Myocardial Perfusion SPECT Imaging Radiomic Features and Machine Learning Algorithms for Cardiac Contractile Pattern Recognition

A U-shaped contraction pattern was shown to be associated with a better Cardiac resynchronization therapy (CRT) response. The main goal of this study is to automatically recognize left ventricular contractile patterns using machine learning algorithms trained on conventional quantitative features (ConQuaFea) and radiomic features extracted from Gated single-photon emission computed tomography myocardial perfusion imaging (GSPECT MPI). Among 98 patients with standard resting GSPECT MPI included in this study, 29 received CRT therapy and 69 did not (also had CRT inclusion criteria but did not receive treatment yet at the time of data collection, or refused treatment). A total of 69 non-CRT patients were employed for training, and the 29 were employed for testing. The models were built utilizing features from three distinct feature sets (ConQuaFea, radiomics, and ConQuaFea + radiomics (combined)), which were chosen using Recursive feature elimination (RFE) feature selection (FS), and then trained using seven different machine learning (ML) classifiers. In addition, CRT outcome prediction was assessed by different treatment inclusion criteria as the study’s final phase. The MLP classifier had the highest performance among ConQuaFea models (AUC, SEN, SPE = 0.80, 0.85, 0.76). RF achieved the best performance in terms of AUC, SEN, and SPE with values of 0.65, 0.62, and 0.68, respectively, among radiomic models. GB and RF approaches achieved the best AUC, SEN, and SPE values of 0.78, 0.92, and 0.63 and 0.74, 0.93, and 0.56, respectively, among the combined models. A promising outcome was obtained when using radiomic and ConQuaFea from GSPECT MPI to detect left ventricular contractile patterns by machine learning.

     

Liquid biopsy of cerebrospinal fluid for MYD88 L265P mutation is useful for diagnosis of central nervous system lymphoma

The current standard of diagnosing central nervous system (CNS) lymphoma is stereotactic biopsy, however the procedure has a risk of surgical complication. Liquid biopsy of the CSF is a less invasive, non-surgical method that can be used for diagnosing CNS lymphoma. In this study, we established a clinically applicable protocol for determining mutations in MYD88 in the CSF of patients with CNS lymphoma. CSF was collected prior to the start of chemotherapy from 42 patients with CNS lymphoma and matched tumor specimens. Mutations in MYD88 in 33 tumor samples were identified using pyrosequencing. Using 10 ng each of cellular DNA and cell-free DNA (cfDNA) extracted from the CSF, the MYD88 L265P mutation was detected using digital PCR. The conditions to judge mutation were rigorously determined. The median Target/Total value of cases with MYD88 mutations in the tumors was 5.1% in cellular DNA and 22.0% in cfDNA. The criteria to judge mutation were then determined, with a Target/Total value of 0.25% as the cutoff. When MYD88 mutations were determined based on these criteria, the sensitivity and specificity were 92.2% and 100%, respectively, with cellular DNA; and the sensitivity and specificity were 100% with cfDNA. Therefore, the DNA yield, mutated allele fraction, and accuracy were significantly higher in cfDNA compared with that in cellular DNA. Taken together, this study highlights the importance of detecting the MYD88 L265P mutation in cfDNA of the CSF for diagnosing CNS lymphoma using digital PCR, a highly accurate and clinically applicable method.     

Penetrating vertebral artery injury treated by combining the “zone” approach and imaging tests: A case report

Patients with vertebral artery injury from penetrating neck trauma may not present with signs of vascular injury because of anatomical characteristics and concomitant conditions, such as hypothermia and shock. If patients are hemodynamically stable, imaging tests should be performed to examine the posterior components, including the vertebral artery.     

Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report

BACKGROUNDSolid pseudopapillary neoplasms (SPNs) are rare tumors of the pancreas. Typically, they occur in young females, often have characteristic imaging features, such as cystic components and calcification, and have few effects on the pancreatic duct.CASE SUMMARYA 31-year-old man was admitted to our hospital with the chief complaint of epigastric pain. There was only mild tenderness in his upper abdomen, and blood tests showed only a slight increase in alkaline phosphatase. Contrast-enhanced computed tomography showed a 40-mm-diameter, hypovascular mass in the head of the pancreas, and the main pancreatic duct upstream of the mass was severely dilated. Magnetic resonance imaging showed low intensity on T1-weighted images, with high intensity on T2-weighted image in some parts. Pancreatic ductal adenocarcinoma was the primary differential diagnosis. Portal vein infiltration could not be ruled out, so this case was a candidate for neoadjuvant chemotherapy. Subsequently, endoscopic ultrasound-guided fine needle aspiration was performed, and pathological evaluation and immunostaining suggested a diagnosis of SPN. Thus, pancreatoduodenectomy was performed. One year after the operation, the patient is alive with no recurrence.CONCLUSIONMain pancreatic duct dilatation is usually a finding of suspected pancreatic cancer. However, pancreatic duct dilatation can occur in SPN depending on the location and growth speed. Therefore, SPN should be considered in the differential diagnosis of tumors with pancreatic duct dilatation, and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.     

A multispecies-monitoring study about bioaccumulation of mercury in Iranian birds (Khuzestan to Persian Gulf): Effect of taxonomic affiliation and trophic level

In the present study, the first baseline concentration of mercury (Hg) in different species of Iranian birds was investigated. From April to October 2005, the tail feathers of 100 birds belonging to 27 species (14 families) from different places in southwest Iran (Khuzestan to Persian Gulf) were collected. The Hg levels were evaluated in relation to taxonomic affiliation and trophic level (type of food). The results showed that the Hg levels in the feathers were between 0.07 and 4.71 mg/kg dry weight (dw), and there was a significant effect of taxonomic groups in relation to Hg concentration (p<0.001). The highest mercury concentrations were in Laridae and Ciconidae. Alcedinidae had intermediate values, whereas Upupidae, Glareolidae, Scolopacidae, Turdidae, Ardeidae, Anatidae were in subsequent orders; and the lowest concentrations of Hg were in Rallidae, Cuculidae, Pycnonotidae, Corvidae and Columbidae. The results indicated a significant difference between the trophic levels (p<0.001). Fish predators had the highest level of Hg (3.07 mg/kg). Invertebrate predators and herbivorous birds had the lowest concentration of Hg (0.84 and 0.64 mg/kg, respectively), whereas crab and fish predators and omnivorous birds had moderate values (1.73 and 1.70 mg/kg, respectively). In the present study, the concentration of Hg was significantly higher in tail feathers than in primary and secondary (p<0.001). A significant positive correlation among Hg concentration of feather types was observed (r>0.96). The results obtained in this study indicated that among 100 birds tested, 6% of them had Hg concentrations greater than 5 mg/kg in feather (adverse level).     

Splenic hydatid cysts in a 20-year-old soldier

Hydatid disease is a parasitic infection of humans and herbivorous animals caused by Echinococcus granulosus. A 20-year-old male soldier from Booshehr province police center was admitted with left upper quadrant pain that began 1 year before admission. Sonography disclosed an echogenic mass measuring 14 x 16 cm near the spleen and kidneys; a computed tomography scan confirmed it as a hypodense mass of the spleen that was 16 x 17 x 18 cm in dimension. Casoni skin test and indirect fluorescent antibody were positive. Through laparatomy, a splenectomy was successfully performed.     

Chondrosarcoma of the hyoid bone: imaging, surgical, and histopathologic correlation

Objectives/Hypothesis: Rare diseases must be diagnosed with great caution, so we present this case to familiarize clinicians with the presentation and treatment of chondrosarcoma of the hyoid bone, a rare disease. Study Design: Case report and review of the literature. Methods: We report one case of chondrosarcoma of the hyoid bone which presented with upper midline neck mass. In addition, we review the literature published in English regarding chondrosarcoma of the hyoid bone. Results: Chondrosarcoma of the hyoid bone is a rare disease of which only 14 cases have been reported until now. Patients with this disease have no sexual or racial preponderance, and most presented with a mass in the upper neck which has splotchy calcification in radiologic imaging without enhancement. The preferred treatment is wide excision. Conclusion: Because chondrosarcoma have indolent growth, are locally noninvasive, and appear encapsulated during operation, they may be mistaken for a benign mass and conservatively resected. On the other hand, incomplete tumor resection may lead to recurrence, which is associated with increased risk of dedifferentiation and histologic grading of tumor. Surgeons should approach this surgery with caution.