Archives
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Lymphatic Malformations & Navigating Anomalous Pulmonary Venous Connections & Denosumab-Induced ONJ
Vol. 13 No. 1 (2024)Lymphatic Malformations
Vascular anomalies correspond to a group of lesions related to disorders of vascular develop- ment, which to date remain a diagnostic and therapeutic challenge for treating physicians. Lymphatic malformations (LM) are congenital malformations that manifest as benign hamartomatous tumors of the lymphatic vessels with a marked predilection for the head, neck and oral cavity. In general terms, LM are classified as macrocystic, microcystic or a combination of both depending on the size of the lesion, which can lead to anatomical alterations and even functional deficits. The aim of this article is to provide a brief and accurate review of head and neck lymphatic malformations considering their clinical aspects, imaging tools and treatment options.
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Navigating complexity: A pictorial representation of anomalous pulmonary venous connection classification in the pediatric population with volume rendering and multiplanar imaging technique
Anomalous pulmonary venous connections represent a heterogeneous group of congenital heart diseases in which a part or all of the pulmonary veins drains into the right atrium instead of draining into the left atrium. Pulmonary venous anomalies can manifest as partial or total anomalous drainage due to the abnormal embryological development. Multidetector CT angiography, with its multiplanar reformatting and volume rendering techniques, precisely offers the information about the three-dimensional anatomy and spatial relationships of the cardiovascular structures. Clinical features of anomalous pulmonary venous connections may be silent or have variable features like neonatal cyanosis, volume overload, and pulmonary arterial hypertension due to the left-to-right shunt, which are often associated with other congenital cardiac disease, so that accurate diagnosis is essential for treatment planning.
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Denosumab-Induced Osteonecrosis of the Jaw with FDG PET/CT Imaging Features
Denosumab is a monoclonal antibody that inhibits receptor activator of nuclear factor-kappa B ligand (RANKL), which plays a crucial role in osteoclast formation, function, and survival. By blocking RANKL, denosumab helps prevent bone resorption, making it an effective therapeutic option for managing conditions associated with bone metastases and osteopenia, such as in patients with lung cancer. Lung cancer, particularly non-small cell lung cancer (NSCLC), often metastasizes to bones, and denosumab is commonly used to reduce the incidence of skeletal-related events (SREs) in these patients. However, denosumab therapy is not without its risks, and one of the most significant side effects is osteonecrosis of the jaw (ONJ), a potentially debilitating condition characterized by bone exposure and necrosis, typically following dental extractions or trauma
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Synchronous endovascular management of post PCNL concurrent pseudoaneurysm and AV fistula & Automatic Joint Teeth Segmentation in Panoramic Dental Images using Mask Recurrent Convolutional Neural Networks with Residual Feature Extraction: Can it be useful in Oral Cancer Diagnosis and Management?
Vol. 12 No. 1 (2024)Synchronous endovascular management of post PCNL concurrent pseudoaneurysm and AV fistula
Percutaneous nephrolithotomy (PCNL) is the standard treatment procedure for large stones associated with complications like pseudoaneurysm and arteriovenous fistula with their incidence being < 1%. A post-PCNL case with left flank pain and delayed haematuria presented with macroscopic haematuria and depleting haemoglobin levels. CT angiography with 3-D reconstruction was used for diagnosing and planning of treatment. The patient was successfully treated with super selective angioembolization (SAE) using peripheral coils while preserving the kidney's remaining vascularization. Early diagnosis and active endovascular treatment using angioembolization techniques can be life-saving and resulting in minimal post-procedure complications and early recovery.
Automatic Joint Teeth Segmentation in Panoramic Dental Images using Mask Recurrent Convolutional Neural Networks with Residual Feature Extraction: Can it be useful in Oral Cancer Diagnosis and Management?
Introduction: Panoramic dental images gives an in-depth understanding of the tooth structure, both lower and upper jaws, and surrounding structures throughout the cavity in our mouth. The Panoramic dental images provided have significance for dental diagnostics since they aid in the detection of an array of dental disorders, including oral cancer. We propose a novel approach to automatic joint teeth segmentation using the pioneer Mask Recurrent Convolutional Neural Network (MRCNN) model for dental image segmentation.
Material and Methods: In this study, a sequence of residual blocks are used to construct a 62-layer feature extraction network in lieu of ResNet50/101 in MRCNN. To evaluate the efficacy of our method, the UFBA-UESC and Tufts dental image dataset (2500 panoramic dental x-rays) were utilised. 252 x-rays were used in test set, rest of the x-rays were utilised as training (1800 images) and validation datasets (448 images) in ratio of 8:2 of the modified MRCNN model.
Results: Modified MRCNN achieved the final training and validation accuracies as 99.67% and 98.94%, respectively. The achieved accuracy of Dice coefficient (97.8%), Intersection over Union, (98.67%), and Pixel Accuracy (96.53%) respectively over the whole dataset. We also compare the performance of proposed model and other well established networks such as FPN, UNet, PSPNet, and DeepLabV3. The Modified MRCNN provides better results segmenting any two teeth which are close to each other.
Conclusion: Our proposed method will serve as a valuable tool for automatic segmentation of individual teeth for medical management. This current method leads to higher accuracy and precision. Segmented images can be used to evaluate periodic changes, providing valuable data for assessing the progression of oral cancer and the efficacy of management. Future research should focus on developing less complex, lightweight, and faster vision models while maintaining high accuracy
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Splenic Artery Aneurysm Occlusion & Nasopharyngeal Metastasis of Papillary Thyroid Carcinoma & Study of Multimodality Imaging Features of Brown Tumor or Osteitis Fibrosa Cystica
Vol. 10 No. 1 (2024)Splenic Artery Aneurysm Occlusion
The first lienal artery aneurysm was discovered and described for the first time in 1770 by the Frenchman Beaussier during an autopsy. It was first visualised using X-rays in 1920 by the physicians Akbulut and Otan. The first surgical treatment of a splenic artery aneurysm was performed by surgeons MacLeod and Maurice in 1940. The first minimally invasive endovascular therapies using coils, stents or a combination of the two devices for minimally invasive treatment of aneurysms of the lienal artery were reported in 1990, 1994 and 1995...
Nasopharyngeal Metastasis of Papillary Thyroid Carcinoma
Papillary thyroid carcinoma (PTC) despite of an indolent clinical behavior is known to cause locoregional recurrence and distant metastasis. Lung and bone are the common site of distant metastasis. Nasopharynx is a very rare site of metastasis.
Study of Multimodality Imaging Features of Brown Tumor or Osteitis Fibrosa Cystica
Brown tumor, also known as osteitis fibrosa cystica, is a rare but significant manifestation of hyperparathyroidism characterized by focal bone lesions resulting from excessive osteoclastic activity. Despite its rarity, Brown tumor poses diagnostic challenges due to its varied clinical presentations and radiographic features, often mimicking other bone lesions such as giant cell tumors or metastatic disease.
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Ultrasound Analysis of the Most Important Musculoskeletal Issues
Vol. 9 No. 2 (2024)This issue shows the most important standard sections of relevant questions in musculoskeletal (MSK) ultrasound of the wrist, elbow, shoulder, hip, knee and ankle. Exemplary images with descriptions of the sections and anatomical structures were created and the positioning of the patient explained. Several patient cases per region are being presented and explained in order to place the described procedures in a clinical context. The advantages and disadvantages of the imaging procedures are being explained and compared.
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Mediastinal Distortions & Archimedes Leverage of Research Funding
Vol. 11 No. 1 (2024)Learnings from Archimedes on the leverage of medical research funding in the post-Corona era
The Corona pandemic has increased pre-existing financial pressure on universities further. Universities will face closure as a realistic scenario in the future, and need to compete for research success. Medical faculties are at a particular risk of being the subject of cost-cutting measures. In this challenging environment, using the concept of financial leverage is key for maximising financial possibilities.
Mediastinal Distortions: A Rare Case of Congenital Anatomic Relocations of Mediastinal Structures and Vascular Anomalies in Combination with Heterotopic Conduction in Pulmonary Veins and Sick Sinus Syndrome
The case we present involves an atypically developed thoracic aorta, resulting in the consecutive displacement of the trachea and esophagus, combined with the unusual formation of vascular bridges between the ascending and descending thoracic aorta and the arising supraaortic branches. This represents a pathological entity further associated with a cardiac condition of Sick Sinus Syndrome and heterotopy of the excitation center in the pulmonary veins. Multiple descriptions of the combination of dextrocardia and Sick Sinus Syndrome have been reported by Aurora Bakalli et al. 2021 (1), as well as the combination of dextrocardia, persistent left superior vena cava, and Sick Sinus Syndrome by Gangliang Guo et al. 2017 (2), and another case of dextrocardia and Sick Sinus Syndrome by Junqian Luo et al. 2022 (3). Such combinations of anomalies have not been reported in larger statistical collections to date.
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PRIMARY CHORIOCARCINOMA OF THE VULVA & OTHER SPECIAL CASES
Vol. 9 No. 1 (2024)Gestational choriocarcinoma usually occurs in the corpus uteri in association with a coincident or antecedent pregnancy. Primary extrauterine choriocarcinoma is a rare entity, with the cervix being the most common site. We report a rare case of primary choriocarcinoma of the vulva in a woman with previous partial molar pregnancy and highlight its Magnetic Resonance Imaging (MRI) features. -
Liver disease & Ovarian Goitre
Vol. 8 No. 1 (2024)Splenic vein thrombosis is frequently diagnosed in the chronic stage, when collaterals have already developed. In this case, the presence of two major spontaneous shunts between the splenic vein and the superior mesenteric vein is preventing complications such as porto-systemic encephalopathy and variceal bleeding.
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AI and ChatGPT help Radiology. Do they?
Vol. 7 No. 2 (2024)Interventional Radiology was, is and will be always busy. Our patients benefit from well planned and skilled performances done by physicians, who are free from bureaucracy. Can AI help? Perhaps it can help, first of all within the field of paperwork and endless documentation...later on perhaps AI will perform pleura drainage or PICC-Line insertion by itself. Time wil show.
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Issue April 2024
Vol. 7 No. 1 (2024)This work provides an overview of the effectiveness of bone scintigraphy and its role in diagnosing various benign conditions in the Nuclear Medicine Department of the University Hospital of Fez. It analyzes the criteria for selecting scintigraphy as a diagnostic tool and outlines the principles, key features, and protocols involved. These details support clinicians in confirming their diagnostic reasoning when evaluating musculoskeletal lesions or bone abnormalities, guiding their choice of imaging modalities. Fibrodysplasia ossificans progressiva (FOP) is an extremely uncommon autosomal dominant condition marked by abnormalities in the big toes and the gradual development of extra-skeletal bone in specific anatomical formations.
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Endovascular Intervention
Vol. 6 No. 1 (2024)In cases where there is insufficient occlusion of the aneurysm with residual perfusion, secondary embolization becomes considerably more complex due to the occlusion of the anatomically antegrade access and the altered hemodynamics around the aneurysm causing retrograde collateralization
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Second Issue
Vol. 2 No. 1 (2023)Swiss Journal of Radiology and Nuclear Medicine (SJORANM) is an open access, peer-reviewed international journal that accepts for review any original scientific work in the fields of radiology and nuclear medicine.
