Delayed migration of a Sapien 3 Ultra Resilia following transcatheter aortic valve implantation after selection of a smaller-sized valve.

This report discusses a rare case of delayed migration of a Sapien 3 Ultra Resilia (S3UR) valve following transcatheter aortic valve implantation. An 81-year-old Japanese woman had a borderline aortic annular size of 20-23 mm according to the manufacturer's size chart. We chose to implant a smaller S3UR of 20 mm with an 80/20 depth ratio to allow for a second intervention, ensuring good hemodynamics and minimizing paravalvular leak. The patient initially had a favorable outcome despite an accidental 50/50 depth ratio during implantation. On postoperative day 3, the S3UR migrated into the left ventricular outflow tract. Emergency surgical aortic valve replacement was performed to retrieve the migrated valve. Use of the S3UR has led to a growing preference for smaller valve sizes. However, the risk of migration should be recognized. When an accidental 50/50 depth ratio implantation is encountered, post-dilation or second valve implantation should be performed immediately.

Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study.

Colorectal adenoma is linked to metabolic dysfunction. Metabolic dysfunction-associated fatty liver disease (MAFLD) has a precise definition and three subtypes, including non-obese MAFLD. We aimed to investigate the impact of MAFLD on the prevalence of colorectal adenoma by comparing it to non-alcoholic fatty liver disease (NAFLD) in health check-up examinees. This is a multicenter retrospective study. We enrolled 124 consecutive health check-up examinees who underwent colonoscopy. NAFLD and MAFLD were present in 58 and 63 examinees, respectively. Colorectal adenoma was diagnosed by biopsy. The impact of the MAFLD definition on the prevalence of colorectal adenoma was investigated by logistic regression, decision-tree, and random forest analyses. In logistic regression analysis, MAFLD was identified as the only independent factor associated with the presence of colorectal adenoma (OR 3.191; 95% CI 1.494-7.070; p = 0.003). MAFLD was also identified as the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (29 variable importance value). Among the three subtypes of MAFLD, non-obese MAFLD was the sole independent factor associated with the presence of colorectal adenoma (OR 3.351; 95% CI 1.589-7.262; p ≤ 0.001). Non-obese MAFLD was also the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (31 variable importance value). MAFLD, particularly non-obese MAFLD, is the most important factor associated with the presence of colorectal adenoma rather than NAFLD. Colonoscopy examination should be considered in patients with MAFLD, especially those who are non-obese.

[Effect of Reconstruction Technique for Metal Artifact Reduction in Computed Tomography by Changing Display Field of View].

We evaluated the effect of orthopedic-metal artifact reduction (O-MAR) for metal artifact in computed tomography with 73 simulated seeds for brachytherapy in different sizes of display field of view (DFOV) obtained by helical scan under the same clinical scan condition. The metal artifacts were analyzed with the Gumbel's method by changing DFOV sizes 80 mm, 160 mm, and 320 mm. Gumbel distribution, scale parameter (γ), and location parameter (ß) of the metal artifacts with O-MAR were compared with that of the metal artifacts with filtered back projection (FBP). In conclusion, it was considered that the effect of metal artifact reduction with O-MAR was influenced by DFOV size in this study. The reduction rates of scale parameter (γ) were 22.3%, 21.3%, and 10.0% in DFOV 80 mm, 160 mm, and 320 mm, respectively. The reduction rates of location parameter (ß) were 27.4%, 23.4 %, and 9.8%. Therefore, the effect of metal artifact reduction with O-MAR showed the tendency of increasing with decreasing DFOV size.

[Evaluation of image quality using the normalized-rank approach for primary class liquid-crystal display (LCD) monitors with different colors and resolution].

The purposes of this study were to evaluate the image quality of five types of liquid-crystal display (LCD) monitors by utilizing the normalized-rank approach and to investigate the effect of LCD monitor specifications, such as display colors, luminance, and resolution, on the evaluators' ranking. The LCD monitors used in this study were 2, 3 and 5 mega-pixel monochrome LCD monitors, and 2 and 3 mega-pixel color LCD monitors (Eizo Nanao Corporation). All LCD monitors were calibrated to the grayscale standard display function (GSDF) with different maximum luminance (recommended luminance) settings. Also, four kinds of radiographs were used for observer study based on the normalized-rank approach: three adult chest radiographs, three pediatric chest radiographs, three ankle joint radiographs, and four double-contrasted upper gastrointestinal radiographs. Ten radiological technologists participated in the observer study. Monochrome LCD monitors exhibited superior ranking with statistically significant differences (p<0.05) compared to color LCD monitors in all kinds of radiographs. The major difference between monochrome and color monitors was luminance. Therefore, it is considered that the luminance of LCD monitors affects observers' evaluations based on image quality. Moreover, in the case of radiographs that include high frequency image components, the monitor resolution also affects the evaluation. In clinical practice, it is necessary to optimize the luminance and choose appropriate LCD monitors for diagnostic images.

[Correlation between basic imaging properties and subjective evaluations of two digital radiographic X-ray systems based on direct-conversion flat panel detector].

The purpose of this study was to examine the correlation between the basic imaging properties of two digital radiographic X-ray systems with a direct conversion flat-panel detector and their image qualities, which were evaluated by the observer in hard copy and soft copy studies. The subjective image quality was evaluated and compared in terms of the low-contrast detectability and image sharpness in the two digital radiographic X-ray systems. We applied the radiographs of a contrast detail phantom to the evaluation of low-contrast detectability and analyzed the contrast detail diagrams. Finally, low-contrast detectability was evaluated by the image quality figure (IQF) calculated from the contrast detail diagrams. Also, the subjective image sharpness of human dry bones of two systems was examined and evaluated by the normalized-rank method. The results indicated that System A tended to provide superior subjective image quality compared to System B in both observer studies. We also found high correlations between IQFs and basic imaging properties, such as the noise power spectrum (NPS) and the noise equivalent quantum (NEQ). In conclusion, the low-contrast detectability of the two digital radiographic X-ray systems with a direct conversion flat-panel detector corresponded to the NPS and the NEQ in both outputs (soft copy and hard copy). On the other hand, the subjective image sharpness of human dry bones was affected by their noise properties.