Predicting adverse cardiac events in sarcoidosis: deep learning from automated characterization of regional myocardial remodeling.

Recognizing early cardiac sarcoidosis (CS) imaging phenotypes can help identify opportunities for effective treatment before irreversible myocardial pathology occurs. We aimed to characterize regional CS myocardial remodeling features correlating with future adverse cardiac events by coupling automated image processing and data analysis on cardiac magnetic resonance (CMR) imaging datasets. A deep convolutional neural network (DCNN) was used to process a CMR database of a 10-year cohort of 117 consecutive biopsy-proven sarcoidosis patients.

Regional Myocardial Remodeling Characteristics Correlates With Cardiac Events in Sarcoidosis.

Background: The poor prognosis of cardiac sarcoidosis (CS) underscores the need for risk stratification.

Purpose: To investigate the prognostic significance of ventricular/myocardial remodeling features in sarcoidosis.

Study Type: Retrospective.

Discrepant myocardial microvascular perfusion and mechanics after acute myocardial infarction: Characterization of the "Tako-tsubo effect" with real-time myocardial perfusion contrast echocardiograph.

Background: In patients with acute anterior myocardial infarction (MI), sometimes an "apical ballooning" contractile dysfunction pattern that exceeds factual myocardial injury is identified in the ventriculography and bedside echocardiography. The hemodynamic consequences/sequela of this "Tako-tsobu effect" has not been well delineated. Of note, this anatomic imaging finding often misleads frontline physicians who assume reciprocal causation of persistent cardiac pump failure and ventricular pressure overload.

Infimal convolution-based regularization for SPECT reconstruction.

Purpose: Total variation (TV) regularization is efficient in suppressing noise, but is known to suffer from staircase artifacts. The goal of this work was to develop a regularization method using the infimal convolution of the first- and the second-order derivatives to reduce or even prevent staircase artifacts in the reconstructed images, and to investigate if the advantage in noise suppression by this TV-type regularization can be translated into dose reduction.

Methods: In the present work, we introduce the infimal convolution of the first- and the second-order total variation (ICTV) as the regularization term in penalized maximum likelihood reconstruction.

Mechanical interventricular dependency supports hemodynamics in tako-tsubo cardiomyopathy.

Background: Although morphological abnormalities of the heart appear to be remarkable, most patients with tako-tsubo cardiomyopathy (TTC) remain clinically stable. We investigate real time changes in the left ventricular (LV) and right ventricular (RV) mechanics and function to explore the mechanism to preserve hemodynamics.

Methods: With deformation and Doppler echocardiography, we evaluated myocardial mechanics and ventricular function/hemodynamics simultaneously in 103 consecutive TTC patients admitted from 01/01/2008 through 12/31/2015.

A 54-year-old man with new-onset ventricular fibrillation.

Clinical Introduction: A 54-year-old man without significant medical history presented with sudden-onset chest discomfort and multiple episodes of ventricular fibrillation requiring external defibrillation and cardiopulmonary resuscitation. Coronary angiography ruled out significant artery stenosis. Both ventriculography and echocardiography revealed decreased left ventricular ejection fraction (25%).

Myocardial contractile patterns predict future cardiac events in sarcoidosis.

The poor prognosis of cardiac sarcoidosis (CS) underscores the need for risk stratification. We evaluated 84 consecutive sarcoidosis patients who were referred for echocardiographic studies for cardiac symptoms or abnormal electrocardiograms. In 54 patients without previous diagnosis of CS or other known structural heart disease, 13 reached endpoints during (median) 24 months follow up.

Preconditioned alternating projection algorithm for solving the penalized-likelihood SPECT reconstruction problem.

Purpose: The authors recently developed a preconditioned alternating projection algorithm (PAPA) for solving the penalized-likelihood SPECT reconstruction problem. The proposed algorithm can solve a wide variety of non-differentiable optimization models. This work is dedicated to comparing the performance of PAPA with total variation (TV) regularization (TV-PAPA) and a novel forward-backward algorithm with nested expectation maximization (EM)-TV iteration scheme (FB-EM-TV).

Effective noise-suppressed and artifact-reduced reconstruction of SPECT data using a preconditioned alternating projection algorithm.

Purpose: The authors have recently developed a preconditioned alternating projection algorithm (PAPA) with total variation (TV) regularizer for solving the penalized-likelihood optimization model for single-photon emission computed tomography (SPECT) reconstruction. This algorithm belongs to a novel class of fixed-point proximity methods. The goal of this work is to investigate how PAPA performs while dealing with realistic noisy SPECT data, to compare its performance with more conventional methods, and to address issues with TV artifacts by proposing a novel form of the algorithm invoking high-order TV regularization, denoted as HOTV-PAPA, which has been explored and studied extensively in the present work.

Electromagnetic effects on forearm disuse osteopenia: a randomized, double-blind, sham-controlled study.

A randomized, double-blind, sham-controlled, feasibility and dosing study was undertaken to determine if a common pulsing electromagnetic field (PEMF) treatment could moderate the substantial osteopenia that occurs after forearm disuse. Ninety-nine subjects were randomized into four groups after a distal radius fracture, or carpal surgery requiring immobilization in a cast. Active or identical sham PEMF transducers were worn on the distal forearm for 1, 2, or 4 h/day for 8 weeks starting after cast removal ("baseline") when bone density continues to decline.

Computerized method for nonrigid MR-to-PET breast-image registration.

We have developed and tested a new simple computerized finite element method (FEM) approach to MR-to-PET nonrigid breast-image registration. The method requires five-nine fiducial skin markers (FSMs) visible in MRI and PET that need to be located in the same spots on the breast and two on the flanks during both scans. Patients need to be similarly positioned prone during MRI and PET scans.

MRI/PET nonrigid breast-image registration using skin fiducial markers.

We propose a finite-element method (FEM) deformable breast model that does not require elastic breast data for nonrigid PET/MRI breast image registration. The model is applicable only if the stress conditions in the imaged breast are virtually the same in PET and MRI. Under these conditions, the observed intermodality displacements are solely due the imaging/reconstruction process.

What does PET imaging add to conventional staging of head and neck cancer patients?

Purpose: To determine the value of PET scans in the staging of patients with head and neck carcinoma.

Methods And Materials: The charts of 25 patients who underwent neck dissection, computed tomography (CT) scan, and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as part of their initial work-up for a head and neck squamous cell cancer between 2000-2003 were reviewed. All patients underwent clinical examination, triple endoscopy, and chest radiograph as part of their clinical staging, adhering to American Joint Commission for Cancer criteria.

Symptomatic and scintigraphic improvement after intravenous pamidronate treatment of Paget's disease of bone in patients with normal serum alkaline phosphatase levels.

Objective: To describe three patients with symptomatic Paget's disease of bone who presented with normal levels of serum alkaline phosphatase.

Methods: We present three cases of Paget's disease of bone and chronicle the laboratory, scintigraphic, and clinical findings relative to treatment with intravenously administered pamidronate.

Results: Although measurement of serum total alkaline phosphatase usually provides a general indication of bone turnover in Paget's disease, about 15% of patients present with normal serum alkaline phosphatase levels.

Abdominal fat distribution in pre- and postmenopausal women: The impact of physical activity, age, and menopausal status.

Age-related increases in total body fat have been reported, but the impact of menopause on abdominal fat distribution is still unclear. The purpose of this study was to determine the impact of menopausal status on abdominal fat distribution using magnetic resonance imaging (MRI). In addition, we investigated the influence of abdominal fat distribution on blood lipid profiles and leptin concentrations.

An EM algorithm for estimating SPECT emission and transmission parameters from emissions data only.

A maximum-likelihood (ML) expectation-maximization (EM) algorithm (called EM-IntraSPECT) is presented for simultaneously estimating single photon emission computed tomography (SPECT) emission and attenuation parameters from emission data alone. The algorithm uses the activity within the patient as transmission tomography sources, with which attenuation coefficients can be estimated. For this initial study, EM-IntraSPECT was tested on computer-simulated attenuation and emission maps representing a simplified human thorax as well as on SPECT data obtained from a physical phantom.

Familial encephalopathy with neuroserpin inclusion bodies.

We report on a new familial neurodegenerative disease with associated dementia that has presented clinically in the fifth decade, in both genders, and in each of several generations of a large family from New York State-a pattern of inheritance consistent with an autosomal dominant mode of transmission. A key pathological finding is the presence of neuronal inclusion bodies distributed throughout the gray matter of the cerebral cortex and in certain subcortical nuclei. These inclusions are distinct from any described previously and henceforth are identified as Collins bodies.

Invasive aspergillosis diagnosed by fine-needle aspiration of the thyroid gland.

Invasive aspergillosis has been increasingly recognized as causing significant morbidity and mortality in immunocompromised patients but has never been diagnosed by fine-needle thyroid aspiration. A 24-year-old female with systemic lupus erythematosus presented with cough, shortness of breath, and fever of unknown origin unresponsive to broad-spectrum antibiotics. History and physical examination failed to indicate a source of infection.

Familial dementia caused by polymerization of mutant neuroserpin.

Aberrant protein processing with tissue deposition is associated with many common neurodegenerative disorders; however, the complex interplay of genetic and environmental factors has made it difficult to decipher the sequence of events linking protein aggregation with clinical disease. Substantial progress has been made toward understanding the pathophysiology of prototypical conformational diseases and protein polymerization in the superfamily of serine proteinase inhibitors (serpins). Here we describe a new disease, familial encephalopathy with neuroserpin inclusion bodies, characterized clinically as an autosomal dominantly inherited dementia, histologically by unique neuronal inclusion bodies and biochemically by polymers of the neuron-specific serpin, neuroserpin.

Liposuction fat-fillant implant for breast augmentation and reconstruction.

The perfect breast implant fillant material would have higher viscosity than water and would be autologous and harmless. We describe the confinement of liposuction fat in implants using the Lipovacutainer during a routine liposuction procedure. This collected fat is prepared inside the Lipovacutainer and is reinjected through a Lipomedia filling cannula into a leaf valve implant as the fillant in place of saline.

Bone marrow reconversion in adults who are smokers: MR Imaging findings.

Objective: Conversion of bone marrow in the extremities from red to yellow is a normal maturation process. Marrow reconversion is present when expected yellow marrow is replaced with active red marrow, and it tends to occur at times of physiologic stress. The significance of this finding on MR imaging is not always clear.