[Artificial intelligence in lung imaging]. / Künstliche Intelligenz in der Bildgebung der Lunge.

CLINICAL/METHODICAL ISSUE: Artificial intelligence (AI) has the potential to improve diagnostic accuracy and management in patients with lung disease through automated detection, quantification, classification, and prediction of disease progression. STANDARD RADIOLOGICAL METHODS: Owing to unspecific symptoms, few well-defined CT disease patterns, and varying prognosis, interstitial lungs disease represents a focus of AI-based research. METHODICAL INNOVATIONS: Supervised and unsupervised machine learning can identify CT disease patterns using features which may allow the analysis of associations with specific diseases and outcomes. PERFORMANCE: Machine learning on the one hand improves computer-aided detection of pulmonary nodules. On the other hand it enables further characterization of pulmonary nodules, which may improve resource effectiveness regarding lung cancer screening programs. ACHIEVEMENTS: There are several challenges regarding AI-based CT data analysis. Besides the need for powerful algorithms, expert annotations and extensive training data sets that reflect physiologic and pathologic variability are required for effective machine learning. Comparability and reproducibility of AI research deserve consideration due to a lack of standardization in this emerging field. PRACTICAL RECOMMENDATIONS: This review article presents the state of the art and the challenges concerning AI in lung imaging with special consideration of interstitial lung disease, and detection and consideration of pulmonary nodules.

[Acute abdomen - a practical approach]. / Akutes Abdomen ­ ein praktischer Zugang.

CLINICAL PROBLEM: Acute abdomen describes a critical clinical condition which includes a heterogeneous group of clinical presentations. Several diseases require immediate surgical treatment. Therefore, fast radiological assessment is demanded. STANDARD RADIOLOGICAL METHODS: Stable patients presenting at the emergency department with acute abdominal pain require an abdominal x­ray, an ultrasound examination and/or a computed tomography (CT) scan, depending on the location and character of their pain. These standard radiological methods provide a quick differentiation between simple and complicated pathologies. Unstable patients should undergo immediate CT and, if positive, be sent directly to surgery. METHODICAL INNOVATIONS AND ASSESSMENT: The ongoing technical developments in the field of computed tomography allow a quick and detailed characterization of pathologic conditions of the abdominal organs. A structured approach, based on the analysis of typical radiological signs and patterns, combined with the evaluation of extra-abdominal findings helps to assign the observed imaging findings to specific diseases. RECOMMENDATION: A systematic 4­point approach for structured analysis of specific and nonspecific imaging features and common pitfalls aids to choose the correct radiological method and help to narrow the broad spectrum of potential differential diagnoses.

Machine learning: from radiomics to discovery and routine.

Machine learning is rapidly gaining importance in radiology. It allows for the exploitation of patterns in imaging data and in patient records for a more accurate and precise quantification, diagnosis, and prognosis. Here, we outline the basics of machine learning relevant for radiology, and review the current state of the art, the limitations, and the challenges faced as these techniques become an important building block of precision medicine. Furthermore, we discuss the roles machine learning can play in clinical routine and research and predict how it might change the field of radiology.

Vaginal Health: Insights, Views & Attitudes (VIVA-LATAM): results from a survey in Latin America.

OBJECTIVE: To investigate awareness in Latin America, knowledge of postmenopausal vaginal atrophy was evaluated in a sample of women from this region. METHODS: A total of 2509 postmenopausal women aged 55-65 years, resident in Argentina, Brazil, Chile, Colombia and Mexico, completed a structured online questionnaire. RESULTS: Over half the surveyed population (57%) reported experiencing symptoms of vaginal atrophy. Only 6% of the overall cohort attributed symptoms of vaginal atrophy directly to the condition, and 71% did not consider the condition to be chronic, resulting in many women not accessing effective therapy. Half the women (49%) affected by vaginal atrophy had used lubricating gels and creams; 36% had used some form of local hormone treatment. To understand symptoms and/or treatment options for vaginal discomfort, the majority of survey participants (92%) were willing to seek advice from health-care professionals; most (61%) felt/would feel comfortable talking to their doctor about this. CONCLUSION: Many women in Latin America lack knowledge of postmenopausal vaginal atrophy, not appreciating the chronic nature of the condition, and may benefit from dialog initiated by health-care professionals to facilitate greater understanding and increased awareness of the availability of effective treatment.

[When is cartilage repair successful?] / Wann ist eine Knorpelreparatur erfolgreich?

Focal cartilage lesions are a cause of long-term disability and morbidity. After cartilage repair, it is crucial to evaluate long-term progression or failure in a reproducible, standardized manner. This article provides an overview of the different cartilage repair procedures and important characteristics to look for in cartilage repair imaging. Specifics and pitfalls are pointed out alongside general aspects. After successful cartilage repair, a complete, but not hypertrophic filling of the defect is the primary criterion of treatment success. The repair tissue should also be completely integrated to the surrounding native cartilage. After some months, the transplants signal should be isointense compared to native cartilage. Complications like osteophytes, subchondral defects, cysts, adhesion and chronic bone marrow edema or joint effusion are common and have to be observed via follow-up. Radiological evaluation and interpretation of postoperative changes should always take the repair method into account.