Feasibility study of deep-learning-based bone suppression incorporated with single-energy material decomposition technique in chest X-rays.

OBJECTIVE: To improve the detection of lung abnormalities in chest X-rays by accurately suppressing overlapping bone structures in the lung area. According to literature on missed lung cancer in chest X-rays, such structures are a significant cause of chest-related diagnostic errors. METHODS: This study presents a deep-learning-based bone suppression method where a residual U-Net model is trained for chest X-rays using data set generated from the single-energy material decomposition (SEMD) technique on CT. Synthetic projection images and soft-tissue selective images were obtained from the CT data set via the SEMD, which were then used as the input and label data of the U-Net network. The trained network was tested on synthetic chest X-rays and two real chest radiographs. RESULTS: Bone-suppressed images of the real chest radiographs obtained by the proposed method were similar to the results from the American Association of Physicists in Medicine lung CT data; pulmonary nodules in the soft-tissue selective images appeared more clearly than in the synthetic projection images. The peak signal-to-noise ratio and structural similarity values measured between the output and the corresponding label images were approximately 17.85 and 0.90, respectively. CONCLUSION: The proposed method effectively yielded bone-suppressed chest X-ray images, indicating its clinical usefulness, and it can improve the detection of lung abnormalities in chest X-rays. ADVANCES IN KNOWLEDGE: The idea of using SEMD to obtain large amounts of paired images for deep-learning-based bone suppression algorithms is novel.

Angiographic embolization for obstetrical hemorrhage: effectiveness and follow-up outcome of fertility.

BACKGROUND: This study was undertaken to describe the results of angiographic embolization for obstetrical hemorrhage and the follow-up outcome of fertility. METHODS: Consecutive patients who received angiographic embolization for the management of obstetrical hemorrhage at a single tertiary center were included in this study. Medical records were reviewed to collect the clinical data and details on the procedure. Patients were interviewed by telephone to obtain the long-term outcomes for complications, menstruation, desire for conception, and subsequent pregnancies. RESULTS: Embolization was successful in 42 (86%) of 49 patients with obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was uterine atony (n=24). The success rate was significantly lower in cases with abnormal placentation than in other causes of hemorrhage (p<0.05). The procedure took an average of 45.6 min (range, 20-120 min). There were no major complications related to the procedure. We were able to follow-up 48 patients. Among 37 patients with preserved uteri, menstruation resumed spontaneously in 36 patients. Nine patients became pregnant, of which six gave birth to healthy babies and three ended in early miscarriage. CONCLUSIONS: Angiographic embolization is an effective noninvasive method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.

Vesicoamniotic shunting using a double-basket catheter appears effective in treating fetal bladder outlet obstruction.

BACKGROUND: To estimate the effect of vesicoamniotic shunting using a double-basket catheter on treating fetal bladder outlet obstruction. METHODS: A retrospective study involving 8 prenatally diagnosed bladder outlet obstruction cases that underwent vesicoamniotic shunt placement using a double-basket catheter from 1998 to 2004. Patients were followed-up for prenatal and neonatal outcome analyses. RESULTS: Vesicoamniotic shunting was performed in 8 fetuses aged between 13.7 and 25.4 weeks' gestation (mean+/-SD, 19.7+/-3.5 weeks). Final diagnoses included 5 posterior urethral valves, 1 cloacal anomaly, 1 urethral stenosis, and 1 unknown. There were no maternal complications associated with the procedures. One woman diagnosed as having a fetus with posterior urethral valves decided to terminate her pregnancy and one fetus died in uterus spontaneously. Six women delivered live babies, and one baby required postnatal ventilatory support. Postnatal follow-up ranged from 3 to 60 months. Of the 6 newborns, 4 survived with normal renal function, 1 had renal insufficiency, and 1 died of renal failure at 3 months of age. CONCLUSIONS: Vesicoamniotic shunt placement using a double-basket catheter may be effective in improving perinatal and neonatal outcomes through long-term decompression of the fetal urinary tract in carefully selected cases.

Effect of dehydroepiandrosterone on lipopolysaccharide-induced interleukin-6 production in DH82 cultured canine macrophage cells.

OBJECTIVE: This study examined the effect of dehydroepiandrosterone (DHEA) on lipopolysaccharide (LPS)-stimulated interleukin-6 (IL-6) production in the DH82 canine macrophage cell line. STUDY DESIGN: Cultured DH82 cells were stimulated with varying concentrations of LPS with or without DHEA for various times. Supernatant IL-6 levels were measured by enzyme-linked immunosorbent assay, and cellular cytoplasmic IkappaBalpha protein expression measured by Western blot analysis. RESULTS: LPS dose-dependently stimulated IL-6 production (p=0.016). Cells stimulated with 20 microg LPS showed a time-dependent increase of IL-6 concentration up to 10 h post-treatment (p=0.007). Co-treatment of DH82 cells with 20 microg LPS and various concentrations of DHEA for 14 h showed that up to 10 microM DHEA dose-dependently decreased the IL-6 concentration (p=0.007). Also, addition of 20 microM DHEA to DH82 cells with 20 microg LPS time-dependently decreased the IL-6 concentration for up to 14 h post-treatment (p=0.018). Stimulation of cultured DH82 cells with 20 microg LPS significantly decreased cellular cytoplasmic IkappaBalpha expression, beginning at 30 min post-treatment and persisting to at least 2 h post-treatment (p=0.012). However, co-treatment of cells with 20 microg LPS and 20 microM DHEA abrogated this effect until 2 h post-treatment. CONCLUSIONS: DHEA decreased the IL-6 concentration in the supernatant of LPS-stimulated DH82 cells by inhibiting the sequestration of IkappaBalpha, which is necessary for the activation of nuclear factor-kappa B. These findings provide new insights into the immunomodulatory effects of DHEA.

Prenatal diagnosis of congenital epulis by three-dimensional ultrasound and magnetic resonance imaging.

Congenital epulis is a benign intraoral tumor that has rarely been diagnosed prenatally. We report a fetus with congenital epulis diagnosed by three-dimensional (3-D) ultrasound and fetal magnetic resonance imaging (MRI) at 35 weeks' gestation. We show an image of congenital epulis using a new ultrasound technique, the 3-D multislice view, which shows images similar to CT or MRI. This is a short case report of congenital epulis diagnosed prenatally by 3-D ultrasound using multislice view and MRI.