Differentiated thyroid carcinoma (DTC) is usually associated with a favorable prognosis. Nevertheless, up to 30% of patients present a local or distant recurrence. The aim of this study was to assess the incidence of recurrence after surgery for DTC and to identify predictive factors of recurrence. We included in this retrospective study 579 consecutive patients who underwent thyroidectomy for DTC from 2011 to 2016 at our institution. We observed biochemical or structural recurrent disease in 36 (6.2%) patients; five-year disease-free survival was 94.1%. On univariate analysis, male sex, histotype, lymph node yield, lymph node metastasis, extrathyroidal invasion and multicentricity were associated with significantly higher risk of recurrence, while microcarcinoma was correlated with significantly lower risk of recurrence. On multivariate analysis, only lymph node metastases (OR 4.724, p = 0.012) and microcarcinoma (OR 0.328, p = 0.034) were detected as independent predictive factors of recurrence. Postoperative management should be individualized and commensurate with the risk of recurrence: Patients with high-risk carcinoma should undergo strict follow-up and aggressive treatment. Furthermore, assessment of the risk should be repeated over time, considering individual response to therapy.

https://www.mdpi.com/2072-6694/11/9/1230/pdf

Predictive Factors of Recurrence in Patients with Differentiated Thyroid Carcinoma: A Retrospective Analysis on 579 Patients.

Background Preoperative evaluation of the consistency of pituitary macroadenomas is important for neurosurgeons to prepare the surgical plan. Purpose To evaluate the diagnostic performance of texture analysis (TA) of diffusion-weighted imaging (DWI) at a standard b-value (b = 1000 s/mm2 ) and a high b-value (b = 2000 s/mm2 ) for their ability to assess the tumor consistency of pituitary macroadenomas. Study type Retrospective. Population/subjects Fifty patients with histologically confirmed pituitary macroadenomas were classified as soft (n = 37) or hard (n = 13) types. Field strength/sequence Coronal T2 -weighted imaging (T2 WI), Readout Segmentation of Long Variable Echo-trains (RESOLVE) DWI at b = 1000 s/mm2 and b = 2000 s/mm2 were acquired with 3.0T MRI. Assessment The corresponding apparent diffusion coefficient (ADC) maps (ADC1000 and ADC2000 ) were registered to T2 WI. Regions of interest (ROIs) were manually drawn along the solid part of the tumor from the coregistered T2 WI-ADC images. The texture parameters from T2 WI, ADC1000 , and ADC2000 were acquired. Statistical tests The texture parameters were compared between the two types by using unpaired Student's t-test. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to assess their diagnostic performance. Results Significant differences in TA parameters of ADC1000 and ADC2000 were observed between soft and hard types (P l 0.05 for all), whereas the TA of T2 WI resulted in no significant difference (P g 0.05 for all). TA of ADC2000 provided a superior diagnostic performance compared with that of ADC1000 (P = 0.038). A combination of mean value and entropy of ADC2000 yielded an AUC, a sensitivity, and a specificity of 0.911, 78.4% and 92.3%, respectively. Data conclusion TA of ADC values were useful for assessing the tumor consistency of pituitary macroadenomas. ADC2000 may facilitate better type discrimination. Level of evidence 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1507-1513.

Texture Analysis of High b-Value Diffusion-Weighted Imaging for Evaluating Consistency of Pituitary Macroadenomas.

In clinical practice, medical imaging technologies, like computed tomography, have become an important and routinely used technique for diagnosis. Advanced 3D visualization techniques of this data, e.g. by using volume rendering, provide doctors a better spatial understanding for reviewing complex anatomy. There already exist sophisticated programs for the visualization of medical imaging data, however, they are usually limited to exactly this topic and can be hardly extended to new functionality; for instance, multi-user support, especially when considering immersive VR interfaces like tracked HMDs and natural user interfaces, can provide the doctors an easier, more immersive access to the information and support collaborative discussions with remote colleagues. We present an easy-to-use and expandable system for volumetric medical image visualization with support for multi-user VR interactions. The main idea is to combine a state-of-the-art open-source game engine, the Unreal Engine 4, with a new volume renderer. The underlying game engine basis guarantees the extensibility and allows for easy adaption of our system to new hardware and software developments. In our example application, remote users can meet in a shared virtual environment and view, manipulate and discuss the volume-rendered data in real-time. Our new volume renderer for the Unreal Engine is capable of real-time performance, as well as, high-quality visualization.

Volumetric Medical Data Visualization for Collaborative VR Environments

Background Uterine myoma is the most common benign gynecologic tumor in reproductive-aged women. During myomectomy for women who want to preserve fertility, it is advisable to detect and remove all myomas to decrease the risk of additional surgery. However, finding myomas during surgery is often challenging, especially for deep-seated myomas. Therefore, three-dimensional (3D) preoperative localization of myomas can be helpful for the surgical planning for myomectomy. However, the previously reported manual 3D segmenting method takes too much time and effort for clinical use. The objective of this study was to propose a new method of rapid 3D visualization of uterine myoma using a uterine template. Methods Magnetic resonance images were listed according to the slide spacing on each plane of the multiplanar reconstruction, and images that were determined to be myomas were selected by simply scrolling the mouse down. By using the selected images, a 3D grid with a slide spacing interval was constructed and filled on its plane and finally registered to a uterine template. Results The location of multiple myomas in the uterus was visualized in 3D and this proposed method is over 95% faster than the existing manual-segmentation method. Not only the size and location of the myomas, but also the shortest distance between the uterine surface and the myomas, can be calculated. This technique also enables the surgeon to know the number of total, removed, and remaining myomas on the 3D image. Conclusion This proposed 3D reconstruction method with a uterine template enables faster 3D visualization of myomas.

/pdf/a-fast-3-dimensional-magnetic-resonance-imaging-400h8k477u.pdf

A Fast 3-Dimensional Magnetic Resonance Imaging Reconstruction for Surgical Planning of Uterine Myomectomy

Preoperative 3-dimensional Magnetic Resonance Imaging of Uterine Myoma and Endometrium Before Myomectomy

CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

Objective To evaluate determinants of prolonged viral RNA shedding in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection. Materials and methods Hospitalized patients tested SARS-CoV-2 positive by nasopharyngeal real-time reverse transcriptase-polymerase chain reaction (RT-PCR) were included in the single-center, retrospective study. Patients were divided into 2 groups according to the timing of viral clearance (≤ 8 days, “early clearance” and ≥15 days, “late clearance”). Results 4,084 patients were included in the study (1,023 late clearance, 3,061 early clearance), with median age of 50 years and a higher proportion (61.4%) of male. Univariate analyses showed that comorbidities (including hypertension, diabetes, and coronary heart disease), receiving vaccine, the number of vaccinations, cycle threshold (Ct) open reading frame 1ab (ORF 1ab), and nucleocapsid protein (N) gene values on admission were associated with late viral clearance. In the multivariable analysis, the number of vaccinations (P = 0.010) and Ct ORF 1ab gene (P < 0.001) values on admission were significantly associated with late viral clearance. Generalized Estimating Equations (GEE) analysis showed that the Ct value of ORF 1ab gene and N gene remained unchanged within 3 days, and showed progressively higher values with increasing days during late viral RNA clearance. Conclusion The number of vaccinations and Ct values of ORF 1ab gene were independently associated with a prolonged SARS-CoV-2 RNA shedding.

/pdf/clinical-predictors-and-rt-pcr-profile-of-prolonged-viral-3ctr6ssf.pdf

Clinical predictors and RT-PCR profile of prolonged viral shedding in patients with SARS-CoV-2 Omicron variant in Shanghai: A retrospective observational study

Purpose:To evaluate the degree of gastric, enteric, colonic, and rectal filling in multidetector computed tomography (MDCT) whole gastroenterography.Methods:In this prospective study involving 124 ...

Evaluation of Low-Dose Multidetector Computed Tomography Whole Gastroenterography With Oral Administration of Contrast Agents.

Purpose 
The aim of the study was to evaluate the role of high b-value (2000 sec/mm2) diffusion-weighted imaging (DWI) by using Readout Segmentation of Long Variable Echo-trains (RESOLVE) in differentiating papillary thyroid carcinomas (PTCs) and papillary thyroid microcarcinomas (PTMCs) from benign thyroid nodules.


Materials and methods 
Consecutive patients with thyroid nodules scheduled for surgery underwent high b-value DWI with 3 b-values: 0, 800 and 2000 sec/mm2. Signal intensity ratios (SIRs) of thyroid nodules to adjacent normal thyroid tissue on DWI were measured as: SIRb0, SIRb800 and SIRb2000. Apparent diffusion coefficient (ADC) values based on the 3 different b-values were acquired as: ADCb0-800, ADCb0-2000, and ADCb0-800-2000. The 6 diagnostic indicators were evaluated by receiver operating characteristic (ROC) and diagnostic ability was compared between high b-value DWI and Ultrasound (US).


Results 
A total of 52 PTCs including 33 PTMCs (38 patients, 8 men and 30 women, aged 45.68 ± 11.93 years) and 62 benign thyroid nodules (46 patients, 7 men and 39 women, aged 48.73 ± 11.98 years) were enrolled into the final statistical analysis. ADCb0-800-2000 had the highest diagnostic ability in differentiating PTCs from benign thyroid nodules with area under curve (AUC) of 0.944, sensitivity of 96.15% and specificity of 85.48%, and PTMCs from benign thyroid nodules with AUC of 0.940, sensitivity of 93.94% and specificity of 85.48%. On the strength of lower false-positive rates than US (14.52% vs. 32.26% for PTCs and 14.52% vs. 32.26% for PTMCs), ADCb0-800-2000 had significantly better diagnostic ability in PTCs (P = 0.002) and PTMCs (P = 0.005).


Conclusion 
High b-value (2000 sec/mm2) DWI can contribute to differentiating PTCs and PTMCs from benign thyroid nodules and can be potentially used as an active surveillance imaging method for PTMCs.

/pdf/utility-of-high-b-value-2000-sec-mm2-dwi-with-resolve-in-1ocuqxyjkw.pdf

Utility of high b-value (2000 sec/mm2) DWI with RESOLVE in differentiating papillary thyroid carcinomas and papillary thyroid microcarcinomas from benign thyroid nodules

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Papers

CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

Clinical predictors and RT-PCR profile of prolonged viral shedding in patients with SARS-CoV-2 Omicron variant in Shanghai: A retrospective observational study

Evaluation of Low-Dose Multidetector Computed Tomography Whole Gastroenterography With Oral Administration of Contrast Agents.

Utility of high b-value (2000 sec/mm2) DWI with RESOLVE in differentiating papillary thyroid carcinomas and papillary thyroid microcarcinomas from benign thyroid nodules