International Federation of Gynecology and Obstetrics (FIGO) system standardizes how fibroid location is described for treatment planning. However, MRI provides highest-resolution, accurate visualization and more precise FIGO classification and lesion mapping, especially in numerous, large, or complex fibroids. Transabdominal and transvaginal ultrasound are primary imaging tools for detecting, characterizing, and classifying uterine fibroids due to their accessibility, low cost, and lack of radiation. The objective of this study was to assess the accuracy and reliability of ultrasonography as a feasible alternative for MRI according to the FIGO classification system. A total of 38 patients with clinically suspected uterine fibroids were included in our study; all of them underwent transabdominal and transvaginal ultrasonography examinations and MRI pelvis as the reference standard. Thirty-eight patients (mean age 43.2 ± 8.93 years) with a total of 75 MRI-confirmed uterine fibroids were included. The combined TAUS and TVUS modalities achieved the highest sensitivity (92.0
Age determination by forensic investigators can be enhanced through artificial intelligence, which has demonstrated significant potential in the analysis of medical images. The study aims to provide an accurate and reliable method for age estimation from chest radiographs and to test the deep neural network’s performance for age classification. This retrospective study included chest x-rays of 562 Egyptian patients obtained from the Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Cairo University. They were analyzed according to age. We tested the deep convolutional neural network for age determination using a new algorithm. Mean absolute error of age prediction was 7.4 years, final loss in age prediction was 6.9, correlation coefficient between actual age and predicted age was 0.844 with P value < 0.001 which is considered statistically significant. Artificial intelligence helps in age determination with some limitations that need further studies. We recommend establishing a national dataset of radiographs and using artificial intelligence in medico-legal investigations requiring positive identification.
Alzheimer’s disease (AD) and vascular dementia (VaD) are the two most common causes of dementia. Differentiation between them is clinically important, especially in settings with a high cerebrovascular disease burden. To assess the diagnostic utility of visual MRI rating scales—Medial Temporal Atrophy (MTA), Global Cortical Atrophy (GCA), and Small Vessel Disease (SVD)—in differentiating AD from VaD, and to examine their correlation with Montreal Cognitive Assessment (MoCA) scores. A cross-sectional case–control study was conducted at a tertiary care hospital between 2020 and 2022. Forty participants were included: VaD (n = 8), AD (n = 8), mixed dementia (n = 4), and controls (n = 20). MRI scans were evaluated using MTA, GCA, and SVD scales, with a second radiologist independently re-scoring all participants to assess inter-rater reliability. MoCA scores were obtained for clinical correlation, in preference to the MMSE, given its greater sensitivity to vascular and executive cognitive deficits. Statistical analysis included ANOVA with Bonferroni post hoc tests and eta-squared effect sizes, Spearman correlation, ROC curve analysis, weighted Cohen’s kappa, and multivariable logistic regression (Firth’s penalized method). MTA scores were significantly higher in AD and mixed dementia compared to controls (p < 0.001, η2 = 0.76). SVD scores were significantly higher in VaD and mixed dementia compared to controls (p < 0.001, η2 = 0.81). No significant differences were observed for GCA. MoCA correlated negatively with both MTA and SVD (rho = − 0.4, p < 0.05). ROC analysis demonstrated strong predictive performance of SVD in identifying VaD (AUC 0.85). Inter-rater reliability was almost perfect for all three scales (weighted κ 0.86–0.99). A multivariable logistic regression model combining MTA, GCA, SVD, and age was significant overall (χ2(4) = 22.40, p < 0.001) in differentiating AD from VaD, though individual predictor estimates were unstable given the small sample. Visual MRI rating scales are simple, reproducible, and reliable tools for dementia assessment that can be scored on routine MRI without specialized sequences or post-processing. MTA is more useful for AD, whereas SVD strongly supports VaD, and their joint diagnostic value is reinforced by a significant multivariable model. Their correlation with the more sensitive MoCA reinforces their role in clinical evaluation, and reliable, accessible imaging-based differentiation of AD from VaD can support earlier, more appropriate treatment selection in routine practice.
Abdominal aortic aneurysm (AAA) management relies heavily on imaging for surveillance, treatment planning, and follow-up. Deep learning (DL)-based segmentation may improve the efficiency and reproducibility of AAA image analysis; however, reported performance varies across studies. This study aimed to systematically review and quantitatively summarize the performance of DL models for AAA-related segmentation. PubMed, Embase, Scopus, and Web of Science were searched for studies applying DL to AAA imaging in adults and reporting Dice score or intersection-over-union (IoU) as segmentation metrics. Each DL model evaluated on a held-out test set was treated as a separate model-level observation. Random-effects meta-analyses were used to pool Dice score and IoU. Subgroup analyses were performed by imaging modality, model category, and input dimensionality, and additional analyses provided structure-specific estimates for aneurysm sac, intraluminal thrombus (ILT), lumen, and EVAR-related segmentations. Across all targets, overall segmentation performance was 0.81 (95
Abstract Background Dynamic shoulder pain limited to a narrow range of abduction may not be adequately explained by static imaging alone. This case report described an angle-specific painful arc evaluated with dynamic digital radiography and multi-position computed tomography with CT-derived three-dimensional pose-based visualization. Case presentation A 32-year-old right-hand-dominant male patient presented with severe right shoulder pain 1 week after an overhead reaching injury. Active abduction was limited to 85 degrees, with maximal pain near 90 degrees and a QuickDASH score of 79.54. Dynamic digital radiography demonstrated narrowing of the acromiohumeral interval at the painful arc. Multi-position CT at 0 degrees, approximately 40 degrees, and approximately 80 degrees supported patient-specific three-dimensional pose-based visualization. For the same contralateral shoulder, the acromiohumeral distance was measured once at each position by one operator, yielding approximate estimates of 7.9, 3.7, and 5.3 mm, respectively. These position-specific values were descriptive and were not affected-side baseline and follow-up measurements. Standard shoulder MRI showed acromioclavicular joint marrow edema. At T1 immediately following one manual therapy session, clinical measures improved, but no imaging was obtained. Apart from this session, no medication, home exercise program, additional rehabilitation, injection, or activity restriction was introduced before the 1-week follow-up. At T2, pain had resolved, active abduction was 180 degrees, provocative tests were negative, and QuickDASH was 0. Repeat imaging was obtained at T2; however, the available data did not support a quantitative affected-side longitudinal comparison. No repeatability or minimal detectable change data were available. The clinical course and imaging observations were temporally associated but cannot establish treatment efficacy or exclude natural recovery. Conclusions This case illustrated that dynamic digital radiography may help identify motion-dependent acromiohumeral narrowing. Pose-specific CT-derived visualization may depict angle-specific spatial relationships and provide exploratory clearance estimates. These uncontrolled, case-specific observations do not establish treatment efficacy, affected-side interval change, or a normative side-to-side threshold.
Seronegative spondyloarthropathies represent a broad spectrum of inflammatory disorders that affect articular and extra-articular structures. MRI is considered the gold standard for diagnosing sacroiliitis. Our study aims to evaluate the added advantages of DWI and ADC value over STIR in identifying acute sacroiliitis among seronegative spondyloarthropathy patients. Seventy-five patients with clinically suspected acute seronegative spondyloarthropathy were included. Laboratory investigations, clinical evaluation, and disease activity scoring using the ASDAS and DAPSA systems were performed. MRI was done, then compared with clinical parameters. Bone marrow edema was the most frequent MRI finding among active group demonstrating high statistical significance (p < 0.001). Both DWI and ADC demonstrated greater ability to detect acute sacroiliitis with a p-value < 0.001 than STIR with a p-value=0.002. However, ADC had the highest specificity and accuracy by 100–89.4
Preeclampsia is a major cause of maternal and neonatal morbidity and mortality with a prevalence in Egypt (6–10.7
This study aimed to determine the associations of apparent diffusion coefficient (ADC) values with the molecular and histological subtypes of adult-type diffuse gliomas classified in accordance with the 2021 World Health Organization (WHO) Classification of Tumors of the Central Nervous System, fifth edition (WHO CNS5). PubMed, Scopus, Cochrane and Google Scholar were searched to identify relevant studies up to December 2025. The search and selection strategies followed the relevant items of the PRISMA 2020 statement. Open-access studies, written in English, that targeted the imaging characterization of adult-type diffuse gliomas classified based on WHO CNS5 and presented quantitative ADC data were included. Studies targeting pediatric gliomas, adult gliomas classified after prior editions of the WHO Classification of Tumors of the Central Nervous System or not presenting numerical ADC values were excluded. Due to high heterogeneity in imaging methodologies, ADC acquisition, ADC quantification and diagnostic targets, meta-analysis was not considered methodologically appropriate. Instead, quantitative data are further presented through a structured narrative synthesis. The quality of the selected studies was analyzed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. This review was not registered and received no funding. Fifteen eligible studies were selected, including a total of 1706 glioma patients. The reported ADC metrics and imaging protocols presented significant variability across studies. IDH-wildtype gliomas exhibited the lowest ADC values (0.78–1.48 × 10⁻3 mm2/s). An inverse correlation between the histological grade and ADC values was observed. The mean ADC sensitivity for IDH status ranged from 65.4
To date, dental panoramic radiography, CT, MRI and SPECT/CT are usability for evaluating medication-related osteonecrosis of the jaw (MRONJ). This study aimed to examine the MRONJ with SPECT/CT, especially comparison of mandibular cortical morphology using computer-aided detection with dental panoramic imaging. Seventy-two MRONJ patients with Stage 2 in the mandible (26 bone metastases and 46 osteoporosis) underwent dental panoramic radiography and bone SPECT/CT. Mandibular cortical index (MCI) and degree of deformation as mandibular cortical morphology were evaluated with a software for dental panoramic imaging. Maximum standardized uptake value (SUVmax) using bone SPECT/CT of the lesions and normal mandible as control was obtained by a workstation and software. Regarding mandibular cortical morphology, degree of deformation in osteoporosis and bone metastases were 52.1 ± 21.5 and 35.8 ± 18.1, respectively (p = 0.002). MCI class 3 in osteoporosis and bone metastases were 94.4–5.6
Rectal cancer is one of the leading causes of cancer-related deaths worldwide. The degree of tumor differentiation is one of the most important factors on which the prognosis of rectal cancer. The pathological grading of rectal adenocarcinoma is the gold standard for diagnosis but it is an invasive procedure. Consequently, the aim of the current study was to assess the possibility of prediction of the pathologic grading of rectal adenocarcinoma, using non-invasive CT-derived extracellular volume fraction (ECV). We assessed 30 patients, pathologically diagnosed with rectal adenocarcinoma, all of whom underwent preoperative enhanced CT imaging. CT values were recorded across the plain, venous, and delayed phases and absolute contrast-enhanced differences were calculated. The extracellular volume (ECV) of the primary tumor was determined by assessing CT values in the regions of interest during the plain and delayed phases. Based on the World Health Organization’s 2010, patients were classified into two groups: a low-grade group and a high-grade group. Statistical analyses were performed to compare parameter differences between the groups, and a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance. Our 30 patients were classified into [17 (56.7
Abstract Background Knee osteoarthritis (KOA) is commonly assessed using radiographic Kellgren–Lawrence (KL) grading; however, manual evaluation is subjective and prone to inter- and intra-observer variability, particularly in early-stage disease. Although deep learning approaches have shown promise, challenges remain in distinguishing adjacent grades and handling label noise. This study developed and evaluated a noise-robust and attention-guided deep learning framework for automated five-class KOA grading from radiographs. Results The proposed framework was evaluated on 9786 knee radiographs using stratified cross-validation. It achieved an overall accuracy of 88.52%, a macro-average F 1-score of 0.8804, and a macro-average area under the curve of 0.94. Class-wise performance was highest for Grade 0 ( F 1 = 0.9388) and Grade 4 ( F 1 = 0.9315), intermediate for Grade 2 ( F 1 = 0.8718) and Grade 3 ( F 1 = 0.9106), and lowest for Grade 1 ( F 1 = 0.7493), with errors concentrated between adjacent early grades. Model interpretability analysis demonstrated that predictions were based on clinically relevant joint regions. However, direct comparison with previous studies is limited due to differences in experimental settings. Conclusions The proposed framework demonstrates the potential of integrating label-noise mitigation and attention-guided feature learning for automated KOA grading. While the results are promising, further validation on independent multicenter datasets is required to confirm generalizability and support clinical applicability.
Achieving optimal esthetic integration and maintaining peri-implant bone stability remain key challenges in implant therapy within the anterior maxilla. While subepithelial connective tissue grafts (CTG) are considered the gold standard for soft tissue augmentation, alternative approaches such as platelet-rich fibrin (PRF) and fascia lata allograft (FLA) have been introduced to minimize patient morbidity. This randomized clinical trial aimed to compare the effects of CTG, PRF, and FLA on Pink Esthetic Score (PES) and marginal bone loss (MBL). Twenty-four systemically healthy adults with a thin peri-implant phenotype were randomly allocated into three equal groups: CTG, PRF or FLA (n = 8/group) at the time of implant placement. Pink Esthetic Score (PES) was assessed at the final esthetic follow-up, and Marginal Bone Loss (MBL) was measured radiographically at 6 months. At 6 months, the CTG group demonstrated a slightly higher median PES (12.00) compared to the FLA and PRF groups (both 10.5). Marginal bone loss was highest in the PRF group (1.038 mm), followed by the FLA group (0.613 mm) and the CTG group (0.475 mm). Statistical analysis revealed a significant difference among the groups (p < 0.001). CTG provided the most favorable combined esthetic and radiographic outcome. FLA represents a promising alternative with reduced morbidity and may represent a clinically acceptable substitute when donor site morbidity is a concern. PRF improved esthetic integration but was associated with greater early marginal bone loss and should be considered an adjunct rather than a full replacement for volume-stable grafting. Clinical trial number: The study was registered on (http://www.clinicaltrials.gov: (NCT06219473) on 12/1/2024), and the date of study start was 1/2/2024, and study completion was 01/02/2025).
Mass-like pulmonary consolidations ≥ 3 cm pose a persistent diagnostic dilemma, as malignancy and pneumonia share overlapping CT features despite fundamentally different management. Although radiomics offers a quantitative approach, most published models lack multivendor external validation, formal radiologist benchmarking, and transparent reproducibility reporting. To develop and externally validate an explainable CT density–texture radiomics model differentiating mass-like pneumonia from pulmonary malignancy across multivendor CT systems, and to benchmark performance against blinded radiologist interpretation. Consecutive adults with mass-like pulmonary lesions (≥ 3 cm) were prospectively recruited at three centres (January–March 2026). Of 183 assessed, 12 excluded, 171 enrolled. Centre A (n = 71) was the development cohort; Centres B + C (n = 100) the external validation cohort. A fixed 9-mm ROI was placed within the lesion; features were extracted using (PyRadiomics 3.1.0a2). 75 candidate features were provided to an XGBoost classifier. Two blinded radiologists independently reviewed 100 external cases. Internal cross-validation AUC was 0.713 ± 0.120 (SD across 100 folds). The locked model achieved external AUC 0.887 (95
Abstract Background Echinococcus granulosus is a parasitic cestode responsible for hydatid disease affecting humans. Hydatid disease may involve multiple organs, with the liver and lungs being the most commonly affected. However, orbital involvement is exceptionally rare, accounting for less than 1% of all hydatid cases. Early surgical excision of the cyst is crucial, and its successful management relies on prompt and accurate diagnosis through appropriate imaging modalities. Case presentation A 17-year-old male from Uttar Pradesh, India who was referred to our tertiary care institute presented with progressive painless right-sided proptosis of one-year duration with occasional diplopia. Multimodality imaging demonstrated a well-defined cystic extraconal orbital lesion of approximate size 22 × 21 mm with no septations or solid component causing smooth bony remodeling and absence of aggressive features. Systemic evaluation showed no hepatic or pulmonary involvement. The patient underwent complete surgical excision of the cyst followed by postoperative albendazole therapy. Histopathological examination confirmed hydatid cyst. Conclusions It is important to consider primary orbital hydatid cyst in the differential diagnosis in case of unilateral painless proptosis with insidious onset, in the endemic regions. Imaging plays a pivotal role in early diagnosis and surgical planning.
Abstract Background Cysticercosis, caused by the larval forms of Taenia solium or Taenia saginata , remains a global public health concern, particularly in developing regions where sanitation and animal husbandry practices are suboptimal. Differentiating benign calcified parasitic lesions from malignant or metastatic deposits on imaging can pose a diagnostic challenge in oncology patients. This case report highlights an incidental finding of residual calcified myocysticercosis in a patient undergoing FDG PET-CT for rectal adenocarcinoma, underscoring the role of imaging in avoiding misinterpretation of benign lesions as metastases. Case presentation A 73-year-old male from a rural background with chronic pork consumption presented with rectal bleeding. Colonoscopy and biopsy confirmed rectal adenocarcinoma. Pelvic MRI revealed circumferential wall thickening involving the upper and mid-third of the rectum with mesorectal and pelvic lymphadenopathy. Following neoadjuvant chemotherapy, F-18 FDG PET-CT performed for response assessment showed metabolically active rectal wall thickening with nodal disease, and multiple metabolically inactive, calcified intramuscular nodules in the anterior abdominal wall and bilateral lower limbs. These were consistent with residual calcified myocysticercosis. No serological or clinical evidence of active parasitic disease was noted, and no specific treatment was required. Conclusion This case emphasizes the importance of recognizing imaging features of benign calcified parasitic lesions to avoid diagnostic confusion with metastatic disease. Awareness of such incidental findings, particularly in patients from endemic regions, prevents mis-staging and unnecessary interventions.
Abstract Background Ischemic cardiomyopathy (ICM) is characterized by profound left ventricular (LV) remodelling, impaired systolic function, and variable myocardial viability. Cardiac magnetic resonance feature tracking (CMR-FT) enables non-invasive quantification of myocardial deformation from standard cine sequences without dedicated tagging sequences. The present study aimed to evaluate the role of CMR-FT in the comprehensive assessment of myocardial function and viability in patients with ICM compared with healthy controls. Results Cases showed markedly elevated end-diastolic and end-systolic volumes with severely reduced ejection fraction (EF: 36.6 ± 16.9% vs. 64.1 ± 10.0%; p < 0.001). Stroke volume was preserved, reflecting Frank-Starling compensation. Wall motion abnormalities were concentrated in mid-cavity and apical territories. Apical segments demonstrated the highest transmural scar burden on LGE (apex 33.3%; apical inferior 35.3%). All three global strain parameters were profoundly impaired with large effect sizes (GRS Cohen’s d = 2.46; GCS d = 2.00; GLS d = 1.38). Segmental circumferential strain (SCS) and segmental radial strain (SRS) demonstrated statistically significant discriminative ability for non-viable myocardium (AUC 0.624–0.637); segmental longitudinal strain (SLS) reached significance uniquely for viable scar versus no scar (AUC 0.566). Conclusion CMR-FT provides comprehensive, non-invasive assessment of myocardial deformation in ICM. A multi-strain approach—SCS and SRS for transmural scar identification, SLS for early subendocardial injury—offers clinically meaningful, contrast-independent viability information that complements LGE imaging and supports risk stratification in this population.
Papillary thyroid carcinoma (PTC) is a common cancer, and cervical lymph node metastasis influences its prognosis. Ultrasound is standard, but detection of central lymph node metastasis (CLNM) is inconsistent, with sensitivity reported at 10.5–61
Abstract Primary chest wall abscess without any predisposing site of infection is uncommon. Progressive enlargement of chest wall mass and weight loss without fever may divert attention towards a tumour rather than an infection. We present a case of a 68-year-old man who initially presented with a right chest wall mass for past 4 months. Computed tomography (CT) was suspicious for a right anterior chest wall tumour with bone invasion. Histopathological examination of the mass, however, demonstrated acute-on-chronic soft-tissue inflammation and abscess formation, favouring a diagnosis of a primary right chest wall abscess.
Accurate preoperative quantification of loss of domain (LOD) is essential in patients with incisional hernia because it influences surgical planning and predicts the need for adjunctive preoperative optimization. Although three-dimensional (3D) CT volumetric reconstruction is considered anatomically more precise, two-dimensional (2D) CT geometric estimation is simpler, faster, and universally available. This study compared both techniques to determine whether 2D assessment provides clinically acceptable agreement with 3D volumetry. In this retrospective study, 50 adults with CT-confirmed incisional hernia underwent LOD assessment using two approaches: (1) ellipsoid-based 2D geometric estimation from linear CT measurements and (2) semi-automated 3D volumetric segmentation. Mean abdominal cavity volume, hernia sac volume, and LOD were compared using paired t-tests, Pearson correlation, Bland–Altman agreement analysis, and intraclass correlation coefficients (ICC). Mean abdominal cavity volume was 6690 ± 2054 cm3 using the 2D method and 6898.9 ± 2122.8 cm3 using the 3D method (p = 0.34). Mean hernia sac volume was 1375 ± 953 cm3 and 1381 ± 947 cm3, respectively (p = 0.81). Corresponding mean LOD values were 20.6 ± 12.38
Abstract Background Primary intraosseous arteriovenous malformations (AVMs) are exceedingly rare vascular anomalies that can weaken bone architecture and predispose to pathological fracture. Their imaging appearance frequently mimics malignant bone tumors, creating significant diagnostic and therapeutic challenges. Recognition of the characteristic imaging features of intraosseous AVMs in the setting of pathological fracture is essential to avoid misdiagnosis and to prevent catastrophic hemorrhagic complications during inadvertent surgical intervention. Case presentation A 25-year-old male presented with severe pain, swelling, deformity of the right thigh, and inability to bear weight following a fall from height. Initial radiographs demonstrated a displaced mid-shaft femoral fracture with permeative lytic and sclerotic changes, raising suspicion of a pathological fracture. Magnetic resonance imaging (MRI) revealed multiple dilated serpiginous intramedullary flow voids extending into adjacent muscle planes, consistent with a high-flow intraosseous AVM, and a large lobulated flow void between the fracture fragments communicating with adjacent dilated tortuous vessels, consistent with a traumatic pseudoaneurysm. Computed tomography (CT) angiography confirmed multiple dilated vessels supplied by branches of the right internal iliac, profunda femoris, and superficial femoral arteries with early venous drainage and a large contrast-filled pseudoaneurysm communicating with the medullary cavity. By the 2018 International Society for the Study of Vascular Anomalies (ISSVA) classification, the lesion was categorized as a simple, high-flow arteriovenous malformation of the lower extremity (Schobinger Stage III). The patient underwent transarterial endovascular embolization of the AVM nidus and pseudoaneurysm using an n-butyl cyanoacrylate (NBCA)–Lipiodol emulsion via a retrograde left common femoral artery approach, with embolization of the nidus and obliteration of the traumatic pseudoaneurysm with reduction in arteriovenous shunting through the embolized territory achieved on post-embolization digital subtraction angiography (DSA). Following multidisciplinary review with Orthopedics and Cardiovascular and Thoracic Surgery (CTVS), definitive intramedullary nailing was deferred because of extensive intraosseous AVM involvement along the medullary trajectory of any intended nail, rendering the femoral cortex fragile and unsuitable for safe internal fixation. The patient was managed conservatively with a Thomas splint, limb immobilization, analgesia, and bone-health optimization. At the time of discharge approximately seven days after the embolization session, the patient was clinically stable, with intact distal neurovascular status and no interval hemorrhagic event. The patient was subsequently lost to follow-up despite repeated attempts at contact through the details provided at admission, and therefore long-term clinical and imaging outcome data are not available for this report. Conclusions This case underscores the pivotal role of multimodality imaging in evaluating pathological fractures with atypical lytic changes, and illustrates that a staged, multidisciplinary management strategy—combining endovascular embolization with individualized, imaging-guided decisions about orthopedic fixation—can safely control a high-flow intraosseous AVM complicated by traumatic pseudoaneurysm while avoiding potentially fatal intraoperative hemorrhage. In this case, conservative orthopedic management after endovascular control was the multidisciplinary strategy selected on the basis of the specific intraosseous anatomy; further multi-case series are needed before this approach can be broadly recommended. Post-embolization DSA follow-up is essential to confirm treatment response and to guide further embolization and orthopedic planning.
