Diagnostics最新文献

{"title":"Echocardiography Report Translation and Inference Based on Parameter-Efficient Fine-Tuning of LLaMA Models.","authors":"Hsin-Ta Chiao, Wei-Wen Lin, Shang-Yang Tseng, Yu-Cheng Hsieh, Chao-Tung Yang","doi":"10.3390/diagnostics16081223","DOIUrl":"10.3390/diagnostics16081223","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Echocardiography reports are essential diagnostic tools, but their complexity and specialized English terminology frequently hinder comprehension for non-specialists and patients. This study addresses these accessibility gaps by developing a resource-efficient large language model (LLM) system designed to translate and summarize English echocardiography results into Traditional Chinese. <b>Methods:</b> To overcome significant hardware constraints, we utilized Quantized Low-Rank Adapter (QLoRA) techniques and the Unsloth acceleration framework to fine-tune LLaMA-3.2-1B and LLaMA-3.2-3B-Instruct models on a single mid-tier GPU. The system employs a dual-stage inference architecture: the first stage provides technical medical translation for clinicians, while the second stage generates simplified, patient-centric educational summaries to enhance health literacy. <b>Results:</b> Evaluation across multiple metrics, including BLEU, ROUGE, METEOR, and Perplexity, demonstrated that the LLaMA-3.2-3B-Instruct model with the AdamW 8-bit optimizer achieved the most stable validation performance, excelling in semantic coherence and structural consistency. A preliminary qualitative error analysis conducted in the Discussion section further identified clinical nuances, such as terminology simplification and minor hallucinations, underscoring the critical necessity of a Human-in-the-Loop verification procedure. <b>Conclusions:</b> These findings validate the feasibility of deploying cutting-edge medical AI in resource-limited clinical environments. While the results reflect validation-only performance on a specialized dataset, the platform offers a scalable foundation for enhancing clinical decision support and health literacy through accessible, automated medical text processing.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812248","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":"Immediate vs. Delayed Implant Placement Following Alveolar Ridge Procedures with Xeno-Hybrid Bovine Bone Graft: A Retrospective Cohort with Operator-Level Comparison.","authors":"Marius Meier, Pascal Grün, Tim Schiepek, Pina Jankowski, Anna Bandura, Sebastian Fitzek, Flora Turhani, Dritan Turhani","doi":"10.3390/diagnostics16081231","DOIUrl":"10.3390/diagnostics16081231","url":null,"abstract":"<p><p><b>Background:</b> In everyday practice, we observed an increased number of complications with a xeno-hybrid bovine graft in challenging cases, prompting a systematic review of timing strategies and the impact of the operator. <b>Objective:</b> To compare early safety and rehabilitation timelines for immediate versus delayed implant placement after alveolar ridge procedures with a xeno-hybrid bovine graft, and to examine operator-level effects. <b>Materials and Methods:</b> Single center retrospective cohort (Danube Private University, Krems, Austria; January 2021-October 2023). Consecutive patients undergoing alveolar ridge preservation (ARP) or reconstruction (ARR; conservative protocol without meshes or rigid frameworks) with a xeno-hybrid bovine graft and subsequent implant were included. Strata: ARP, ARR, ARP with immediate implant placement (ARP+II), ARR with immediate implant placement (ARR+II). Primary endpoint: early implant loss < 12 months after the index surgery. Secondary endpoints: days to implant exposure and days to definitive prosthesis. <b>Results:</b> We analyzed 158 coded interventions (ARP 33; ARR 16; ARP+II 32; ARR+II 77). Early implant loss was uncommon (7/158; 4.4%) and occurred only with immediate implant placement (ARP+II 6.3%; ARR+II 6.5%); no early failures occurred in delayed strata. Immediate implant placement accelerated rehabilitation (exposure: 358/364 vs. 144/162 days; prosthesis: 406/419 vs. 196/204 days; both <i>p</i> < 0.0001). After adjustment for treatment base, timing, and age, no independent operator level effect on early loss was detected. <b>Conclusions:</b> In this university cohort using a xeno-hybrid bovine graft, early implant loss was rare and confined to immediate implant placement, which nonetheless shortened the pathway to exposure and restoration by ~5-7 months. Differences across providers were explained by case selection and protocol choice after adjustment. <b>Clinical Significance:</b> With appropriate case selection and surgical execution, immediate implant placement after ARP/ARR can reduce treatment time by ~5-7 months without a clear increase in early failure within the limits of this cohort; treatment protocol and case triage are the main levers of early outcome.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812119","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":"Zinner Syndrome: A Narrative Review of Imaging Findings with an Illustrative Case Report.","authors":"Calin Schiau, Roxana Pintican, Simona Manole, Andrei Roman, Ioana Teofana Dulgheriu, Delia Doris Donci, Loredana Elisabeta Popa, Anca Ileana Ciurea, Ioana Bene","doi":"10.3390/diagnostics16081228","DOIUrl":"10.3390/diagnostics16081228","url":null,"abstract":"<p><p>Zinner syndrome is a rare congenital anomaly of the male genitourinary tract, characterized by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. Owing to its low prevalence and nonspecific clinical presentation, diagnosis is often delayed or incidental, with imaging playing a central role in detection and characterization. This study presents a narrative review with an illustrative case report, aiming to summarize the imaging features of Zinner syndrome, outline the main radiologic differential diagnoses of seminal vesicle cysts, and highlight common diagnostic pitfalls, with emphasis on cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). The narrative review of the literature highlights that CT and MRI are essential for accurate anatomical localization, characterization of cystic content, and identification of associated genitourinary anomalies. MRI, in particular, provides superior soft-tissue contrast and is considered the reference modality for diagnosis and differential evaluation of male pelvic cystic lesions. Key differential diagnoses include Müllerian duct cysts, prostatic utricle cysts, and ejaculatory duct cysts. As an illustrative example, we report the case of a young adult male presenting with pelvic discomfort, infertility, and mild lower urinary tract symptoms. Imaging findings, including ultrasound and cross-sectional studies, demonstrated a seminal vesicle cyst associated with ipsilateral renal agenesis, consistent with Zinner syndrome. Zinner syndrome should be considered in the evaluation of male pelvic cystic lesions, particularly in the presence of unilateral renal agenesis. Awareness of its characteristic imaging features is essential for accurate diagnosis and appropriate management, with MRI playing a pivotal role in confirming the diagnosis and distinguishing it from other pelvic cystic entities.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812294","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-Assessed Brachial Artery Flow-Mediated Dilation and Carotid Plaque Burden as Markers of Vascular Health in Relation to Weekly Physical Activity Duration in Older Adults.","authors":"Michał Fułek, Tomasz Harych, Piotr Macek, Katarzyna Fułek, Krzysztof Kraik, Barbara Dziadkowiec-Macek, Jarosław Domaradzki, Małgorzata Poręba, Andrzej Wysocki, Paweł Gać, Rafał Poręba","doi":"10.3390/diagnostics16081229","DOIUrl":"10.3390/diagnostics16081229","url":null,"abstract":"<p><p><b>Objectives</b>: This study assessed the association between physical activity and vascular endothelial function and carotid atherosclerotic plaques in older adults using ultrasound imaging. <b>Methods and Results</b>: A total of 60 older adults were divided into three groups based on weekly physical activity: low (<4 h/week), moderate (4-12 h/week), and high (>12 h/week). All participants underwent flow-mediated dilation (FMD) assessment and carotid ultrasound to determine plaque burden. Participants with moderate physical activity demonstrated greater FMD (12.3 ± 2.5%) than those with low (1.2 ± 1.8%) or high activity (7.1 ± 1.3%), and a lower carotid plaque burden. In adjusted logistic regression models, moderate activity remained independently associated with a lower likelihood of impaired FMD (OR 0.22; 95% CI 0.18-0.27) and lower carotid plaque burden (OR 0.16; 95% CI 0.11-0.19). <b>Conclusions</b>: Moderate physical activity was associated with more favorable vascular endothelial function and reduced carotid atherosclerosis in older adults, indicating an association with a more favorable vascular profile.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812114","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":"A Multi-Teacher Knowledge Distillation Framework for Enhancing the Robustness of Automated Sperm Morphology Assessment.","authors":"Osman Emre Tutay, Hamza Osman Ilhan, Hakkı Uzun, Merve Huner Yigit, Gorkem Serbes","doi":"10.3390/diagnostics16081230","DOIUrl":"10.3390/diagnostics16081230","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The manual analysis of sperm morphology, crucial for male infertility diagnosis, is subjective and time-consuming. Automated methods using deep learning, offer a promising alternative; however, standard deep models are prone to overfitting when applied to small, heavily unbalanced clinical datasets, limiting their generalization capability. This study proposes a knowledge distillation approach that functions as a strong regularizer, improving the robustness of automated sperm morphology analysis. <b>Methods:</b> We utilize soft distillation to transfer knowledge from a set of high-capacity teacher models to a smaller student model (SwinV2-base). The teacher architectures include SwinV2-large, EfficientNetV2-m, and ConvNeXtV2-large. To maximize performance, we investigated two distillation strategies: a single-teacher approach, where the student learns from one specific architecture, and a multi-teacher approach, where the student learns from an averaged response of multiple teachers. The models were trained on the imbalanced Hi-LabSpermMorpho dataset, which comprises 18 different sperm morphology categories derived from three differently stained (BesLab, Histoplus, GBL) sample sets. We adopted a cross-dataset training approach in which the teacher models were fine-tuned using the combination of two stained datasets, and the student model was trained on the third, distinct stained dataset. The global loss function combined cross-entropy loss with Kullback-Leibler divergence, employing the teacher's soft probabilities to prevent the student from over-confidence. <b>Results:</b> The experimental results demonstrate that the student model trained in a multi-teacher setup with augmentation and soft distillation attains higher accuracies (70.94% on BesLab, 73.61% on Histoplus, 71.63% on GBL) than the baseline models. <b>Conclusions:</b> This approach mitigates challenges associated with data scarcity and heavily unbalanced sperm morphology datasets, providing consistent improvements and offering a highly generalizable solution for clinical diagnostics.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812065","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":"Shear-Dependent Agreement and Clinical Reclassification of Whole-Blood Viscosity Measurements: A Paired Comparison of Rheovis 2000A and Hemovister.","authors":"Jongho Yi, Hong-Geun Jung, Seoung Joon Lee, Tae-Young Kim, Hahn Young Kim, Kyeong Ryong Lee, Hyun Suk Yang, Mina Hur","doi":"10.3390/diagnostics16081232","DOIUrl":"10.3390/diagnostics16081232","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Whole-blood viscosity (WBV) is increasingly used in cardiovascular risk assessment; however, inter-device comparability may depend on shear-rate definition. We performed a paired comparison of two scanning capillary viscometers to evaluate shear-dependent analytical agreement and its impact on clinical classification. <b>Methods</b>: In 300 identical blood samples, WBV was measured using Rheovis 2000A and Hemovister. Systolic WBV was defined at 300 s^-1 for both devices (shear-matched), whereas clinically defined diastolic WBV corresponded to 1 s^-1 for Rheovis 2000A and 5 s^-1 for Hemovister. Agreement was assessed using linear regression and Bland-Altman analysis. Hematocrit tertiles were examined as effect modifiers. Clinical agreement was evaluated using quadratic weighted Cohen's κ. <b>Results</b>: Across matched shear rates (1000 to 1 s^-1), Hemovister yielded consistently higher WBV values than Rheovis 2000A, with statistically significant inter-device differences at all shear levels except 1000 s^-1. The magnitude of bias increased progressively as shear rate decreased, reaching -8.34 mPa·s at 1 s^-1. Under shear-matched systolic conditions (300 s^-1), the mean difference was -0.25 mPa·s (limits of agreement -1.72 to 1.22). In contrast, under clinically defined diastolic conditions (1 vs. 5 s^-1), the mean difference was 14.54 mPa·s (3.93 to 25.15), increasing across hematocrit tertiles. Clinical agreement was fair for systolic (κ = 0.31; 95% CI 0.24 to 0.39) and moderate for diastolic WBV (κ = 0.44; 95% CI 0.37 to 0.51). Notably, among samples classified as high by Hemovister, 72.8% (systolic) and 54.0% (diastolic) were reclassified as normal by Rheovis 2000A. <b>Conclusions</b>: Inter-device agreement in WBV measurement is strongly shear-dependent. Although numerical divergence increases at low shear, categorical concordance may remain moderate when device-specific reference thresholds are applied. Harmonization of shear definitions and reference frameworks may therefore be essential for consistent cross-platform interpretation.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812214","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":"CT-Based Radiomic Signatures Associated with Serum CEA Status in Colon Cancer.","authors":"Demet Doğan, Coşku Öksüz, Özgür Çakır, Oğuzhan Urhan","doi":"10.3390/diagnostics16081221","DOIUrl":"10.3390/diagnostics16081221","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Carcinoembryonic antigen (CEA) is widely used in colon cancer management; however, its diagnostic and prognostic accuracy is limited by biological variability, as well as false-positive or false-negative results. Radiomics provides quantitative descriptors of tumor heterogeneity and offers objective assessment of tumor characteristics. This study aimed to evaluate the potential of computed tomography (CT)-based radiomic features to distinguish between CEA-positive and CEA-negative colon cancer patients. <b>Methods:</b> In this retrospective study, 150 patients with histopathologically confirmed colon cancer were screened, and 109 were eligible after image-quality assessment (53 CEA-positive, 56 CEA-negative). A total of 107 radiomic features were extracted from preoperative contrast-enhanced CT images. After z-score normalization, feature robustness was assessed using intra- and inter-observer agreement. Correlation-based feature selection (|ρ| ≥ 0.7) was applied. Five machine-learning classifiers-Support Vector Machine (SVM), Decision Tree, Ensemble, k-Nearest Neighbor (k-NN), and Neural Network (NN)-were trained using stratified 5-fold cross-validation. Performance was evaluated using accuracy, recall, specificity, F1-score, and ROC-AUC. <b>Results:</b> The best performance was obtained with 41 selected features. The k-NN classifier achieved the highest accuracy (77.4 ± 2%) and ROC-AUC (0.8523 ± 0.013), while SVM and NN achieved the highest recall (83.0 ± 0.3). These models showed balanced and robust performance in distinguishing CEA-positive from CEA-negative patients. <b>Conclusions:</b> CT-based radiomic analysis combined with machine learning-particularly k-NN, SVM, and neural network classifiers-showed promising performance in differentiating colon cancer patients according to serum CEA status. Radiomic features may provide imaging-based information associated with serum biomarkers such as CEA, potentially enhancing tumor characterization and supporting more personalized decision-making.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812088","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":"Additional Diagnostic Yield of Endocervical Curettage in Type 3 Transformation Zone for High-Grade Cervical Lesions: A Retrospective Analysis by Human Papillomavirus Genotype.","authors":"Elena Lavinia Rusu, Victor Bogdan Buciu, Lavinia Balan, Denis Mihai Serban, Jasmina Chiriac, Veronica Daniela Chiriac","doi":"10.3390/diagnostics16081220","DOIUrl":"10.3390/diagnostics16081220","url":null,"abstract":"<p><p><b>Background/Objectives:</b> When the squamocolumnar junction is not fully visible (type 3 transformation zone), colposcopy-directed biopsy may under-sample endocervical disease. Endocervical curettage (ECC) is recommended in selected settings, but its incremental diagnostic yield in this setting, and whether this yield is concentrated in women with HPV16/18, remains clinically debated. <b>Methods:</b> We performed a retrospective cohort study of women referred to colposcopy because of HPV16/18 positivity regardless of cytology, persistent non-16/18 high-risk HPV positivity, and non-16/18 high-risk HPV positivity with abnormal cytology. Persistent non-16/18 high-risk HPV positivity was defined as repeated positivity on two tests performed at least 6 months apart. Eligible women had type 3 transformation zone documented and underwent paired ectocervical biopsy plus ECC at the same visit; biopsy was obtained in all women, including targeted sampling of the most abnormal ectocervical area when no discrete lesion was evident. Women were stratified by HPV genotype into HPV16/18 and non-16/18 high-risk HPV groups. The primary outcome was index high-grade cervical lesion, defined histologically as CIN2, CIN3, or carcinoma in situ; invasive cervical cancer was excluded. The added diagnostic yield of ECC was defined as ECC-only CIN2+, that is, CIN2+ detected on ECC when biopsy was <CIN2. <b>Results:</b> The cohort included 690 women (HPV16/18: 310; non-16/18 high-risk HPV: 380). Baseline cytology was negative for intraepithelial lesion or malignancy in 116 individuals (16.8%), ASC-US in 155 (22.5%), LSIL in 205 (29.7%), and ASC-H/HSIL in 214 (31.0%). On index composite histology, 122/690 (17.7%) had CIN2, 198/690 (28.7%) had CIN3, and 11/690 (1.6%) had carcinoma in situ. ECC identified CIN2+ not detected by biopsy in 19/690 (2.8%) cases, representing 19/331 (5.7%) of all CIN2+ diagnoses. ECC-only CIN2+ was more frequent in HPV16/18 than non-16/18 high-risk HPV (4.5% vs. 1.3%, <i>p</i> = 0.017). In multivariable analysis, HPV16/18 was associated with increased odds of ECC-only CIN2+ (aOR 3.22, 95% CI 1.10-9.44). No invasive cervical cancers were included in the analytic cohort. <b>Conclusions:</b> In type 3 transformation zone colposcopy, ECC adds a modest incremental yield for CIN2+ detection, with higher yield in HPV16/18-positive women. These findings support a risk-weighted approach to ECC rather than universal routine sampling.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812139","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":"Exploring Tissue Transglutaminase Antibodies as a Confirmatory Tool for Diagnosing Coeliac Disease in Children.","authors":"Petra Riznik, Patricija Levstik, Mojca Kukovic, Jernej Dolinsek","doi":"10.3390/diagnostics16081216","DOIUrl":"10.3390/diagnostics16081216","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The prerequisite for diagnosing celiac disease (CD) in children without duodenal biopsy is a tissue transglutaminase antibody (TGA) level exceeding 10 times the upper limit of normal levels, along with a positive confirmatory anti-endomysial antibody (EMA) test in a secondary blood sample. The aim of our study was to determine whether determination of TGA in a second blood sample could be as reliable as determination of EMA as the confirmatory test in children eligible for the no-biopsy approach. <b>Methods:</b> A retrospective analysis of medical data was conducted, including children under 19 years old who were diagnosed with coeliac disease at our department from January 2013 to June 2025. We examined the diagnostic process, focusing on TGA levels at the time of diagnosis. <b>Results:</b> Data from 185 CD patients (59.5% female, median age 8 years) were available for the analysis. 49 (26.5%) patients were diagnosed using no-biopsy approach and 46 (93.9%) of those had TGA > 10 × ULN in second blood sample as well. In the group of children diagnosed using duodenal biopsy (<i>N</i> = 136; 96.3% 3 Marsh), 78 (57.4%) children had initial TGA > 10 × ULN. In 34 (43.6%) of those children, secondary serology performed before introducing a diet showed that 30 (88.2%) of them had TGA > 10 × ULN. <b>Conclusions:</b> Our study suggests that TGA levels > 10 × ULN could serve as a reliable test for confirming the diagnosis of CD in children, eligible for the no-biopsy approach, thus making the diagnostic process more cost-effective and efficient, while maintaining accuracy.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811998","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":"Quantitative Evaluation of Pectoral Muscle Visualisation as an Indicator of Positioning Quality in Screening Mammography.","authors":"Maja Karić, Doris Šegota Ritoša, Petra Valković Zujić","doi":"10.3390/diagnostics16081218","DOIUrl":"10.3390/diagnostics16081218","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Image quality of mammograms in breast cancer screening is strongly operator-dependent, particularly in the mediolateral oblique (MLO) projection where adequate visualisation of the pectoralis major muscle serves as a surrogate marker of posterior tissue inclusion. Current positioning assessment is predominantly qualitative and subject to inter-observer variability. This study aimed to quantitatively evaluate pectoral muscle visualisation and compression force variability among radiographers participating in a national screening programme. <b>Methods:</b> A retrospective observational study was conducted at Clinical Hospital Center Rijeka in January and February 2020. A total of 464 digital MLO mammograms were analysed. Images from nine radiographers were randomly retrieved from the institutional Picture Archiving and Communication System (PACS). Pectoral muscle length and width were measured using a standard clinical workstation with an integrated distance measurement tool. Additional variables included radiographer gender, breast side (LMLO vs. RMLO), imaging order, and applied compression force. Statistical analyses included Welch's ANOVA, one-way ANOVA, <i>t</i>-tests, and appropriate post hoc comparisons. <b>Results:</b> Across all MLO projections, the combined mean pectoral muscle width was 41.0 ± 11.4 mm and the mean length was 134.3 ± 21.7 mm. Significant inter-operator differences were observed in pectoral muscle width (<i>p</i> < 0.001) and length (<i>p</i> = 0.023). Mean muscle width ranged from 35.0 mm to 54.2 mm, and mean length from 126.5 mm to 139.4 mm across radiographers. No significant differences were found with respect to radiographer gender, breast side, or imaging order (all <i>p</i> > 0.05). Compression force differed significantly among radiographers (<i>p</i> < 0.001), ranging from 117.0 ± 18.3 N to 184.8 ± 33.9 N. <b>Conclusions:</b> This study demonstrates significant inter-operator variability in both pectoral muscle visualisation and applied compression force during MLO mammography. These findings indicate that important technical aspects of mammographic examination remain strongly operator-dependent and highlight the need for more consistent positioning practices within screening programmes. Quantitative measurement of pectoral muscle dimensions may serve as a practical and objective approach for monitoring positioning quality and supporting quality assurance in routine clinical practice.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812128","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}