radiograph

射线照片
  • 文章类型: Journal Article
    研究12-24个月胫骨股关节内侧负重区域的影像学关节间隙宽度(JSW)损失与磁共振成像(MRI)为基础的软骨厚度损失之间的关系。通过有临床意义的亚组(性别和疼痛状态)对这种关系进行分层。
    我们根据关节间隙狭窄(JSN)测量,分析了骨关节炎倡议(OAI)可能在早期OA中的膝盖子集(n​=256)。使用自然对数变换来近似JSW损失的近正态分布。Pearson相关系数描述了ln变换的JSW损失与几个版本的基于深度学习的基于MRI的软骨厚度损失参数之间的关系(最小,最大值,和平均值)在股骨髁的亚区域,胫骨平台,以及合并的股骨和胫骨区域。线性混合效应模型评估了ln转换的射线照相和MRI衍生措施之间的关联,包括潜在的混杂因素。
    我们发现ln转换的JSW损失与基于MRI的软骨厚度之间的相关性较弱,范围从R​=-0.13(p​​=0.20)到R=0.26(p<0.01)。与男性相比,女性的相关性更高(仍然较差),与非疼痛的膝盖相比,疼痛。模型结果显示,几乎所有基于MRI的措施的关联都很弱,从无关联到β(95%CI)​=0.25(0.11,0.39)。与男性相比,女性的协会更高,疼痛和非疼痛的膝盖之间的差异最小。
    尽管建议将其用于改善疾病的OA药物临床试验,结果表明,JSW丢失是12-24个月内和胫股关节局部区域内软骨厚度丢失的无效替代测量。
    UNASSIGNED: To investigate the relationship between measures of radiographic joint space width (JSW) loss and magnetic resonance imaging (MRI)-based cartilage thickness loss in the medial weight-bearing region of the tibiofemoral joint over 12-24 months. To stratify this relationship by clinically meaningful subgroups (sex and pain status).
    UNASSIGNED: We analyzed a subset of knees (n ​= ​256) from the Osteoarthritis Initiative (OAI) likely in early stage OA based on joint space narrowing (JSN) measurements. Natural logarithm transformation was used to approximate near normal distributions for JSW loss. Pearson Correlation coefficients described the relationship between ln-transformed JSW loss and several versions of deep learning-derived MRI-based cartilage thickness loss parameters (minimum, maximum, and mean) in subregions of the femoral condyle, tibial plateau, and combined femoral and tibial regions. Linear mixed-effects models evaluated the associations between the ln-transformed radiographic and MRI-derived measures including potential confounders.
    UNASSIGNED: We found weak correlations between ln-transformed JSW loss and MRI-based cartilage thickness ranging from R ​= ​-0.13 (p ​= ​0.20) to R ​= ​0.26 (p ​< ​0.01). Correlations were higher (still poor) among females compared to males and painful compared to non-painful knees. Model results showed weak associations for nearly all MRI-based measures, ranging from no association to β (95% CI) ​= ​0.25 (0.11, 0.39). Associations were higher among females compared to males and minimal differences between painful and non-painful knees.
    UNASSIGNED: Despite its recommended use in disease-modifying OA drug clinical trials, results suggest that JSW loss is an ineffective proxy measure of cartilage thickness loss over 12-24 months and within a localized region of the tibiofemoral joint.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    腋窝X光片可以测量关节盂逆行,这与全肩关节置换术后临床结局恶化和关节盂松动有关。由于射线照相技术的可变性,这项研究旨在确定通过腋窝X光片测量的逆行准确性是否受到1)肩胛骨旋转和/或2)内侧肩胛骨的正确可视化的影响。
    使用五个尸体肩胛骨,研究人员获得了真实中立位置以及前后旋转10°和20°的腋窝X光片。对于每张射线照片,两名受过研究训练的肩关节外科医生测量关节盂后向,并完全可视化肩胛骨(技术1),可视化仅限于肩胛骨的外半部(技术2)。观察者还通过CT扫描测量了关节盂逆行,以用作金标准技术。Spearman的Rho用于评估测量之间的一致性。
    通过CT扫描评估的五个肩胛骨的平均关节盂逆行为3.8°(R:1.5-6.9)。与使用技术2获得的测量结果相比,使用技术1获得的测量结果证明了观察者之间的一致性水平(ICC:0.412)得到了提高,后者证明了一致性(ICC:0.103)。使用两种技术,肩胛骨旋转与协议不一致。
    关节盂逆行测量的可靠性受到内侧肩胛骨脊柱不完全可视化的限制。当测量肩胛骨底部的后向时,改善的一致性和准确性与不同程度的肩胛骨旋转。
    UNASSIGNED: Axillary radiographs enable the measurement of glenoid retroversion, which is associated with worsened clinical outcomes and glenoid loosening following total shoulder arthroplasty. Due to the variability in radiographic technique, this study aims to determine if the accuracy of retroversion measured by axillary radiograph is affected by 1) scapular rotation and/or 2) proper visualization of the medial scapula.
    UNASSIGNED: Using five cadaveric scapulae, investigators obtained axillary radiographs in true neutral position as well as in 10° and 20° of anterior and posterior rotation. For each radiograph, two fellowship trained shoulder surgeons measured glenoid retroversion with complete visualization of the scapula (Technique 1) and with visualization limited to the lateral half of scapula (Technique 2). The observers also measured glenoid retroversion by CT scan to use as a gold standard technique. Spearman\'s Rho was used to assess agreement between measurements.
    UNASSIGNED: Average glenoid retroversion of the five scapulae assessed by CT scan was 3.8° (R: 1.5-6.9). Measurements obtained using Technique 1 demonstrated improved levels of interobserver agreement (ICC: 0.412) compared to measurements obtained with Technique 2, which demonstrated no agreement (ICC: 0.103). Scapular rotation was inconsistently associated with agreement using both techniques.
    UNASSIGNED: The reliability of glenoid retroversion measurements was limited by incomplete visualization of the medial scapular spine. When measuring retroversion to the base of the scapular spine, improved agreement and accuracy were seen with various degrees of scapular rotation.
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  • 文章类型: Journal Article
    膝关节骨性关节炎(OA)影响全球超过6.5亿患者。全膝关节置换术旨在缓解终末期OA的疼痛症状,刚度和流动性降低。然而,影像学检查在监测有症状的疾病进展中的作用尚不清楚.本研究旨在比较机器学习(ML)模型,有和没有成像特征,预测膝关节OA患者的两年西安大略省和麦克马斯特大学关节炎指数(WOMAC)评分。我们纳入了骨关节炎倡议(OAI)数据库中的2408名患者,多中心骨关节炎研究(MOST)数据库中的629例患者。临床数据集包括18个临床特征,而成像数据集包含额外的10个成像特征。最小临床重要差异(MCID)设置为24,反映有意义的身体损伤。临床和成像数据集模型产生了相似的曲线下面积(AUC)评分,突出显示性能AUC<0.025的低差异)。对于临床和成像数据集,梯度提升机(GBM)模型在外部验证中表现最好,临床可接受的AUC为0.734(95%CI0.687-0.781)和0.747(95%CI0.701-0.792),分别。确定的五个特征包括教育背景,骨关节炎家族史,合并症,使用骨质疏松症药物和以前的膝盖程序。这是第一项证明ML模型在有和没有成像特征的情况下实现可比性能的研究。
    Knee osteoarthritis (OA) affects over 650 million patients worldwide. Total knee replacement is aimed at end-stage OA to relieve symptoms of pain, stiffness and reduced mobility. However, the role of imaging modalities in monitoring symptomatic disease progression remains unclear. This study aimed to compare machine learning (ML) models, with and without imaging features, in predicting the two-year Western Ontario and McMaster Universities Arthritis Index (WOMAC) score for knee OA patients. We included 2408 patients from the Osteoarthritis Initiative (OAI) database, with 629 patients from the Multicenter Osteoarthritis Study (MOST) database. The clinical dataset included 18 clinical features, while the imaging dataset contained an additional 10 imaging features. Minimal Clinically Important Difference (MCID) was set to 24, reflecting meaningful physical impairment. Clinical and imaging dataset models produced similar area under curve (AUC) scores, highlighting low differences in performance AUC < 0.025). For both clinical and imaging datasets, Gradient Boosting Machine (GBM) models performed the best in the external validation, with a clinically acceptable AUC of 0.734 (95% CI 0.687-0.781) and 0.747 (95% CI 0.701-0.792), respectively. The five features identified included educational background, family history of osteoarthritis, co-morbidities, use of osteoporosis medications and previous knee procedures. This is the first study to demonstrate that ML models achieve comparable performance with and without imaging features.
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  • 文章类型: Journal Article
    目的:改善报告和可比性,并减少牙科计算机视觉研究中的偏差,我们的目标是为这一领域制定一套核心成果衡量标准(COMS)。COMS是在世卫组织/国际电联/知识产权组织全球健康人工智能倡议(世卫组织/国际电联/知识产权组织AI4H)的基础上达成共识的。
    方法:我们首先评估了诊断准确性研究的现有指导文件,并与该领域专家进行了访谈。结果结果测量列表被映射到计算机视觉建模任务,临床领域和报告水平。由此产生的系统化侧重于提供相关的成果措施,同时保留元研究和技术复制的细节,显示针对(1)不同临床领域和任务的报告级别的建议,(2)结果测量。COMS是使用2阶段的e-Delphi同意的,来自不同IADR小组的26名参与者,世卫组织/国际电联/WIPOAI4H,ADEA和AAOMFR。
    结果:我们为不同的计算机视觉任务分配了一致的报告级别。我们一致认为,人类专家评估和诊断准确性考虑是达到临床意义评估水平的唯一可行方法。研究至少应报告八个核心成果指标:混淆矩阵,准确度,灵敏度,特异性,精度,F-1得分,接收器工作特性曲线下的面积,和精确召回曲线下的面积。
    结论:牙科研究人员应致力于报告计算机视觉研究沿着概述的COMS。审稿人和编辑在评估研究时可能会考虑定义的COMS,建议作者在不使用COMS时证明其合理性。
    结论:比较和综合牙科计算机视觉研究受到报告结果测量的多样性的阻碍。遵守定义的COMS有望增加研究之间的可比性,启用合成,减少选择性报告。
    OBJECTIVE: To improve reporting and comparability as well as to reduce bias in dental computer vision studies, we aimed to develop a Core Outcome Measures Set (COMS) for this field. The COMS was derived consensus based as part of the WHO/ITU/WIPO Global Initiative AI for Health (WHO/ITU/WIPO AI4H).
    METHODS: We first assessed existing guidance documents of diagnostic accuracy studies and conducted interviews with experts in the field. The resulting list of outcome measures was mapped against computer vision modeling tasks, clinical fields and reporting levels. The resulting systematization focused on providing relevant outcome measures whilst retaining details for meta-research and technical replication, displaying recommendations towards (1) levels of reporting for different clinical fields and tasks, and (2) outcome measures. The COMS was consented using a 2-staged e-Delphi, with 26 participants from various IADR groups, the WHO/ITU/WIPO AI4H, ADEA and AAOMFR.
    RESULTS: We assigned agreed levels of reporting to different computer vision tasks. We agreed that human expert assessment and diagnostic accuracy considerations are the only feasible method to achieve clinically meaningful evaluation levels. Studies should at least report on eight core outcome measures: confusion matrix, accuracy, sensitivity, specificity, precision, F-1 score, area-under-the-receiver-operating-characteristic-curve, and area-under-the-precision-recall-curve.
    CONCLUSIONS: Dental researchers should aim to report computer vision studies along the outlined COMS. Reviewers and editors may consider the defined COMS when assessing studies, and authors are recommended to justify when not employing the COMS.
    CONCLUSIONS: Comparing and synthesizing dental computer vision studies is hampered by the variety of reported outcome measures. Adherence to the defined COMS is expected to increase comparability across studies, enable synthesis, and reduce selective reporting.
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  • 文章类型: Journal Article
    次生牙本质沉积后牙髓空间的减少是与老化相关的影像学可见形态特征。目前,当涉及到X射线照相可见的牙齿特征以进行年龄估计时,北巴西人口没有参考形态样本。本研究旨在测试基于犬齿/牙髓面积(PTA)比率的现有年龄估计方法,并开发特定于人群的方程。样本包括来自北部地理区域的100例巴西男性(n=46)和女性(n=54)的心尖X射线照片。抽样参与者的年龄在18至72岁之间(平均年龄=45.43±14.39岁)。估计年龄是用Cameriere方法获得的。在永久性犬PTA和实际年龄之间观察到统计学上显着的负相关(r=-0.595)(P=0.0001)。用4倍(75%×25%)交叉验证构建了一个特定群体的方程,导致9.59年的平均绝对误差,均方根误差为11.66年(r2=0.363)。这项研究提供了证据来支持使用Cameriere的牙髓/牙齿面积比进行巴西北部成年人的放射学牙齿年龄估计,特别是用特定于人口的等式进行了调整。
    The reduction of the pulpal space following the deposition of secondary dentin is a radiographically visible morphological feature associated with aging. Currently, there is no reference morphological sample for the Northern Brazilian population when it comes to the radiographically visible dental features for age estimation. This study aimed to test an existing method for age estimation based on the canine pulp/tooth area (PTA) ratio and develop a population-specific equation. The sample consisted of 100 peri-apical radiographs of Brazilian males (n=46) and females (n=54) from the Northern geographic region. The age of the sampled participants was between 18 and 72 years (mean age=45.43±14.39years). The estimated age was obtained with the Cameriere\'s method. A statistically significant negative (r=-0.595) association was observed between the permanent canine PTA and the chronological age (P=0.0001). A population-specific equation was structured with a 4-fold (75%×25%) cross-validation, leading to a mean absolute error of 9.59years, and root mean square error of 11.66years (r2=0.363). This study provided evidence to support the use of Cameriere\'s pulp/tooth area ratio for the radiographic dental age estimation of Northern Brazilian adults, especially adjusted with a population-specific equation.
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  • 文章类型: Journal Article
    低骨密度(BMD)的患者面临骨折的风险增加,但经常无法诊断。因此,在接受其他医学评估的患者中,必须对低BMD进行机会性筛查.这项回顾性研究涵盖了422名年龄≥50岁的患者,他们在12个月内接受了来自三个不同供应商的双能X射线吸收法(DXA)和手部X射线照相(数字X射线的模态)。将数据集随机分为训练/验证(n=338)和测试(n=84)数据集。我们试图预测骨质疏松/骨质减少,并建立骨质构分析和DXA测量之间的相关性。我们的结果表明,深度学习模型达到了77.38%的准确率,灵敏度为77.38%,特异性73.63%,检测骨质疏松症/骨质减少的曲线下面积(AUC)为83%。这些发现表明,手部X光片可以作为一种可行的筛查工具,用于识别需要对骨质疏松症/骨质减少进行正式DXA评估的个体。
    Patients with low bone mineral density (BMD) face an increased risk of fractures, yet are frequently undiagnosed. Consequently, it is imperative to have opportunistically screen for low BMD in patients undergoing other medical evaluations. This retrospective study encompassed 422 patients aged ≥ 50 who underwent both dual-energy X-ray absorptiometry (DXA) and hand radiographs (modality of digital X-ray) from three different vendors within a 12-month period. The dataset was randomly divided into training/validation (n=338) and test (n=84) datasets. we sought to predict osteoporosis/osteopenia and establish correlations between bone textural analysis and DXA measurements. Our results demonstrate that the deep learning model achieved an accuracy of 77.38%, sensitivity of 77.38%, specificity of 73.63%, and an area under the curve (AUC) of 83% in detecting osteoporosis/osteopenia. These findings suggest that hand radiographs can serve as a viable screening tool for identifying individuals warranting formal DXA assessment for osteoporosis/osteopenia.
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  • 文章类型: Journal Article
    目的:本研究旨在(I)在巴西人口的不同地理样本中测试Willems\'牙科年龄估计方法,和(II)提出了一种新的模型,将地理样本组合在巴西成熟度分数的单个参考表中。
    方法:样本包括6至15.99岁(平均年龄=10.99±2.76岁)的巴西男性(n=2443)和女性(n=2574)的5017张全景照片。X射线照片是从东南部(SE)(n=2920)收集的,中西部(CW)(n=1176),和南部(SO)(n=921)地理区域。应用了Demirjian的技术,然后是Willems的方法和提出的巴西模型。
    结果:Willems\'方法导致男性和女性的平均绝对误差(MAE)为0.79和0.81年,分别。均方根误差(RMSE)分别为1.01年和1.03年,分别。巴西模式导致男性和女性的MAE分别为0.72和0.74岁,分别,男女的RMSE为0.93年。在70%的年龄段中,MAE降低了。区域之间的差异具有统计学意义(p<0.05),但没有临床意义。
    结论:与Willems模型相比,基于组合人群的新模型具有增强的性能,并为巴西人提供了参考结果。
    结论:通过牙科分析评估患者的生物学发育与计划骨科治疗和随访有关。为巴西儿童的牙科年龄估计建立了综合区域统计模型,有助于实现最佳的年龄估计实践。
    OBJECTIVE: This study aimed (I) to test the Willems\' dental age estimation method in different geographic samples of the Brazilian population, and (II) to propose a new model combining the geographic samples in a single reference table of Brazilian maturity scores.
    METHODS: The sample consisted of 5017 panoramic radiographs of Brazilian males (n = 2443) and females (n = 2574) between 6 and 15.99 years (mean age = 10.99 ± 2.76 years). The radiographs were collected from the Southeastern (SE) (n = 2920), Central-Western (CW) (n = 1176), and Southern (SO) (n = 921) geographic regions. Demirjian\'s technique was applied followed by Willems\' method and the proposed Brazilian model.
    RESULTS: Willems\' method led to mean absolute errors (MAE) of 0.79 and 0.81 years for males and females, respectively. Root mean squared errors (RMSE) were 1.01 and 1.03 years, respectively. The Brazilian model led to MAE of 0.72 and 0.74 years for males and females, respectively, and RMSE of 0.93 years for both sexes. The MAE was reduced in 70% of the age categories. Differences between regions were statistically (p < 0.05) but not clinically significant.
    CONCLUSIONS: The new model based on a combined population had an enhanced performance compared to Willems\' model and led to reference outcomes for Brazilians.
    CONCLUSIONS: Assessing patients\' biological development by means of dental analysis is relevant to plan orthopedic treatments and follow up. Having a combined-region statistic model for dental age estimation of Brazilian children contributes to optimal age estimation practices.
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  • 文章类型: Journal Article
    小儿舟骨骨折在X线平片诊断中具有挑战性。在初始成像时,舟状骨骨折的漏诊率可高达30%至37%,总体敏感性范围为21%至97%。很少有研究,然而,检查了X线片在诊断舟骨骨折中的可靠性,没有一个是儿科人群特有的。可靠性,无论是在不同的专家之间还是对于个人评估者,可能会阐明一些诊断挑战。
    我们对儿科骨科医生进行了两次迭代调查,整形外科医生,放射科医生,和急诊医生在三级儿童医院。要求参与者评估10系列小儿腕部X光片,以寻找舟骨骨折的证据。使用2.1的组内相关系数计算了评估者之间和内部的可靠性。
    第一次迭代分析中包括42名受访者。外科医生之间的评估者间可靠性(0.66;95%置信区间,0.43-0.87),放射科医师(0.76;0.55-0.92),急诊医师(0.65;0.46-0.86)从“好”到“优”。“26名受访者参与了第二次迭代的内部可靠性(0.73;0.67-0.78)。腕部X线片诊断舟骨骨折的敏感性(0.75;0.69-0.81)和特异性(0.78;0.71-0.83)与其他研究结果一致。
    在X线片上诊断小儿舟骨骨折的评估者和评估者之间的可靠性都很好。专家之间没有发现显着差异。普通射线照片,虽然对明显的舟骨骨折有用,无法可靠地排除细微的骨折。我们的研究表明,灵敏度差源于测试本身,而不是评分者的可变性。
    UNASSIGNED: Pediatric scaphoid fractures can be challenging to diagnose on plain radiograph. Rates of missed scaphoid fractures can be as high as 30% to 37% on initial imaging and overall sensitivity ranging from 21% to 97%. Few studies, however, have examined the reliability of radiographs in the diagnosis of scaphoid fractures, and none are specific to the pediatric population. Reliability, both between different specialists and for individual raters, may elucidate some of the diagnostic challenges.
    UNASSIGNED: We conducted a 2-iteration survey of pediatric orthopedic surgeons, plastic surgeons, radiologists, and emergency physicians at a tertiary children\'s hospital. Participants were asked to assess 10 series of pediatric wrist radiographs for evidence of scaphoid fracture. Inter-rater and intrarater reliability was calculated using the intraclass correlation coefficient of 2.1.
    UNASSIGNED: Forty-two respondents were included in the first iteration analysis. Inter-rater reliability between surgeons (0.66; 95% confidence interval, 0.43-0.87), radiologists (0.76; 0.55-0.92), and emergency physicians (0.65; 0.46-0.86) was \"good\" to \"excellent.\" Twenty-six respondents participated in the second iteration for intrarater reliability (0.73; 0.67-0.78). Sensitivity (0.75; 0.69-0.81) and specificity (0.78; 0.71-0.83) of wrist radiographs for diagnosing scaphoid fractures were consistent with results in other studies.
    UNASSIGNED: Both inter-rater and intrarater reliability for diagnosing pediatric scaphoid fractures on radiographs was good to excellent. No significant difference was found between specialists. Plain radiographs, while useful for obvious scaphoid fractures, are unable to reliably rule out subtle fractures routinely. Our study demonstrates that poor sensitivity stems from the test itself, and not rater variability.
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