Abnormal interhemispheric resting state functional connectivity of the insula in heroin users under methadone maintenance treatment.

Abnormal interhemispheric functional connectivity is attracting more and more attention in the field of substance use. This study aimed to examine 1) the differences in interhemispheric functional connections of the insula with the contralateral insula and other brain regions between heroin users under methadone maintenance treatment (MMT) and healthy controls, and 2) the association between heroin users' interhemispheric insular functional connectivity using resting functional magnetic resonance imaging (fMRI) and the results of urine heroin analysis. Sixty male right-handed persons, including 30 with heroin dependence under MMT and 30 healthy controls, were recruited to this study. Resting fMRI experiments and urine heroin analysis were performed. Compared with the controls, the heroin users had a significantly lower interhemispheric insular functional connectivity. They also exhibited lower functional connectivity between insula and contralateral inferior orbital frontal lobe. After controlling for age, educational level and methadone dosage, less deviation of the interhemispheric insula functional connectivity was significantly associated with a lower risk of a positive urine heroin analysis result. Our findings demonstrated that the heroin users under MMT had abnormal long-range and interhemispheric resting functional connections. Those with a less dysfunctional interhemispheric insula functional connectivity had a lower risk of a positive urine heroin test.

Added value of diffusion-weighted imaging to MR cholangiopancreatography for the diagnosis of bile duct dilatations.

PURPOSE: To investigate the added value of diffusion-weighted imaging (DWI) when used with conventional T2-weighted magnetic resonance (MR) imaging (T2WI) and MR cholangiopancreatography (MRCP) for diagnosing bile duct dilatations. METHODS: Our institutional review board approved this retrospective study protocol and waived the informed consent requirement. The study included 151 consecutive patients (70 men, 81 women) with intra- and/or extra-hepatic bile duct dilatation examined using MR imaging. Two radiologists independently and randomly reviewed 3 image sets (A: MRCP and T2WI; B: DWI; and C: combined T2WI, MRCP, and DWI) at different occasions to differentiate between malignancy, biliary lithiasis, and benign dilatation. The sensitivity, specificity, and diagnostic accuracy of these imaging sets were calculated and compared. RESULTS: For both readers, combined T2WI, MRCP, and DWI exhibited significantly higher sensitivity and diagnostic accuracy for malignant dilatation, compared with conventional T2WI and MRCP (P < 0.01 for both readers). However, DWI did not significantly affect the sensitivity and diagnostic accuracy for biliary lithiasis or benign dilatation. CONCLUSION: The addition of DWI to T2WI and MRCP sequences yields significantly higher sensitivity and diagnostic accuracy when examining bile duct dilatations, particularly malignant dilatations.

Diagnostic Performance of Split-Bolus Portal Venous Phase Dual-Energy CT Urography in Patients With Hematuria.

OBJECTIVE: The purpose of this study is to evaluate the diagnostic performance of split-bolus portal venous phase dual-energy CT (DECT) urography in patients with hematuria. MATERIALS AND METHODS: True unenhanced and split-bolus portal venous phase contrast-enhanced weighted-average images were obtained in 171 patients with hematuria. Virtual unenhanced and iodine-overlay images were reconstructed from contrast-enhanced 80-kVp and tin-filtered 140-kVp scans. Images were independently reviewed by two radiologists who were blinded to the final diagnoses in two separate reading sessions: virtual unenhanced and iodine-overlay images (single phase) in the first session and true unenhanced and contrast-enhanced weighted-average images (dual phase) in the second session (mean ± SD, 52 ± 8 days later). Sensitivity, specificity, and accuracy of mass detection were calculated from the data of both reading sessions. The number of calculi detected on virtual unenhanced images was compared with the number detected on true unenhanced images. The difference in radiation dose between the single- and dual-phase protocols was calculated. The statistical significance was determined by ANOVA. RESULTS: The sensitivity, specificity, and accuracy were 98.7%, 98.9%, and 98.8%, respectively, for the single-phase approach to malignant mass detection and 98.7%, 97.9%, and 98.3%, respectively, for the dual-phase approach (p > 0.05 for all comparisons). The overall sensitivity of stone detection was 86.7% (39/45) for virtual unenhanced images. Omitting the unenhanced scan reduced the mean radiation dose from 15.4 to 6.7 mSv. CONCLUSION: The diagnostic performance of both the single- and dual-phase approaches of portal venous phase split-bolus DECT urography is equally good in patients with hematuria, and single-phase acquisition has the added benefit of radiation reduction.

Development of Bifunctional Gadolinium-Labeled Superparamagnetic Nanoparticles (Gd-MnMEIO) for In Vivo MR Imaging of the Liver in an Animal Model.

Liver tumors are common and imaging methods, particularly magnetic resonance imaging (MRI), play an important role in their non-invasive diagnosis. Previous studies have shown that detection of liver tumors can be improved by injection of two different MR contrast agents. Here, we developed a new contrast agent, Gd-manganese-doped magnetism-engineered iron oxide (Gd-MnMEIO), with enhancement effects on both T1- and T2-weighted MR images of the liver. A 3.0T clinical MR scanner equipped with transmit/receiver coil for mouse was used to obtain both T1-weighted spoiled gradient-echo and T2-weighted fast spin-echo axial images of the liver before and after intravenous contrast agent injection into Balb/c mice with and without tumors. After pre-contrast scanning, six mice per group were intravenously injected with 0.1 mmol/kg Gd-MnMEIO, or the control agents, i.e., Gd-DTPA or SPIO. The scanning time points for T1-weighted images were 0.5, 5, 10, 15, 20, 25, and 30 min after contrast administration. The post-enhanced T2-weighted images were then acquired immediately after T1-weighted acquisition. We found that T1-weighted images were positively enhanced by both Gd-DTPA and Gd-MnMEIO and negatively enhanced by SPIO. The enhancement by both Gd-DTPA and Gd-MnMEIO peaked at 0.5 min and gradually declined thereafter. Gd-MnMEIO (like Gd-DTPA) enhanced T1-weighted images and (like SPIO) T2-weighted images. Marked vascular enhancement was clearly visible on dynamic T1-weighted images with Gd-MnMEIO. In addition, the T2 signal was significantly decreased at 30 min after administration of Gd-MnMEIO. Whereas the effects of Gd-MnMEIO and SPIO on T2-weighted images were similar (p = 0.5824), those of Gd-MnMEIO and Gd-DTPA differed, with Gd-MnMEIO having a significant T2 contrast effect (p = 0.0086). Our study confirms the feasibility of synthesizing an MR contrast agent with both T1 and T2 shortening effects and using such an agent in vivo. This agent enables tumor detection and characterization in single liver MRI sections.

Altered Functional Connectivity of the Insula and Nucleus Accumbens in Internet Gaming Disorder: A Resting State fMRI Study.

AIMS: A possible addiction mechanism has been represented by altered functional connectivity (FC) in the resting state. The aim of this study was to evaluate the FCs of the insula and nucleus accumbens among subjects with Internet gaming disorder (IGD). METHODS: We recruited 30 males with IGD and 30 controls and evaluated their FC using functional magnetic imaging scanning under resting, a state with relaxation, closed eyes, with inducement to think of nothing systematically, become motionless, and instructed not to fall asleep. RESULTS: Subjects with IGD had a lower FC with the left insula over the left dorsolateral prefrontal cortex (DLPFC) and orbital frontal lobe and a higher FC with the insula with the contralateral insula than controls. The inter-hemispheric insula connectivity positively correlated with impulsivity. Further, they had lower FC with the left nucleus accumbens over the left DLPFC and with the right nucleus accumbens over the left DLPFC, and insula and a higher FC with that over the right precuneus. CONCLUSION: The elevated inter-hemispheric insula FC is found to be associated with impulsivity and might explain why it is involved in IGD. The attenuated frontostriatal suggests that the emotion-driven gaming urge through nucleus accumbens could not be well regulated by the frontal lobe of subjects with IGD.

Follow-up for covered stent treatment of carotid blow-out syndrome in patients with head and neck cancer.

OBJECTIVE: Carotid blow-out syndrome (CBS) is a life-threatening complication of head and neck cancer (HNC). One of the various methods used for emergency management of CBS is covered stent placement (CSP). Our initial experience in CSP is evaluated and compared with reports in the literature. METHODS: This study analysed 17 patients with HNC who had received CSP for CBS at Kaohsiung Medical University Chung-Ho Memorial Hospital from May 2005 to December 2013. The medical records and images for these patients were retrospectively reviewed to evaluate the causes of CBS, treatment success rates and complications. RESULTS: The initial angiography success rate was 100%. Procedural or periprocedural complications were noted in two (12%) cases, both suffering from cerebral vascular accident (CVA). Short-term complications were noted in eight (47%) cases, including four rebleeding cases and four CVA cases. Medium- to long-term complications were noted in nine cases, which included two asymptomatic in-stent thrombosis cases, one symptomatic CVA case, two abscess formation cases and four rebleeding cases. Overall, eight (47%) cases of rebleeding occurred during follow-up. Three of the eight cases were fatal, accounting for 27% of the all-cause mortality. CONCLUSION: Although CSP is considered effective for achieving haemostasis in patients with HNC with CBS, the medium- to long-term outcomes are unfavourable owing to high risks of rebleeding, CVA and other complications. Therefore, CSP should be considered a temporary life-saving technique rather than a definitive treatment. ADVANCES IN KNOWLEDGE: Analysis of the relatively large series of patients with HNC in this study suggests that CSP is a useful temporary treatment for CBS.

Pleural Tags on CT Scans to Predict Visceral Pleural Invasion of Non-Small Cell Lung Cancer That Does Not Abut the Pleura.

PURPOSE: To evaluate the association of pleural tags with visceral pleural invasion of non-small cell lung cancer (NSCLC) that does not abut the pleural surface. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board. Informed consent was waived. The study of NSCLC that does not abut the pleura in 141 patients (44 patients [31.2%] with visceral pleural invasion proved by pathologic analysis and 97 patients [68.8%] without pleural invasion) was conducted at a single tertiary center. The pleural tags were classified into three types (type 1, one or more linear pleural tag; type 2, one or more linear pleural tag with soft tissue component at the pleural end; and type 3, one or more soft tissue cord-like pleural tag) and prioritized into types 3, 2, and 1 when more than one type was present. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive likelihood ratio (LR) were calculated. RESULTS: In the absence of pleural tags, no pleural invasion was found. The presence of type 2 pleural tags was moderately associated with visceral pleural invasion with the following results: positive LR, 5.06; accuracy, 71%; sensitivity, 36.4%; specificity, 92.8%; PPV, 76.2%; and NPV, 69.6%. Type 1 pleural tags provided weak evidence to rule out visceral pleural invasion (positive LR, 0.38). Type 3 pleural tags indicated minimal increase in the likelihood of visceral pleural invasion (positive LR, 1.68). CONCLUSION: Type 2 pleural tags on conventional CT images can increase the accuracy of early diagnosis of visceral pleural invasion by NSCLC that does not abut the pleura.

Split-Bolus Portal Venous Phase Dual-Energy CT Urography: Protocol Design, Image Quality, and Dose Reduction.

OBJECTIVE: The purpose of this study is to evaluate the image quality of split-bolus portal venous phase urography and the potential reduction of radiation dose by using a second-generation dual-source dual-energy CT (DECT) scanner. MATERIALS AND METHODS: DECT urography was performed in 84 patients. Unenhanced CT was performed 20 minutes after drinking 800 mL of water. The split-bolus protocol consisted of a sequence of injections, as follows: 200 mL of normal saline (2.0 mL/s), 50 mL of contrast medium (2.5 mL/s) at 0 second, 70 mL of contrast medium (2.5 mL/s) at 360 seconds, and a saline flush of 25 mL. The scan was started at 420 seconds. Virtual unenhanced images were reconstructed from contrast-enhanced images. The mean CT density and signal-to-noise ratio (SNR) of the renal parenchyma, vessels, upper urinary tract, normal reference tissues, and tumors were measured for image quantitative analysis. Image quality and opacification of the collecting systems were rated by two radiologists using 3- or 4-point scales. RESULTS: The SNR of all measured sites, except the renal pelvis, showed a statistically significant correlation (p < 0.001) between the true unenhanced and virtual unenhanced images. The overall sensitivity of stone detection was 87.5% (28/32) in virtual unenhanced images. Image quality of the renal parenchyma, arteries, and veins was excellent in 59.5%, 75.0%, and 97.6% of cases, respectively. Opacification of the intrarenal collecting systems, proximal, middle, and distal ureters, and bladder was complete in 92.9%, 83.9%, 78.6%, 77.4%, and 26.2% of patients, respectively. Omitting the unenhanced scan can reduce the mean radiation dose from 15.6 to 6.7 mSv. CONCLUSION: Portal venous phase split-bolus DECT urography provides sufficient image quality with potential to reduce radiation exposure.

Lowering radiation dose during dedicated colorectal cancer MDCT: comparison of low tube voltage and sinogram-affirmed iterative reconstruction at 80 kVp versus blended dual-energy images in a population of patients with low body mass index.

PURPOSE: To assess the diagnostic accuracy, cancer staging, image quality, and radiation dose of 80-kVp computed tomography (CT) images for patients with colorectal cancers (CRCs) using sinogram-affirmed iterative reconstruction (SAFIRE). METHODS: Sixty-four consecutive patients (mean weight 62.5  ±  11.3 kg, mean BMI 24.1  ±  3.3 kg/m(2)) with known CRC underwent dual-energy CT. Data were reconstructed as a weighted average (WA) 120-kVp dataset. Both filtered back projection (FBP) and SAFIRE were applied to reconstruct the WA 120-Kvp (Protocol A, B) and 80-kVp (Protocol C, D) image sets. The image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the cancers, the normal reference tissues, and the effective dose for each protocol were assessed. The cancer detection, staging, and image quality were evaluated. Analysis of variance was used for statistical analysis. RESULTS: Compared with the FBP datasets at WA 120-kVp (Protocol A) and 80-kVp (Protocol C), the SAFIRE-reconstructed images (Protocols B, D) demonstrated significantly lower image noise (P  <  0.0083). Protocol D yielded significantly higher CNRs and SNRs for the CRCs and normal reference tissues than did Protocols A and C (P  <  0.0083). Protocol D also exhibited a significantly higher CNR for the CRC and some normal reference tissues than did Protocol B (P  <  0.0083). For hypovascular liver metastases (n  =  10), Protocol D yielded better SNRs and significantly higher CNRs than did Protocol A (P  <  0.0083). Overall, accuracy for tumor staging and liver metastasis was 95.3% (61/64) and 100%, respectively, in all of the 4 protocols. The mean effective dose decreased 41% from the WA 120-kVp to the 80-kVp protocols (6.23 vs. 3.68 mSv). CONCLUSIONS: The 80-kVp technique with SAFIRE provided high SNR, high CNR, and good accuracy for staging in nonobese patients with CRC. Our study results should be extrapolated to patient populations with a high BMI with caution. Further studies of high BMI patients are therefore warranted.

Aberrant brain activation of error processing among adults with attention deficit and hyperactivity disorder.

Individuals with adult attention deficit/hyperactivity disorder (ADHD) have a deficit in their cognitive control. The aim of this study was to reveal the brain correlates of the deficits in response inhibition or error processing in adult ADHD. A total of 29 adults with ADHD and 25 control individuals were recruited. They completed an event-related-design Go/No-go task under functional magnetic resonance imaging scanning. Both the ADHD group and the control group exhibited activation of the frontostriatal network when processing response inhibition. They also exhibited activation of the frontoinsula cortex and anterior cingulate in error processing. Adults with ADHD have a lower brain activation of error processing over the right inferior frontal lobe adjacent to the insula than control individuals. The altered frontoinsula cortex activation may represent the mechanism of error processing deficit among adults with ADHD.

Brain correlates of response inhibition in Internet gaming disorder.

AIMS: The present study aimed to evaluate the brain correlates of response inhibition among subjects with Internet gaming disorder (IGD). METHODS: For this purpose, 15 men with IGD for at least 1 year, and 15 controls with no history of IGD were recruited to perform the Go/Nogo task under functional magnetic resonance imaging investigation. Prior to scanning, the subjects were assessed using the Chen Internet Addiction Scale and the Barrett Impulsivity Scale. RESULTS: The control group exhibited activation of the right supplement motor area (SMA), dorsolateral prefrontal cortex, and caudate for response inhibition. However, the IGD group had a higher impulsivity and lower activity of the right SMA/pre-SMA in comparison to the control group. CONCLUSIONS: The results obtained suggest that dysfunctional activation of the SMA for response inhibition is one of the candidate mechanisms of IGD.

Automated detection of endotracheal tubes in paediatric chest radiographs.

The aim of this study was to develop an automated method for the detection of endotracheal tube and location of its tip in paediatric chest radiographs. In this method, a seed point was first determined from the line crossing the cervical region and a line path was traced from the seed point. Two features, Lmax and C, were determined from the path and were combined to detect the existence of the endotracheal tube. Multiple thresholds applied to the line path were used to determine the candidate locations for the tip, and the most suitable location was selected from these candidates by analysing the image features. To evaluate the performance of detection of endotracheal tube existence, support vector machine was used to classify the images with and without endotracheal tubes on the basis of Lmax and C. The discriminant performance of the method was evaluated using receiver operating characteristic (ROC) analysis. To evaluate the precision of the detected tip locations, the tip locations in paediatric chest images were annotated by a radiologist. The distance (error) between the detected and annotated locations was used to evaluate detection precision for the tip location. The proposed method was evaluated using 528 images with endotracheal tubes and 816 images without endotracheal tubes. The discriminant performance in this study, evaluated as Az (area under the ROC curve), for detecting the existence of endotracheal tubes on the basis of the two features was 0.943±0.009, and the detection error of the tip location was 1.89±2.01mm. The proposed method obtained high performance results and could be useful for detecting the malposition of endotracheal tubes in paediatric chest radiographs.

Computer-aided detection system for chest radiography: reducing report turnaround times of examinations with abnormalities.

BACKGROUND: The ability to give high priority to examinations with pathological findings could be very useful to radiologists with large work lists who wish to first evaluate the most critical studies. A computer-aided detection (CAD) system for identifying chest examinations with abnormalities has therefore been developed. PURPOSE: To evaluate the effectiveness of a CAD system on report turnaround times of chest examinations with abnormalities. MATERIAL AND METHODS: The CAD system was designed to automatically mark chest examinations with possible abnormalities in the work list of radiologists interpreting chest examinations. The system evaluation was performed in two phases: two radiologists interpreted the chest examinations without CAD in phase 1 and with CAD in phase 2. The time information recorded by the radiology information system was then used to calculate the turnaround times. All chest examinations were reviewed by two other radiologists and were divided into normal and abnormal groups. The turnaround times for the examinations with pathological findings with and without the CAD system assistance were compared. RESULTS: The sensitivity and specificity of the CAD for chest abnormalities were 0.790 and 0.697, respectively, and use of the CAD system decreased the turnaround time for chest examinations with abnormalities by 44%. CONCLUSION: The turnaround times required for radiologists to identify chest examinations with abnormalities could be reduced by using the CAD system. This system could be useful for radiologists with large work lists who wish to first evaluate the most critical studies.

Utility of the iodine overlay technique and virtual nonenhanced images for the preoperative T staging of colorectal cancer by dual-energy CT with tin filter technology.

OBJECTIVES: To evaluate the diagnostic accuracy and the potential radiation dose reduction of dual-energy CT (DECT) for tumor (T) staging of colorectal cancer (CRC) using iodine overlay (IO) and virtual nonenhanced (VNE) images. MATERIALS AND METHODS: This retrospective study included 103 consecutive patients who underwent nonenhanced CT and enhanced DECT for preoperative CRC staging. Enhanced weighted-average (WA), IO and VNE images were reconstructed from enhanced 80 kVp and Sn140 kVp scans. Two radiologists assessed image qualities of the true nonenhanced (TNE) and VNE images. For T-staging, another two radiologists independently interpreted all scans in two separate reading sessions: in the first session, only images derived from the single phase DECT acquisition (IO and VNE images) were read. In the second reading session after 30 to 50 (average:42) days, the same assessment was again performed with the TNE and enhanced WA images thereby simulating conventional dual-phase single-energy CT. The tumor node metastasis (TNM) system was used for staging with histopathologic reports as gold standard. Analysis of variance was used for statistical analysis. RESULTS: The signal-to-noise ratios (SNRs) of the tumors and normal reference tissues showed significant correlation between the TNE and VNE images (P<0.01). The mean iodine overlay value (48.4 HU±12.2) and enhancement (49.4 HU±11.8) value of CRCs had no significant difference (P = 0.52).The mean image noise on TNE (5.0±1.1) and VNE (5.3±1.1) images were similar (P = 0.07). The quantitative qualities of the VNE images were mildly inferior to the TNE images. Overall accuracy of T-stage CRC when using single-phase acquisition was slightly better than the dual-phase acquisition (90.3% vs 87.4%) (P = 0.51). The mean dose of the single-phase DECT acquisition was 6.2 mSv comparing with 14.3 mSv of dual-phase. CONCLUSION: Single-phase DECT using IO and VNE images yields a high accuracy in T-staging of CRCs. Thereby, the radiation exposure of the patients can be reduced.

Correlation between EGFR mutation status and computed tomography features in patients with advanced pulmonary adenocarcinoma.

PURPOSE: To correlate computed tomography (CT) imaging features and epidermal growth factor receptor (EGFR) mutation status in patients with advanced lung adenocarcinoma. MATERIALS AND METHODS: Patients with advanced pulmonary adenocarcinoma who were diagnosed between January 1, 2009 and December 31, 2011 and who had available chest CT and their tumors analyzed for EGFR mutations at a university hospital were enrolled in this retrospective study. Two radiologists independently evaluated the CT images and recorded the target lesion's size, shape, margin, density, and the presence or absence of an air bronchogram and calcification. RESULTS: One hundred and forty-nine patients were enrolled into this study (66 men, 83 women), with a mean age of 63±11 years (range 32 to 89 y). Seventy-eight (52.3%) patients had EGFR mutations. The tumors in the patients harboring no EGFR mutations (EGFR wild type) were larger than in those whose tumors harbored EGFR mutations (P=0.01). An irregular shape was more common in the tumors with wild-type EGFR (P=0.01), and an oval shape was more common in tumors with EGFR mutations. Tumors with exon 21 mutations were larger than those with exon 19 deletions (P=0.02). Air bronchograms were more common in tumors with exon 19 deletions than in those with wild-type EGFR or exon 21 mutations (P=0.004 and 0.01, respectively). Calcification was more common in the tumors with wild-type EGFR than in those with EGFR mutations (P=0.03). CONCLUSIONS: Adenocarcinomas with wild-type EGFR were significantly associated with larger tumors and an irregular shape. In particular, calcification was more common in the tumors with wild-type EGFR than in those with EGFR mutations. In addition, air bronchograms were more common in the tumors with exon 19 deletions.

Automated detection of fovea in fundus images based on vessel-free zone and adaptive Gaussian template.

This study developed a computerised method for fovea centre detection in fundus images. In the method, the centre of the optic disc was localised first by the template matching method, the disc-fovea axis (a line connecting the optic disc centre and the fovea) was then determined by searching the vessel-free region, and finally the fovea centre was detected by matching the fovea template around the centre of the axis. Adaptive Gaussian templates were used to localise the centres of the optic disc and fovea for the images with different resolutions. The proposed method was evaluated using three publicly available databases (DIARETDB0, DIARETDB1 and MESSIDOR), which consisted of a total of 1419 fundus images with different resolutions. The proposed method obtained the fovea detection accuracies of 93.1%, 92.1% and 97.8% for the DIARETDB0, DIARETDB1 and MESSIDOR databases, respectively. The overall accuracy of the proposed method was 97.0% in this study.

Altered brain activation during response inhibition and error processing in subjects with Internet gaming disorder: a functional magnetic imaging study.

The aim of the present study was to evaluate the impulsivity and brain correlates of response inhibition and error processing among subjects with Internet gaming disorder (IGD). We evaluated the response inhibition and error processing by functional magnetic resonance imaging (fMRI) in subjects with IGD and controls. Twenty-six men with IGD for at least 2 years and 23 controls with no history of IGD were recruited as the IGD and control groups, respectively. All subjects performed the event-related designed Go/No-go task under fMRI and completed questionnaires related to Internet addiction and impulsivity. The IGD group exhibited a higher score for impulsivity than the control group. The IGD group also exhibited higher brain activation when processing response inhibition over the left orbital frontal lobe and bilateral caudate nucleus than controls. Both the IGD and control groups exhibited activation of the insula and anterior cingulate cortex during error processing. The activation over the right insula was lower in the subjects with IGD than the control group. Our results support the fact that the fronto-striatal network involved in response inhibition, and the salience network, anchored by the anterior cingulate and insula, contributes to error processing. Further, adults with IGD have impaired insular function in error processing and greater activation of the fronto-striatal network in order to maintain their response inhibition performance.

Brain activation for response inhibition under gaming cue distraction in internet gaming disorder.

We evaluated neural substrates related to the loss of control in college students with internet gaming disorder (IGD). We hypothesized that deficit in response inhibition under gaming cue distraction was the possible mechanism for the loss of control internet use. Eleven cases of IGD and 11 controls performed Go/NoGo tasks with/without gaming distraction in the functional magnetic resonance imaging scanner. When the gaming picture was shown as background while individuals were performing Go/NoGo tasks, the IGD group committed more commission errors. The control group increased their brain activations more over the right dorsolateral prefrontal cortex (DLPFC) and superior parietal lobe under gaming cue distraction in comparison with the IGD group. Furthermore, brain activation of the right DLPFC and superior parietal lobe were negatively associated with performance of response inhibition among the IGD group. The results suggest that the function of response inhibition was impaired under gaming distraction among the IGD group, and individuals with IGD could not activate right DLPFC and superior parietal lobe to keep cognitive control and attention allocation for response inhibition under gaming cue distraction. This mechanism should be addressed in any intervention for IGD.

Altered neurochemical metabolites in Alzheimer's disease patients with unawareness of deficits.

BACKGROUND: Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes. METHODS: Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated. RESULTS: Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (ß = -0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (ß = 0.41, p = 0.009) after controlling for dementia severity. CONCLUSIONS: These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.

Automated patient identity recognition by analysis of chest radiograph features.

RATIONALE AND OBJECTIVES: The aim of this study was to develop a computerized scheme for automated identity recognition based on chest radiograph features. MATERIALS AND METHODS: The proposed method was evaluated on a database consisting of 1000 pairs of posteroanterior chest radiographs. The method was based on six features: length of the lung field, size of the heart, area of the body, and widths of the upper, middle, and lower thoracic cage. The values for the six features were determined from a chest image, and absolute differences in feature values between the two images (feature errors) were used as indices of image similarity. The performance of the proposed method was evaluated by receiver operating characteristic (ROC) analysis. The discriminant performance was evaluated as the area Az under the ROC curve. RESULTS: The discriminant performance Az of the feature errors for lung field length, heart size, body area, upper cage width, middle cage width, and lower cage width were 0.794 ± 0.005, 0.737 ± 0.007, 0.820 ± 0.008, 0.860 ± 0.005, 0.894 ± 0.006, and 0.873 ± 0.006, respectively. The combination of the six feature errors obtained an Az value of 0.963 ± 0.002. CONCLUSION: The results indicate that combining the six features yields a high discriminant performance in recognizing patient identity. The method has potential usefulness for automated identity recognition to ensure that chest radiographs are associated with the correct patient.