Diagnostics最新文献

{"title":"Automated Computer-Assisted Diagnosis of Pleural Effusion in Chest X-Rays via Deep Learning.","authors":"Ya-Yun Huang, Yu-Ching Lin, Sung-Hsin Tsai, Tsun-Kuang Chi, Tsung-Yi Chen, Shih-Wei Chung, Kuo-Chen Li, Wei-Chen Tu, Patricia Angela R Abu, Chih-Cheng Chen","doi":"10.3390/diagnostics15182322","DOIUrl":"10.3390/diagnostics15182322","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Pleural effusion is a common pulmonary condition that, if left untreated, may lead to respiratory distress and severe complications. Chest X-ray (CXR) imaging is routinely used by physicians to identify signs of pleural effusion. However, manually examining large volumes of CXR images on a daily basis can require substantial time and effort. To address this issue, this study proposes an automated pleural effusion detection system for CXR images. <b>Methods:</b> The proposed system integrates image cropping, image enhancement, and the EfficientNet-B0 deep learning model to assist in detecting pleural effusion, a task that is often challenging due to subtle symptom presentation. Image cropping was applied to extract the region from the heart to the costophrenic angle as the target area. Subsequently, image enhancement techniques were employed to emphasize pleural effusion features, thereby improving the model's learning efficiency. Finally, EfficientNet-B0 was used to train and classify pleural effusion cases based on processed images. <b>Results:</b> In the experimental results, the proposed image enhancement approach improved the model's recognition accuracy by approximately 4.33% compared with the non-enhanced method, confirming that enhancement effectively supports subsequent model learning. Ultimately, the proposed system achieved an accuracy of 93.27%, representing a substantial improvement of 21.30% over the 77.00% reported in previous studies, highlighting its significant advancement in pleural effusion detection. <b>Conclusions:</b> This system can serve as an assistive diagnostic tool for physicians, providing standardized detection results, reducing the workload associated with manual interpretation, and improving the overall efficiency of pulmonary care.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Iodine Contrast Augmentation for Suboptimally Enhanced CT Pulmonary Angiography: Implications for Pulmonary Embolism Diagnosis.","authors":"Kyungsoo Bae, Tae Hoon Kim, Kyung Nyeo Jeon","doi":"10.3390/diagnostics15182325","DOIUrl":"10.3390/diagnostics15182325","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to assess the impact of a deep learning-based iodine contrast augmentation (DLCA) algorithm on image quality and diagnostic performance for pulmonary embolism (PE) detection in suboptimally enhanced CT pulmonary angiography (CTPA). <b>Methods</b>: We retrospectively included 103 suboptimal CTPA cases performed between May 2020 and March 2025. Image quality (attenuation, noise, SNR, and CNR) was compared between original and DLCA-processed images. Diagnostic performance for PE detection was assessed per segment, with and without DLCA processing. <b>Results</b>: DLCA increased pulmonary artery opacification by 57.7% and reduced noise by 56.7%, significantly improving SNR (13.2 → 47.5) and CNR (8.7 → 37.2; both <i>p</i> < 0.001). Incorporation of DLCA-processed images improved diagnostic accuracy for overall (AUC: 0.874/0.845 → 0.958/0.938), central (0.939/0.895 → 0.987/0.972), and peripheral (0.824/0.807 → 0.935/0.912) PE detection (all <i>p</i> ≤ 0.003). In suboptimal CTPA, a pulmonary artery attenuation threshold of 130 HU was identified, above which DLCA processing significantly improved PE detection accuracy compared with original images in both readers (<i>p</i> < 0.001). <b>Conclusions</b>: DLCA processing in suboptimal CTPA significantly enhances image quality and diagnostic accuracy for PE detection, providing a promising strategy to optimize scans without additional contrast or radiation.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Prognostic Nutritional Index in Predicting Coronary Slow Flow Phenomena.","authors":"Murat Özmen, Onur Altınkaya, Selim Aydemir, Sidar Şiyar Aydın, Faruk Aydınyılmaz","doi":"10.3390/diagnostics15182324","DOIUrl":"10.3390/diagnostics15182324","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Coronary slow flow phenomenon (SSF) is a syndrome defined by the filling of low-velocity contrast material into the distal portion of one or more coronary arteries despite the absence of coronary artery stenosis on coronary angiography (CAG). The exact cause of this condition has not yet been determined. In our study, we planned to investigate the relationship between prognostic nutritional index (PNI) and BOS. <b>Methods:</b> In total, 2585 patients who underwent coronary angiography between October 2021 and October 2023 were included in the study. In total, 181 patients with BOS and available serum albumin and lymphocyte data were evaluated. <b>Results:</b> The mean age of the study group was 58 ± 11 years. Specifically, in univariate and multivariate regression analyses, age, diabetes mellitus (DM), hemoglobin (Hb), and PNI were found to be statistically significant in predicting BOS. In ROC analysis, the cut-off value for PNI was 39.01, with 76.2% sensitivity and 76.2% specificity (AUC: 0.788; 95% CI: 0.749-0.824) in predicting CSF. <b>Conclusions:</b> Our study demonstrated that PNI, an easily measured, accessible, and inexpensive parameter that reflects inflammation and nutritional status, can be used in predicting CSF.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Tuberculosis in Central Asia and Southern Caucasus: A Systematic Literature Review.","authors":"Malika Idayat, Elena von der Lippe, Nailya Kozhekenova, Oyunzul Amartsengel, Kamila Akhmetova, Ainash Oshibayeva, Zhansaya Nurgaliyeva, Natalya Glushkova","doi":"10.3390/diagnostics15182314","DOIUrl":"10.3390/diagnostics15182314","url":null,"abstract":"<p><p><b>Background</b>: In 2023, tuberculosis (TB) caused 1.25 million deaths globally, remaining a leading infectious killer. Central Asia and Southern Caucasus face high TB burdens, particularly Mongolia. This review synthesizes TB prevalence data and diagnostic capabilities in these regions to support public health strategies. <b>Methods</b>: This systematic review aimed to synthesize current data on TB prevalence in Central Asia, Southern Caucasus, and Mongolia to support public health strategies and research priorities. A comprehensive search of PubMed and Google Scholar was conducted for English-language articles published up to 2023. Studies were assessed using a modified Newcastle-Ottawa Scale. Nine studies met the inclusion criteria, covering Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Turkmenistan, Mongolia, Georgia, Armenia, and Azerbaijan. <b>Results</b>: TB incidence ranged from 67 per 100,000 in Kazakhstan to 190 per 100,000 in Kyrgyzstan, with the highest prevalence of 68.5% in Mongolia. TB affected men more frequently (65.3%), and the key risk factors included HIV (30.5%), comorbidities, and undernutrition. Diagnostic performance varied significantly (microscopy sensitivity, 45-65%; GeneXpert MTB/RIF, 89-96% sensitivity and 98% specificity for rifampicin resistance). Diagnostic turnaround times ranged from hours (molecular) to weeks (conventional). Only 58% of TB facilities had GeneXpert technology, with urban-rural disparities in diagnostic access. Drug-resistant TB imposed a significant economic burden, with treatment costs ranging from USD 106 to USD 3125. <b>Conclusions</b>: Strengthening surveillance, improving data collection, and conducting longitudinal studies are essential for designing effective TB control strategies in these regions. Significant diagnostic gaps persist across these regions, especially with regard to drug-resistant strains. Point-of-care molecular diagnostics, improved algorithms, and expanded laboratory training show promise. Future research should focus on rapid biomarker-based diagnostics, field-deployable technologies for settings with limited resources, and AI integration to enhance diagnostic accuracy and efficiency.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orchidopexy Timing and Follow Up: From Guidelines to Clinical Practice.","authors":"Cristina Gavrilovici, Alma-Raluca Laptoiu, Elena Hanganu, Iulia Carmen Ciongradi, Monika Glass, Valentin Munteanu, Anastasia Chirvasa, Ancuta Lupu, Petronela Pirtica, Elena-Lia Spoială, Lucian Boiculese","doi":"10.3390/diagnostics15182318","DOIUrl":"10.3390/diagnostics15182318","url":null,"abstract":"<p><p><b>Background</b>: Undescended testis (UDT) is the most frequent pediatric anomaly of the male genitals, with a high incidence in premature male neonates. Due to the risk of long-term complications such as infertility, testicular malignancy, and psychological distress, special attention on the accuracy of management is needed. Despite the existence of well-established guidelines recommending early surgical intervention, significant delays in diagnosis, referral, and treatment are still observed in practice. <b>Objectives</b>: This study aims to evaluate the clinical management practices of undescended testis at a tertiary pediatric referral center over a ten-year period, with a particular focus on identifying risk factors associated with the development of postoperative testicular atrophy. <b>Material and Methods</b>: The following variables were extracted from patient records: the UDT location, age at surgery (we also recorded the mean age per year during the 10 years period), laterality (unilateral or bilateral), associated malformations and comorbidities, family history of UDT in first-degree relatives, type of surgical intervention (open vs. laparoscopic orchidopexy), and imaging diagnosis (ultrasonography, computer tomography). We considered testicular atrophy (TA) as negative outcome after orchidopexy. To identify the variables that independently contribute to the risk of postoperative testicular atrophy, we conducted a multivariate logistic regression analysis. <b>Results</b>: A total of 1082 pediatric patients UDT underwent orchidopexy between 2014 and 2023. The median age at surgery was 5.07 years, significantly exceeding current guideline recommendations. TA was observed in 24.8% of cases. Non-palpable testes, higher testicular position (particularly intra-abdominal), associated comorbidities, positive family history, and delayed surgical intervention were identified as independent risk factors for negative outcomes. The multivariate logistic regression model identified the most significant predictors of postoperative testicular atrophy as the presence of comorbidities (associated with more than an eightfold increase in risk), non-palpable testes (3.35 times higher risk compared to palpable ones), a positive family history of undescended testis (approximately 2.7 times higher risk), and older age at surgery, with each additional year of delay increasing the risk by 28.6%. <b>Conclusions</b>: Despite the availability of well-established guidelines, significant delays in the diagnosis and treatment of UDT persist in clinical practice. Testicular atrophy remains a relevant postoperative complication, particularly in patients with non-palpable testes, high testicular position, comorbidities, and late surgical intervention.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric Analysis of Maxillary Sinus and Nasal Conchae According to Skeletal Classes and Cranio-Maxillary Relation.","authors":"Berfu Çerçi Öngün, İbrahim Tekdemir, Seçil Aksoy, Nimet İlke Akçay, Kaan Orhan","doi":"10.3390/diagnostics15182319","DOIUrl":"10.3390/diagnostics15182319","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to evaluate the volumetric characteristics of the inferior and middle nasal conchae and maxillary sinuses in individuals with different skeletal malocclusion classes and cranio-maxillary relationships using cone beam computed tomography (CBCT). <b>Methods</b>: A total of 150 adult patients were retrospectively analyzed. CBCT scans were used to obtain volumetric measurements of the right and left inferior nasal conchae (INC), middle nasal conchae (MNC), and maxillary sinuses (MS). Patients were categorized into skeletal Classes I, II, or III based on ANB angles, and into retrognathic, normal, or prognathic groups according to SNA angles. Gender- and age-related differences were also analyzed. Statistical comparisons were performed using appropriate parametric and non-parametric tests. <b>Results:</b> Class II individuals exhibited significantly lower conchal volumes compared to Class I and III groups, while MS volumes were highest in Class II, although statistical significance was reached only on the left side. Gender differences were evident, with males presenting greater volumes than females in both the right and left INC and MS; however, significant differences were observed only for the left INC and left MS. A significant age-related decrease in left INC volume was found between the 21-30 and 61+ age groups. No statistically significant correlation was detected between conchal and sinus volumes. <b>Conclusions:</b> Skeletal malocclusion patterns, gender, and age significantly influence concha and sinus volumes. These findings emphasize the utility of CBCT-based three-dimensional assessments in enhancing diagnostic accuracy and informing interdisciplinary treatment planning in orthodontics and craniofacial care.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Intraoperative Portal Venography in Liver Transplantation Vascular Surgery.","authors":"Szu-Kai Wang, Yu-Fan Cheng, Wei-Xiong Lim, Chao-Long Chen, Leung-Chit Tsang, Chun-Yen Yu, Hsien-Wen Hsu, Po-Hsun Huang, Chun-Hua Chiu, Hsin-You Ou","doi":"10.3390/diagnostics15182321","DOIUrl":"10.3390/diagnostics15182321","url":null,"abstract":"<p><p><b>Background/Aim:</b> Adequate portal inflow is essential for liver graft regeneration following transplantation. Intraoperative portal venography (IOPV) provides real-time assessment of portal vein patency, stenosis, thrombus formation, and portosystemic collaterals. In addition to imaging, portal vein pressure gradient (portal vein pressure minus inferior vena cava pressure) was also measured. This study assessed the impact of IOPV on surgical decision-making and post-transplant outcomes to establish criteria for patient selection. <b>Methods:</b> From November 2016 to November 2024, 34 liver transplant patients with portal inflow insufficiency (flow velocity < 10 cm/s), large shunts (>1 cm), or portal vein thrombosis underwent IOPV. Of the patients, one received deceased donor liver transplantation (DDLT), and the others received living donor liver transplantation (LDLT). Preoperative computed tomography (CT) and ultrasound (US) assessed portal vein patency, thrombus, and shunts. Postoperative US and CT monitored portal flow and graft regeneration. <b>Results:</b> IOPV influenced surgical planning in all cases, leading to shunt ligation or stenting, and improved portal vein flow velocity from 6.3 (IQR, 0-9.0) to 30.8 (IQR, 22.2-36.7) cm/s (<i>p</i> < 0.001). Adequate inflow was achieved in 32 patients, 2 had persistent low flow or occluded flow owing to severe adhesion after transplant and failure to close large collateral veins. Graft regeneration ranged from 104% to 255% within a year. <b>Conclusions:</b> IOPV is a valuable tool in liver transplantation vascular surgery, optimizing surgical strategies and portal inflow. Early integration into routine practice may improve graft outcomes. Further prospective, longitudinal research is needed to refine patient selection and assess long-term benefits.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Bone Mineral Density and Spinal Remodelling Responses to Zoledronate Treatment in Chronic Recurrent Multifocal Osteomyelitis.","authors":"Fahim Patel, Penelope J C Davis, Nicola Crabtree, Suma Uday","doi":"10.3390/diagnostics15182320","DOIUrl":"10.3390/diagnostics15182320","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare auto-inflammatory condition affecting the growing skeleton. The standard first-line treatment of high-dose NSAIDs (non-steroidal anti-inflammatory drugs) is adequate only in a subset of patients. The American College of Rheumatology Consensus Guidelines suggest considering bisphosphonates in a certain category of patients based on evidence from a handful of case series reporting the outcome of pamidronate use. &lt;b&gt;Aims:&lt;/b&gt; The aim of this study was to report the efficacy and safety of bisphosphonate, predominantly zoledronate, use in CRMO. &lt;b&gt;Methods:&lt;/b&gt; A retrospective cohort study of children with CRMO receiving bisphosphonates was conducted between January 2008 and September 2023 at a single tertiary referral centre. We described the baseline characteristics; clinical indication, regimen and response to bisphosphonate treatment; changes in bone mineral density (BMD) and spine remodelling on dual-energy X-ray absorptiometry (DXA) scans; and safety data. &lt;b&gt;Results:&lt;/b&gt; During the study period, 64 (72%, &lt;i&gt;n&lt;/i&gt; = 46 females) patients with CRMO with a median age at diagnosis of 10 years (range: 3 to 16 years) were identified. Approximately 31% (&lt;i&gt;n&lt;/i&gt; = 20) received either pamidronate (&lt;i&gt;n&lt;/i&gt; = 2) or zoledronate (&lt;i&gt;n&lt;/i&gt; = 14) or both (&lt;i&gt;n&lt;/i&gt; = 4) due to changes in local protocols. The most frequent indications for bisphosphonate use were refractory pain [55%, &lt;i&gt;n&lt;/i&gt; = 11/20], pain + spine involvement [35% (&lt;i&gt;n&lt;/i&gt; = 7/20)] and spine involvement only [10% (&lt;i&gt;n&lt;/i&gt; = 2)]. Prior to bisphosphonate therapy, 100% took regular NSAIDs (&lt;i&gt;n&lt;/i&gt; = 19/19), 21% (&lt;i&gt;n&lt;/i&gt; = 4/19) used opioids, 47% (&lt;i&gt;n&lt;/i&gt; = 9/19) received oral steroid courses, and 10% (&lt;i&gt;n&lt;/i&gt; = 2/19) received methotrexate. The median age at bisphosphonate treatment initiation was 12 years (range 6-18 years), and the duration of treatment was 2 years (range: 6 months to 5 years). Improvement in pain was reported by 88% of patients (&lt;i&gt;n&lt;/i&gt;= 15/17, 1 was excluded as they had not started treatment yet). All non-responders (&lt;i&gt;n&lt;/i&gt; = 2/17;) to bisphosphonate therapy were later recognised clinically to have pain amplification syndrome and were referred to the chronic pain multi-disciplinary team. This correlated to the complete treatment de-escalation of opioids (&lt;i&gt;n&lt;/i&gt; = 3/3; 1 was excluded as they had not yet started treatment), steroids (&lt;i&gt;n&lt;/i&gt; = 8/8) and methotrexate (&lt;i&gt;n&lt;/i&gt; = 2/2). NSAIDs were discontinued in 44% of patients (&lt;i&gt;n&lt;/i&gt; = 7 of 16; 1 was excluded due to missing data, and 3 were excluded due to NSAID intolerance). The median first-year increase in the LS BMAD (lumbar spine bone mineral apparent density) Z-score was +1.35, and that in the TBLH BMD (total body less head bone mineral density) Z-score was +0.7 (&lt;i&gt;n&lt;/i&gt; = 11). Subsequently, median average annual increases in the LS BMAD Z-score of +0.65 and in the TBLH BMD Z-score of +0.45 (&lt;i&gt;n&lt;/i&gt; = 5) were recorded. Arou","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of a Vision-Language Model in Detecting Common Dental Conditions on Panoramic Radiographs Using Different Tooth Numbering Systems.","authors":"Zekai Liu, Qi Yong H Ai, Andy Wai Kan Yeung, Ray Tanaka, Andrew Nalley, Kuo Feng Hung","doi":"10.3390/diagnostics15182315","DOIUrl":"10.3390/diagnostics15182315","url":null,"abstract":"<p><p><b>Objectives</b>: The aim of this study was to evaluate the performance of GPT-4o in identifying nine common dental conditions on panoramic radiographs, both overall and at specific tooth sites, and to assess whether the use of different tooth numbering systems (FDI and Universal) in prompts would affect its diagnostic accuracy. <b>Methods</b>: Fifty panoramic radiographs exhibiting various common dental conditions including missing teeth, impacted teeth, caries, endodontically treated teeth, teeth with restorations, periapical lesions, periodontal bone loss, tooth fractures, cracks, retained roots, dental implants, osteolytic lesions, and osteosclerosis were included. Each image was evaluated twice by GPT-4o in May 2025, using structured prompts based on either the FDI or Universal tooth numbering system, to identify the presence of these conditions at specific tooth sites or regions. GPT-4o responses were compared to a consensus reference standard established by an oral-maxillofacial radiology team. GPT-4o's performance was evaluated using balanced accuracy, sensitivity, specificity, and F1 score both at the patient and tooth levels. <b>Results</b>: A total of 100 GPT-4o responses were generated. At the patient level, balanced accuracy ranged from 46.25% to 98.83% (FDI) and 49.75% to 92.86% (Universal), with the highest accuracies for dental implants (92.86-98.83%). F1-scores and sensitivities were highest for implants, missing, and impacted teeth, but zero for caries, periapical lesions, and fractures. Specificity was generally high across conditions. Notable discrepancies were observed between patient- and tooth-level performance, especially for implants and restorations. GPT-4o's performance was similar between using the two numbering systems. <b>Conclusions</b>: GPT-4o demonstrated superior performance in detecting dental implants and treated or restored teeth but inferior performance for caries, periapical lesions, and fractures. Diagnostic accuracy was higher at the patient level than at the tooth level, with similar performances for both numbering systems. Future studies with larger, more diverse datasets and multiple models are needed.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purtscher-like Retinopathy in a Patient with Acute Alcoholic Pancreatitis and a Literature Review.","authors":"Vesela Todorova Mitkova-Hristova, Marin Anguelov Atanassov, Yumyut Remzi Idriz, Steffanie Hristova Hristova","doi":"10.3390/diagnostics15182317","DOIUrl":"10.3390/diagnostics15182317","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Purtscher-like retinopathy is a rare occlusive microangiopathy that causes sudden vision loss of varying severity. It presents with diverse retinal findings, such as cotton-wool spots, haemorrhages, and optic disc and macular edema, among others. A key characteristic is the absence of trauma. This condition has been observed in patients with acute pancreatitis, renal failure, preeclampsia, HELLP syndrome, childbirth, and other systemic disorders. <b>Case Presentation</b>: A 35-year-old male presented with complaints of seeing spots in front of both eyes, with a duration of ten days following the initiation of treatment for acute alcoholic pancreatitis. On examination, best-corrected visual acuity (BCVA) in both eyes was 5/6. Fundus examination revealed multiple cotton-wool spots and haemorrhages located in the posterior pole and around the optic disc, more pronounced in the left eye, where the optic disc had blurred margins and the macular reflex was absent. Perimetry showed paracentral scotomas, and optical coherence tomography (OCT) revealed thickening and disruption of the inner retinal layers in the papillomacular region of both eyes. Fundus fluorescein angiography demonstrated adequate perfusion of the vascular network, with hypofluorescent areas in the arteriovenous phase, peripapillary and in the papillomacular zone, due to masking by cotton-wool spots and haemorrhages. Treatment included systemic antiplatelet agents, anticoagulants, and vitamins, along with topical non-steroidal anti-inflammatory drugs. Two months after the initial presentation visual acuity improved to 6/6 in both eyes. Follow-up OCT scans showed atrophy of the inner retinal layers corresponding to the previous cotton-wool spot and the areas of reduced light sensitivity on perimetry had decreased in size. <b>Conclusions</b>: Acute pancreatitis is the most common systemic condition associated with the development of Purtscher-like retinopathy. Timely diagnosis and management of the underlying systemic disease are essential for preventing ocular complications. Ophthalmological evaluation is necessary in patients with acute pancreatitis who present with visual symptoms in order to detect this often-overlooked rare condition.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}