Introduction Developmental dysplasia of the hip (DDH) encompasses a spectrum of acetabular and hip‐joint abnormalities that may progress from dysplasia and instability to subluxation or frank dislocation. Radiographers are central to the acquisition of paediatric pelvic radiographs, but their ability to recognise radiographic features suggestive of DDH is not well established. This exploratory study evaluated abnormality recognition rather than formal diagnostic reporting and described radiographers’ confidence and perceived image‐quality requirements. Methods A prospective, cross‐sectional observer‐performance study was conducted at the European Congress of Radiology 2023. Thirty radiographers independently reviewed 25 anonymised paediatric anteroposterior pelvic radiographs selected from the DDH teaching dataset. The observer set comprised 13 normal and 12 DDH‐positive radiographs: four left‐sided, four right‐sided and four bilateral cases. Reference labels were provided by three specialists in the source dataset. For each case, participants selected bilateral DDH, right‐sided DDH, left‐sided DDH, or no DDH; rated confidence from 1 to 10; and graded subjective image quality from perfect to inadequate. For the primary binary analysis, any response indicating DDH in at least one hip was classified as DDH‐positive. A unilateral response to a bilateral case was therefore counted as positive because it would prompt referral or further assessment. Observer characteristics and technical factors were described but were not tested as independent predictors of performance. Results Mean reported sensitivity for DDH detection was 56.2% (SD 21.6%; range 0%–92.3%), and mean reported specificity was 40.2% (SD 28.4%; range 0%–100%). Confidence was generally moderate, with image‐level mean ratings predominantly between 4 and 6. Participants most frequently rated appropriate collimation, absence of pelvic rotation, lower‐limb positioning, radiographic centring and removal of artefacts as important technical considerations. These descriptive findings do not establish statistically significant predictors of observer performance. Conclusion Radiographers demonstrated substantial variability and overall limited recognition of DDH in this small, convenience‐sampled observer study. The findings support further development and prospective evaluation of targeted education and clearly defined preliminary image‐evaluation pathways, but they do not establish that radiographer flagging, training, or artificial intelligence support improves diagnostic timeliness or patient outcomes.
Objective This study aimed to compare the clinical efficacy and safety of the robot‐assisted trans‐costotransverse joint approach and transpedicular approach in the treatment of upper thoracic single‐segment osteoporotic vertebral compression fractures (OVCFs). Methods The data of 60 patients who underwent robot‐assisted percutaneous kyphoplasty (PKP) from October 2023 to January 2025 were retrospectively analyzed. According to the different surgical approaches, they were divided into two groups: trans‐costotransverse joint group (Group A n = 30) and transpedicular group (Group B n = 30). Perioperative indicators and clinical outcomes were compared. Results The rate of satisfactory bone cement distribution was significantly higher in Group A than in Group B (90.0% vs. 66.7%, p = 0.028; OR = 4.50, 95% CI: 1.09–18.50), and the bone cement injection volume was greater (2.35 ± 0.34 mL vs. 2.13 ± 0.28 mL, p = 0.008), with mean difference (MD) = 0.22 mL (95% CI: 0.06–0.38 mL). The 1‐year follow‐up showed that the vertebral recollapse rate in Group A was significantly lower than that in Group B (3.3% vs. 20%, p = 0.044; OR = 0.14, 95% CI: 0.02–1.23). The incidence of bone cement leakage was lower in Group A than in Group B (6.7% vs. 26.7%, p = 0.038; OR = 0.20, 95% CI: 0.04–1.02). Although the VAS score, ODI indices, and local Cobb angle of the two groups were significantly improved compared with those before operation, there was no significant difference between the two groups. Conclusion In this retrospective analysis of patients with upper thoracic OVCF, robot‐assisted trans‐costotransverse joint PKP may result in a more favorable distribution of bone cement and improved short‐ to medium‐term vertebral stability as compared with the transpedicular approach. This procedure shows acceptable safety profile, though further prospective studies are required to validate its clinical benefit.
Background It is well established that diagnostic X‐ray practices must be optimized to keep patient radiation dose as low as possible with providing the diagnostic information required. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical means to optimize radiation doses in diagnostic radiology and nuclear medicine. The aim of this study was to propose national diagnostic reference levels for routine pediatric chest X‐ray examinations in Ethiopia. Methods Anthropometric and radiographic parametric data were collected from 975 patients. A standard patient was defined based on the mean values of weight, height, and BMI for the age groups of 5 to 10 and 10 to 15 years old. The exposure parameter, entrance surface air kerma, was calculated. NDRLs for entrance surface air kerma were defined as the 75 th percentile of dose values. Results The suggested national diagnostic reference levels of chest X‐ray examinations were 0.07 mGy and 0.53 mGy for age groups 5‐< 10 and 10‐< 15, respectively. Conclusion The 75th percentile of dose values determined in this study was higher than those published in the literature. The findings reveal significant variability in ESD across hospitals, primarily due to the use of inappropriate radiological parameters. A notable inconsistency in the selection of kV and mAs parameters was also observed, underscoring the need for standardized radiological protocols.
Introduction:Autologous materials for vessel replacement in infected fields have high morbidity and mortality rates. Custom-made bovine pericardial tubes (CMBPTs) offer a promising alternative with advantages such as reliability, strength, and availability. However, limited biomechanical data hinder predictions of in vivo performance. This study evaluates the physiological strain and distensibility of CMBPTs in vitro under simulated abdominal aortic flow using magnetic resonance imaging (MRI). A secondary objective is to compare strain and distensibility calculations using phase contrast (PC) and steady-state free precession (SSFP) MRI sequences. Methods:Seven CMBPTs were tested under physiological aortic conditions with a pulsatile flow rate of 1650 mL/min using in vitro MRI. PC and SSFP sequences were employed, with PC estimating velocity and strain, while SSFP assessed strain separately. Image analysis was performed using QIR-MR software. Results:Strain was measured using magnitude images. The mean maximum cross-sectional areas were 419 ± 22.1 (PC) and 438.4 ± 24.3 mm2 (SSFP), while minimum areas were 374.5 ± 21.1 and 397.6 ± 23.4 mm2, respectively. The mean strain percentages were 12.1% ± 3.60% (PC) and 10.3% ± 3.20% (SSFP), with distensibility values of 1.5 ± 0.5 × 10-3 and 1.3 ± 0.4 × 10-3 mmHg-1, respectively. Conclusion:CMBPTs exhibit biomechanical properties similar to the abdominal aorta, suggesting potential for vascular applications. Both MRI sequences provided comparable results, supporting their reliability. Further research is needed to confirm long-term performance.
Objective:To evaluate the performance of the Deep Learning reconstruction algorithm Precise Image (PI) in improving abdominal computed tomography (CT) image quality and its diagnostic efficacy for adrenal and renal lesions. Methods:A total of 191 patients who underwent abdominal CT scan were retrospectively enrolled. All image datasets were reconstructed into four sequences with a slice thickness of 1 mm: Filtered back projection (FBP), Iterative Reconstruction (iDose), PI Standard, and PI Smooth. We measured CT attenuation values and the standard deviation (SD) of adrenal glands, renal parenchyma, and intra-abdominal fat for each reconstruction group. The contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of adrenal and renal parenchyma were subsequently calculated. Two radiologists independently performed subjective assessments for overall image quality and diagnostic confidence for adrenal nodules and renal cysts using the Likert 5 and 4 scales, respectively. Inter-reader agreement was quantified via the Kappa test. Intergroup comparisons were conducted using the Kruskal-Wallis test with Bonferroni post hoc correction. A priori power analysis was performed to verify the adequacy of the sample size. Results:Statistically significant intergroup differences were identified for all subjective evaluation metrics (p < 0.05). The image quality score increases sequentially from FBP to PI Smooth group, and PI Smooth group has the highest subjective score. There were significant differences in diagnostic confidence scores among all groups (p < 0.05). PI Smooth has the highest score. There were significant differences in CT values, SD values, SNR, and CNR of the adrenal glands and renal parenchyma among the four groups of reconstructed images (p < 0.05). SD values declined progressively from FBP to iDose and further to PI Smooth, while SNR and CNR increased in the same order. Post hoc power analysis demonstrated statistical power > 0.99 for all primary clinical endpoints, confirming robust and reproducible statistical findings. Conclusion:Compared with FBP and iDose, the PI reconstruction algorithm substantially improves abdominal CT image quality. PI Smooth delivers the highest diagnostic confidence for small lesions and renal cysts, providing robust quantitative and qualitative support for precise clinical evaluation.
