Unicompartmental knee arthroplasty approximates healthy knee kinematics more closely than total knee arthroplasty.

Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are effective surgeries to treat end-stage knee osteoarthritis. Clinicians assume that TKA alters knee kinematics while UKA preserves native knee kinematics; however, few studies of in vivo kinematics have evaluated this assumption. This study used biplane radiography to compare side-to-side tibiofemoral kinematics during chair rise, stair ascent, and walking in 16 patients who received either TKA or UKA. We hypothesized that TKA knees would have significant kinematic changes and increased asymmetry with the contralateral knee, while UKA knee kinematics would not change after surgery and preoperative knee symmetry would be maintained. Native bone and implant motion were tracked using a volumetric model-based tracking technique. Six degrees of freedom kinematics were calculated throughout each motion. Kinematics were compared between the operated and contralateral knees pre- and post-surgery using a linear mixed-effects model. TKA knees became less varus with the tibia more medial, posterior, and distal relative to the femur. UKA knees became less varus with the tibia less lateral on average. Postoperative TKA knees were in less varus than UKA knees on average and at low flexion angles, with an internally rotated tibia during chair rise and stair ascent. At high flexion angles, the tibia was more medial and posterior after TKA than UKA. Side-to-side kinematic symmetry worsened after TKA but was maintained or improved after UKA. Greater understanding of kinematic differences between operated and contralateral knees after surgery may help surgeons understand why some patients remain unsatisfied with their new knees.

Workload as a predictor of radiographer preliminary image evaluation accuracy.

INTRODUCTION: Despite a demonstrated high accuracy and reported successful implementations, radiographer preliminary image evaluation (PIE) has been slow and infrequent in its rollout across Australia. A key barrier reported to hamper radiographer PIE service implementation is lack of adequate time to review radiographs and provide an accurate interpretation. This study sought to conduct a correlational analysis between radiographer imaging workload and PIE service accuracy. METHODS: A total of 45,373 exams and 1152 PIE comments evenly distributed each month from January 1, 2022, to December 31, 2022, were reviewed. PIE comments were assessed for consistency with the radiologist's report. The imaging workload (average exams completed per hour) was separated into three, eight-hour 'shifts' based on time of imaging. Correlational analysis was performed using linear regression models and assessed for normality using the Shapiro-Wilks test. RESULTS: The study reported no significant linear association between increasing average workload and reduced service accuracy (P = 0.136). It was however noted that when the average workload increased beyond 7 exams/hour, average service accuracy for PIE was always below 85%. CONCLUSION: This study has demonstrated that, although perceived, there is no statistically significant correlation between x-ray imaging workload and radiographer PIE service accuracy. Consideration of this correlation to be a significant barrier to participation in such a service was not reported at this site.

Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry.

This review discusses the role of diagnostic measures in the lifelong management of periodontal disease and peri-implant complications. After active treatment, these conditions require regular monitoring of the supporting structures of teeth and dental implants to assess bone and soft tissue health over time. Several clinical measures have been developed for the routine assessment of periodontal and peri-implant tissues, including periodontal and peri-implant probing, bleeding on probing, intraoral radiography, biomarker analysis, and microbiological testing. This review highlights the evolution of diagnostic practices, integrating traditional methods with emerging technologies such as resonance frequency analysis and ultrasound imaging to provide a holistic view of peri-implant health assessment. In addition to objective measurements, patient risk factors are considered. The goals of periodontal and peri-implant maintenance are to control disease activity and stabilize tissues through supportive care, which includes diagnostic measures at follow-up visits. This enables clinicians to monitor treatment outcomes, assess health status, and detect recurrence or progression early through routine evaluation, allowing additional interventions, including adjustment of supportive therapy intervals, to further improve and maintain periodontal and peri-implant stability over time.

Selective postmortem arterial angiography of head and neck using digital x-ray or computed tomography: A practical and rapid method to identify vascular injuries.

Identification of vascular injuries is crucial for complete postmortem evaluation and understanding of trauma deaths by the Medical Examiner. Some vascular injuries are difficult to evaluate due to challenging anatomic locations, especially in the head and neck. Documenting injuries of the facial and vertebral arteries is challenging and necessitates time-consuming dissections that can create artifacts and disfigurement. In busy medical examiner offices with a significant number of traumatic injuries, finding a creative solution to employ reliable postmortem angiography is desirable. At the Office of the Chief Medical Examiner for the State of Maryland (OCME), we created and effectively implemented a selective angiography procedure using traditional indwelling Foley catheters and water-soluble barium swallow contrast to evaluate arterial injuries using either digital radiography or computed tomography imaging modalities. This technique and imaging interpretation can be performed by a medical examiner or forensic pathology fellow after basic technical training and basic radiology training. This study outlines the technique, methods, and utilization of the procedure and describes the findings of six deaths due to vascular lesions from different injury mechanisms and disease processes and describes the ease of implementation on a broader scale in busy Medical Examiner's offices.

Radiographic assessment of the peri-implant site.

While peri-implant mucositis relies solely on clinical parameters, radiological assessment becomes indispensable for diagnosing peri-implantitis. Intraoral radiography, with its simplicity of application, low radiation exposure, and adequate representation of peri-implant structures, stands out as the standard of care for both immediate and follow-up assessments. Standardization by custom-made radiologic splints allows for excellent comparability with previous images and allows for the determination of even small changes in contour and density of the peri-implant bone. Furthermore, other radiographic modalities like panoramic radiography and cone beam computed tomography (CBCT) may provide useful features for specific patients and clinical cases while also showing innate limitations. Beyond the assessment of the marginal peri-implant bone level as the crucial parameter of clinical relevance, radiologic assessment may reveal various other findings related to the prosthetic restoration itself, the precision of its fit to the implant, and the peri-implant soft and hard tissues. Since such findings can be crucial for the assessment of peri-implant health and the implants' prognosis, a systematic diagnostic evaluation pathway for a thorough assessment is recommended to extract all relevant information from radiologic imaging. This article also provides an overview of the clinical and chronological indications for different imaging modalities in peri-implant issues.

A Cone-Beam Computed Tomography-Based Evaluation of Root Dilaceration in Permanent Premolars: A Retrospective Study.

Statement of the Problem: As a developmental disorder characterized by an abnormal bend and angle in the longitudinal axis of the tooth root, dilaceration can cause complications in routine dental procedures such as endodontics, orthodontics, and surgical treatments. Purpose: The purpose of this study was to investigate the prevalence of dilaceration in maxillary and mandibular premolar teeth in a population of Shiraz city based on cone-beam computed tomography (CBCT). Materials and Method: This is a retrospective cross-sectional study on 927 premolar teeth and 132 CBCT radiographs of patients obtained from four private radiology clinics in Shiraz (Iran). In this study, the presence, location, direction, and severity of dilaceration in premolar roots as well as its relationship with gender were investigated. Chi-square and Fisher tests were used to analyze the data. Results: The results showed that 17% of the studied 927 teeth had dilaceration. The prevalence of dilaceration was significantly higher in women than in men (20.3% vs. 13.6%, p= 0.005). The dilaceration rates were significantly higher in the mandibular first and second premolar teeth (31.6% and 26%, p= 0.002) than in the other teeth. In addition, the highest prevalence was in the distal direction with mild severity in the apical third of the root (p< 0.001). Conclusion: According to the results of this study, the prevalence of dilaceration was relatively high in mandibular premolar teeth especially in women.

Mandibular bone mass density in a medieval population and its relationship with stable isotopes δ13C and δ15N.

The aim of this study was to compare the level of bone mass in digital orthopantomograms in two populations (medieval and current) using two radiomorphometric indexes, and to correlate the mandibular bone mass value, in the medieval mandible population, with stable isotope data δ13C and δ15N. An observational, cross-sectional, and analytical study on mandibles from two diachronic groups, 15 mandibles from the medieval settlement of La Torrecilla (Granada, Spain) and 15 mandibles from current patients at the Faculty of Dentistry of the University of Granada (Spain), matched by age and sex was conducted. The bone mass density was determined using the Mandibular Cortical Width Index (MCW) and the Mandibular Panoramic Index (PMI) in digital panoramic radiographs. In the medieval group, the values of bone mass density were correlated with those of two stable isotopes (δ13C and δ15N). The mean value of MCW in mm in the medieval group was 3.96 ± 0.60 (mean ± standard deviation) and in the current group was 4.02 ± 1.01. The PMI was 0.33 ± 0.06 and 0.35 ± 0.08 in the medieval and current groups respectively, with similar results in both groups (p = 0.820 and p = 0.575). A negative correlation was found between both morphometric indices and the δ15N isotope (rs = 0.56, p = 0.030 and rs = 0.61, p = 0.016, respectively). The bone mass density in mandibles belonging to the two compared populations, determined by two quantitative radiomorphometric indices, is similar. Within the medieval population, there is an inverse correlation between the δ15N value and bone mass density.

Traumatismos periféricos atendidos en el Servicio de Urgencias Pediátricas. Estudio descriptivo.

INTRODUCTION: Peripheral trauma is a very frequent cause of consultation in paediatric emergency departments but few studies have been published describing the characteristics of these patients. MATERIAL AND METHODS: We performed a retrospective descriptive study by reviewing computerised emergency department forms during January and February 2020. OBJECTIVE: To describe the characteristics of traumatic injuries in our area and to detect possible areas for improvement. RESULTS: A total of 714 peripheral trauma cases were attended, which represents 9.5% of the total consultations. A total of 52.7% were schoolchildren (6-11 years). The most frequent locations were the ankle (27.5%) and fingers (17.2%). Fracture was detected in 6.7% of cases. Radiographs were requested in 78.6% of the patients, with pathological findings in 9.6% of them. Half of the X-rays were requested due to ankle or finger trauma. Referral to traumatology was made in 16.4% of patients, mainly for elbow and knee trauma, and the most commonly used treatment was general measures (49%) and bandaging (29.4%). CONCLUSIONS: Peripheral trauma is very common and, in general, banal. A large number of X-rays are requested with a very low yield, so it seems necessary to establish new protocols to reduce the number of requests. Improving training in elbow and knee trauma could improve paediatricians' autonomy in dealing with these more complex injuries.

Assessing the Fractional Curve for Proper Management of Adult Degenerative Scoliosis.

Adult degenerative scoliosis (ADS) is a coronal plane deformity often accompanied by sagittal plane malalignment. Surgical correction may involve the major and/or distally-located fractional curves (FCs). Correction of the FC has been increasingly recognized as key to ameliorating radicular pain localized to the FC levels. The present study aims to summarize the literature on the rationale for FC correction in ADS. Three databases were systematically reviewed to identify all primary studies reporting the rationale for correcting the FC in ADS. Articles were included if they were English full-text studies with primary data from ADS ( ≥ 18 years old) patients. Seventy-four articles were identified, of which 12 were included after full-text review. Findings suggest FC correction with long-segment fusion terminating at L5 increases the risk of distal junctional degeneration as compared to constructs instrumenting the sacrum. Additionally, circumferential fusion offers greater FC correction, lower reoperation risk, and shorter construct length. Minimally invasive surgery (MIS) techniques may offer effective radiographic correction and improve leg pain associated with foraminal stenosis on the FC concavity, though experiences are limited. Open surgery may be necessary to achieve adequate correction of severe, highly rigid deformities. Current data support major curve correction in ASD where the FC concavity and truncal shift are concordant, suggesting that the FC contributes to the patient's overall deformity. Circumferential fusion and the use of kickstand rods can improve correction and enhance the stability and durability of long constructs. Last, MIS techniques show promise for milder deformities but require further investigation.

Green radiography: Exploring perceptions, practices, and barriers to sustainability.

INTRODUCTION: Previous research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. METHODS: Institutional ethical approval was obtained (IRB-COHS-FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. RESULTS: One hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. CONCLUSION: Participants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. IMPACT ON PRACTICE: Radiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.

Femorotibial angle scan-rescan reproducibility: A high-precision calculation on a large cohort.

PURPOSE: Femorotibial angle (FTA) is a convenient measure of coronal knee alignment that can be extracted from a short knee radiograph, avoiding the additional radiation exposure and specialist equipment required for full-leg radiographs. While intra- and inter-reader reproducibility from the same image has been reported, the full scan-rescan reproducibility across images, as calculated in this study, has not. METHODS: In this study, 4589 FTA measurement pairs from 2586 subjects acquired a year apart were used to estimate FTA scan-rescan reproducibility using data from the Osteoarthritis Initiative. Subjects with radiographic progression of osteoarthritis or other conditions that may cause a change in coronal knee alignment were excluded. Measurement pairs were analysed using paired-samples  t $t$ tests to detect differences and compared to symptomatic changes in Western Ontario and McMaster Universities Arthritis Index scores for joint pain, stiffness and physical function to detect correlations. RESULTS: The 95% limit of agreement and the paired-samples correlation were calculated with high precision to be [-1.76°, +1.78°] and 0.938, considerably worse than the corresponding figures for intra- and inter-reader reproducibility, without relation to symptomatic or radiographic changes in knee condition. This error will weakly attenuate R 2 ${R}^{2}$ and r $r$ values from their true values in correlative studies involving FTA. The realistic maximum value for R 2 ${R}^{2}$ is 87% and for Pearson's r $r$ is 93%. CONCLUSION: The scan-rescan reproducibility in FTA is almost double the intra- and inter-reader reliability from a single scan. At almost ±2° accuracy, FTA is inappropriate for surgical use, but it is sufficiently reproducible to produce good correlations in studies predicting disease incidence and progression. LEVEL OF EVIDENCE: Level II, retrospective study.

Non-contrast spectral CT vs chemical-shift MRI in discriminating lipid-poor adrenal lesions.

OBJECTIVES: To compare the diagnostic performance of conventional non-contrast CT, dual-energy spectral CT, and chemical-shift MRI (CS-MRI) in discriminating lipid-poor adenomas (> 10-HU on non-contrast CT) from non-adenomas. METHODS: A total of 110 patients (69 men; 41 women; mean age 66.5 ± 13.4 years) with 80 lipid-poor adenomas and 30 non-adenomas who underwent non-contrast dual-layer spectral CT and CS-MRI were retrospectively identified. For each lesion, non-contrast attenuation on conventional 120-kVp images, ΔHU-index ([attenuation difference between virtual monoenergetic 140-keV and 40-keV images]/conventional attenuation × 100), and signal intensity index (SI-index) were quantified. Each parameter was compared between adenomas and non-adenomas using the Mann-Whitney U-test. The area under the receiver operating characteristic curve (AUC) and sensitivity to achieve > 95% specificity for adenoma diagnosis were determined. RESULTS: Conventional non-contrast attenuation was lower in adenomas than in non-adenomas (22.4 ± 8.6 HU vs 32.8 ± 48.5 HU), whereas ΔHU-index (148.0 ± 103.2 vs 19.4 ± 25.8) and SI-index (41.6 ± 19.6 vs 4.2 ± 10.2) were higher in adenomas (all, p < 0.001). ΔHU-index showed superior performance to conventional non-contrast attenuation (AUC: 0.919 [95% CI: 0.852-0.963] vs 0.791 [95% CI: 0.703-0.863]; sensitivity: 75.0% [60/80] vs 27.5% [22/80], both p < 0.001), and near equivalent to SI-index (AUC: 0.952 [95% CI: 0.894-0.984], sensitivity 85.0% [68/80], both p > 0.05). Both the ΔHU-index and SI-index provided a sensitivity of 96.0% (48/50) for hypoattenuating adenomas (≤ 25 HU). For hyperattenuating (> 25 HU) adenomas, SI-index showed higher sensitivity than ΔHU-index (66.7% [20/30] vs 40.0% [12/30], p = 0.022). CONCLUSIONS: Non-contrast spectral CT and CS-MRI outperformed conventional non-contrast CT in distinguishing lipid-poor adenomas from non-adenomas. While CS-MRI demonstrated superior sensitivity for adenomas measuring > 25 HU, non-contrast spectral CT provided high discriminative values for adenomas measuring ≤ 25 HU. CLINICAL RELEVANCE STATEMENT: Spectral attenuation analysis improves the diagnostic performance of non-contrast CT in discriminating lipid-poor adrenal adenomas, potentially serving as an alternative to CS-MRI and obviating the necessity for additional diagnostic workup in indeterminate adrenal incidentalomas, particularly for lesions measuring ≤ 25 HU. KEY POINTS: Incidental adrenal lesion detection has increased as abdominal CT use has become more frequent. Non-contrast spectral CT and CS-MRI differentiated lipid-poor adenomas from non-adenomas better than conventional non-contrast CT. For lesions measuring ≤ 25 HU, spectral CT may obviate the need for additional evaluation.

Radiological Evaluation of the Accuracy of Demirjian, Nolla, and Willems Methods for Dental Age Estimation in 3-17-Year-Old Iranian Children.

Background: The stage of tooth formation is one of the most reliable indicators for predicting a patient's developmental age by radiographs. This study compared the accuracy of three distinct dental age estimation methods (Demirjian, Nolla, and Willems) in children aged 3-17 in the northern Iranian population. Methods: This cross-sectional study examined panoramic radiographs of 434 children aged 3-17 from Mazandaran Province, Iran, who had teeth 31-37 present on the left mandible. This study employed the Demirjian, Nolla, and Willems methods to estimate the dental age of the sample and compare it with the chronological age. The data were analyzed using SPSS v16. A paired t-test was used to compare chronological and dental ages. The Pearson correlation was used to correlate the chronological and dental ages. The errors of different methods were compared using the Wilcoxon test. P values < 0.05 were considered significant for all tests except Wilcoxon. For Wilcoxon, a P value < 0.017 was considered significant. Results: The three methods presented differing mean estimated ages. The Demirjian method delivered the highest mean, and all three methods differed significantly when compared in pairs. The results showed that the Demirjian method overestimated chronological age by 0.25 years (P < 0.001) in girls and 0.09 years (P = 0.28) in boys. The Willems method underestimated chronological age by 0.05 years (P = 0.47) in girls and 0.12 years (P = 0.13) in boys. The Nolla method underestimated chronological age by 0.41 years (P < 0.001) in girls and 0.40 years (P < 0.001) in boys. The accuracy of each method varied with the patient's age. Conclusion: According to the findings, the Willems method outperformed the Demirjian method, and the Demirjian method exceeded the Nolla method for estimating dental age in Iranian children aged 3-17. Overall, the Demirjian method overestimated the age of the study population, whereas the other two underestimated it.

Next-generation digital chest tomosynthesis.

The objective of this study was to demonstrate the performance characteristics and potential utility of a novel tomosynthesis device as applied to imaging the chest, specifically relating to lung nodules. The imaging characteristics and quality of a novel digital tomosynthesis prototype system was assessed by scanning, a healthy volunteer, and an andromorphic lung phantom with different configurations of simulated pulmonary nodules. The adequacy of nodule detection on the phantoms was rated by chest radiologists using a standardized scale. Results from using this tomosynthesis device demonstrate in plane resolution of 16lp/cm, with estimated effective radiation doses of 90% less than low dose CT. Nodule detection was adequate across various anatomic locations on a phantom. These proof-of-concept tests showed this novel tomosynthesis device can detect lung nodules with low radiation dose to the patient. This technique has potential as an alternative to low dose chest CT for lung nodule screening and tracking.

In vitro Accuracy of Ultra-Low Dose Cone-Beam Computed Tomography for Detection of Proximal Caries.

OBJECTIVES: This study aimed to assess the accuracy of ultra-low dose (ULD) cone-beam computed tomography (CBCT) for detection of proximal caries. METHODS: This in vitro study evaluated 104 molar and premolar teeth. The teeth were mounted in dry skulls and underwent CBCT with four protocols of high-resolution (HR), normal (NORM), ULD-HR, and ULD-NORM; 78 CBCT images were scored by three observers for presence and penetration depth of caries twice with a 2-week interval using a 5-point Likert scale. The teeth were then sectioned and observed under a stereomicroscope (gold standard). The four protocols were compared with each other and with the gold standard. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated and compared by the Chi-square test (alpha = 0.05). RESULTS: The interobserver agreement ranged from 0.5233 to 0.6034 for ULD-NORM, 0.5380 to 0.6279 for NORM, 0.5856 to 0.6300 for ULD-HR, and 0.6614 to 0.7707 for HR images. The intra-observer agreement ranged from 0.6027 to 0.8812 for ULD-HR, 0.7083 to 0.7556 for HR, 0.6076 to 0.9452 for ULD-NORM, and 0.7012 to 0.9221 for NORM images. Comparison of AUC revealed no significant difference between NORM and ULD-NORM (P > 0.05), or HR and ULD-HR (P > 0.05). The highest AUC belonged to HR (0.8529) and the lowest to NORM (0.7774). CONCLUSIONS: Considering the significant reduction in radiation dose in ULD CBCT and its acceptable diagnostic accuracy for detection of proximal caries, this protocol may be used for detection of proximal carious lesions and assessment of their depth.

Comparative analysis of clinical image evaluation charts for panoramic radiography.

OBJECTIVE: To compare and analyze professional (P chart) and simple (S chart) clinical image evaluation charts for evaluating panoramic radiograph image quality. METHODS: Ten evaluators assessed 285 clinical panoramic radiograph images. The evaluators were divided into oral and maxillofacial radiologists (OMFR, n = 5) and general dentist (dentists not specializing in oral and maxillofacial radiology, G, n = 5) groups. For image evaluation, P and S charts provided by the Korean Academy of Oral and Maxillofacial Radiology were used. Scores of items for each evaluation chart were used to compare the reliability, correlation, evaluation scores, evaluation time, and preference, and statistical analyses were performed using IBM SPSS Statistics. RESULTS: The S chart showed similar levels of evaluation scores at shorter evaluation time, as compared to the P chart. In the results for each evaluation chart, all analyzed correlations were statistically significant. Total score, image density/contrast/sharpness, and overall image quality items showed a very high positive correlation in the P chart. While the overall range of correlation coefficients was relatively lower in the S chart than the P chart, the same items showed high correlation coefficients. In the preference evaluation, both the professional and generalist groups preferred the S chart. CONCLUSIONS: A comparative analysis with the P chart, revisions, and upgrades are needed for the S chart items that showed low correlations in this study, such as artifacts, coverage area, and patient movement.

Radiological presentation of active pulmonary tuberculosis in kidney transplant recipients: a retrospective study of four cases and a review of the literature.

Although kidney transplantation is the best therapeutic option for patients with chronic kidney disease, the immunosuppression required greatly increases susceptibility to infections that are responsible for high post-transplant mortality. Pulmonary tuberculosis (TB) represents a major cause of such infections, and its early diagnosis is therefore quite important. In view of that, we researched the manifestations of active pulmonary TB in kidney transplant recipients, through chest X-ray and computed tomography (CT), as well as determining the number of cases of active pulmonary TB occurring over a 3.5-year period at our institution. We identified four cases of active pulmonary TB in kidney transplant recipients. The CT scans provided information complementary to the chest X-ray findings in all four of those cases. We compared our CT findings with those reported in the literature. We analyzed our experience in conjunction with an extensive review of the literature that was nevertheless limited because few studies have been carried out in lowand middle-income countries, where the incidence of TB is higher.

Apesar de o transplante renal ser a melhor opção terapêutica para pacientes com doença renal crônica, a imunodepressão decorrente desse tratamento eleva muito a suscetibilidade desses pacientes a infecções, responsáveis por altas taxas de mortalidade pós-operatórias. A tuberculose (TB) pulmonar é uma significativa causa dessas infecções, sendo muito importante o seu diagnóstico precoce. Assim, nós pesquisamos as manifestações da TB pulmonar ativa nessa população de transplantados renais por meio de radiografias simples e tomografia computadorizada (TC) do tórax, também para estabelecer o número de casos de TB pulmonar ativa em nossa instituição após levantamento de 3,5 anos. Encontramos quatro casos de TB pulmonar ativa em pacientes transplantados renais. A TC forneceu informações adicionais em relação às radiografias de tórax em 100% dos casos analisados. Comparamos os nossos achados de TC com os relatados na literatura. Somamos a experiência obtida com extensa revisão da literatura, ainda limitada nessa questão, com poucos estudos realizados em países em desenvolvimento onde a incidência de TB é maior.

Deep learning classification performance for diagnosing condylar osteoarthritis in patients with dentofacial deformities using panoramic temporomandibular joint projection images.

OBJECTIVE: The present study aimed to assess the consistencies and performances of deep learning (DL) models in the diagnosis of condylar osteoarthritis (OA) among patients with dentofacial deformities using panoramic temporomandibular joint (TMJ) projection images. METHODS: A total of 68 TMJs with or without condylar OA in dentofacial deformity patients were tested to verify the consistencies and performances of DL models created using 252 TMJs with or without OA in TMJ disorder and dentofacial deformity patients; these models were used to diagnose OA on conventional panoramic (Con-Pa) images and open (Open-TMJ) and closed (Closed-TMJ) mouth TMJ projection images. The GoogLeNet and VGG-16 networks were used to create the DL models. For comparison, two dental residents with < 1 year of experience interpreting radiographs evaluated the same condyle data that had been used to test the DL models. RESULTS: On Open-TMJ images, the DL models showed moderate to very good consistency, whereas the residents' demonstrated fair consistency on all images. The areas under the curve (AUCs) of both DL models on Con-Pa (0.84 for GoogLeNet and 0.75 for VGG-16) and Open-TMJ images (0.89 for both models) were significantly higher than the residents' AUCs (p < 0.01). The AUCs of the DL models on Open-TMJ images (0.89 for both models) were higher than the AUCs on Closed-TMJ images (0.72 for both models). CONCLUSIONS: The DL models created in this study could help residents to interpret Con-Pa and Open-TMJ images in the diagnosis of condylar OA.

Micronuclei as an indicator of genotoxic change in epithelial cells of buccal mucosa after panoramic radiographs.

BACKGROUND: The radiation released at the time of dental panoramic radiographs causes genotoxic and cytotoxic effects on epithelial cells. OBJECTIVE: This research aimed to evaluate the changes in the frequencies of micronucleated cells in patients' buccal epithelial cells following dental panoramic radiography. METHODS: 74 patients were recruited for the study who were advised for panoramic radiographs. Using a wooden spatula, the buccal epithelial cells were scraped from both cheeks before to panoramic radiation exposure and ten days after the panoramic radiation exposure. Giemsa stain was used to stain the cells, and 500 cells were scored on a slide to determine the frequency of micronuclei. To determine the difference between the frequency of micronuclei before and after radiation exposure, a paired t-test was used in the statistical analysis. RESULTS: The proportion of micronuclei cells was 0.11% before radiation exposure and 0.57% following radiation exposure after 10 days. A statistically significant increase in the frequencies of micronuclei was noted after radiation exposure values. CONCLUSION: This study revealed the genotoxicity of epithelial cells with dental panoramic radiation exposure. It is advised to reduce the use of such radiographs and to use only when there is no other diagnostic tool that is helpful or when absolutely essential.