Search results for: non-invasive tomography

Authors: Lucas M. Furlan, Cesar A. Moreira, Jepherson F. Sales, Guilherme T. Bueno, Manuel E. Ferreira, Carla V. S. Coelho, Vania Rosolen

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Located in the western part of the State of Minas Gerais, Brazil, the study area consists of a savanna environment, represented by sedimentary plateau and a soil cover composed by lateritic and hydromorphic soils - in the latter, occurring the deferruginization and concentration of high-alumina clays, exploited as refractory material. In the hydromorphic topographic depressions (wetlands) the hydropedogical relationships are little known, but it is observed that in times of rainfall, the depressed region behaves like a natural seasonal reservoir - which suggests that the wetlands on the surface of the plateau are places of recharge of the aquifer. The aquifer recharge areas are extremely important for the sustainable social, economic and environmental development of societies. The understanding of hydrodynamics in relation to the functioning of the ferruginous and hydromorphic lateritic soils system in the savanna environment is a subject rarely explored in the literature, especially its understanding through the joint application of geoprocessing by UAV (Unmanned Aerial Vehicle) and electrical tomography. The objective of this work is to understand the hydrogeological dynamics in a wetland (with an area of 426.064 m²), in the Brazilian savanna,as well as the understanding of the subsurface architecture of hydromorphic depressions in relation to the recharge of aquifers. The wetland was compartmentalized in three different regions, according to the geoprocessing. Hydraulic conductivity studies were performed in each of these three portions. Electrical tomography was performed on 9 lines of 80 meters in length and spaced 10 meters apart (direction N45), and a line with 80 meters perpendicular to all others. With the data, it was possible to generate a 3D cube. The integrated analysis showed that the area behaves like a natural seasonal reservoir in the months of greater precipitation (December – 289mm; January – 277,9mm; February – 213,2mm), because the hydraulic conductivity is very low in all areas. In the aerial images, geotag correction of the images was performed, that is, the correction of the coordinates of the images by means of the corrected coordinates of the Positioning by Precision Point of the Brazilian Institute of Geography and Statistics (IBGE-PPP). Later, the orthomosaic and the digital surface model (DSM) were generated, which with specific geoprocessing generated the volume of water that the wetland can contain - 780,922m³ in total, 265,205m³ in the region with intermediate flooding and 49,140m³ in the central region, where a greater accumulation of water was observed. Through the electrical tomography it was possible to identify that up to the depth of 6 meters the water infiltrates vertically in the central region. From the 8 meters depth, the water encounters a more resistive layer and the infiltration begins to occur horizontally - tending to concentrate the recharge of the aquifer to the northeast and southwest of the wetland. The hydrodynamics of the area is complex and has many challenges in its understanding. The next step is to relate hydrodynamics to the evolution of the landscape, with the enrichment of high-alumina clays, and to propose a management model for the seasonal reservoir.

Keywords: electrical tomography, hydropedology, unmanned aerial vehicle, water resources management

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Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Achraf Al Faraj, Asma Sultana Shaik, Baraa Al Sayed

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Specific and effective targeting of drug delivery systems (DDS) to cancerous sites remains a major challenge for a better diagnostic and therapy. Recently, SWCNTs with their unique physicochemical properties and the ability to cross the cell membrane show promising in the biomedical field. The purpose of this study was first to develop a biocompatible iron oxide tagged SWCNTs as diagnostic nanoprobes to allow their noninvasive detection using MRI and their preferential targeting in a breast cancer murine model by placing an optimized flexible magnet over the tumor site. Magnetic targeting was associated to specific antibody-conjugated SWCNTs active targeting. The therapeutic efficacy of doxorubicin-conjugated SWCNTs was assessed, and the superiority of diffusion-weighted (DW-) MRI as sensitive imaging biomarker was investigated. Short Polyvinylpyrrolidone (PVP) stabilized water soluble SWCNTs were first developed, tagged with iron oxide nanoparticles and conjugated with Endoglin/CD105 monoclonal antibodies. They were then conjugated with doxorubicin drugs. SWCNTs conjugates were extensively characterized using TEM, UV-Vis spectrophotometer, dynamic light scattering (DLS) zeta potential analysis and electron spin resonance (ESR) spectroscopy. Their MR relaxivities (i.e. r1 and r2*) were measured at 4.7T and their iron content and metal impurities quantified using ICP-MS. SWCNTs biocompatibility and drug efficacy were then evaluated both in vitro and in vivo using a set of immunological assays. Luciferase enhanced bioluminescence 4T1 mouse mammary tumor cells (4T1-Luc2) were injected into the right inguinal mammary fat pad of Balb/c mice. Tumor bearing mice received either free doxorubicin (DOX) drug or SWCNTs with or without either DOX or iron oxide nanoparticles. A multi-pole 10x10mm high-energy flexible magnet was maintained over the tumor site during 2 hours post-injections and their properties and polarity were optimized to allow enhanced magnetic targeting of SWCNTs toward the primary tumor site. Tumor volume was quantified during the follow-up investigation study using a fast spin echo MRI sequence. In order to detect the homing of SWCNTs to the main tumor site, susceptibility-weighted multi-gradient echo (MGE) sequence was used to generate T2* maps. Apparent diffusion coefficient (ADC) measurements were also performed as a sensitive imaging biomarker providing early and better assessment of disease treatment. At several times post-SWCNT injection, histological analysis were performed on tumor extracts and iron-loaded SWCNT were quantified using ICP-MS in tumor sites, liver, spleen, kidneys, and lung. The optimized multi-poles magnet revealed an enhanced targeting of magnetic SWCNTs to the primary tumor site, which was found to be much higher than the active targeting achieved using antibody-conjugated SWCNTs. Iron-loading allowed their sensitive noninvasive tracking after intravenous administration using MRI. The active targeting of doxorubicin through magnetic antibody-conjugated SWCNTs nanoprobes was found to considerably decrease the primary tumor site and may have inhibited the development of metastasis in the tumor-bearing mice lung. ADC measurements in DW-MRI were found to significantly increase in a time-dependent manner after the injection of DOX-conjugated SWCNTs complexes.

Keywords: single-walled carbon nanotubes, nanomedicine, magnetic resonance imaging, cancer diagnosis and therapy

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Authors: J. Visser, C. Driver, T. Ebenhan

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[¹⁸F]-FDG (fluorodeoxyglucose) is a radiopharmaceutical compound that is used for non-invasive cancer tumor imaging through positron emission tomography (PET). This radiopharmaceutical is used to visualise the metabolic processes in tumour tissues, which can be applied for the diagnosis and prognosis of various types of cancer. [¹⁸F]-FDG has widespread use in both clinical and pre-clinical research settings. Imaging using [¹⁸F]-FDG results in representative normal tissue distribution as well as visualisation of hypermetabolic lesions ([¹⁸F]-FDG avid foci). The metabolic tissue concentration of these lesions following [¹⁸F]-FDG administration can be quantified using Standard Uptake Values (SUV). Standard uptake values of [¹⁸F]-FDG-based Positron Emission Tomography can be influenced by various biological and technical handling factors. Biological factors that affect [¹⁸F]-FDG uptake include the blood glucose levels of subjects, normal physiological variants between subjects and administration of certain pharmaceutical agents. Technical factors that can have an effect include the route of radiopharmaceutical or pharmaceutical agents administered and environmental conditions such as ambient temperature and lighting. These factors influencing tracer uptake need to be investigated to improve the robustness of the imaging protocol, which will achieve reproducible image acquisition across various research projects, optimised tumor visualisation and increased data validity and reliability.

Keywords: fluorodeoxyglucose, tumour imaging, Rodent, Blood Glucose, PET/CT Imaging

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Authors: Jessica Chorostecki, Aashka Shah, Fen Bao, Ginny Bao, Edwin George, Navid Seraji-Bozorgzad, Veronica Gorden, Christina Caon, Elliot Frohman

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Background: Parkinson’s Disease (PD) is a neuro degenerative disorder associated with the loss of dopaminergic cells and the presence α-synuclein (AS) aggregation in of Lewy bodies. Both dopaminergic cells and AS are found in the retina. Optical coherence tomography (OCT) allows high-resolution in-vivo examination of retinal structure injury in neuro degenerative disorders including PD. Methods: We performed a cross-section OCT study in patients with definite PD and healthy controls (HC) using Spectral Domain SD-OCT platform to measure the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV). We performed intra-retinal segmentation with fully automated segmentation software to measure the volume of the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and the outer nuclear layer (ONL). Segmentation was performed blinded to the clinical status of the study participants. Results: 101 eyes from 52 PD patients (mean age 65.8 years) and 46 eyes from 24 HC subjects (mean age 64.1 years) were included in the study. The mean pRNFL thickness was not significantly different (96.95 μm vs 94.42 μm, p=0.07) but the TMV was significantly lower in PD compared to HC (8.33 mm3 vs 8.58 mm3 p=0.0002). Intra-retinal segmentation showed no significant difference in the RNFL volume between the PD and HC groups (0.95 mm3 vs 0.92 mm3 p=0.454). However, GCL, IPL, INL, and ONL volumes were significantly reduced in PD compared to HC. In contrast, the volume of OPL was significantly increased in PD compared to HC. Conclusions: Our finding of the enlarged OPL corresponds with mRNA expression studies showing localization of AS in the OPL across vertebrate species and autopsy studies demonstrating AS aggregation in the deeper layers of retina in PD. We propose that the enlargement of the OPL may represent a potential biomarker of AS aggregation in PD. Longitudinal studies in larger cohorts are warranted to confirm our observations that may have significant implications in disease monitoring and therapeutic development.

Keywords: Optical Coherence Tomography, biomarker, Parkinson's disease, alpha-synuclein, retina

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Authors: Khalid M. Kheiralla, Georgios Boutsis, Mohammed Y. Abdelgalil, Mohammed A. Ali, Nuha E. Mohamed

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The present study focus on integrated geoelectrical surveys carried out in the mineralization zone in Erkowit region, Eastern Sudan to determine the extensions of the potential ore deposits on the topographically high hilly area and under the cover of alluvium along the nearby wadi and to locate other occurrences if any. The magnetic method (MAG) and the electrical resistivity tomography (ERT) were employed for the survey. Eleven traverses were aligned approximately at right angles to the general strike of the rock formations. The disseminated sulfides are located on the alteration shear zone which is composed of granitic and dioritic highly ferruginated rock occupying the southwestern and central parts of the area, this was confirmed using thin and polished sections mineralogical analysis. The magnetic data indicates low magnetic values for wadi sedimentary deposits in its southern part of the area, and high anomalies which are suspected as gossans due to magnetite formed during wall rock alteration consequent to mineralization. The significant ERT images define low resistivity zone as traced as sheared zones which may associated with the main loci of ore deposition. By itself, no geophysical anomaly can simply be correlated with lithology, instead, magnetic and ERT anomalies raised due to variations in some specific physical properties of rocks which were extremely useful in mineral exploration.

Keywords: ERT, magnetic, mineralization, Red Sea, Sudan

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Authors: Frantisek Kopriva, Kamila Michalkova, Radim Dudek, Jana Volejnikova

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Rationale: Diagnostic criteria of asthma–COPD overlap syndrome (ACOS) are controversial in pediatrics. Emphysema is characteristic of COPD and usually does not occur in typical asthma; its presence in patients with asthma suggests the concurrence with COPD. Low-dose chest computed tomography (CT) allows a non-invasive assessment of the lung tissue structure. Here we present CT findings of emphysematous changes in a child with ACOS. Patient and Methods: In a 6-year-old boy, atopy was confirmed by a skin prick test using common allergen extracts (grass and tree pollen, house dust mite, molds, cat, dog; manufacturer Stallergenes Greer, London, UK), where reactions over 3 mm were considered positive. Treatment with corticosteroids was started during the course of severe asthma. At 12 years of age, his spirometric parameters deteriorated despite treatment adjustment (VC 1.76 L=85%, FEV1 1.13 L=67%, TI%VCmax 64%, MEF25 19%, TLC 144%) and the bronchodilator test became negative. Results: Low-dose chest CT displayed irregular regions with increased radiolucency of pulmonary parenchyma (typical for hyperinflation in emphysematous changes) in both lungs. This was in accordance with the results of spirometric examination. Conclusions: ACOS is infrequent in children. However, low-dose chest CT scan can be considered to confirm this diagnosis or eliminate other diagnoses when the clinical condition is deteriorating and treatment response is poor.

Keywords: child, asthma, low-dose chest CT, ACOS

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Authors: Marwa Al-Subhi, Eiman Al-Ajmi, Mallak Al-Maamari, Humood Al-Dhuhli, Srinivasa Rao

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The orbit and its contents are affected by various pathologies and craniofacial anomalies. Sound knowledge of the normal orbital dimensions is clinically essential for successful surgical outcomes and also in the field of forensic anthropology. Racial, ethnic, and regional variations in the orbital dimensions have been reported. This study sought to determine the orbital dimensions of Omani subjects who had been referred for computed tomography (CT) images at a tertiary care hospital. A total of 273 patients’ CT images were evaluated retrospectively by using an electronic medical records database. The orbital dimensions were recorded using both axial and sagittal planes of CT images. The mean orbital index (OI) was found to be 83.25±4.83 and the prevalent orbital type was categorized as mesoseme. The mean orbital index was 83.34±5.05 and 83.16±4.57 in males and females, respectively, with their difference being statistically not significant (p=0.76). A statistically significant association was observed between the right and left orbits with regard to horizontal distance (p<0.05) and vertical distance (p<0.01) of orbit and OI (p<0.05). No significant difference between the OI and age groups was observed in both males and females. The mean interorbital distance and interzygomatic distance were found to be 19.45±1.52 mm and 95.59±4.08 mm, respectively. Both of these parameters were significantly higher in males (p<0.05). Results of the present study provide reference values of orbital dimensions in Omani subjects. The prevalent orbital type of Omani subjects is mesoseme, which is a hallmark of the white race.

Keywords: orbit, orbital index, mesoseme, ethnicity, variation

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Authors: Hye-Young Shin, Chan Kee Park

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Background: To compare the thinning patterns of the ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) as measured using Cirrus high-definition optical coherence tomography (HD-OCT) in patients with visual field (VF) defects that respect the vertical meridian. Methods: Twenty eyes of eleven patients with VF defects that respect the vertical meridian were enrolled retrospectively. The thicknesses of the macular GCIPL and pRNFL were measured using Cirrus HD-OCT. The 5% and 1% thinning area index (TAI) was calculated as the proportion of abnormally thin sectors at the 5% and 1% probability level within the area corresponding to the affected VF. The 5% and 1% TAI were compared between the GCIPL and pRNFL measurements. Results: The color-coded GCIPL deviation map showed a characteristic vertical thinning pattern of the GCIPL, which is also seen in the VF of patients with brain lesions. The 5% and 1% TAI were significantly higher in the GCIPL measurements than in the pRNFL measurements (all P < 0.01). Conclusions: Macular GCIPL analysis clearly visualized a characteristic topographic pattern of retinal ganglion cell (RGC) loss in patients with VF defects that respect the vertical meridian, unlike pRNFL measurements. Macular GCIPL measurements provide more valuable information than pRNFL measurements for detecting the loss of RGCs in patients with retrograde degeneration of the optic nerve fibers.

Keywords: brain lesion, macular ganglion cell, inner plexiform layer, spectral-domain optical coherence tomography

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Authors: Rima Zakzouk, Yasushi Shimada, Yuan Zhou, Yasunori Sumi, Junji Tagami

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Background and Purpose: Swept source optical coherence tomography (OCT) is an interferometric imaging technique that has been recently used in cariology. In spite of progress made in adhesive dentistry, the composite restoration has been failing due to secondary caries which occur due to environmental factors in oral cavities. Therefore, a precise assessment to effective marginal sealing of restoration is highly required. The aim of this study was evaluating gap formation at composite/cavity walls interface with or without phosphoric acid etching using SS-OCT. Materials and Methods: Round tapered cavities (2×2 mm) were prepared in three locations, mid-coronal, cervical, and root of bovine incisors teeth in two groups (SE and PA Groups). While self-etching adhesive (Clearfil SE Bond) was applied for the both groups, Group PA had been already pretreated with phosphoric acid etching (K-Etchant gel). Subsequently, both groups were restored by Estelite Flow Quick Flowable Composite Resin. Following 5000 thermal cycles, three cross-sectionals were obtained from each cavity using OCT at 1310-nm wavelength at 0°, 60°, 120° degrees. Scanning was repeated after two months to monitor the gap progress. Then the average percentage of gap length was calculated using image analysis software, and the difference of mean between both groups was statistically analyzed by t-test. Subsequently, the results were confirmed by sectioning and observing representative specimens under Confocal Laser Scanning Microscope (CLSM). Results: The results showed that pretreatment with phosphoric acid etching, Group PA, led to significantly bigger gaps in mid-coronal and cervical compared to SE group, while in the root cavity no significant difference was observed between both groups. On the other hand, the gaps formed in root’s cavities were significantly bigger than those in mid-coronal and cervical within the same group. This study investigated the effect of phosphoric acid on gap length progress on the composite restorations. In conclusions, phosphoric acid etching treatment did not reduce the gap formation even in different regions of the tooth. Significance: The cervical region of tooth was more exposing to gap formation than mid-coronal region, especially when we added pre-etching treatment.

Keywords: image analysis, optical coherence tomography, phosphoric acid etching, self-etch adhesives

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Authors: Chady El Hachem, Pan Ye, Kamilia Abahri, Rachid Bennacer

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Considered as a building construction material, and regarding its environmental benefits, wood fiber insulation is the material of interest in this work. The definition of adequate elementary representative volume that guarantees reliable understanding of the hygrothermal macroscopic phenomena is very critical. At the microscopic scale, when subjected to hygric solicitations, fibers undergo local dimensionless variations. It is therefore necessary to master this behavior, which affects the global response of the material. This study consists of an experimental procedure using the non-destructive method, X-ray tomography, followed by morphological post-processing analysis using ImageJ software. A refine investigation took place in order to identify the representative elementary volume and the sufficient resolution for accurate structural analysis. The second part of this work was to evaluate the microscopic hygric behavior of the studied material. Many parameters were taken into consideration, like the evolution of the fiber diameters, distribution along the sorption cycle and the porosity, and the water content evolution. In addition, heat transfer simulations based on the energy equation resolution were achieved on the real structure. Further, the problematic of representative elementary volume was elaborated for such heterogeneous material. Moreover, the material’s porosity and its fibers’ thicknesses show very big correlation with the water content. These results provide the literature with very good understanding of wood fiber insulation’s behavior.

Keywords: hygric behavior, morphological characterization, wood fiber insulation material, x-ray tomography

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Authors: Nesrine Frifita

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In recent years, serious interest in underground sources has led to more intensive studies of depth, thickness, geometry and properties of aquifers. Geophysical method is the common technique used in discovering the subsurface. However, determining the exact location of groundwater in subsurface layers is one of problems that needs to be resolved. While the biggest problem is the quality of the groundwater which suffers from pollution risk especially with water shortage in arid regions under a remarkable climate change. The present study was conducted using electrical resistivity tomography at Jeffara coastal area in Southeast Tunisia to image the potential shallow aquifer and studying their physical properties. The purpose of this study is to understand the characteristics and depth of the Smar aquifer. Therefore, it can be used as a reference in groundwater drilling in order to guide the farmers and to improve the living of the inhabitants of nearby cities. The use of the Winner-Schlumberger array for data acquisition is suitable to obtain a deeper profile in areas with homogeneous layers. For that, six electrical resistivity profiles were carried out in Smar watershed using 72 electrodes with 4 and 5 m spacing. The resistivity measurements were carefully interpreted by a least-square inversion technique using the RES2DINV program. Findings show that the Smar aquifer has about 31 m thickness and it extends to 36.5 m depth in the downstream area of Oued Smar. The defined depth and geometry of Smar aquifer indicate that the sedimentary cover thins toward the coast, and the Smar shallow aquifer becomes deeper toward the West. While the resistivity values show a significant contrast even reaching < 1 Ωm in ERT1, this resistivity value can be related to the saline water that foretells a risk of pollution and bad groundwater quality. The ERT1 geoelectrical model defines an unsaturated zone, while under ERT3 site, the geoelectrical model presents a saturated zone, which reflect a low resistivity values indicate the locally surface water coming from the nearby Office of the National Sanitation Utility (ONAS) that can be a source of recharge of the studied shallow aquifer and more deteriorate the groundwater quality in this region.

Keywords: electrical resistivity tomography, groundwater, recharge, smar aquifer, southeastern tunisia

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Authors: Zeena Dcosta, Junaid Ahmed, Ceena Denny, Nandita Shenoy

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In the field of dentistry, there are many conditions which warrant the requirement of three-dimensional imaging that can aid in diagnosis and therapeutic management. Cone beam computed tomography (CBCT) is considered highly accurate in producing a three-dimensional image of an object and provides a complete insight of various findings in the captured volume. But, most of the clinicians focus primarily on the teeth and jaws and numerous unanticipated clinically significant incidental findings may be missed out. Rapid integration of CBCT into the practice of dentistry has led to the detection of various incidental findings. However, the prevalence of these incidental findings is still unknown. Thus, the study aimed to discern the reason for referral and to identify incidental findings on the referred CBCT scans. Patient’s demographic data such as age and gender was noted. CBCT scans of multiple fields of views (FOV) were considered. The referral for CBCT scans was broadly classified into two major categories: diagnostic scan and treatment planning scan. Any finding on the CBCT volumes, other than the area of concern was recorded as incidental finding which was noted under airway, developmental, pathological, endodontics, TMJ, bone, soft tissue calcifications and others. Few of the incidental findings noted under airway were deviated nasal septum, nasal turbinate hypertrophy, mucosal thickening and pneumatization of sinus. Developmental incidental findings included dilaceration, impaction, pulp stone and gubernacular canal. Resorption of teeth and periapical pathologies were noted under pathological incidental findings. Root fracture along with over and under obturation was noted under endodontics. Incidental findings under TMJ were flattening, erosion and bifid condyle. Enostosis and exostosis were noted under bone lesions. Tonsillolth, sialolith and calcified styloid ligament were noted under soft tissue calcifications. Incidental findings under others included foreign body, fused C1- C2 vertebrae, nutrient canals, and pneumatocyst. Maxillofacial radiologists should be aware of possible incidental findings and should be vigilant about comprehensively evaluating the entire captured volume, which can help in early diagnosis of any potential pathologies that may go undetected. Interpretation of CBCT is truly an art and with the experience, we can unravel the secrets hidden in the grey shades of the radiographic image.

Keywords: cone beam computed tomography, incidental findings, maxillofacial region, radiologist

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Authors: Ana Ferreira, Ines Costa, Patricia Polónia, Josué Pereira, Olinda Faria, Pedro Alberto Silva

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Introduction: Optical coherence tomography (OCT) and visual field tools are pivotal in evaluating neurological deficits and predicting potential visual improvement following surgical decompression in neurosurgical patients. Despite their clinical significance, a comprehensive understanding of their utility in this context is lacking in the literature. This study aims to elucidate the applications of OCT and visual field assessment, delineating distinct patterns of visual deficit presentations within the studied cohort. Methods: This retrospective analysis considered all adult patients who underwent a single surgery for pituitary adenoma or anterior skull base meningioma with optic nerve involvement, coupled with neuro-ophthalmology evaluation, between July 2020 and January 2023. A minimum follow-up period of 6 months was deemed essential. Results: A total of 24 patients, with a median age of 61, were included in the analysis. Three primary patterns emerged: 1) Low visual field involvement with compromised OCT, 2) High visual field involvement with relatively unaffected OCT, and 3) Significant compromise observed in both OCT and visual fields. Conclusion: This study delineates various findings in OCT and visual field assessments with illustrative examples. Based on the current findings, a prospective cohort will be systematically collected to further investigate and validate these patterns and their prognostic significance, enhancing our understanding of the utility of OCT and visual fields in neurosurgical patients.

Keywords: OCT, neurosurgery, visual field, optic nerve

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Authors: Mohamed Salah El-Din Mahmoud, Ahmed Hamed, Asmaa Anwar Mohamed

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Purpose: To study the tear film parameters, total corneal thickness (CT), corneal epithelial thickness and, corneal power in Juvenile systemic lupus erythematosus (JSLE) patients compared to age-matched controls using anterior segment optical coherence tomography (AS-OCT). Methods: This was a cross-sectional study. Study participants were divided into 2 groups: Group A: 75 eyes of JSLE patients, Group B: 75 eyes of healthy controls. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were the lower tear meniscus parameters that were measured. The corneal power, CT, and epithelial thickness were all determined automatically. Results: In the JSLE group, the range of age was 10 to 15 years while the control group was 11 to 16 years. TMH, TMA, and TMD were 527.7±46.8, 0.059±0.015 and 343.3±59.9 respectively in JSLE group while 525.4±44.6, 0.058±0.011 and 340.6±58.0 respectively in control group without significant difference (p-value<0.001). The corneal power was 43.3±0.55 in the JSLE while 43.2±0.54 in the control group without significant difference (p-value= 0.407). CT was 551.1±13.5 in JSLE group while 551.2±15.3 in control group without significant difference (p-value= 0.982). Epithelial thickness was 52.66±1.35 in the JSLE group while 52.60±1.36 in the control group without significant difference (p-value= 0.765). Conclusion: We demonstrated no significant difference in tear meniscus dimensions, CT, epithelial thickness, and corneal power in the JSLE patients compared to age-matched controls using AS-OCT.

Keywords: tear film, ASOCT, JSLE, pachymetry, corneal thickness

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Authors: Murat Durucu

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Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

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Authors: Sarah K. Hagi, Majdi Alnowaimi

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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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Authors: Mahya Naghipoor

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Purpose: Non-small cell lung cancer (NSCLC) is the most common lung cancer type. Epidermal growth factor receptor (EGFR) mutation is the main reason which causes NSCLC. Computed tomography (CT) is used for diagnosis and prognosis of lung cancers because of low price and little invasion. Semantic analyses of qualitative CT features are based on visual evaluation by radiologist. However, the naked eye ability may not assess all image features. On the other hand, radiomics provides the opportunity of quantitative analyses for CT images features. The aim of this review study was comparing accuracy of semantic and radiomics features in prognosis of EGFR mutation in NSCLC. Methods: For this purpose, the keywords including: non-small cell lung cancer, epidermal growth factor receptor mutation, semantic, radiomics, feature, receiver operating characteristics curve (ROC) and area under curve (AUC) were searched in PubMed and Google Scholar. Totally 29 papers were reviewed and the AUC of ROC analyses for semantic and radiomics features were compared. Results: The results showed that the reported AUC amounts for semantic features (ground glass opacity, shape, margins, lesion density and presence or absence of air bronchogram, emphysema and pleural effusion) were %41-%79. For radiomics features (kurtosis, skewness, entropy, texture, standard deviation (SD) and wavelet) the AUC values were found %50-%86. Conclusions: In conclusion, the accuracy of radiomics analysis is a little higher than semantic in prognosis of EGFR mutation in NSCLC.

Keywords: lung cancer, radiomics, computer tomography, mutation

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Authors: Amir Moslemi, Amir movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise.Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjected to low quality due to the noise. The quality of CT images is dependent on the absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on the purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete wavelet transform(DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result in good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: computed tomography (CT), noise reduction, curve-let, contour-let, signal to noise peak-peak ratio (PSNR), structure similarity (Ssim), absorbed dose to patient (ADP)

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Authors: S. Gharbi, S. Labidi, M. Mars, M. Chelli, F. Ladeb

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The purpose of this study is to reduce radiation dose for chest CT examination by including Tube Current Modulation (TCM) to a standard CT protocol. A scan of an anthropomorphic male Alderson phantom was performed on a 128-slice scanner. The estimation of effective dose (ED) in both scans with and without mAs modulation was done via multiplication of Dose Length Product (DLP) to a conversion factor. Results were compared to those measured with a CT-Expo software. The size specific dose estimation (SSDE) values were obtained by multiplication of the volume CT dose index (CTDIvol) with a conversion size factor related to the phantom’s effective diameter. Objective assessment of image quality was performed with Signal to Noise Ratio (SNR) measurements in phantom. SPSS software was used for data analysis. Results showed including CARE Dose 4D; ED was lowered by 48.35% and 51.51% using DLP and CT-expo, respectively. In addition, ED ranges between 7.01 mSv and 6.6 mSv in case of standard protocol, while it ranges between 3.62 mSv and 3.2 mSv with TCM. Similar results are found for SSDE; dose was higher without TCM of 16.25 mGy and was lower by 48.8% including TCM. The SNR values calculated were significantly different (p=0.03<0.05). The highest one is measured on images acquired with TCM and reconstructed with Filtered back projection (FBP). In conclusion, this study proves the potential of TCM technique in SSDE and ED reduction and in conserving image quality with high diagnostic reference level for thoracic CT examinations.

Keywords: anthropomorphic phantom, computed tomography, CT-expo, radiation dose

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Authors: Qasim Munye, Juned Islam, Haseeb Qureshi, Syed Jung

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Lung nodules are commonly identified in computed tomography (CT) scans by experienced radiologists at a relatively late stage. Early diagnosis can greatly increase survival. We propose using a pix2pix conditional generative adversarial network to generate realistic images simulating early-stage lung nodule growth. We have applied deep images prior to 2341 slices from 895 computed tomography (CT) scans from the Lung Image Database Consortium (LIDC) dataset to generate pseudo-healthy medical images. From these images, 819 were chosen to train a pix2pix network. We observed that for most of the images, the pix2pix network was able to generate images where the nodule increased in size and intensity across epochs. To evaluate the images, 400 generated images were chosen at random and shown to a medical student beside their corresponding original image. Of these 400 generated images, 384 were defined as satisfactory - meaning they resembled a nodule and were visually similar to the corresponding image. We believe that this generated dataset could be used as training data for neural networks to detect lung nodules at an early stage or to improve the accuracy of such networks. This is particularly significant as datasets containing the growth of early-stage nodules are scarce. This project shows that the combination of deep image prior and generative models could potentially open the door to creating larger datasets than currently possible and has the potential to increase the accuracy of medical classification tasks.

Keywords: medical technology, artificial intelligence, radiology, lung cancer

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Authors: Idris Garba, Aisha Rabiu Abdullahi, Mansur Yahuza, Akintade Dare

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Background: CT urography (CTU) is efficient radiological examination for the evaluation of the urinary system disorders. However, patients are exposed to a significant radiation dose which is in a way associated with increased cancer risks. Objectives: To determine Computed Tomography Dose Index following CTU, and to evaluate organs equivalent doses. Materials and Methods: A prospective cohort study was carried at a tertiary institution located in Kano northwestern. Ethical clearance was sought and obtained from the research ethics board of the institution. Demographic, scan parameters and CT radiation dose data were obtained from patients that had CTU procedure. Effective dose, organ equivalent doses, and cancer risks were estimated using SPSS statistical software version 16 and CT dose calculator software. Result: A total of 56 patients were included in the study, consisting of 29 males and 27 females. The common indication for CTU examination was found to be renal cyst seen commonly among young adults (15-44yrs). CT radiation dose values in DLP, CTDI and effective dose for CTU were 2320 mGy cm, CTDIw 9.67 mGy and 35.04 mSv respectively. The probability of cancer risks was estimated to be 600 per a million CTU examinations. Conclusion: In this study, the radiation dose for CTU is considered significantly high, with increase in cancer risks probability. Wide radiation dose variations between patient doses suggest that optimization is not fulfilled yet. Patient radiation dose estimate should be taken into consideration when imaging protocols are established for CT urography.

Keywords: CT urography, cancer risks, effective dose, radiation exposure

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Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Mahdi Farajzadeh Ajirlou

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Prior evidence of normal cardiac anatomy is desirable to relieve the anxiety of cases with a family history of congenital heart disease or to offer the option of early gestation termination or close follow-up should a cardiac anomaly be proved. Fetal heart discovery plays an important part in the opinion of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system. Acquisition of ventricular volume and inflow data would be useful to quantify more valve regurgitation and ventricular function to determine the degree of cardiovascular concession in fetal conditions at threat for hydrops fetalis. This study discusses imaging the fetal heart with transvaginal ultrasound, Doppler ultrasound, three-dimensional ultrasound (3DUS) and four-dimensional (4D) ultrasound, spatiotemporal image correlation (STIC), glamorous resonance imaging and cardiac catheterization. Doppler ultrasound (DUS) image is a kind of real- time image with a better imaging effect on blood vessels and soft tissues. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. Spatiotemporal image correlation (STIC) enables the acquisition of a volume of data concomitant with the beating heart. The automated volume accession is made possible by the array in the transducer performing a slow single reach, recording a single 3D data set conforming to numerous 2D frames one behind the other. The volume accession can be done in a stationary 3D, either online 4D (direct volume scan, live 3D ultrasound or a so-called 4D (3D/ 4D)), or either spatiotemporal image correlation-STIC (off-line 4D, which is a circular volume check-up). Fetal cardiovascular MRI would appear to be an ideal approach to the noninvasive disquisition of the impact of abnormal cardiovascular hemodynamics on antenatal brain growth and development. Still, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the mortal fetus, the lack of conventional cardiac gating styles to attend data accession, and the implicit corruption of MRI data due to motherly respiration and unpredictable fetal movements. Fetal cardiac MRI has the implicit to complement ultrasound in detecting cardiovascular deformations and extracardiac lesions. Fetal cardiac intervention (FCI), minimally invasive catheter interventions, is a new and evolving fashion that allows for in-utero treatment of a subset of severe forms of congenital heart deficiency. In special cases, it may be possible to modify the natural history of congenital heart disorders. It's entirely possible that future generations will ‘repair’ congenital heart deficiency in utero using nanotechnologies or remote computer-guided micro-robots that work in the cellular layer.

Keywords: fetal, cardiac MRI, ultrasound, 3D, 4D, heart disease, invasive, noninvasive, catheter

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Authors: Behnaz Sohani, Sahand Shahalinezhad, Amir Rahmani, Aliyu Aliyu

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Recently, medical imaging and specifically medical image processing is becoming one of the most dynamically developing areas of medical science. It has led to the emergence of new approaches in terms of the prevention, diagnosis, and treatment of various diseases. In the process of diagnosis of lung cancer, medical professionals rely on computed tomography (CT) scans, in which failure to correctly identify masses can lead to incorrect diagnosis or sampling of lung tissue. Identification and demarcation of masses in terms of detecting cancer within lung tissue are critical challenges in diagnosis. In this work, a segmentation system in image processing techniques has been applied for detection purposes. Particularly, the use and validation of a novel lung cancer detection algorithm have been presented through simulation. This has been performed employing CT images based on multilevel thresholding. The proposed technique consists of segmentation, feature extraction, and feature selection and classification. More in detail, the features with useful information are selected after featuring extraction. Eventually, the output image of lung cancer is obtained with 96.3% accuracy and 87.25%. The purpose of feature extraction applying the proposed approach is to transform the raw data into a more usable form for subsequent statistical processing. Future steps will involve employing the current feature extraction method to achieve more accurate resulting images, including further details available to machine vision systems to recognise objects in lung CT scan images.

Keywords: lung cancer detection, image segmentation, lung computed tomography (CT) images, medical image processing

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Authors: Shubham Gogri, Lucia Florescu

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Medical diagnosis and radiotherapy treatment planning using Computed Tomography (CT) rely on the quantitative accuracy and quality of the CT images. At the same time, requirements for CT imaging include reducing the radiation dose exposure to patients and minimizing scanning time. A solution to this is the sparse-view CT technique, based on a reduced number of projection views. This, however, introduces a new problem— the incomplete projection data results in lower quality of the reconstructed images. To tackle this issue, deep learning methods have been applied to enhance the quality of the sparse-view CT images. A first approach involved employing Mir-Net, a dedicated deep neural network designed for image enhancement. This showed promise, utilizing an intricate architecture comprising encoder and decoder networks, along with the incorporation of the Charbonnier Loss. However, this approach was computationally demanding. Subsequently, a specialized Generative Adversarial Network (GAN) architecture, rooted in the Pix2Pix framework, was implemented. This GAN framework involves a U-Net-based Generator and a Discriminator based on Convolutional Neural Networks. To bolster the GAN's performance, both Charbonnier and Wasserstein loss functions were introduced, collectively focusing on capturing minute details while ensuring training stability. The integration of the perceptual loss, calculated based on feature vectors extracted from the VGG16 network pretrained on the ImageNet dataset, further enhanced the network's ability to synthesize relevant images. A series of comprehensive experiments with clinical CT data were conducted, exploring various GAN loss functions, including Wasserstein, Charbonnier, and perceptual loss. The outcomes demonstrated significant image quality improvements, confirmed through pertinent metrics such as Peak Signal-to-Noise Ratio (PSNR) and Structural Similarity Index (SSIM) between the corrected images and the ground truth. Furthermore, learning curves and qualitative comparisons added evidence of the enhanced image quality and the network's increased stability, while preserving pixel value intensity. The experiments underscored the potential of deep learning frameworks in enhancing the visual interpretation of CT scans, achieving outcomes with SSIM values close to one and PSNR values reaching up to 76.

Keywords: generative adversarial networks, sparse view computed tomography, CT image correction, Mir-Net

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Authors: Muna Khushaim

Abstract:

Aluminum-based alloys play a key role in modern engineering, especially in the aerospace industry. Introduction of solute atoms such as Li and Cu is the main approach to improve the strength in age-hardenable Al alloys via the precipitation hardening phenomenon. Knowledge of the decomposition process of the microstructure during the precipitation reaction is particularly important for future technical developments. The objective of this study is to investigate the nano-scale chemical composition in the Al-Cu, Al-Li and Al-Li-Cu during the early stage of the precipitation sequence and to describe whether this compositional difference correlates with variations in the observed precipitation kinetics. Comparing the random binomial frequency distribution and the experimental frequency distribution of concentrations in atom probe tomography data was used to investigate the early stage of decomposition in the different binary and ternary alloys which were experienced different heat treatments. The results show that an Al-1.7 at.% Cu alloy requires a long ageing time of approximately 8 h at 160 °C to allow the diffusion of Cu atoms into Al matrix. For the Al-8.2 at.% Li alloy, a combination of both the natural ageing condition (48 h at room temperature) and a short artificial ageing condition (5 min at 160 °C) induces increasing on the number density of the Li clusters and hence increase number of precipitated δ' particles. Applying this combination of natural ageing and short artificial ageing conditions onto the ternary Al-4 at.% Li-1.7 at.% Cu alloy induces the formation of a Cu-rich phase. Increasing the Li content in the ternary alloy up to 8 at.% and increasing the ageing time to 30 min resulted in the precipitation processes ending with δ' particles. Thus, the results contribute to the understanding of Al-alloy design.

Keywords: aluminum alloy, atom probe tomography, early stage, decomposition

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Authors: Benhammadi Hocine, Djamel Boubaya, Chaffai Hicham

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Meskiana Area is characterized by a semi-arid climate where the water supply for irrigation and industry is not sufficient as the priority goes for domestic use. To meet the increasing population growth and development, the authorities have considered building a new water retaining structure on some major temporary water streams. For this purpose Chebabta site on Oued Meskiana was chosen as the future dam site. It is large enough to store the desired volume of water. This study comes to investigate the conditions of the site and the adequacy of the ground as a foundation for the projected dam. The conditions of the site include the geological structure and mainly the presence of discontinuities in the formation on which the dam will be built, the nature of the lithologies under the foundation and the future lake, and the presence of any hazard. This site characterization is usually carried out using different methods in order to highlight any underground buried problematic structure. In this context, the different geophysical technics remain the most used ones. Three geophysical methods were used in the case of the Chebabta dam site, namely, electric survey, seismic refraction, and tomography. The choice of the technics and the location of the scan line was made on the basis of the available geological data. In this sense, profiles have been established on both banks of Oued Meskiana. The obtained results have allowed a better characterization of the geological structure, defining the limit between the surface cover and the bedrock, which is, in other words, the limit between the weathered zone and the bedrock. Their respective thicknesses were also determined by seismic refraction and electrical resistivity sounding. However, the tomography imaging technic has succeeded in positioning a fault structure passing through the right bank of the wadi.

Keywords: dam site, fault, geophysic, investigation, Meskiana

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Authors: Angelis P. Barlampas

Abstract:

Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.

Keywords: phycosis, intraventricular masses, CT, brain calcifications

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