scholarly journals Assessing spontaneous passage of prophylactic pancreatic duct stents by X-ray: is a radiology report adequate?

2019 ◽  
Vol 12 ◽  
pp. 263177451986289
Author(s):  
Justin Loloi ◽  
Jacob S. Lipkin ◽  
Eileen M. Gagliardi ◽  
John M. Levenick
Keyword(s):  
Pancreatic Duct ◽  
False Negative ◽  
Retrospective Chart Review ◽  
Pancreatic Ducts ◽  
X Rays ◽  
X Ray ◽  
Radiology Reports ◽  
Spontaneous Passage ◽  
Pancreatic Duct Stent

Background: Pancreatic duct stents are frequently placed for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis. Because of concern for possible secondary ductal changes from a retained stent, these stents need to be monitored and removed if retained. Usually an abdominal X-ray is performed to assess retained stent, and if present, an esophagogastroduodenoscopy is performed to remove the stent. Limited data is published on false-negative radiology reports for spontaneous passage of stents. Methods: Using an Institutional Review Board–approved stent log, a retrospective chart review of all pancreatic duct stents placed at our institution from 2008 to 2014 was performed. Results: A total of 856 pancreatic duct stents were placed during the study period. Of these, 435 (50.8%) were prophylactic stents and 421 (49.2%) were therapeutic. Complete follow-up data were available in 426 (97.9%) patients with prophylactic stents. Six patients (1.4%) were lost to follow up and three (0.7%) expired prior to removal. In all, 283 (66%) had follow-up imaging, with 167 (39.2%) having the official radiology read with no retained pancreatic duct stent in place. Eight of these cases were “false-negative” radiology interpretation (4.8% of cases read as “no stent,” NNH = 20). The stent was found either by review of image by an endoscopist or incidental stent discovery during a follow-up procedure. Conclusion: Radiologist interpretation of abdominal X-rays to assess spontaneous passage of prophylactic pancreatic ducts stents resulted in a false-negative interpretation in approximately 5% of cases. Independent review of the images by the endoscopist may be beneficial given unfamiliarity of these stents by radiologists.

Classification of Fresh Fractures of the Lunate

1988 ◽  
Vol 13 (4) ◽  
pp. 458-462
Author(s):  
H. TEISEN ◽  
J. HJARBAEK
Keyword(s):  
Vascular Anatomy ◽  
X Rays ◽  
Lunate Bone ◽  
X Ray

The X-rays of 17 patients with fresh fractures of the lunate bone have been reviewed. The fractures were classified according to their radiological appearances and according to the vascular anatomy of the lunate. A long term X-ray follow-up examination was performed.

scholarly journals Finding COVID-19 from Chest X-rays using Deep Learning on a Small Dataset

2020 ◽  
Author(s):  
Lawrence Hall ◽  
Dmitry Goldgof ◽  
Rahul Paul ◽  
Gregory M. Goldgof
Keyword(s):  
False Negative ◽  
True Positive Rate ◽  
Small Data ◽  
Good Resolution ◽  
X Rays ◽  
True Positive ◽  
Data Set ◽  
X Ray ◽  
Negative Rate ◽  
Positive Rate

<p>Testing for COVID-19 has been unable to keep up with the demand. Further, the false negative rate is projected to be as high as 30% and test results can take some time to obtain. X-ray machines are widely available and provide images for diagnosis quickly. This paper explores how useful chest X-ray images can be in diagnosing COVID-19 disease. We have obtained 135 chest X-rays of COVID-19 and 320 chest X-rays of viral and bacterial pneumonia. </p><p> A pre-trained deep convolutional neural network, Resnet50 was tuned on 102 COVID-19 cases and 102 other pneumonia cases in a 10-fold cross validation. The results were </p><p> an overall accuracy of 89.2% with a COVID-19 true positive rate of 0.8039 and an AUC of 0.95. Pre-trained Resnet50 and VGG16 plus our own small CNN were tuned or trained on a balanced set of COVID-19 and pneumonia chest X-rays. An ensemble of the three types of CNN classifiers was applied to a test set of 33 unseen COVID-19 and 218 pneumonia cases. The overall accuracy was 91.24% with the true positive rate for COVID-19 of 0.7879 with 6.88% false positives for a true negative rate of 0.9312 and AUC of 0.94. </p><p> This preliminary study has flaws, most critically a lack of information about where in the disease process the COVID-19 cases were and the small data set size. More COVID-19 case images at good resolution will enable a better answer to the question of how useful chest X-rays can be for diagnosing COVID-19.</p>

scholarly journals The Effect of Image Resolution on Automated Classification of Chest X-rays

2021 ◽  
Author(s):  
Md Inzamam Ul Haque ◽  
Abhishek K Dubey ◽  
Jacob D Hinkle
Keyword(s):  
High Resolution ◽  
Automated Analysis ◽  
Image Resolution ◽  
Free Text ◽  
X Rays ◽  
Training Time ◽  
X Ray ◽  
Radiology Reports ◽  
Chest X Ray ◽  
High Resolution Images

Deep learning models have received much attention lately for their ability to achieve expert-level performance on the accurate automated analysis of chest X-rays. Although publicly available chest X-ray datasets include high resolution images, most models are trained on reduced size images due to limitations on GPU memory and training time. As compute capability continues to advance, it will become feasible to train large convolutional neural networks on high-resolution images. This study is based on the publicly available MIMIC-CXR-JPG dataset, comprising 377,110 high resolution chest X-ray images, and provided with 14 labels to the corresponding free-text radiology reports. We find, interestingly, that tasks that require a large receptive field are better suited to downscaled input images, and we verify this qualitatively by inspecting effective receptive fields and class activation maps of trained models. Finally, we show that stacking an ensemble across resolutions outperforms each individual learner at all input resolutions while providing interpretable scale weights, suggesting that multi-scale features are crucially important to information extraction from high-resolution chest X-rays.

159 The Need Of Six Monthly Follow Up X-Rays Post Total Knee Replacement(TKR)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Baig ◽  
M Ferrari ◽  
A Lukaszewicz
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Trauma Centre ◽  
X Rays ◽  
Data Set ◽  
X Ray ◽  
Major Trauma Centre ◽  
Plain Films ◽  
Total Knee

Abstract Background There is a longstanding culture of repeat x-rays after total knee replacement (TKR) as part of follow up, often combined with a clinic review. This is to check that the prosthesis is in a satisfactory position. There are inherently a number of issues with this historic approach including exposure of patients to further radiation who may be asymptomatic, time delays in busy clinics or x-ray departments and costs. Objectives The aim of this audit was to assess whether follow up plain films after TKR are methodically undertaken and of benefit to confirm satisfactory appearance if immediate post -operative x-rays were unremarkable. The findings of a six month follow up x-ray was specifically evaluated. The secondary aim was to establish the timing of further follow up x-rays within the department. Method 200 patients were included within the analysis, they all received a TKR at a major trauma centre, over a one-year period between December 2017 and December 2018. Results It was found that 100% of those patients having a post-operative film had a satisfactory appearance. 78% of patients had at least one further follow op x-ray of which 99.4% were satisfactory. Up to five follow up x-rays were taken with 53.5% of patients having a follow up x-ray at 6 months. Conclusions From the above results there is minimal, if any, evidence within the data set to support routine, additional follow up imaging if initial post-operative films are satisfactory, and the patient is asymptomatic.

Isoelastic Cementless Total Hip Replacement in Rheumatoid Arthritis. Long-Term Results

1992 ◽  
Vol 2 (2) ◽  
pp. 43-46
Author(s):  
U. Fusco ◽  
R. Capelli ◽  
A. Avai ◽  
M. Gerundini ◽  
L. Colombini ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hip Replacement ◽  
The Other ◽  
Long Term Results ◽  
X Rays ◽  
X Ray ◽  
The Mean ◽  
Cementless Total Hip Replacement

Between 1980 and 1987 we have implanted 46 isoelastic cementless THR in 40 patients affected with rheumatoid arthritis. We have reviewed 38 hips clinically and by X-ray. The mean follow-up was 8,5 years. Harris hip scores ranged from 30.6 preoperatively to 73,4 post-operatively when reviewed. While on the other hand Merle D'Aubigné hip scores ranged from 7,06 pre-operatively to 15,59 post-operatively. All patients have been satisfied, and X-rays showed an improvement for both Charnely and Gruen X-ray score.

scholarly journals Discovery and follow-up of ASASSN-19dj: an X-ray and UV luminous TDE in an extreme post-starburst galaxy

2020 ◽  
Vol 500 (2) ◽  
pp. 1673-1696 ◽  
Author(s):  
Jason T Hinkle ◽  
T W-S Holoien ◽  
K Auchettl ◽  
B J Shappee ◽  
J M M Neustadt ◽  
...  
Keyword(s):  
Optical Emission ◽  
Starburst Galaxy ◽  
Late Time ◽  
X Rays ◽  
Tidal Disruption ◽  
X Ray ◽  
Bolometric Luminosity ◽  
Order Of Magnitude ◽  
High Cadence

ABSTRACT We present observations of ASASSN-19dj, a nearby tidal disruption event (TDE) discovered in the post-starburst galaxy KUG 0810+227 by the All-Sky Automated Survey for Supernovae (ASAS-SN) at a distance of d ≃ 98 Mpc. We observed ASASSN-19dj from −21 to 392 d relative to peak ultraviolet (UV)/optical emission using high-cadence, multiwavelength spectroscopy and photometry. From the ASAS-SN g-band data, we determine that the TDE began to brighten on 2019 February 6.8 and for the first 16 d the rise was consistent with a flux ∝t2 power law. ASASSN-19dj peaked in the UV/optical on 2019 March 6.5 (MJD = 58548.5) at a bolometric luminosity of L = (6.2 ± 0.2) × 1044 erg s−1. Initially remaining roughly constant in X-rays and slowly fading in the UV/optical, the X-ray flux increased by over an order of magnitude ∼225 d after peak, resulting from the expansion of the X-ray emitting region. The late-time X-ray emission is well fitted by a blackbody with an effective radius of ∼1 × 1012 cm and a temperature of ∼6 × 105 K. The X-ray hardness ratio becomes softer after brightening and then returns to a harder state as the X-rays fade. Analysis of Catalina Real-Time Transient Survey images reveals a nuclear outburst roughly 14.5 yr earlier with a smooth decline and a luminosity of LV ≥ 1.4 × 1043 erg s−1, although the nature of the flare is unknown. ASASSN-19dj occurred in the most extreme post-starburst galaxy yet to host a TDE, with Lick HδA = 7.67 ± 0.17 Å.

Development of a System that Generates Structured Reports for Chest X-ray Radiography

2010 ◽  
Vol 49 (04) ◽  
pp. 360-370 ◽  
Author(s):  
Y. Matsumura ◽  
N. Mihara ◽  
Y. Kawakami ◽  
K. Sasai ◽  
H. Takeda ◽  
...  
Keyword(s):  
Narrative Form ◽  
Free Text ◽  
X Rays ◽  
Sentence Structure ◽  
X Ray ◽  
Radiology Reports ◽  
Chest X Ray ◽  
Structured Reports ◽  
Description Framework ◽  
Resource Description

Summary Objectives: Radiology reports are typically made in narrative form; this is a barrier to the implementation of advanced applications for data analysis or a decision support. We developed a system that generates structured reports for chest x-ray radiography. Methods: Based on analyzing existing reports, we determined the fundamental sentence structure of findings as compositions of procedure, region, finding, and diagnosis. We categorized the observation objects into lung, mediastinum, bone, soft tissue, and pleura and chest wall. The terms of region, finding, and diagnosis were associated with each other. We expressed the terms and the relations between the terms using a resource description framework (RDF) and developed a reporting system based on it. The system shows a list of terms in each category, and modifiers can be entered using templates that are linked to each term. This system guides users to select terms by highlighting associated terms. Fifty chest x-rays with abnormal findings were interpreted by five radiologists and reports were made either by the system or by the free-text method. Results: The system decreased the time needed to make a report by 12.5% compared with the free-text method, and the sentences generated by the system were well concordant with those made by free-text method (F-measure = 90%). The results of the questionnaire showed that our system is applicable to radiology reports of chest x-rays in daily clinical practice. Conclusions: The method of generating structured reports for chest x-rays was feasible, because it generated almost concordant reports in shorter time compared with the free-text method.

scholarly journals Motion - Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments for the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 57-59
Author(s):  
Stanley M Branch
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Clinical Problem ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Ducts ◽  
Success Rates ◽  
Long Term Follow Up

Pain is the dominant clinical problem in patients with chronic pancreatitis. It can be due to pseudocysts, as well as strictures and stones in the pancreatic ducts. Most experts agree that obstruction could cause increased pressure within the main pancreatic duct or its branches, resulting in pain. Endoscopic therapy aims to alleviate pain by reducing the pressure within the ductal system and draining pseudocysts. Approaches vary according to the specific nature of the problem, and include transgastric, transduodenal and transpapillary stenting and drainage. Additional techniques for the removal of stones from the pancreatic duct include extracorporeal shockwave lithotripsy. Success rates for stone extraction and stenting of strictures are high in specialized centres that employ experienced endoscopists, but pain often recurs during long term follow-up. Complications include pancreatitis, bleeding, infection and perforation. In the case of pancreatic pseudocysts, percutaneous or even surgical drainage should be considered if septae or large amounts of debris are present within the lesion. This article describes the techniques, indications and results of endoscopic therapy of pancreatic lesions.

scholarly journals COVIDPEN: A Novel COVID-19 Detection Model using Chest X-Rays and CT Scans

2020 ◽  
Author(s):  
Amit Kumar Jaiswal ◽  
Prayag Tiwari ◽  
Vipin Kumar Rathi ◽  
Jia Qian ◽  
Hari Mohan Pandey ◽  
...  
Keyword(s):  
False Negative ◽  
Healthcare Providers ◽  
False Negative Rate ◽  
X Rays ◽  
X Ray ◽  
Detection Model ◽  
Global Pandemic ◽  
High False Negative Rate ◽  
Proposed Model ◽  
Chest X Ray

The trending global pandemic of COVID-19 is the fastest ever impact which caused people worldwide by severe acute respiratory syndrome~(SARS)-driven coronavirus. However, several countries suffer from the shortage of test kits and high false negative rate in PCR test. Enhancing the chest X-ray or CT detection rate becomes critical. The patient triage is of utmost importance and the use of machine learning can drive the diagnosis of chest X-ray or CT image by identifying COVID-19 cases. To tackle this problem, we propose~COVIDPEN~-~a transfer learning approach on Pruned EfficientNet-based model for the detection of COVID-19 cases. The proposed model is further interpolated by post-hoc analysis for the explainability of the predictions. The effectiveness of our proposed model is demonstrated on two systematic datasets of chest radiographs and computed tomography scans. Experimental results with several baseline comparisons show that our method is on par and confers clinically explicable instances, which are meant for healthcare providers.

scholarly journals Chest X-Ray findings and visual quantitative assessment of COVID-19 pneumonia

2020 ◽  
Author(s):  
Michaela Cellina ◽  
Marcello Orsi ◽  
Marta Panzeri ◽  
Giulia van der Byl ◽  
Giancarlo Oliva
Keyword(s):  
Severity Score ◽  
Quantitative Assessment ◽  
X Rays ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Disease Evolution ◽  
X Ray ◽  
Radiological Score ◽  
Chest X Ray

Abstract AimTo assess the most common chest X-Ray findings and distribution in patients with confirmed diagnosis of COVID-19; to verify the repeatability of a radiological severity score, based on visual quantitative assessment; to assess the evolution of chest X-Ray findings at follow-up; to evaluate chest X-Ray sensitivity.MethodsWe analysed chest X-Rays at baseline of 110 consecutive COVID-19 patients (79 males, 31 females; mean age: 64±16 years) with RT-PCR confirmation, who presented to our ED.Two radiologists evaluated the imaging findings and distribution.A severity score, based on the extension of lung abnormalities, was assigned by two other radiologists, independently, to the baseline and follow-up X-Rays, executed in 77/110 cases; interobserver agreement was calculated. Chest X-Ray sensitivity was assessed, with RT-PCR as gold standard.ResultsInterobserver agreement was excellent for baseline and follow-up X-Rays (Cohen's K=0.989, p<0.001, Cohen's K=0.985, p<0.001, respectively). The mean score at baseline was 2.87±1.7 for readers 1 and 2. We observed radiological worsening in 52/77 (67%) patients, with significantly higher scores at follow-up (mean score: 4.27±2.15 for reader 1 and 4.28±2.14 for reader 2, respectively); p<0.001.Ground glass opacities were the most common findings (97/110, 88%). Abnormalities showed bilateral involvement in 67/110 (61%), with prevalent peripheral distribution (48/110, 43.5%).The X-Ray sensitivity for the detection of COVID-19 infection was 91%.ConclusionChest X-Ray highlighted imaging findings in line with those previously reported for chest CT. The use of a radiological score can result in clearer communication with Clinicians and a more precise assessment of disease evolution.

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