Peer-review medical journal. Editor-in-Chief: Professor Valentin Sinitsyn, MD, PhD. Indexation: SCOPUS, Russian Science Citation Index, CNKI, Google Scholar, Ulrich's Periodicals Directory, Dimensions. Open Access & Publication frequency: Gold Open Access; quarterly issuing. Peer-Review & APC: double blind; no article processing charge. ISSN: 2712-8490 (Print) ISSN 2712-8962 (Online)
Authors who publish with this journal agree to the following terms: Authors transfer article copyright to the publisher only after the acceptance to publication. Authors are able to use and distribute the article in accordance with Self-Archiving policy of the journal (see details). The article can be accepted for publication only by decision of the Editor-in-Chief and the Editorial board of the journal in accordance with the Manuscript stelection policy of the journal (see details). Published Article will be distributed in print and electronic version an will be available under subscription with Delayed Open Access or in Immediate Open Access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). The access model depends on the publisher's decision or is determined by a separate Open Access publishing agreement with the authors. Other copyrights not directly transferred to the publisher under the License Agreement, including patent rights to any process, method etc., described by the Authors in the article, as well as trademark rights, are reserved for the Authors. All the Copyright statements for authors are present in the standart Publishing Agreement (Public Offer) to Publish an Article in an Academic Periodical 'Digital Diagnostics'. READ the details online (tap to see in details) Copyright transfer agreement for publishing a scientific work in a scientific journal (public offer) ver. 18.11.2025 LLC "Eco-Vector", represented by its CEO Evgeniy Schepin acting on the basis of the Charter (“Publisher”), on the one part, offers an indefinite number of persons (“Author”), on the other part, hereinafter jointly referred to as the Parties, to execute this agreement (“Agreement”) on the transfer of the exclusive right to the intellectual property – the scientific article and its publication in the Publisher’s journal under the following conditions. I. General Provisions This Agreement, in accordance with clause 2 of Article 437 of the Civil Code of the Russian Federation, is a public offer (“Offer”), full and unconditional acceptance of which, in accordance with Article 438 of the Civil Code of the Russian Federation, means the sending by the Author of his/her materials by uploading the same to the online electronic manuscript submission system, placed in the corresponding section of the Journal’s website on the Internet information and telecommunications network (“Internet”). II. Terms used in the Agreement “Author” refers to an individual (or individuals) whose creative work has led to the creation of the manuscript of a scientific Article, or to an authorized representative of these persons. “Manuscript” is the result of intellectual activity in the form of a scientific work containing text, graphic and numerical data, audiovisual information, program code and other elements submitted by the Author for publication in the Journal. “Acceptance of the offer” refers to the full and unconditional acceptance of the offer on the terms specified in paragraph 3 of this agreement (the Author accepts offer by submitting a Manuscript to the Publisher via the online electronic manuscript submission system on the Journal’s Internet website). “Journal” is a scientific peer-reviewed periodical (and/or online media) registered as a mass media entity in the register of Federal Service for Supervision of Communications, Information Technology, and Mass Media (Roskomnadzor). “Submission” is an electronic application of the Author to the Publisher for the publication of an Article Manuscript in the Journal by uploading the manuscript, additional files and accompanying materials to the online electronic manuscript submission system on the Journal’s Internet website). “Publisher” refers to Eco-Vector LLC. Article metadata includes the information on the Article Manuscript and/or Article that are intended for inclusion in International Scientific Databases, namely the following: Title of the Article; Information about each of the Authors (surname and first name, patronymic; place of work with the postal address indicated, contact information (e-mail)); Abstract; Keywords; Thematic rubricator: UDC (Universal Decimal Classification) or other library and bibliographic classification and subject indexes; List of references. “Offer” is the current agreement (an offer to the Author for the publication of an Article in the Journal). “Publication” is the process of placement of an Article in the Journal. “Article” is an article’s manuscript that has undergone the process of peer-review and editorial and publishing processing. “Editorial board” is the creative team that prepares the journal for publication. “Parties” refers to the Author and the Publisher. “Author Guidelines” are the requirements for Articles and additional materials to be published in the Journal (their design, structure, content, originality, ethics), placed in the “For authors” section of the Journal’s Internet website. III. Subject of the Agreement (Offer) Under this Agreement, the Author transfers to the Publisher on a gratuitous basis for the entire term of validity of exclusive copyright provided for by the legislation of the Russian Federation, the exclusive (property) right to the Article created by the Author, including (but not limited to) the following rights: Reproduction of the Article or its sections or parts, as well as the metadata of the Article in Russian and foreign languages, in any material form, including on paper and electronic media, as a separate work in Journals and/or databases (local or in the Internet) of the Publisher and/or other persons, at the discretion of the Publisher; Distribution of the Article or its sections or parts, as well as the metadata of the Article in Russian or foreign languages, on any medium as part of the Journal and/or databases of the Publisher or other persons, at the discretion of the Publisher, or as an independent work around the world whether on Open-Access terms or for a fee without remuneration to the Author; Making the Article or any of its sections or parts, as well as the Article’s metadata in Russian or foreign languages, publicly available in such a way that any person can access the Article from any place, including via the Internet, and at any time of their own choice; Granting permission/s for the use of the Article or its sections or parts, as well as its metadata in Russian or foreign languages, to third parties with notice to the Author made by posting relevant information on the Journal’s website, without paying remuneration to the Author; Processing the Article, including translating to any languages and using the revised (translated) Article in the aforementioned ways. Other rights not directly transferred to the Publisher under this Agreement, including patent rights to any process, method etc., ideas or discoveries described by the Author in the Article, as well as trademark rights, will be retained by the Author. The terms and conditions of this Agreement, obliging the Publisher to publish the Article, on the transfer of the exclusive right to the Article to the Publisher, as well as the terms and conditions granting the Publisher and the Author the right to use the Article in accordance with the Agreement, will take effect only in case of acceptance of the Article for publication in the Journal (condition precedent). The moment of acceptance of the Article for publication in the Journal is the moment of sending the notification of acceptance of the Article for publication to the Author from the official e-mail of the Journal. The rights are transferred by the Author to the Publisher free of charge, publication of the Article in the Journal does not entail any financial obligations of the Publisher towards the Author. If the Editorial board decides to reject the Submission or refuse to publish the Article in the Journal (i.e., retraction of the published Article), this Agreement becomes invalid. The decision to refuse publication (retraction of the published Article) will be sent to the Author at the e-mail address specified in the Submission. IV. Rights and Duties of the Parties The Author guarantees that: He/she is a legal holder of the copyright to the materials submitted to the Publisher as part of the manuscript of the Article; The rights transferred to the Publisher under this agreement have not been previously transferred and will not be transferred to third parties; The manuscript of the Article contains all references to the cited authors and/or publications (materials) provided for under the current copyright legislation; The Author has obtained all the necessary permissions for all deliverables, facts and other borrowed materials he/she holds no copyright to and that are used in the manuscript of the Article; The Article manuscript contains only materials permitted to be published in the open press in accordance with the current legislative acts of the Russian Federation, and its publication and distribution will not lead to the disclosure of secret (confidential) information (including state secrets); The Author has informed co-authors about the terms of this Agreement and has received their consent to execute this Agreement under the terms provided for in the Agreement. The Author undertakes: To make amendments to the manuscript of the Article in accordance with the Author Guidelines posted on the Journal’s website and recommendations of the Editorial board; Not to use an electronic copy of the Article for commercial purposes and in other journal publications without the consent of the Publisher; in the process of preparing a manuscript for publication, the Author undertakes: To make corrections to the text of the manuscript that have been marked by the peer-reviewers and accepted by the Editorial board, and/or as necessary, upon the request of The Publisher and the Editorial board, finalize the manuscript of the Article; In a timely manner (within the deadlines specified by the Editorial board) to review and coordinate the editorial revisions made to the manuscript (including answering the editors' questions), and proofread the made-up Article (original layout in PDF); While proofreading, suggest only the minimum of corrections to the made-up Article in order to eliminate factual errors made. The Author has the right to: Make changes to the Article (both during the review process and in the process of preparing the Article for publication and after publication); Use preprint or prior-to publication electronic versions of an unpublished Article in the form and content accepted by the Publisher for publication in the Journal. Such prior-to-publish versions can be placed as electronic files on the personal websites of the Author (co-authors) or on the protected external websites of the employers of the Author; however, the Author cannot use the unpublished version(s) for commercial use or for systematic external distribution by a third party The author or co-authors must: Include the following warning in the prior-to-publish version: “This is prior-to-publish version of the article accepted for publication in (Journal’s name), © Eco-Vector (year)”; Provide the corresponding electronic link to the Publisher’s website at https://journals.eco-vector.com/ and/or via the DOI. Copy or transfer a copy of the published Article in whole or in part to colleagues free of charge for their personal or professional use, for the promotion of academic or scientific research, or for informational purposes of the Author’s employer. Use materials (including data, text, images, tables) from a published Article in a book written by any co-author or other non-periodical scientific or educational publication. Use figures, tables, data and text excerpts from the Article for his or her own education purposes, or to include them in other works to be published in print or electronic format by a third party, or to submit them in electronic format on an internal computer network protected from uncontrolled use, or on the public website of the Author (co-authors) or his/her employer. f) Include the Article materials in educational and methodical works distributed free of charge within the educational process among students (cadets, graduate students, doctoral students) of the Author (co-authors) or to save the Article in electronic format on the local server for students' access (as to the methodical material necessary for mastering within the training), as well as for internal training programs in the institution of the Author's employer. Withdraw the Submission for publication of the Article until the Editorial board of the Journal makes a final decision on the possibility of publication. The Publisher undertakes: To carry out editorial and publishing preparation of the Article (copyediting and academic editing, formatting, bibliographic design, layout, proofreading, checking of corrections made, translation of the description of the Article or full-text translation – at the option of the Publisher) in accordance with the editorial standards of the Publisher and the original layout accepted at the time of publication; To publish the Author’s article in the Journal in printed and electronic form in accordance with the terms of this Agreement; If necessary, as so decided by the Journal’s Editorial board, to provide the Author with the made-up Article and make a reasonable editing; To provide to the Author the unlimited access to the final electronic version of the published Article through the Author’s personal account on the Journal’s website from the date of publication of the corresponding issue of the Journal; To comply with the copyrights as provided for by the current legislation, as well as protect them and take all necessary measures to prevent copyright infringement by third parties. The Publisher has a right to: Make any decision on the Author's Submission for publication of the Article, including "accept for publication", "refuse to publish" and "recommend revision of the Article for re-evaluation" (the right to evaluate the Article and make decisions on publication of the Article is managed by the Editorial board of the Journal headed by the Editor-in-Chief); Conduct an expert evaluation of the Article manuscript and invite the Author to make the necessary changes (revisions) to the manuscript. The Article will not be published in the Journal unless such changes are not made. Independently determine the issue of the Journal for the publication of the Article, make decisions on the terms of publication and their changes, on the withdrawal of the Article and its retraction in cases stipulated by the Code of Ethics of the Publishing House (see details: https://eco-vector.com/Eco-Vector_Ethic_Policy.php); Provide technical editing, copyediting of the Article’s manuscript without altering the main content; Require from the Authors and all target audience of readers to indicate the correct reference to the final version of the Article published in the Journal (name of the Journal, Publisher, Author, title of the Article, issue number of the Journal and year of publication indicated in the Journal, DOI); Post preliminary and/or advertising information about the upcoming publication of the Article in the media and other information sources; Make changes to the Offer in accordance with the procedure established by the Offer. In all cases not stipulated and not provided for in this agreement, the parties are obliged to be guided by the relevant current laws of the Russian Federation. V. Acceptance of the Offer and Execution of the Agreement. Validity of the Agreement The Author accepts the Offer by submitting the manuscript of the Article to the Publisher through the electronic manuscript submission system on the Journal's Internet website. Acceptance of the offer by the Author creates an Agreement in writing (Articles 438 and 1286.1 of the Civil Code of the Russian Federation) on the terms of the offer. This Agreement is valid for the duration of the exclusive rights to the Article. VI. Procedure for changing and terminating the Agreement The Publisher has the right to unilaterally change the terms of this Agreement, in advance, at least ten (10) calendar days before the entry into force of the intended relevant changes, but with notice to the Author through the Journal’s website or by e-mail to the Author’s e-mail address specified in the Author’s Submission. The changes will take effect from the date specified in the relevant notification. If the Author rejects the changes to the terms of this Agreement, he/she has the right to notify the Publisher by sending a written notification through the online manuscripts submission system placed in the corresponding section of the Journal’s website on the Internet, or by sending a notification to the official e-mail address of the editorial office. This Agreement may be terminated prematurely, either by agreement of the parties at any time, or on other grounds provided for in this Agreement. The Author has the right to unilaterally withdraw from the execution of this Agreement by sending the Publisher a corresponding notification in writing at least sixty (60) calendar days in advance before the expected date of publication of the Article in the Journal. Termination of the Agreement for any reason does not release the parties from liability for any violation of the terms of the Agreement that occurred during the validity period. VII. Responsibility The parties are responsible for non-fulfillment or improper fulfillment of their obligations under the Agreement in accordance with the current relevant legislation of the Russian Federation. All information provided by the Author must be reliable. The author is responsible for the accuracy and completeness of the information and guarantees he/she transfers to the Publisher. When using false information received from the Author, the Publisher is not responsible for the negative consequences caused by his actions on the basis of the false information provided. With regard to the content of the Article, the Author is solely responsible for compliance with the requirements of the laws of the Russian Federation pertaining to advertising, copyright and related rights’ protection, protection of trademarks and service marks, and the protection of consumer rights. The Publisher will have no liability under the agreement: for any actions that are a direct or indirect result of Author’s illegal actions for any loss incurred by the Author, regardless of whether the Publisher could have foreseen the possibility of such losses or not. The Publisher is released from liability for violation of the terms of the Agreement if such violation is caused by force majeure, including actions of state authorities (including the adoption of legal acts), fire, flood, earthquake, other natural disasters, lack of electricity and/or computer network failures, strikes, civil unrest, riots, and any other circumstances directly affecting the ability to fulfill the obligations of the Parties. VIII. Dispute resolution Disputes and disagreements will be resolved by the Parties through negotiations, and in case of failure to reach an Agreement they will strive to seek resolution in accordance with the current legislation of the Russian Federation. If there are unresolved disagreements, the Parties agree to resolve the disputes in court at the location of the Publisher in accordance with the current legislation of the Russian Federation. IX. Miscellaneous All notifications, messages, requests, etc. (with the exception of documents that must be sent as originals in accordance with the laws of the Russian Federation) are considered received by the Author if they were transmitted (sent) by the Publisher through the Journal’s website (including by publication), by e-mail and other communication channels specified in the Submission, and other communication channels. The parties recognize the legal force of notifications, messages, requests, etc., transmitted (sent) by the above methods. In the event of claims against the Publisher related to the violation of the exclusive copyright and other intellectual property rights of third parties when creating an Article or in connection with the execution of this Agreement by the Author, as well as in connection with the use of the Article by the Publisher in accordance with the Agreement, the author undertakes: To immediately take measures to resolve disputes with third parties soon after receiving Publisher’s notification, and if necessary, enter into legal proceedings on the Publisher’s side and take all appropriate actions needed to exclude the Publisher from the list of defendants; To reimburse the Publisher for the court costs incurred, expenses and losses caused by the application of measures to secure the claim and execute a court decision, and the amounts paid to a third party for the violation of exclusive copyright and other intellectual property rights, as well as other losses incurred by the Publisher in connection with the Author’s non-compliance with the guarantees provided by them under this Agreement. X. Legal address and details of the Publisher Eco-Vector Address: 191186, St. Petersburg, Aptekarsky Pereulok, 3 letter A, room 1N TIN: 7806423692; KPP: 784101001; OGRN: 1099847039907.
Predicting high proliferative Ki-67 index in patients with adrenocortical carcinoma based on texture analysis of contrast-enhanced computed tomography images: a cross-sectional study
BACKGROUND: Adrenocortical carcinoma is characterized by a high risk of aggressive disease progression and limited effectiveness of available treatment. Therefore, early diagnosis and assessment of its potential development are crucial. Although computed tomography is highly accurate in detecting the structural characteristics of tumors, its ability to predict adrenocortical carcinoma progression is unclear. AIM: This study aimed to evaluate the accuracy of using texture analysis of contrast-enhanced computed tomography images in predicting a high index of proliferative activity (Ki-67) in patients with adrenocortical carcinoma. METHODS: The study examined four-phase contrast-enhanced computed tomography images of patients with histologically verified adrenocortical carcinoma (retrospective part) and reevaluated these images (prospective part). Computed tomography image analysis included labeling a tumor lesion, assessing and post-processing texture features, decreasing dimensions, and performing a cluster analysis to evaluate the discriminatory ability of computed tomography texture parameters. The predictive accuracy of texture analysis of computed tomography images was assessed based on its ability to identify increased proliferative activity (KI-67 > 10%). The index was derived from the results of immunohistopathological testing of adrenal tissue samples obtained during surgery. RESULTS: Texture analysis of contrast-enhanced computed tomography images of 24 patients with histologically diagnosed adrenocortical carcinoma was performed: Ki-67 ≤ 10% in 9 patients and Ki-67 > 10% in 15 patients. The analysis revealed a statistically significant association (p = 0.015, Fisher’s exact test) between two fuzzy clusters based on texture features and the Ki-67 classification of patients with adrenocortical carcinoma. These results indicate the ability to predict high proliferative activity with a 0.05 level of significance. CONCLUSION: Texture analysis of contrast-enhanced computed tomography images of patients with adrenocortical carcinoma enables noninvasive assessment of tumor progression risk following surgical removal.
Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0
Consensus-based labeling algorithms for texture analysis of prostate lesions
BACKGROUND: Texture analysis improves the diagnostic accuracy of magnetic resonance imaging and differential diagnosis of prostate lesions, which are primarily segmented through manual labeling, resulting in significant inter-expert variability of masks. A consensus-based technique can help reduce inconsistencies in prostate lesion segmentation. However, global scientific studies have not described any standardized, consensus-based labeling protocols. AIM: This study aimed to develop a consensus algorithm for manual labeling of prostate lesions by several independent experts and evaluate inter-expert consistency in lesion segmentation. METHODS: This retrospective study included 60 biparametric magnetic resonance imaging scans of the prostate gland performed according to PI-RADS 2.1 technical specification. The scans showed PI-RADS 3, 4, and 5 lesions. Two independent radiologists manually segmented the prostate lesions using 3D Slicer. Then, the resulting masks were compared using the Dice–Sørensen coefficient (DSC). For lesions with DSC ≥ 0.75, the final mask was based on the overlap between the two original masks. Conversely, for lesions with DSC < 0.75, the final mask was determined using the proposed consensus algorithm. RESULTS: The proposed consensus algorithm significantly increased the DSC values, from 0.61 [0.48; 0.73] for primary labeling to 0.74 [0.62; 0.79] for labeling using the proposed algorithm (p = 0.01). CONCLUSION: The proposed consensus-based algorithm for labeling prostate lesions using magnetic resonance imaging data is crucial in addressing inadequate approaches to objective segmentation in research and clinical settings.
Radiographic markers of cardiovascular risk based on digital mammograms: a cross-sectional study
BACKGROUND: Studies have demonstrated an association between cardiovascular risk and mammographic density and breast arterial calcification. However, their combined impact remains poorly understood. AIM: This study aimed to evaluate the correlation between mammographic density, breast artery calcification, and cardiovascular risk category in asymptomatic women aged ≥40 years. METHODS: This retrospective, single-center, selective study included women who underwent preventive screening mammography at the University Clinic of Lomonosov Moscow State University between 2019 and 2023. The Systematic Coronary Risk Evaluation 2 was used to determine cardiovascular risk categories. A radiologist evaluated mammograms at a workstation to obtain data on mammographic density and glandular calcifications. The data were analyzed using a machine learning technique called Uniform Manifold Approximation and Projection. Univariate logistic regression was employed to calculate odds ratios and 95% confidence intervals. The reference group included mammograms showing high breast density and no calcifications. The odds ratio for each selected group is presented relative to the reference. The contingency tables were assessed using Pearson’s chi-squared (χ2) test. The significance level for all tested hypotheses was set at 0.05. RESULTS: The mammograms of 1030 women aged 40–89 years were evaluated. Based on the study results, eight groups (G7–G0) were formed, depending on combinations of the following criteria: high or low glandular density, presence or absence of vascular and nonvascular calcification, and extent of calcification. Women with low mammographic density and vascular calcifications in more than one quadrant were found to have a >75% likelihood of high or extremely high cardiovascular risk. The probability exceeded 90% for a combination of vascular and nonvascular calcifications in two or more quadrants. CONCLUSION: A correlation was found between calcifications, mammographic density, and cardiovascular risk category.
Diagnostic accuracy of radionuclide imaging for parathyroid lesions in patients with primary hyperparathyroidism and nodular and autoimmune thyroid disorders: a cross-sectional study
BACKGROUND: Concomitant thyroid disorders can decrease the diagnostic accuracy of topical imaging modalities used to localize primary hyperparathyroidism. Therefore, in such cases, the effectiveness of radionuclide imaging for parathyroid lesions should be confirmed. AIM: This study aimed to evaluate the effects of nodular and autoimmune thyroid disorders on the diagnostic accuracy of radionuclide imaging for parathyroid lesions in patients with primary hyperparathyroidism and compare the accuracy of radionuclide imaging with that of other imaging modalities. METHODS: The study included three patient groups: patients with primary hyperparathyroidism without a concomitant thyroid disease (group 1; n = 50), patients with autoimmune thyroid disorder (group 2; n = 50), and patients with thyroid nodule/multinodular goiter (group 3; n = 50). All the patients underwent ultrasound, planar scintigraphy, and single-photon emission computed tomography with X-ray computed tomography prior to parathyroidectomy. If negative or equivocal results were obtained (e.g., suspected parathyroid lesion), a contrast-enhanced computed tomography scan was performed. The intervals between scans and between the first scan and parathyroidectomy did not exceed 6 months and 12 months, respectively. Sensitivity and the positive predictive value were estimated. RESULTS: In group 2, the diagnostic accuracy of radionuclide imaging for parathyroid lesions was lower than that of other imaging modalities. Moreover, in group 2, contrast-enhanced computed tomography demonstrated a diagnostic sensitivity of 79%, and its combination with ultrasound achieved a higher sensitivity of 85%. In group 3, the highest diagnostic value was obtained for single-photon emission computed tomography combined with X-ray computed tomography (85%) or ultrasound (88%). The results of radionuclide imaging of parathyroid lesions in patients with primary hyperparathyroidism and autoimmune thyroid disease depended on the volume, density, and vascularization of the thyroid gland. CONCLUSION: Single-photon emission computed tomography combined with X-ray computed tomography is an accurate diagnostic modality for identifying parathyroid lesions in patients with primary hyperparathyroidism and concomitant nodular thyroid disorder. Contrast-enhanced computed tomography showed the highest sensitivity in patients with primary hyperparathyroidism and autoimmune thyroid disease.
Comparison of single-dose and split-dose fecal tagging with iohexol in computed tomographic colonography
BACKGROUND: Proper fecal tagging allows for high-quality computed tomography colonography. However, there is no single tagging scheme. Therefore, the effects of a contrast enhancement regimen on fecal tagging should be evaluated. AIM: This study aimed to compare the quality of single-dose fecal tagging with that of split-dose fecal tagging with iohexol during computed tomographic colonography and to assess the impact of these regimens on procedure tolerability. METHODS: In this retrospective, selective, single-center study, the patients were divided into two groups based on whether they received single-dose (group 1) or split-dose (group 2) fecal tagging. Both groups received 50 mL of the iodine-containing contrast agent iohexol, with iodine concentration of 350 mg/mL. The residual liquid density was assessed using three parameters: maximum, minimum, and mean values. Additionally, the residual fluid homogeneity was assessed by calculating the mean standard deviation within the region of interest. Tolerability of preparation for colonography was assessed using a 10-point visual analog scale. RESULTS: The final sample included 338 patients: 116 in group 1 and 222 in group 2. The mean, minimum, and maximum density values in group 2 were significantly higher than those in group 1: 943 [722; 1245], 753 [525; 1082], and 1079 HU [801; 1456] versus 681 [420; 907], 570 [374; 820], and 825 HU [496; 1154], respectively (p < 0.001). The residual fluid homogeneity was significantly higher in group 2 than in group 1: 59 [46; 78] versus 67 HU [54; 81] (р = 0.012). Group 2 showed a significantly lower subjective difficulty of preparation than did group 1: 4 [2; 6] and 5 [4; 7], respectively (p = 0.004). CONCLUSION: A single dose of 50 mL of iohexol (iodine concentration: 350 mg/mL) provides higher-quality fecal tagging than a split-dose provides because of higher residual fluid density with maintained homogeneity. Moreover, single-dose tagging was found to be more tolerable.
Quantitative parameters of magnetic resonance imaging of the brachial plexus in healthy adults and associated signs: a pilot cross-sectional study
BACKGROUND: Standard magnetic resonance imaging sequences only provide qualitative image assessment, which is rather subjective. However, some quantitative techniques can interpret findings more objectively and expand diagnostic capabilities. Previously, they were mainly used for brain and joint scans; however, current technology allows using them for evaluating peripheral nerve function. AIM: This study aimed to evaluate quantitative parameters of magnetic resonance imaging of the brachial plexus elements in healthy adults, depending on the side and level of spinal nerves and demographic and anthropometric characteristics. METHODS: Ten healthy volunteers were included. Their main demographic and anthropometric characteristics were recorded before they underwent magnetic resonance imaging. A 3T magnetic resonance imaging scanner was used. In addition to standard sequences, the scan protocol included regimens for obtaining T2 relaxation times and magnetization transfer ratios from nerve elements of the brachial plexus. Data were post-processed using the MATLAB software package. Then, regions of interest were manually assigned to in the maps, and numerical values were obtained. Furthermore, thickness of the nerve elements was measured. Data were statistically processed using the SPSS software. RESULTS: In each participant, the numerical values of the quantitative magnetic resonance imaging parameters (measured T2 relaxation time, proton density, magnetization transfer ratio, and thickness) in the anterior rami of the spinal nerves that form the brachial plexus were obtained. The thickness gradient of the normal anterior rami was revealed, with the highest value occurring at the level of the anterior rami of cervical spinal nerve C7. Significant positive correlations between T2 relaxation time and age were determined by analysis of the associations between quantitative magnetic resonance imaging parameters and demographic and anthropometric characteristics. In addition, negative correlations were found between height and measured T2 relaxation time and proton density. CONCLUSION: The study results indicate that future research on T2 relaxation parameters should consider age and height in both healthy volunteers and patients with a brachial plexus condition. Additionally, when measuring the thickness of the anterior rami of the brachial plexus using standard sequences, the size and thickness gradient of the nerve elements should be considered.
Fuzzy controller design for predicting the systolic area of photoplethysmogram signal using Persian medicine pulsology
BACKGROUND: Photoplethysmography, a method used to measure blood volume changes per pulse, is widely applied in healthcare. In Persian medicine, pulsology is considered one of the most important methods for clinical diagnosis. However, recently the theory of fuzzy sets has provided a valuable foundation for developing knowledge-based systems in medical research. AIM: To estimate and predict the systolic area of photoplethysmography signals using Persian medicine pulsology, by leveraging the potential of fuzzy systems. METHODS: To design the fuzzy controller, a Persian medicine specialist simultaneously recorded data on PM pulse characteristics including pulse frequency and pulse strength—along with photoplethysmography signals, from 55 healthy volunteers. Initially, rules were generated based on the input and output variables. After evaluating these rules using the collected data, 35 were retained and presented in a two-input–one-output lookup table. RESULTS: The fuzzy system was then constructed using MATLAB. It included 35 rules, triangular and trapezoidal membership functions, a singleton fuzzifier, a product inference engine, and a center-average defuzzifier. This system, which used pulse frequency and pulse strength as inputs and provided the systolic area as output, demonstrated acceptable performance within the defined input range. CONCLUSIONS: The proposed fuzzy controller system reasonably predicted the systolic area of photoplethysmography signals using Persian medicine pulse parameters. The results revealed that increasing pulse frequency decreased the systolic area, while increasing pulse strength increased it, in alignment with previous results. Therefore, this system may boost the clinical skills of Persian medicine students and practitioners. It also holds promise for application in disease diagnosis and prediction and for facilitating integration between Persian medicine and mainstream medicine.
Application of artificial intelligence technologies in detecting adrenal neoplasms on computed tomography scans
BACKGROUND: Adrenal neoplasms are a common incidental finding on computed tomography, which remains the primary imaging method used to make a presumptive diagnosis of the lesion’s nosological type. Artificial intelligence-based software solutions for detecting adrenal neoplasms on computed tomography scans have been actively developed and implemented. AIM: This study aimed to assess the diagnostic effectiveness of artificial intelligence-based software in identifying adrenal neoplasms on computed tomography images of the chest and abdominal organs available as of the first quarter of 2024. METHODS: Artificial intelligence-based software was tested in two modifications: a single-purpose service designed to detect adrenal neoplasms and comprehensive artificial intelligence service for analyzing non-contrast computed tomography image series of the chest and abdominal organs (including contrast-enhanced studies). Two datasets were used: dataset 1 included abdominal computed tomography scans, and dataset 2 comprised chest computed tomography scans. Each dataset consisted of 100 anonymized computed tomography studies of patients with (n = 50) and without (n = 50) adrenal neoplasms. The diagnostic accuracy of artificial intelligence-based software was determined by calculating the following statistical metrics: area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. RESULTS: Testing of the artificial intelligence-based software on datasets with signs of adrenal neoplasms demonstrated high diagnostic accuracy metrics that exceeded the declared performance values. AUC ranged from 0.858 to 0.995 (the highest value was achieved by the artificial intelligence single-purpose service-2 for analyzing abdominal computed tomography images); specificity ranged from 0.920 to 1.000 (the highest value was achieved by the artificial intelligence comprehensive service-2 for analyzing chest computed tomography images); and sensitivity ranged from 0.739 to 1.000 (the highest values were achieved by the artificial intelligence single-purpose and artificial intelligence comprehensive service-2 for analyzing abdominal computed tomography images). CONCLUSION: Artificial intelligence-based software for detecting adrenal neoplasms showed high diagnostic accuracy across all the evaluated metrics. Therefore, such systems may be effective for identifying adrenal neoplasms on chest and abdominal computed tomography scans of the chest and abdominal organs.
Role of myocardial strain parameters in assessing indications for pulmonary valve replacement in children after tetralogy of Fallot repair: a cross-sectional study
BACKGROUND: Radical repair of tetralogy of Fallot significantly improves patients’ survival and quality of life. However, in the long-term postoperative period, most patients develop progressive pulmonary valve insufficiency. Pulmonary regurgitation gradually increases the volume load on the right ventricle, causing dilation, impaired systolic and diastolic function, and higher risk of arrhythmias and sudden cardiac death. In turn, pulmonary valve replacement decreases afterload and improves myocardial function. Nevertheless, the optimal timing of valve replacement in asymptomatic patients after tetralogy of Fallot repair remains unclear. AIM: This study aimed to evaluate myocardial strain parameters as potential criteria for determining the need for pulmonary valve replacement. METHODS: This single-center retrospective (medical record-based) cross-sectional study included data from patients treated at the departments of Cardiothoracic Surgery and Cardiology within the National Research Cardiac Surgery Center (Astana, Kazakhstan). Cardiac magnetic resonance imaging was performed between December 2011 and June 2020 in patients who had undergone radical tetralogy of Fallot repair. Because a threshold value of right ventricular end-diastolic volume (RVEDV) between 150 and 170 mL/m2 indicates a need for pulmonary valve replacement in asymptomatic patients, the sample was divided into two groups based on RVEDV: group 1, RVEDV <150 mL/m2, and group 2, RVEDV ≥150 mL/m2. The prognostic value of myocardial strain parameters in decision-making for timely pulmonary valve replacement was assessed. RESULTS: The study included 69 patients aged 3–18 years (11 ± 4 years) who had undergone radical tetralogy of Fallot repair. Circumferential strain in the basal anteroseptal segment of the left ventricle significantly differed between groups 1 (n = 52) and 2 (n = 17): −23.2 ± 5.8% vs −16.7 ± 8.4% (p = 0.003). Moreover, in the basal inferior segment of the left ventricle, significant differences were observed: −10.8 ± 5.2% in group 1 and −7.8 ± 6.8% in group 2 (p = 0.014). The right ventricular end-systolic volume in group 1 was approximately twice as low as in group 2: 56.9 ± 19.1 vs 103.9 ± 111.9 mL/m2 (p < 0.001). CONCLUSION: The findings indicate the diagnostic value of myocardial strain parameters and their potential as additional criteria for evaluating indications for pulmonary valve replacement.
Automated radiology workstation: comparing two approaches for selecting radiodiagnostic solutions (technical report)
BACKGROUND: Patient examinations generate large amounts of data on various diseases, which are virtually impossible to process manually. Currently, automated radiology workstations incorporate clinical decision–support systems that facilitate image analysis. At present, two options are used: built-in vendor-dependent and vendor-independent software solutions. Both have broad functionality, but they also have their advantages and drawbacks. Therefore, the choice of the best clinical decision–support system depends on the healthcare organization. AIM: This study aimed to compare two approaches for selecting radiodiagnostic solutions for automated radiology workstations in Moscow. METHODS: The study conducted a two-stage, cross-sectional survey between September 2023 and March 2024. Data on vendor-independent software were obtained from participants of the Experiment on the use of innovative computer vision technologies for analysis of medical images in the Moscow healthcare system. Conversely, data on vendor-dependent solutions was collected from the manufacturers’ websites. Furthermore, a survey of 40 radiologists was performed to evaluate the relevance of software functions. RESULTS: At the time of the survey, the vendor-independent software demonstrated slightly more functions than the vendor-dependent solutions. The greatest differences were observed in the functionality of computed tomography and magnetic resonance imaging modalities, whereas the functionality for X-ray imaging and mammography was nearly identical. The survey of radiologists showed that 6 of 17 functions were unique to built-in vendor-dependent software. However, <40% of the radiologists actually needed these functions, whereas the shared functions were relevant for >50% of the respondents. CONCLUSION: Vendor-independent and built-in vendor-dependent software solutions share only half of their functions. Thus, in choosing between these two options, healthcare facilities should consider their specialization and their radiologists’ requests. Moreover, approximately two-thirds of the built-in vendor-dependent software functions used by radiologists in Moscow can be implemented using vendor-independent solutions. Therefore, the choice of software should be based on the facility’s technical capacity and economic feasibility.
Evaluation of the radiation dose from dental cone-beam computed tomography: short communication
BACKGROUND: Dental cone-beam computed tomography offers several advantages, including superior image quality, an acceptable size, and a lower radiation dose compared to conventional CT scanning. Moreover, cone-beam computed tomography is more suitable for dentists to acquire and analyze images, and it provides greater comfort for patients due to technological advancements. Cone-beam computed tomography generates three-dimensional images of the head and neck and is utilized across various dental fields, including dental surgery, endodontics, trauma, implant dentistry, head and neck lesions and diseases, and orthodontics. AIM: To evaluate seven tissue doses using three scan protocols on a cone-beam computed tomography scanner KaVo OP 3D Pro, and to investigate the effect of resolution options on the effective dose. METHODS: Three protocols were employed in this study. Three voxel size settings were assessed: 420 μm, 380 μm, and 320 μm. The field of view and tube voltage were kept constant at 13 cm × 15 cm and 90 kV, respectively. Other were, scan time (8–27 seconds) and dose range (50–350 μSv). The absorbed and effective doses were calculated for each cone-beam computed tomography scan protocol. RESULTS: In the throat, the highest dose was absorbed by tissue-2 (7.719 mGy). In the teeth, the highest dose was absorbed by tissue-3 (16.326 mGy). In the cheek, the maximum dose was absorbed by tissue-3 (25.053 mGy). In the eyes, the highest dose was absorbed by tissue-3 (12.962 mGy). In the forehead, the highest dose was absorbed by tissue3 (8.465 mGy). In the mid-skull, the highest dose was absorbed by tissue-3 (20.904 mGy). In the occipital region, the highest dose was absorbed by tissue-2 (7.8 mGy). Regarding effective doses, protocol-3 generally resulted in higher values, except in the throat and occipital regions, where tissue-2 absorbed more. CONCLUSION: This study demonstrates that changes in cone-beam computed tomography exposure parameters influence the effective dose. Adjusting resolution settings results in variations in effective doses, highlighting the significance of selecting appropriate exposure factors, such as voxel size or resolution options. Dentists must carefully consider imaging parameters, as these decisions have a direct impact on patient exposure.
Experience of using machine learning to optimize renal replacement therapy: a review
This review examined studies on the use of machine learning tools to optimize renal replacement therapy. Publications were searched using the databases eLibrary, PubMed, and Scopus. The TITLE and ABSTRACT fields were used to select the metadata for the following queries: artificial intelligence AND (dialys* OR hemodialys*) and machine learning AND (dialys* OR hemodialys*). The use of different word forms for key concepts was considered, and the period of publications was not limited. The primary search yielded 669 full-text articles. Three independent experts (i.e., two nephrologists and one machine learning specialist) manually selected articles. Article selection focused on the use of machine learning algorithms, solution of a specific issue of optimization of dialysis therapy, and availability of a model specifically developed for patients on dialysis and not intended for other clinical tasks. Review of articles revealed that predicting dialysis adequacy is the most common dialysis-related task wherein machine learning tools are used. Dialysis adequacy refers to the effective removal of nitrogenous waste products. Post-procedural complications are a potential indirect sign of dialysis inadequacy, the risk of which is what artificial intelligence models are trained to identify. They are also used as basis for selecting therapy for renal anemia and phosphorus–calcium metabolism disorders, as various factors should be considered in these cases, including changes over time. Several studies of machine learning are aimed at predicting survival of patients on dialysis and determining the optimal time to initiate renal replacement therapy in patients with chronic kidney disease. A comprehensive review of the articles showed several limitations, including small sample sizes, insufficient testing during the preliminary preparation and analysis stages, and low reproducibility of many studies. The most relevant studies described the clinical implementation of systems based on machine learning algorithms after testing them on different patient populations.
Visual images in radiography: pareidolia as a useful tool for physicians and artificial intelligence
This article explored the role of pareidolia in radiography and its potential in improving diagnosis and medical personnel training. Pareidolia is the phenomenon of perceiving familiar patterns in random objects, such as faces on the moon’s surface and animal figures in clouds. In radiography, pareidolia can manifest as recognizable patterns in medical images. This enables radiographers to identify abnormalities and improve their diagnostic skills. This work aimed to evaluate pareidolia caused by the interpretation of X-ray images and determine its potential applications. From June to December 2023, a competition was held to create a dataset of pareidolic illusions. Thirty-one individuals participated, including medical imaging specialists who had access to radiographic images. Images from nine additional participants were obtained outside the competition. Overall, 71 images were received. Participants uploaded images using a form on Yandex Forms. Data quality was ensured by clearly defined inclusion and exclusion criteria. Data analysis revealed that people most frequently perceive human faces, animal snouts, and the heart symbol. These findings indicate the possibility of further research. This article discusses the potential applications of pareidolia in developing neural networks for automated medical image analysis and in educational activities that stimulate creative thinking and association. Moreover, the article emphasizes the importance of ongoing research in this area to develop effective diagnostic tools and educational programs by expanding the evidence base.