-cause mortality in the general population. Less is known about its relationship with subclinical atherosclerosis. We aimed to assess the prevalence of microalbuminuria and its relationship with subclinical atherosclerosis in middle-aged, nondiabetic, apparently healthy individuals (N = 187; 40.1% men, 59.9% women; aged 35–55 years) as well as to evaluate its potential associations with established risk modifiers, especially with the presence of carotid plaque. Clinical and laboratory parameters, the estimated 10-year fatal cardiovascular risk (SCORE), as well as circulating, functional (flow mediated vasodilation, ankle-brachial index, augmentation index, and pulse wave velocity), and morphological markers (mean carotid intima–media thickness, and carotid plaque) of subclinical atherosclerosis were analysed in group with vs. without microalbuminuria. Microalbuminuria was present in 3.8% of individuals with SCORE risk 0.43 ± 0.79%. Functional markers predominated in both groups. Carotid intima–media thickness (mean ± SD) in both groups was in range: 0.5–0.55 ± 0.09–0.14 mm. Carotid plaque was more frequent in group with (14.3%) vs. without (4.4%) microalbuminuria. Microalbuminuria had no statistically significant effect on most markers of subclinical atherosclerosis, but the increasing value of microalbuminuria was significantly associated with the occurrence of carotid plaque (p = 0.035; OR = 1.035; 95% CI = 1.002–1.07). Additional multiple logistic regression analysis, where variables belonged to microalbuminuria, number of risk factors, and family history, finally showed only two variables: microalbuminuria (p = 0.034; OR = 1.04; 95%CI = 1.003–1.09) and the number of risk factors (p = 0.006; OR = 2.15; 95% CI = 1.24–3.73) with independent and significant impact on the occurrence of carotid plaque. Our results may indicate an association of microalbuminuria with the presence of carotid atherosclerotic plaque; in addition, microalbuminuria and the number of risk factors appear to be possible predictors of the carotid plaque occurrence. Monitoring microalbuminuria may improve the personalized cardiovascular risk assessment in nondiabetic, low-to-moderate cardiovascular risk individuals with or without hypertension. Full article
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Case Report
MALT Lymphoma of the Tongue in a Patient with Sjögren’s Syndrome: A Case Report and Literature Review
Diagnostics 2021, 11(9), 1715; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091715 - 19 Sep 2021
Viewed by 555
Abstract
Sjögren’s syndrome (SS) is a systemic chronic autoimmune disorder characterized by lymphocytic infiltration of the exocrine glands, as well as oral and ocular dryness. Among the late complications, malignant lymphoma is the most serious complication of SS. The risk of lymphoma in patients [...] Read more.
Sjögren’s syndrome (SS) is a systemic chronic autoimmune disorder characterized by lymphocytic infiltration of the exocrine glands, as well as oral and ocular dryness. Among the late complications, malignant lymphoma is the most serious complication of SS. The risk of lymphoma in patients with SS has been estimated to be approximately 7–19 times higher than that in a generally healthy population. Although various histologic subtypes of lymphoma can occur in patients with SS, mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 48–75% of malignant lymphomas that are frequently located in the parotid gland. However, MALT lymphoma affecting the tongue in patients with SS is extremely rare. Here, we share our experience with a unique case of MALT lymphoma of the tongue, originating from the minor salivary gland tissue in a patient with SS. Through this case report, we emphasize that MALT lymphoma should be considered in the differential diagnosis of a tongue mass in patients with SS. Full article
(This article belongs to the Special Issue Oral and Maxillofacial Image Diagnosis)
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Article
Diagnosis of Diabetes Mellitus Using Gradient Boosting Machine (LightGBM)
Diagnostics 2021, 11(9), 1714; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091714 - 19 Sep 2021
Cited by 1 | Viewed by 631
Abstract
Diabetes mellitus (DM) is a severe chronic disease that affects human health and has a high prevalence worldwide. Research has shown that half of the diabetic people throughout the world are unaware that they have DM and its complications are increasing, which presents [...] Read more.
Diabetes mellitus (DM) is a severe chronic disease that affects human health and has a high prevalence worldwide. Research has shown that half of the diabetic people throughout the world are unaware that they have DM and its complications are increasing, which presents new research challenges and opportunities. In this paper, we propose a preemptive diagnosis method for diabetes mellitus (DM) to assist or complement the early recognition of the disease in countries with low medical expert densities. Diabetes data are collected from the Zewditu Memorial Hospital (ZMHDD) in Addis Ababa, Ethiopia. Light Gradient Boosting Machine (LightGBM) is one of the most recent successful research findings for the gradient boosting framework that uses tree-based learning algorithms. It has low computational complexity and, therefore, is suited for applications in limited capacity regions such as Ethiopia. Thus, in this study, we apply the principle of LightGBM to develop an accurate model for the diagnosis of diabetes. The experimental results show that the prepared diabetes dataset is informative to predict the condition of diabetes mellitus. With accuracy, AUC, sensitivity, and specificity of 98.1%, 98.1%, 99.9%, and 96.3%, respectively, the LightGBM model outperformed KNN, SVM, NB, Bagging, RF, and XGBoost in the case of the ZMHDD dataset. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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Article
Association of Upper Lip Morphology Characteristics with Sagittal and Vertical Skeletal Patterns: A Cross Sectional Study
Diagnostics 2021, 11(9), 1713; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091713 - 18 Sep 2021
Viewed by 385
Abstract
Background: Upper lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery. This study is aimed to evaluate the association between upper lip characteristics (ULCs) and skeletal patterns (SPs). Methods: 2079 patients were involved and grouped by sagittal and vertical. [...] Read more.
Background: Upper lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery. This study is aimed to evaluate the association between upper lip characteristics (ULCs) and skeletal patterns (SPs). Methods: 2079 patients were involved and grouped by sagittal and vertical. Class I, II, and III were identified by ANB angle, while normodivergent, hyperdivergent, and hypodivergent were identified by Facial Height Index and Sum of Angles. ULCs were evaluated by superior sulcus depth, nasolabial angle, upper lip length, basic upper lip thickness, and upper lip thickness. Confounders including demography, malocclusion, upper incisors, and upper lips were adjusted by multivariate linear regression to identify the association between ULCs and SPs. Group differences were evaluated with analysis of variance and Chi-square test. Results: The mean value of ULCs and prevalence of SPs were explored in the Western China population. ULCs were significantly different in various sagittal, vertical, and combined SPs. Superior sulcus depth was negatively related to Class II, and positively related to Class III and the hypodivergent pattern after adjusted by confounders. Conclusions: ULCs significantly varied among different SPs, while only superior sulcus depth was independently associated with SPs, indicating superior sulcus depth is the only ULC that might be significantly corrected by intervention of skeletal growth. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Article
CSGBBNet: An Explainable Deep Learning Framework for COVID-19 Detection
Diagnostics 2021, 11(9), 1712; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091712 - 18 Sep 2021
Viewed by 587
Abstract
The COVID-19 virus has swept the world and brought great impact to various fields, gaining wide attention from all walks of life since the end of 2019. At present, although the global epidemic situation is leveling off and vaccine doses have been administered [...] Read more.
The COVID-19 virus has swept the world and brought great impact to various fields, gaining wide attention from all walks of life since the end of 2019. At present, although the global epidemic situation is leveling off and vaccine doses have been administered in a large amount, confirmed cases are still emerging around the world. To make up for the missed diagnosis caused by the uncertainty of nucleic acid polymerase chain reaction (PCR) test, utilizing lung CT examination as a combined detection method to improve the diagnostic rate becomes a necessity. Our research considered the time-consuming and labor-intensive characteristics of the traditional CT analyzing process, and developed an efficient deep learning framework named CSGBBNet to solve the binary classification task of COVID-19 images based on a COVID-Seg model for image preprocessing and a GBBNet for classification. The five runs with random seed on the test set showed our novel framework can rapidly analyze CT scan images and give out effective results for assisting COVID-19 detection, with the mean accuracy of 98.49 ± 1.23%, the sensitivity of 99.00 ± 2.00%, the specificity of 97.95 ± 2.51%, the precision of 98.10 ± 2.61%, and the F1 score of 98.51 ± 1.22%. Moreover, our model CSGBBNet performs better when compared with seven previous state-of-the-art methods. In this research, the aim is to link together biomedical research and artificial intelligence and provide some insights into the field of COVID-19 detection. Full article
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Review
Lavage, Simethicone, and Prokinetics—What to Swallow with a Video Capsule
Diagnostics 2021, 11(9), 1711; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091711 - 18 Sep 2021
Viewed by 368
Abstract
The development of new capsules now allows endoscopic diagnosis in all segments of the gastrointestinal tract and comes with new needs for differentiated preparation regimens. Although the literature is steadily increasing, the results of the conducted trials on preparation are sometimes conflicting. The [...] Read more.
The development of new capsules now allows endoscopic diagnosis in all segments of the gastrointestinal tract and comes with new needs for differentiated preparation regimens. Although the literature is steadily increasing, the results of the conducted trials on preparation are sometimes conflicting. The ingestion of simethicone before gastric and small bowel capsule endoscopy for prevention of air bubbles is established. The value of a lavage before small bowel capsule endoscopy (SBCE) is recommended, although not supported by all studies. Ingestion in the morning before the procedure seems useful for the improvement of mucosa visualization. Lavage after swallowing of the capsule seems to improve image quality, and in some studies also diagnostic yield. Prokinetics has been used with first generation capsules to shorten gastric transit time and increase the rate of complete small bowel visualization. With the massively prolonged battery capacity of the new generation small bowel capsules, prokinetics are only necessary in significantly delayed gastric emptying as documented by a real-time viewer. Lavage is crucial for an effective colon capsule or pan-intestinal capsule endoscopy. Mainly high or low volume polyethylene glycol (PEG) is used. Apart from achieving optimal cleanliness, propulsion of the capsule by ingested boosts is required to obtain a complete passage through the colon within the battery lifetime. Boosts with low volume sodium picosulfate (NaP) or diatrizoate (gastrografin) seem most effective, but potentially have more side effects than PEG. Future research is needed for more patient friendly but effective preparations, especially for colon capsule and pan-intestinal capsule endoscopy. Full article
(This article belongs to the Special Issue Capsule Endoscopy: Clinical Impacts and Innovation since 2001)
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Review
Intradural Pediatric Spinal Tumors: An Overview from Imaging to Novel Molecular Findings
Diagnostics 2021, 11(9), 1710; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091710 - 18 Sep 2021
Viewed by 369
Abstract
Pediatric spinal tumors are rare and account for 10% of all central nervous system tumors in children. Onset usually occurs with chronic nonspecific symptoms and may depend on the intra- or extradural neoplastic location. Meningiomas, schwannomas, and neurofibromas are the most common intradural-extramedullary [...] Read more.
Pediatric spinal tumors are rare and account for 10% of all central nervous system tumors in children. Onset usually occurs with chronic nonspecific symptoms and may depend on the intra- or extradural neoplastic location. Meningiomas, schwannomas, and neurofibromas are the most common intradural-extramedullary lesions, while astrocytomas and ependymomas represent the majority of intramedullary tumors. The new molecular discoveries regarding pediatric spinal cancer currently contribute to the diagnostic and therapeutic processes. Moreover, some familial genetic syndromes can be associated with the development of spinal tumors. Currently, magnetic resonance imaging (MRI) is the standard reference for the evaluation of pediatric spinal tumors. Our aim in this review was to describe the imaging of the most frequent intradural intra/extramedullary pediatric spinal tumors and to investigate the latest molecular findings and genetic syndromes. Full article
(This article belongs to the Special Issue Advances in Pediatric Neuro-Oncology)
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Article
Antibodies against SARS-CoV-2 Time Course in Patients and Vaccinated Subjects: An Evaluation of the Harmonization of Two Different Methods
Diagnostics 2021, 11(9), 1709; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091709 - 18 Sep 2021
Cited by 1 | Viewed by 448
Abstract
The time course of antibodies against SARS-CoV-2 is not yet well elucidated, especially in people who underwent a vaccination campaign. In this study, we measured the antibodies anti-S1 and anti-RBD with two different methods, both in patients and in vaccinated subjects. One hundred [...] Read more.
The time course of antibodies against SARS-CoV-2 is not yet well elucidated, especially in people who underwent a vaccination campaign. In this study, we measured the antibodies anti-S1 and anti-RBD with two different methods, both in patients and in vaccinated subjects. One hundred and eight specimens from 48 patients with COVID-19 (time from the onset of symptoms from 3 to 368 days) and 60 specimens from 20 vaccinated subjects (collected after 14 days from the first dose, 14 days and 3 months after a second dose of Comirnaty) were evaluated. We used an ELISA method that measured IgG against anti-Spike 1, and a chemiluminescence immunoassay that measured IgG anti-RBD. In the patients, the antibodies concentrations tended to decline after a few months, with both the methods, but they persisted relatively high up to nearly a year after the symptoms. In the vaccinated subjects, the antibodies were already detectable after the first dose, but after the booster, they showed a significant increase. However, the decrease was rapid, given that 3 months after the second vaccination, they were reduced to less than a quarter. The conversion of the results into BAU units improves the relationship between the two methods. However, in the vaccinated subjects, there was no evidence of proportional error after the conversion, while in the patients, the difference between the two methods remained significant. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
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Article
Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans
Diagnostics 2021, 11(9), 1708; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091708 - 18 Sep 2021
Cited by 1 | Viewed by 838
Abstract
We evaluated the accuracy of coronary artery calcium (CAC) scoring on a dual-source photon-counting detector CT (PCD-CT). An anthropomorphic chest phantom underwent ECG-gated sequential scanning on a PCD-CT at 120 kV with four radiation dose levels (CTDIvol, 2.0–8.6 mGy). Polychromatic images at 120 [...] Read more.
We evaluated the accuracy of coronary artery calcium (CAC) scoring on a dual-source photon-counting detector CT (PCD-CT). An anthropomorphic chest phantom underwent ECG-gated sequential scanning on a PCD-CT at 120 kV with four radiation dose levels (CTDIvol, 2.0–8.6 mGy). Polychromatic images at 120 kV (T3D) and virtual monoenergetic images (VMI), from 60 to 75 keV without quantum iterative reconstruction (no QIR) and QIR strength levels 1–4, were reconstructed. For reference, the same phantom was scanned on a conventional energy-integrating detector CT (120 kV; filtered back projection) at identical radiation doses. CAC scoring in 20 patients with PCD-CT (120 kV; no QIR and QIR 1–4) were included. In the phantom, there were no differences between CAC scores of different radiation doses (all, p > 0.05). Images with 70 keV, no QIR (CAC score, 649); 65 keV, QIR 3 (656); 65 keV; QIR4 (648) and T3D, QIR4 (656) showed a <1% deviation to the reference (653). CAC scores significantly decreased at increasing QIR levels (all, p < 0.001) and for each 5 keV-increase (all, p < 0.001). Patient data (median CAC score: 86 [inter-quartile range: 38–978] at 70 keV) confirmed relationships and differences between reconstructions from the phantom. First phantom and in-vivo experience with a clinical dual-source PCD-CT system shows accurate CAC scoring with VMI reconstructions at different radiation dose levels. Full article
(This article belongs to the Special Issue Advances in Photon Counting Detector Imaging)
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Review
Patterns of Myometrial Invasion in Endometrial Adenocarcinoma with Emphasizing on Microcystic, Elongated and Fragmented (MELF) Glands Pattern: A Narrative Review of the Literature
Diagnostics 2021, 11(9), 1707; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091707 - 18 Sep 2021
Viewed by 573
Abstract
Endometrioid endometrial adenocarcinoma (EEC) is the most common malignancy of the female genital tract. According to the 2009 FIGO staging system, the depth of myometrial invasion (MI), and tumor spread to adjacent organs or tissues are the staging criteria for endometrial carcinoma (EC). [...] Read more.
Endometrioid endometrial adenocarcinoma (EEC) is the most common malignancy of the female genital tract. According to the 2009 FIGO staging system, the depth of myometrial invasion (MI), and tumor spread to adjacent organs or tissues are the staging criteria for endometrial carcinoma (EC). Therefore, assessment of the depth of MI is of great importance. There is a spectrum of morphological patterns of MI. Still, their number and features vary according to the scientific literature, with a certain overlap that creates difficulties and controversies in the precise assessment of MI depth. The purpose of this review is to present and discuss the most important and recent information about patterns of MI, focusing on the more aggressive and the elongated and fragmented glands (MELF) pattern in particular. Assessment of MI depth and correct staging of EC is possible only after the precise recognition of each MI pattern. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gynecological Cancers)
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Article
Circulating Hsa-miR-431-5p as Potential Biomarker for Squamous Cell Vulvar Carcinoma and Its Premalignant Lesions
Diagnostics 2021, 11(9), 1706; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091706 - 17 Sep 2021
Viewed by 652
Abstract
Vulvar squamous cell carcinoma (VSCC) develops from high-grade squamous intraepithelial lesions (HSIL) and differentiated vulvar intraepithelial neoplasia (dVIN). This study aimed to assess the diagnostic value of circulating hsa-miR-431-5p in vulvar precancers and VSCC. Expression levels of hsa-miR-431-5p were analyzed by quantitative RT-PCR [...] Read more.
Vulvar squamous cell carcinoma (VSCC) develops from high-grade squamous intraepithelial lesions (HSIL) and differentiated vulvar intraepithelial neoplasia (dVIN). This study aimed to assess the diagnostic value of circulating hsa-miR-431-5p in vulvar precancers and VSCC. Expression levels of hsa-miR-431-5p were analyzed by quantitative RT-PCR in plasma samples of 29 patients with vulvar precancers (HSIL or dVIN), 107 with VSCC as well as 15 healthy blood donors. We used hsa-miR-93-5p and hsa-miR-425-5p as normalizers. The levels of miR-431-5p were increased in the blood of patients with VSCC compared to those with vulvar precancers. Statistically significant differences in the survival rates (time to progression) were revealed for VSCC patients categorized by miR-431-5p levels. Low levels of circulating miR-431-5p were found to be indicative of unfavorable survival rates. In summary, our data reveal the diagnostic potential of circulating miR-431-5p in patients with vulvar precancers and VSCC. Full article
(This article belongs to the Special Issue MicroRNA in Diagnosis and Prognosis)
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