Diagnostics最新文献

{"title":"Clinical Factors Associated with Diagnostic Delay in Axial Spondyloarthritis in Saudi Arabia: A Retrospective Cohort Study.","authors":"Mohamed Bedaiwi, Aos Aboabat, Ibrahim Almaghlouth, Eman Alqurtas, Norah Alshafi","doi":"10.3390/diagnostics16193246","DOIUrl":"10.3390/diagnostics16193246","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Diagnostic delay remains a major challenge in axial spondyloarthritis (axSpA), yet factors associated with delay in Saudi Arabia and the Arabian Gulf remain poorly characterized. We examined clinical factors associated with diagnostic delay in a single-center Saudi cohort. <b>Methods</b>: This retrospective cohort included 160 of 220 screened registry patients with rheumatologist-confirmed axSpA who fulfilled ASAS classification criteria. Diagnostic delay was measured in whole years from documented symptom onset to diagnosis. Twenty-four patients had fibromyalgia documented before axSpA diagnosis. The primary negative binomial model included sex, axSpA subtype, HLA-B27 status, documented prediagnosis fibromyalgia, and symptom-onset age; logistic regression evaluated delay > 5 years. Standardized predictions estimated absolute differences, and a 2-year landmark analysis reduced differential opportunity for fibromyalgia ascertainment. <b>Results</b>: Median delay was 3 years (IQR 2-6), and 41 patients (25.6%) had delay >5 years. Documented prediagnosis fibromyalgia was associated with longer expected delay (ratio of expected diagnostic delays, 1.59; 95% CI 1.24-2.04; <i>p</i> < 0.001), corresponding to an adjusted difference of 2.33 years (bootstrap 95% CI 0.87-4.13), and with greater odds of delay >5 years (OR 5.56; 95% CI 2.08-14.85). Older symptom-onset age was also associated with longer delay. In the landmark analysis (<i>n</i> = 107), fibromyalgia documented by 2 years remained associated with longer subsequent delay (ratio of expected diagnostic delays, 1.51; 95% CI 1.05-2.19; <i>p</i> = 0.027). <b>Conclusions</b>: Documented prediagnosis fibromyalgia and older symptom-onset age were associated with longer diagnostic delay. The fixed-window landmark analysis reduced concern about differential ascertainment opportunity but remained subject to selection and reverse causation and did not establish causality. Persistent features suggestive of inflammatory axial disease in patients with fibromyalgia warrant selective diagnostic reconsideration.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191786","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":"Ultrasound Normalized Weighted Cumulative Residual Entropy Imaging: A New Quantitative Ultrasound Method for Characterizing Hepatic Steatosis.","authors":"Huilin Si, Ruiyang Gao, Dar-In Tai, Po-Hsiang Tsui, Zhuhuang Zhou","doi":"10.3390/diagnostics16193253","DOIUrl":"10.3390/diagnostics16193253","url":null,"abstract":"<p><p><b>Background/Objectives:</b> In this paper, we propose ultrasound normalized weighted cumulative residual entropy (NWCRE) imaging, a novel quantitative ultrasound (QUS) technique derived from the information-theoretic weighted cumulative residual entropy (WCRE) for hepatic steatosis characterization. <b>Methods:</b> The proposed ultrasound NWCRE imaging method adopted cumulative distribution function (CDF)-driven non-parametric estimation, and parallel computing was implemented to improve computational efficiency. For a comparison study, the previously reported ultrasound normalized cumulative residual entropy (NCRE) imaging was also implemented. We further mathematically derived the finite upper bound of integrals for both NWCRE and NCRE to convert improper integrals into proper integrals for numerical calculation. Phantom simulations with varied scatterer number densities and two groups of clinical datasets for hepatic steatosis assessment were investigated for validation. <b>Results:</b> Phantom results demonstrated that both NWCRE and NCRE values decreased with increasing scatterer concentrations. For clinical group A (72 liver donors; magnetic resonance spectroscopy-measured hepatic fat fraction (HFF) served as the reference), NWCRE imaging exhibited a slightly stronger correlation with log₁₀(HFF) (Spearman <i>r</i> = -0.6749, <i>p</i> < 0.0001) than NCRE (Spearman <i>r</i> = -0.6695, <i>p</i> < 0.0001). For clinical group B (204 chronic hepatitis B patients; liver biopsy served as the histopathological ground-truth reference), NWCRE imaging yielded comparable diagnostic performance to NCRE for discriminating hepatic steatosis grades (all <i>p</i> > 0.05), with area under the receiver operating characteristic curve (AUC) values of 0.78, 0.85 and 0.86 for ≥G1, ≥G2 and ≥G3 steatosis, respectively. Across phantom simulations and both clinical groups, the dynamic ranges of NWCRE imaging were statistically significantly higher than those of NCRE imaging (all <i>p</i> < 0.0001). <b>Conclusions:</b> The proposed parallelized ultrasound NWCRE imaging delivers diagnostic performance comparable to NCRE imaging while improving the dynamic range over NCRE imaging, providing a potential CDF-based QUS tool for quantitative evaluation of hepatic steatosis.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192088","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":"Heterotopic Cutaneous Adnexa Arising from the Ascending Colon Presenting as a Chronic Abdominal Wall Sinus: A Rare Congenital Anomaly and Diagnostic Challenge.","authors":"Gang Xiao, Dan-Dan Li, Qiu-Shi Huang, Shan He, Yuan Liang, Jian Shen","doi":"10.3390/diagnostics16193251","DOIUrl":"10.3390/diagnostics16193251","url":null,"abstract":"<p><p>A chronic abdominal wall sinus tract caused by heterotopic cutaneous adnexa arising from the colonic serosa is extremely rare and readily misdiagnosed. We report a 39-year-old woman with congenital scoliosis and a 30-year history of intermittent, odorless, non-feculent discharge from a cutaneous opening in the right lower abdominal wall; she had no prior abdominal surgery. Contrast-enhanced computed tomography (CT) revealed a non-enhancing sinus tract extending from the ascending colon toward the abdominal wall, whereas colonoscopy showed normal colonic mucosa with no fistulous communication. Laparoscopic exploration revealed a tubular structure arising from the serosal surface of the middle ascending colon that bifurcated into an abdominal wall branch and a pelvic branch, the latter not identified on preoperative imaging. Because the lesion was considered benign but preoperative imaging could not determine the depth of involvement, and an unexpected pelvic branch was found intraoperatively, a laparoscopic limited right hemicolectomy was performed with en bloc excision of both branches. Histopathological examination confirmed the absence of intestinal epithelial components, and immunohistochemistry was positive for cytokeratin 7 (CK7), GATA-binding protein 3 (GATA-3), and p63, confirming a cutaneous adnexal origin. The patient recovered uneventfully, with no recurrence at the 6-month follow-up. This case may represent a rare congenital developmental anomaly related to abnormal persistence of ectodermal components during embryologic development; however, definitive embryologic proof is lacking. It emphasizes the importance of a detailed history, the inclusion of congenital heterotopic cutaneous adnexal lesions in the differential diagnosis of refractory abdominal wall sinus tracts, and complete excision of all sinus tract branches to prevent recurrence and repeated ineffective interventions.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192068","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":"From Divergent Pathogenesis to Precision Medicine: The Road to Targeted Therapy in HIV-Associated and HIV-Unrelated Diffuse Large B-Cell Lymphoma.","authors":"Stephanie Murugan, Zivanai Cuthbert Chapanduka, Nadine Rapiti","doi":"10.3390/diagnostics16193242","DOIUrl":"10.3390/diagnostics16193242","url":null,"abstract":"<p><p>Diffuse large B-cell lymphoma (DLBCL) is the most common and biologically heterogeneous subtype of non-Hodgkin lymphoma. While immunochemotherapy has improved outcomes, survival remains variable due to substantial molecular diversity. In people living with HIV (PLWH), DLBCL is the predominant lymphoma subtype and demonstrates more aggressive clinical behaviour, characterised by advanced-stage disease, extranodal involvement, and a potentially poorer prognosis despite antiretroviral therapy. Clarifying differences in the pathogenesis of HIV-associated and HIV-unrelated DLBCL is essential for informing precision therapies. This narrative review highlights the contrasting pathogenic mechanisms, with an emphasis on the interplay between viral oncogenesis, host immunity, and molecular alterations in HIV-associated DLBCL versus DLBCL in immunocompetent individuals. Understanding these differences is critical for refining diagnostic approaches, improving risk stratification, and identifying novel therapeutic strategies tailored to both groups.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192070","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":"Early Use of Molecular Diagnostics in the Emergency Department Reduces All-Cause Mortality in Patients with Pneumonia at Risk of Multidrug-Resistant Pathogens.","authors":"Lorenzo Pelagatti, Francesca Mangani, Antonio Susanna, Lorenzo Corbetta, Michele Spinicci, Alessandro Bartoloni, Peiman Nazerian, Gian Maria Rossolini, Simone Vanni","doi":"10.3390/diagnostics16193243","DOIUrl":"10.3390/diagnostics16193243","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Patients with community-acquired pneumonia at risk of multidrug-resistant pathogens (CAP-MDR) represent a high-risk population in which empiric therapy is frequently inadequate. Evidence on the impact of multiplex syndromic panels (MSP) on clinical outcomes in CAP-MDR pneumonia remains limited, particularly in the emergency department (ED). <b>Methods</b>: We conducted a single-center observational pre-post study including patients presenting to the ED with CAP-MDR. Patients were managed either with early MSP-guided therapy (prospective cohort) or standard empiric treatment (retrospective cohort). The primary outcome was 30-day mortality. Analyses were performed in the overall population and subsequently in a propensity score-matched cohort. <b>Results</b>: A total of 718 patients were included (MSP n = 128; no-MSP n = 590). Thirty-day mortality was significantly lower in the MSP group (22.7% vs. 31.9%; <i>p</i> = 0.04). At multivariable logistic regression, MSP use was independently associated with reduced mortality (OR 0.51, 95% CI 0.30-0.88; <i>p</i> = 0.016), confirmed by Cox analysis (HR 0.60, 95% CI 0.36-0.99; <i>p</i> = 0.04). Kaplan-Meier analysis showed improved survival (log-rank <i>p</i> = 0.002). After propensity score-matching (MSP n = 128; no-MSP n = 128), mortality remained lower in the MSP group (22.7% vs. 35.1%; <i>p</i> = 0.02). MSP use was independently associated with reduced mortality (OR 0.45, 95% CI 0.20-0.99; <i>p</i> = 0.04), confirmed by Cox regression (HR 0.50, 95% CI 0.31-0.82; <i>p</i> = 0.006). <b>Conclusions</b>: Early use of MSP in patients with CAP-MDR was associated with a significant reduction in 30-day mortality. Rapid molecular diagnostics may provide the greatest clinical benefit when applied early in high-risk populations in which empiric therapy is frequently inadequate.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191930","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":"SBRF-Det: Scale-Boundary Representative Fusion for Multi-Finding Detection in Panoramic Dental Radiographs.","authors":"Furkan Karatas, Omer Aslan, Mehmet Burukanli, Shahid Mohammad Ganie, Merve Ersoy, Faruk Ozger, Ishak Pacal","doi":"10.3390/diagnostics16193259","DOIUrl":"10.3390/diagnostics16193259","url":null,"abstract":"<p><p><b>Background</b>: Panoramic dental radiographs frequently contain multiple coexisting pathological, anatomical, and treatment-related findings that vary in scale, contrast, and boundary definition. Although recent one-stage detectors provide strong performance, reliable localization of small or weakly defined findings remains challenging. <b>Methods</b>: We propose SBRF-Det, a one-stage multi-finding detector integrating scale-dependent representative allocation with boundary-conditioned local-global feature fusion at P4/16. The method was evaluated on OralXrays-9, comprising 12,688 panoramic radiographs and 84,099 retained annotations across nine categories, using a fixed 2688-image hold-out cohort. Twenty-two detector configurations were compared under a common protocol, and A0-A2 were further assessed using three independent seeds and paired radiograph-level bootstrap analysis. <b>Results</b>: SBRF-Det achieved 0.8777 precision, 0.8979 recall, 0.9152 mAP50, and 0.7029 mAP50-95. Relative to the matched YOLO12l baseline, mAP50-95 increased by 0.95 percentage points. Performance remained class dependent, with apical periodontitis reaching 0.4526 mAP50-95 versus 0.8401-0.8842 for implants, porcelain crowns, and ceramic bridges. SBRF-Det used 93.06 GFLOPs versus 95.99 for A0, but inference latency increased from 5.946 to 8.851 ms/image. Three-seed experiments preserved the A0-A1-A2 ordering, while paired bootstrap intervals for A2-A0 and A2-A1 excluded zero. <b>Conclusions</b>: SBRF-Det improves strict localization through representative and boundary-aware feature modeling, but the gain is modest and introduces a runtime trade-off. Patient-linked, multi-center, and reader-centered validation remains necessary before clinical deployment.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192162","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 Assessment of Centrifugation-Based Hematocrit Testing in Primary Care Units: Evidence from Seventy-Two Proficiency Testing Datasets over Eight Years.","authors":"Watcharinthon Theansun, Kunchit Kongros, Napaporn Apiratmateekul, Ornuma Haonon, Munthana Wadthaisong, Butsabawan Chaireunsung, Gerald J Kost, Wanvisa Treebuphachatsakul","doi":"10.3390/diagnostics16193252","DOIUrl":"10.3390/diagnostics16193252","url":null,"abstract":"<p><p><b>Background:</b> Centrifugation-based hematocrit (Hct) testing remains widely used in decentralized primary care settings where access to automated hematology analyzers may be limited. Appropriate proficiency testing (PT) performance assessment therefore requires consideration of the analytical variability associated with this measurement method. This study evaluated longitudinal PT data to characterize method-specific variability and compare alternative approaches to RSD estimation for centrifugation-based Hct testing. <b>Methods:</b> Seventy-two datasets from 32 PT rounds conducted during 2017-2024 were analyzed, with 12 to 310 participants per dataset. PT materials were assessed for homogeneity and stability in accordance with ISO 13528. The relative standard deviation (RSD) was estimated using two approaches: Method A, based on all statistically processed valid results to reflect total interlaboratory variability, and Method B, based on the satisfactory-performance subset (∣<i>z</i>∣ ≤ 2), within which robust statistics were recalculated. Temporal trends were evaluated by linear regression using dataset-specific RSD values. Sensitivity analysis evaluated Method B using alternative z-score inclusion thresholds of ∣<i>z</i>∣ ≤ 1.5, 2.0, 2.5, and 3.0. Performance classifications in 2024 were compared descriptively. <b>Results:</b> All PT materials met predefined homogeneity and stability criteria. The final cumulative pooled relative standard deviation (RSD_pooled) was 10.81% for Method A and 4.86% for Method B. was 10.81% for Method A and 4.86% for Method B. Method A showed an increasing temporal trend, whereas Method B showed minimal temporal change; however, participant numbers increased substantially over the study period and may have contributed to the Method A trend. Sensitivity analysis showed that Method B was threshold-dependent, with final RSD_pooled values of 3.90%, 4.86%, 5.59%, and 6.28% at ∣<i>z</i>∣ ≤ 1.5, 2.0, 2.5, and 3.0, respectively. In the 2024 datasets, satisfactory rates ranged from 75.68-99.12% for Method A and 43.15-95.61% for Method B. <b>Conclusions:</b> Methods A and B provide complementary information whereas Method B characterizes dispersion among participants meeting a predefined satisfactory-performance criterion. The Method B RSD_pooled of 4.86% is specific to inclusion criterion and should not be interpreted as a threshold-independent estimate of analytical imprecision. Further studies using prospectively defined statistical methods and appropriately structured participant-level data are needed to determine its potential utility for PT/EQA performance assessment.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191900","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":"Influenza in Pregnancy: From the Maternal Lung to the Placenta and Fetus.","authors":"Radu Vlădăreanu, Andreea Borislavschi, Emanuel Moisă, Mihaela Boț","doi":"10.3390/diagnostics16193250","DOIUrl":"10.3390/diagnostics16193250","url":null,"abstract":"<p><p>Influenza in pregnancy is associated with a higher risk of severe respiratory disease and adverse maternal and perinatal outcomes, particularly later in gestation. This narrative review synthesizes evidence on epidemiology, pathophysiology, placental and fetal consequences, clinical presentation, diagnosis, antiviral management, and vaccination. Pregnancy involves dynamic immune adaptation together with reduced respiratory reserve, increased oxygen consumption, and cardiovascular changes that may amplify the effects of influenza pneumonia. Placental and fetal consequences appear to be mediated predominantly by maternal hypoxemia, fever, systemic inflammation, and hemodynamic disturbance; transplacental viral transmission is rare. Therefore, adverse fetal and neonatal outcomes are more closely linked to the severity and timing of maternal illness, placental dysfunction, and prematurity than to direct fetal infection. Prompt recognition is essential, and antiviral treatment should not await laboratory confirmation when influenza is suspected. Oseltamivir remains the preferred antiviral therapy and should be initiated as early as possible, including in patients presenting after 48 h with progressive or severe disease. Seasonal inactivated or recombinant influenza vaccination is the cornerstone of prevention, protecting both the mother and the infant through transplacental transfer of influenza-specific IgG. This integrated perspective supports vaccination, early diagnosis, and timely treatment to reduce maternal and perinatal risk.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191938","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":"Dual-Energy Computed Tomography Versus Conventional Magnetic Resonance In-Phase/Opposed-Phase Imaging for Liver Fat Fraction Quantification: A Retrospective Cohort Study.","authors":"Jing Hong Loo, Shi Min Yeow, Kang Ren Yong, Harvard Zhi Rui Lee, Sze Ying Yee, Srinivas Anandswaroop Uppaluri, Syed Aftab, Sandeep Halagatti Venkatesh, Freda Jawan, Shawn Shi Xian Kok, Praveen M Yogendra, Min On Tan","doi":"10.3390/diagnostics16193260","DOIUrl":"10.3390/diagnostics16193260","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Multiple imaging modalities are available for non-invasive hepatic fat quantification. We performed a hypothesis-generating methods-comparison study to compare liver fat fraction (FF) measurements obtained using magnetic resonance imaging (MRI) in-phase/opposed-phase (IP/OP) with dual-energy computed tomography (DECT) multi-material decomposition (MMD) techniques. <b>Methods</b>: This retrospective method-comparison study included 45 patients who underwent abdominal DECT and MRI. Corresponding 2-cm² regions of interest were placed in hepatic segments VI and VII. DECT and MRI fat fraction measurements were compared using Spearman's correlation and Bland-Altman and Passing-Bablok analyses. Exploratory receiver operating characteristic area under the curve (ROC AUC) analyses evaluated the ability of DECT fat fraction measurements to discriminate MRI-defined steatosis thresholds. <b>Results</b>: DECT FF was positively associated with MRI FF in segment VI (Spearman's ρ = 0.50, <i>p</i> < 0.001) and segment VII (ρ = 0.57, <i>p</i> < 0.001). Bland-Altman analysis showed that DECT measurements were lower than MRI measurements on average, with mean biases (MRI-DECT) of 3.39% and 2.57% for segments VI and VII respectively, accompanied by wide limits of agreement. Passing-Bablok analysis showed no statistically significant proportional or constant bias. The ability of DECT FF to classify MRI-defined steatosis improved with increasing disease severity, with AUCs of 0.77 for mild steatosis and 0.88-0.99 for moderate-to-severe steatosis. <b>Conclusions</b>: This preliminary method-comparison study demonstrates an association between DECT and MRI fat fraction measurements and supports the feasibility of DECT for opportunistic hepatic fat quantification. Although exploratory AUC analyses provide preliminary estimates for future validation studies, substantial inter-modality variability currently limits definitive clinical application.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191952","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":"Hashimoto Thyroiditis Modifies the Association Between Nuclear Atypia and Malignancy in Bethesda III Thyroid Nodules.","authors":"Adem Şentürk, Yusuf Öztürk, Emre Gönüllü, İsmail Özer, Kübra Tuba Çayir, Ahmet Tarık Harmantepe, Yavuz Selim Kahraman, Fuldem Mutlu","doi":"10.3390/diagnostics16193235","DOIUrl":"10.3390/diagnostics16193235","url":null,"abstract":"<p><p><b>Background:</b> Nuclear atypia is associated with an increased risk of malignancy in Bethesda III thyroid nodules; however, reactive nuclear changes related to Hashimoto thyroiditis (HT) may complicate its interpretation. We investigated whether HT modifies the association between nuclear atypia and malignancy in Bethesda III nodules. <b>Methods:</b> This retrospective single-center study included 426 surgically selected patients with Bethesda III nodules who underwent thyroidectomy between January 2015 and August 2026. HT was defined by postoperative histopathology. The association between nuclear atypia and malignancy was evaluated according to HT status. Effect modification was assessed using an HT × nuclear atypia interaction term in unadjusted and multivariable logistic regression models. <b>Results:</b> HT was present in 199 (46.7%) patients. Malignancy was less frequent in patients with HT than in those without HT (26.1% vs. 38.8%, <i>p</i> = 0.006), whereas nuclear atypia was more frequent (91.0% vs. 45.8%, <i>p</i> < 0.001). In patients without HT, nuclear atypia was strongly associated with malignancy and remained an independent predictor after multivariable adjustment (adjusted OR 13.24, 95% CI 5.46-32.10; <i>p</i> < 0.001). In patients with HT, nuclear atypia was not associated with malignancy (OR 0.68, 95% CI 0.24-1.94; <i>p</i> = 0.466). The HT × nuclear atypia interaction was significant in both unadjusted (OR 0.040, <i>p</i> < 0.001) and adjusted models (OR 0.031, <i>p</i> < 0.001). <b>Conclusions:</b> HT significantly modified the association between nuclear atypia and malignancy in Bethesda III nodules. Nuclear atypia strongly predicted malignancy in the absence of HT but not in its presence. Given the postoperative definition of HT, prospective validation using preoperative HT indicators is required before clinical application.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192027","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}