Journal Description
Diagnostics
Diagnostics
is an international, peer-reviewed, open access journal on medical diagnosis published semimonthly online by MDPI. The British Neuro-Oncology Society (BNOS), the International Society for Infectious Diseases in Obstetrics and Gynaecology (ISIDOG) and the Swiss Union of Laboratory Medicine (SULM) are affiliated with Diagnostics and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Inspec, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.7 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journal: LabMed.
Impact Factor:
3.6 (2022);
5-Year Impact Factor:
3.7 (2022)
Latest Articles
Rare Driver Mutations in Advanced, Oncogene-Addicted Non-Small Cell Lung Cancer: A North Italian, Real-World, Registry Experience
Diagnostics 2024, 14(10), 1024; https://doi.org/10.3390/diagnostics14101024 - 15 May 2024
Abstract
The real-world, retrospective, NEROnE registry investigated the impact of next-generation sequencing (NGS) in advanced non-small-cell lung cancer (NSCLC) patients (pts) at three oncology units in the north of Italy between January 2020 and December 2022. We focused on the clinical characterization and outcomes
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The real-world, retrospective, NEROnE registry investigated the impact of next-generation sequencing (NGS) in advanced non-small-cell lung cancer (NSCLC) patients (pts) at three oncology units in the north of Italy between January 2020 and December 2022. We focused on the clinical characterization and outcomes of NSCLC with rare molecular alterations: EGFR exon 20 insertion, non-activating EGFR mutations, BRAF V600E and non-V600, ROS1 and RET rearrangements, MET, ErbB2, and FGFR mutations. Overall, these represented 6.4% (62/970) of the pts analysed with NGS in the daily practice. The most heavily represented rare alterations were ROS1 rearrangement (15 pts—24%) and MET exon 14 skipping mutation (11 pts—18%). No associations were found with the demographic and clinical features. Forty-nine pts received targeted therapies, of which 38.8% were first- and 9.8% were second-line. The remaining pts received chemotherapy and/or immunotherapy. In terms of the clinical outcomes, although not statistically significant, a tendency toward shorter OS was seen when therapies other than specific targeted therapies were used (HR: 1.84, 95% CI: 0.79–4.33, p = 0.158). The pts with co-mutations (19.4%) seemed to receive an advantage from the front-line chemotherapy-based regimen. Finally, an NLR score (a well-known inflammatory index) ≥ 4 seemed to be related to shorter OS among the pts treated with immunotherapy alone or in combination with chemotherapy (HR: 2.83, 95% CI: 1.08–7.40, p = 0.033). Prospective evaluations need to be performed to clarify whether these indexes may help to identify patients with oncogene-addicted NSCLC who could benefit from immunotherapy.
Full article
(This article belongs to the Special Issue Lung Cancer: Screening, Diagnosis and Management)
Open AccessArticle
Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer
by
Andreea-Corina Ilie-Petrov, Daniel-Alin Cristian, Florin Andrei Grama, Andrei Chitul, Angela Blajin, Andrei Popa, Draga-Maria Mandi, Luminița Welt, Marina Alina Bara, Rareș Vrîncianu and Carmen Maria Ardeleanu
Diagnostics 2024, 14(10), 1023; https://doi.org/10.3390/diagnostics14101023 - 15 May 2024
Abstract
Encoded by the CDX2 homeobox gene, the CDX2 protein assumes the role of a pivotal transcription factor localized within the nucleus of intestinal epithelial cells, orchestrating the delicate equilibrium of intestinal physiology while intricately guiding the precise development and differentiation of epithelial tissue.
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Encoded by the CDX2 homeobox gene, the CDX2 protein assumes the role of a pivotal transcription factor localized within the nucleus of intestinal epithelial cells, orchestrating the delicate equilibrium of intestinal physiology while intricately guiding the precise development and differentiation of epithelial tissue. Emerging research has unveiled that positive immunohistochemical expression of this protein shows that the CDX2 gene exerts a potent suppressive impact on tumor advancement in colorectal cancer, impeding the proliferation and distant dissemination of tumor cells, while the inhibition or suppression of CDX2 frequently correlates with aggressive behavior in colorectal cancer. In this study, we conducted an immunohistochemical assessment of CDX2 expression on a cohort of 43 intraoperatively obtained tumor specimens from patients diagnosed with colon cancer at Colțea Clinical Hospital in Bucharest, between April 2019 and December 2023. Additionally, we shed light on the morphological diversity within colon tumors, uncovering varying differentiation grades within the same tumor, reflecting the variations in CDX2 expression as well as the genetic complexity underlying these tumors. Based on the findings, we developed an innovative immunohistochemical scoring system that addresses the heterogeneous nature of colon tumors. Comprehensive statistical analysis of CDX2 immunohistochemical expression unveiled significant correlations with known histopathological parameters such as tumor differentiation grades (p-value = 0.011) and tumor budding score (p-value = 0.002), providing intriguing insights into the complex involvement of the CDX2 gene in orchestrating tumor progression through modulation of differentiation processes, and highlighting its role in metastatic predisposition. The compelling correlation identified between CDX2 expression and conventional histopathological parameters emphasizes the prognostic significance of the CDX2 biomarker in colon cancer. Moreover, our novel immunohistochemical scoring system reveals a distinct subset of colon tumors exhibiting reserved prognostic outcomes, distinguished by their “mosaic” CDX2 expression pattern.
Full article
(This article belongs to the Special Issue Diagnosis and Management in Digestive Surgery)
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Open AccessArticle
Normal Values for Echocardiographic Myocardial Work in a Large Pediatric Population
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Pietro Marchese, Marco Scalese, Nadia Assanta, Eliana Franchi, Cecilia Viacava, Giuseppe Santoro, Giulia Corana, Alessandra Pizzuto, Francesca Valeria Contini, Shelby Kutty and Massimiliano Cantinotti
Diagnostics 2024, 14(10), 1022; https://doi.org/10.3390/diagnostics14101022 - 15 May 2024
Abstract
Background: Echocardiographic myocardial work is a new load-independent echocardiographic technique to quantify left ventricle (LV) systolic performance. Our aim was to establish normal values for echocardiographic myocardial work in a large population of healthy children. Methods: For all the subjects 4-, 2-, and
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Background: Echocardiographic myocardial work is a new load-independent echocardiographic technique to quantify left ventricle (LV) systolic performance. Our aim was to establish normal values for echocardiographic myocardial work in a large population of healthy children. Methods: For all the subjects 4-, 2-, and 3-chamber-view videos were stored. The following parameters were obtained by offline analysis: the global myocardial work (GMW), the global myocardial constructive work (GCW), the global myocardial wasted work (GWW), and the global myocardial work efficiency (GWE). Age, weight, height, heart rate, and body surface area (BSA) were used as independent variables in the statistical analysis. Results: In all, 516 healthy subjects (age range, 1 day—18 years; median age, 8.2 ± 5.3 years; 55.8% male; body surface area (BSA) range, 0.16 to 2.12 m2) were included. GWI, GCW, and GWW increased with weight, height, and BSA (ρ ranging from 0.635 to 0.226, p all < 0.01); GWI and GCW positively correlated with age (ρ 0.653 and 0.507). After adjusting for BSA differences, females showed higher mean GWI (p = 0.002) and GCW values (p < 0.001), thus Z-score equations for gender have been presented. Conclusions: We provided MW values in a large population of healthy pediatric subjects including lower ages. MW values increased with age and body size and, interestingly, were higher in females than in men. These data cover a gap in current nomograms and may serve as a baseline for the evaluation of MW analysis in children with congenital and acquired heart diseases.
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(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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Open AccessArticle
Is Incisor Compensation Related to Skeletal Discrepancies in Skeletal Class III? A Retrospective Cephalometric Study
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Jirath Mathapun and Chairat Charoemratrote
Diagnostics 2024, 14(10), 1021; https://doi.org/10.3390/diagnostics14101021 - 15 May 2024
Abstract
This study investigated compensation in skeletal Class III subjects to compare various severities of abnormal jaws. A retrospective analysis of 137 skeletal Class III cephalograms (63 males and 74 females) was conducted, with cephalometric assessments determining skeletal and dental values. The results were
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This study investigated compensation in skeletal Class III subjects to compare various severities of abnormal jaws. A retrospective analysis of 137 skeletal Class III cephalograms (63 males and 74 females) was conducted, with cephalometric assessments determining skeletal and dental values. The results were compared with Class I cephalograms. Incisor compensation was examined by pairing normal jaws with varied abnormal jaws, classified by severity using one standard deviation (SD). Statistical analyses included Kruskal–Wallis tests, Bonferroni tests, Spearman’s correlations, and multiple linear regression. Four skeletal Class III groups were identified: OMx+PMd, RMx+OMd, OMx+OMd, and PMx+PMd (P = prognathic; O = orthognathic; R = retrognathic; Mx = maxilla; Md = mandible.). The upper central incisor (U1) showed proclination, and the lower central incisor (L1) showed retroclination across all groups except for U1 in PMx+PMd and L1 in OMx+OMd, which exhibited normal inclination. U1 exhibited limited compensation even with progressive maxillary retrognathism, while L1 showed limited compensation after one SD of mandibular prognathism. Maxilla (SNA) and jaw discrepancy (ANB) were inversely related to the U1 degree, whereas only jaw discrepancy (ANB) was positively related to the L1 degree. U1 in PMx+PMd and L1 in OMx+OMd showed no incisor compensation. U1 had limited compensation even with progressive maxillary retrognathism while L1 showed limited compensation after one SD mandibular prognathism.
Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Oral Diseases)
Open AccessArticle
The Association between Low Fetal Fraction of Non-Invasive Prenatal Testing and Adverse Pregnancy Outcomes for Placental Compromise
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Soo Hyun Kim, You Mi Hong, Ji Eun Park, Sung Shin Shim, Hee Jin Park, Yeon Kyung Cho, June Seek Choi, Joong Sik Shin, Hyun Mee Ryu, Moon Young Kim, Dong Hyun Cha and You Jung Han
Diagnostics 2024, 14(10), 1020; https://doi.org/10.3390/diagnostics14101020 - 15 May 2024
Abstract
(1) Background: Non-invasive prenatal testing (NIPT) is a screening test for fetal aneuploidy using cell-free fetal DNA. The fetal fragments (FF) of cell-free DNA (cfDNA) are derived from apoptotic trophoblast of the placenta. The level of fetal cfDNA is known to be influenced
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(1) Background: Non-invasive prenatal testing (NIPT) is a screening test for fetal aneuploidy using cell-free fetal DNA. The fetal fragments (FF) of cell-free DNA (cfDNA) are derived from apoptotic trophoblast of the placenta. The level of fetal cfDNA is known to be influenced by gestational age, multiple pregnancies, maternal weight, and height. (2) Methods: This study is a single-center retrospective observational study which examines the relationship between the fetal fraction (FF) of cell-free DNA in non-invasive prenatal testing (NIPT) and adverse pregnancy outcomes in singleton pregnancies. A total of 1393 samples were collected between 10 weeks and 6 days, and 25 weeks and 3 days of gestation. (3) Results: Hypertensive disease of pregnancy (HDP) occurred more frequently in the low FF group than the normal FF group (5.17% vs. 1.91%, p = 0.001). Although the rates of small for gestational age (SGA) and placental abruption did not significantly differ between groups, the composite outcome was significantly higher in the low FF group (7.76% vs. 3.64%, p = 0.002). Furthermore, women who later experienced complications such as HDP or gestational diabetes mellitus (GDM) had significantly lower plasma FF levels compared to those without complications (p < 0.001). After adjustments, the low FF group exhibited a significantly higher likelihood of placental compromise (adjusted odds ratio: 1.946). (4) Conclusions: Low FF in NIPT during the first and early second trimesters is associated with adverse pregnancy outcomes, particularly HDP, suggesting its potential as a predictive marker for such outcomes.
Full article
(This article belongs to the Special Issue Advancements in Maternal–Fetal Medicine)
Open AccessArticle
Cranial Computer Tomography with Photon Counting and Energy-Integrated Detectors: Objective Comparison in the Same Patients
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Anna Klempka, Alexander Schröder, Philipp Neumayer, Christoph Groden, Sven Clausen and Svetlana Hetjens
Diagnostics 2024, 14(10), 1019; https://doi.org/10.3390/diagnostics14101019 - 15 May 2024
Abstract
This study provides an objective comparison of cranial computed tomography (CT) imaging quality and radiation dose between photon counting detectors (PCCTs) and energy-integrated detectors (EIDs). We retrospectively analyzed 158 CT scans from 82 patients, employing both detector types on the same individuals to
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This study provides an objective comparison of cranial computed tomography (CT) imaging quality and radiation dose between photon counting detectors (PCCTs) and energy-integrated detectors (EIDs). We retrospectively analyzed 158 CT scans from 82 patients, employing both detector types on the same individuals to ensure a consistent comparison. Our analysis focused on the Computed Tomography Dose Index and the Dose-Length Product together with the contrast-to-noise ratio and the signal-to-noise ratio for brain gray and white matter. We utilized standardized imaging protocols and consistent patient positioning to minimize variables. PCCT showed a potential for higher image quality and lower radiation doses, as highlighted by this study, thus achieving diagnostic clarity with reduced radiation exposure, underlining its significance in patient care, particularly for patients requiring multiple scans. The results demonstrated that while both systems were effective, PCCT offered enhanced imaging and patient safety in neuroradiological evaluations.
Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Nervous System Diseases—2nd Edition)
Open AccessInteresting Images
Tuberculous Spondylodiscitis with Psoas Abscess Descending into the Anterior Femoral Compartment Identified Using 2-deoxy-2-[18F]fluoroglucose Positron Emission Tomography Computed Tomography
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Julian Scherer, Tessa Kotze, Zintle Mdiza, Andrew Lawson, Michael Held and Friedrich Thienemann
Diagnostics 2024, 14(10), 1018; https://doi.org/10.3390/diagnostics14101018 - 15 May 2024
Abstract
A 24-year-old immunocompetent woman underwent whole-body 18F-FDG PET/CT for the evaluation of MRI-suspicious tuberculous spinal lesions. The PET/CT results showed no pathological uptake in either lung, and there were no pathological changes on CT. There was increased uptake in the right psoas muscle,
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A 24-year-old immunocompetent woman underwent whole-body 18F-FDG PET/CT for the evaluation of MRI-suspicious tuberculous spinal lesions. The PET/CT results showed no pathological uptake in either lung, and there were no pathological changes on CT. There was increased uptake in the right psoas muscle, extending continuously down anterior to the right hip joint, posterior to and around the trochanteric region of the right femur, and into the right thigh, with an SUVmaxbw of 17.0. Subsequently, the patient underwent CT-guided biopsy as per protocol, which revealed drug-sensitive Mycobacterium tuberculosis, and the patient was started on standard tuberculosis treatment for 12 months.
Full article
(This article belongs to the Special Issue 18F-FDG PET/CT: Current and Future Clinical Applications)
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Open AccessArticle
Texture-Based Classification to Overcome Uncertainty between COVID-19 and Viral Pneumonia Using Machine Learning and Deep Learning Techniques
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Omar Farghaly and Priya Deshpande
Diagnostics 2024, 14(10), 1017; https://doi.org/10.3390/diagnostics14101017 - 15 May 2024
Abstract
The SARS-CoV-2 virus, responsible for COVID-19, often manifests symptoms akin to viral pneumonia, complicating early detection and potentially leading to severe COVID pneumonia and long-term effects. Particularly affecting young individuals, the elderly, and those with weakened immune systems, the accurate classification of COVID-19
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The SARS-CoV-2 virus, responsible for COVID-19, often manifests symptoms akin to viral pneumonia, complicating early detection and potentially leading to severe COVID pneumonia and long-term effects. Particularly affecting young individuals, the elderly, and those with weakened immune systems, the accurate classification of COVID-19 poses challenges, especially with highly dimensional image data. Past studies have faced limitations due to simplistic algorithms and small, biased datasets, yielding inaccurate results. In response, our study introduces a novel classification model that integrates advanced texture feature extraction methods, including GLCM, GLDM, and wavelet transform, within a deep learning framework. This innovative approach enables the effective classification of chest X-ray images into normal, COVID-19, and viral pneumonia categories, overcoming the limitations encountered in previous studies. Leveraging the unique textures inherent to each dataset class, our model achieves superior classification performance, even amidst the complexity and diversity of the data. Moreover, we present comprehensive numerical findings demonstrating the superiority of our approach over traditional methods. The numerical results highlight the accuracy (random forest (RF): 0.85; SVM (support vector machine): 0.70; deep learning neural network (DLNN): 0.92), recall (RF: 0.85, SVM: 0.74, DLNN: 0.93), precision (RF: 0.86, SVM: 0.71, DLNN: 0.87), and F1-Score (RF: 0.86, SVM: 0.72, DLNN: 0.89) of our proposed model. Our study represents a significant advancement in AI-based diagnostic systems for COVID-19 and pneumonia, promising improved patient outcomes and healthcare management strategies.
Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
Open AccessReview
Vasa Previa and the Role of Fetal Fibronectin and Cervical Length Surveillance: A Review
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Antonia F. Oladipo, Kaitlyn Voity, Kimberly Murphy, Manuel Alvarez and Jesus Alvarez-Perez
Diagnostics 2024, 14(10), 1016; https://doi.org/10.3390/diagnostics14101016 - 15 May 2024
Abstract
Vasa previa is a pregnancy complication that occurs when unprotected fetal blood vessels traverse the cervical os, placing the fetus at high risk of exsanguination and fetal death. These fetal vessels may be compromised by fetal movement and compression, leading to poor oxygen
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Vasa previa is a pregnancy complication that occurs when unprotected fetal blood vessels traverse the cervical os, placing the fetus at high risk of exsanguination and fetal death. These fetal vessels may be compromised by fetal movement and compression, leading to poor oxygen distribution and asphyxiation. Diagnostic tools for vasa previa management and preterm labor (PTL) include transvaginal ultrasound, cervical length (CL) surveillance and use of fetal fibronectin (FFN) testing. These tools can prove to be quite useful as they allow for lead time in the prediction of PTL and spontaneous rupture of membranes which can result in devastating outcomes for pregnancies affected by vasa previa. We conducted a literature review on vasa previa management and the usefulness of FFN and CL surveillance in predicting PTL and found 36 related papers. Although there is limited research available to show the impact of FFN and CL surveillance in the management of vasa previa, there is sufficient evidence to support FFN and CL surveillance in predicting the onset of PTL, which can have devastating consequences for the pregnancies affected. It can be extrapolated that these tools, by helping to determine pregnancies at risk for PTL, could improve management and outcomes in patients with vasa previa. Future studies investigating the management of vasa previa with FFN and CL surveillance to reduce the burden of PTL and its associated comorbidities are warranted.
Full article
(This article belongs to the Special Issue Insights in Maternal-Fetal Medicine—Preventing Preterm Births)
Open AccessArticle
Breast Delineation in Full-Field Digital Mammography Using the Segment Anything Model
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Andrés Larroza, Francisco Javier Pérez-Benito, Raquel Tendero, Juan Carlos Perez-Cortes, Marta Román and Rafael Llobet
Diagnostics 2024, 14(10), 1015; https://doi.org/10.3390/diagnostics14101015 - 15 May 2024
Abstract
Breast cancer is a major health concern worldwide. Mammography, a cost-effective and accurate tool, is crucial in combating this issue. However, low contrast, noise, and artifacts can limit the diagnostic capabilities of radiologists. Computer-Aided Diagnosis (CAD) systems have been developed to overcome these
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Breast cancer is a major health concern worldwide. Mammography, a cost-effective and accurate tool, is crucial in combating this issue. However, low contrast, noise, and artifacts can limit the diagnostic capabilities of radiologists. Computer-Aided Diagnosis (CAD) systems have been developed to overcome these challenges, with the accurate outlining of the breast being a critical step for further analysis. This study introduces the SAM-breast model, an adaptation of the Segment Anything Model (SAM) for segmenting the breast region in mammograms. This method enhances the delineation of the breast and the exclusion of the pectoral muscle in both medio lateral-oblique (MLO) and cranio-caudal (CC) views. We trained the models using a large, multi-center proprietary dataset of 2492 mammograms. The proposed SAM-breast model achieved the highest overall Dice Similarity Coefficient (DSC) of 99.22% ± 1.13 and Intersection over Union (IoU) 98.48% ± 2.10 over independent test images from five different datasets (two proprietary and three publicly available). The results are consistent across the different datasets, regardless of the vendor or image resolution. Compared with other baseline and deep learning-based methods, the proposed method exhibits enhanced performance. The SAM-breast model demonstrates the power of the SAM to adapt when it is tailored to specific tasks, in this case, the delineation of the breast in mammograms. Comprehensive evaluations across diverse datasets—both private and public—attest to the method’s robustness, flexibility, and generalization capabilities.
Full article
(This article belongs to the Special Issue Advances in Breast Radiology)
Open AccessInteresting Images
Late Outcomes of Undiagnosed Unilateral Condylar Hyperplasia and Reoccurrence of Mandibular Asymmetry
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Kamil Nelke, Wojciech Pawlak, Klaudiusz Łuczak, Maciej Janeczek, Edyta Pasicka, Jan Nienartowicz, Grzegorz Gogolewski and Maciej Dobrzyński
Diagnostics 2024, 14(10), 1014; https://doi.org/10.3390/diagnostics14101014 - 15 May 2024
Abstract
Unilateral condylar hyperplasia (UCH) is a rare cause of asymmetrical mandibular overgrowth because of the presence of an atypical growth in the affected condyle. SPECT (single-photon emission computed tomography) can easily establish the presence of an atypical, prolonged growth exceeding far beyond normal
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Unilateral condylar hyperplasia (UCH) is a rare cause of asymmetrical mandibular overgrowth because of the presence of an atypical growth in the affected condyle. SPECT (single-photon emission computed tomography) can easily establish the presence of an atypical, prolonged growth exceeding far beyond normal condylar growth and activity. A CT, CBCT, or LDCT (computed tomography, cone-beam computed tomography, or low-dose computed tomography) can confirm the diagnosis by evaluating the scope of bone overgrowth, mandibular basis/ramus asymmetry, tendency to condylar head enlargement, changes in bone density, and occurrence of differences in condylar head shapes, size, and bone structure. In most cases, a condylectomy is the procedure of choice in growing cases of UCH to remove the pathological condyle and reduce asymmetry levels. Sometimes, the growth is very slow and progressive over time, causing slowly growing asymmetry with similar symptoms to any other mandibular asymmetry, and this causes some troublesome procedures in UCH diagnostics, resulting in patients being underdiagnosed; it can even lead to some relapses in mandibular asymmetry and skeletal malocclusion after previously performed orthodontic and surgical treatment of such discrepancies. When the source of asymmetry is not identified in time, possible inadequate treatment protocols can be used. If any relapse of facial and mandibular asymmetry re-occur, SPECT and CT evaluation are necessary to evaluate if condylar hyperplasia is present and to establish what kind of surgical intervention should be used in each case.
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(This article belongs to the Collection Interesting Images)
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Reply to Kawasaki et al. Comment on “Manole et al. Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review. Diagnostics 2022, 12, 158”
by
Simona Manole, Roxana Pintican, Emanuel Palade, Maria Magdalena Duma, Alexandra Dadarlat-Pop, Calin Schiau, Ioana Bene, Raluca Rancea, Diana Miclea, Viorel Manole, Adrian Molnar and Carolina Solomon
Diagnostics 2024, 14(10), 1013; https://doi.org/10.3390/diagnostics14101013 - 15 May 2024
Abstract
Thank you for your comment; it adds value to the article and highlights the importance of molecular testing [...]
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(This article belongs to the Section Pathology and Molecular Diagnostics)
Open AccessComment
Comment on Manole et al. Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review. Diagnostics 2022, 12, 158
by
Tomonori Kawasaki, Jiro Ichikawa, Hiroki Imada, Satoshi Kanno and Kojiro Onohara
Diagnostics 2024, 14(10), 1012; https://doi.org/10.3390/diagnostics14101012 - 15 May 2024
Abstract
With great interest, we read the article by Manole et al [...]
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(This article belongs to the Section Pathology and Molecular Diagnostics)
Open AccessArticle
In Vivo Regulation of Active Matrix Metalloproteinase-8 (aMMP-8) in Periodontitis: From Transcriptomics to Real-Time Online Diagnostics and Treatment Monitoring
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Nur Rahman Ahmad Seno Aji, Tülay Yucel-Lindberg, Ismo T. Räisänen, Heidi Kuula, Mikko T. Nieminen, Maelíosa T. C. Mc Crudden, Dyah Listyarifah, Anna Lundmark, Fionnuala T. Lundy, Shipra Gupta and Timo Sorsa
Diagnostics 2024, 14(10), 1011; https://doi.org/10.3390/diagnostics14101011 - 15 May 2024
Abstract
Background: This study investigated in vivo regulation and levels of active matrix metalloproteinase-8 (aMMP-8), a major collagenolytic protease, in periodontitis. Methods: Twenty-seven adults with chronic periodontitis (CP) and 30 periodontally healthy controls (HC) were enrolled in immunohistochemistry and transcriptomics analytics in order to
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Background: This study investigated in vivo regulation and levels of active matrix metalloproteinase-8 (aMMP-8), a major collagenolytic protease, in periodontitis. Methods: Twenty-seven adults with chronic periodontitis (CP) and 30 periodontally healthy controls (HC) were enrolled in immunohistochemistry and transcriptomics analytics in order to assess Treponema denticola (Td) dentilisin and MMP-8 immunoexpression, mRNA expression of MMP-8 and its regulators (IL-1β, MMP-2, MMP-7, TIMP-1). Furthermore, the periodontal anti-infective treatment effect was monitored by four different MMP-8 assays (aMMP-8-IFMA, aMMP-8-Oralyzer, MMP-8-activity [RFU/minute], and total MMP-8 by ELISA) among 12 CP (compared to 25 HC). Results: Immunohistochemistry revealed significantly more Td-dentilisin and MMP-8 immunoreactivities in CP vs. HC. Transcriptomics revealed significantly elevated IL-1β and MMP-7 RNA expressions, and MMP-2 RNA was slightly reduced. No significant differences were recorded in the relatively low or barely detectable levels of MMP-8 mRNAs. Periodontal treatment significantly decreased all MMP-8 assay levels accompanied by the assessed clinical indices (periodontal probing depths, bleeding-on-probing, and visual plaque levels). However, active but not total MMP-8 levels persisted higher in CP than in periodontally healthy controls. Conclusion: In periodontal health, there are low aMMP-8 levels. The presence of Td-dentilisin in CP gingivae is associated with elevated aMMP-8 levels, potentially contributing to a higher risk of active periodontal tissue collagenolysis and progression of periodontitis. This can be detected by aMMP-8-specific assays and online/real-time aMMP-8 chair-side testing.
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(This article belongs to the Special Issue Advances in the Diagnosis of Oral and Maxillofacial Disease)
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Open AccessArticle
Simplified Assessment of Radioiodine Biokinetics for Thyroid Cancer Patients: A Practical Approach Using Continuous External Radiation Monitoring
by
Yao-Kuang Tsai, Li-Fan Lin, Cheng-Yi Cheng, Ching-Yee Oliver Wong, Wei-Hsung Wang, Daniel Hueng-Yuan Shen, Sui-Lung Su, En-Shih Chen, Tzai-Yang Chen and I-Feng Chen
Diagnostics 2024, 14(10), 1010; https://doi.org/10.3390/diagnostics14101010 - 14 May 2024
Abstract
Introduction: The biokinetics of radioiodine (RAI) in thyroid cancer patients are complex. This study aims to develop a practical approach for assessing RAI biokinetics to predict patient discharge time and estimate radiation exposure to caregivers. Methods: We retrospectively reviewed data from patients with
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Introduction: The biokinetics of radioiodine (RAI) in thyroid cancer patients are complex. This study aims to develop a practical approach for assessing RAI biokinetics to predict patient discharge time and estimate radiation exposure to caregivers. Methods: We retrospectively reviewed data from patients with differentiated thyroid carcinoma undergoing RAI treatment. Serial radiation dose rates were dynamically collected during hospitalization and fitted to a biexponential model to assess the biokinetic features: RAI uptake fraction of thyroid tissue (Ft) and effective half-life of extra-thyroid tissue (Tet). Correlations with 99mTc thyroid uptake ratio (TcUR), radiation retention ratio (RR), renal function, and body mass index (BMI) were analyzed. Results: Thirty-five patients were enrolled. The derived Ft was 0.08 ± 0.06 and Tet was 7.57 ± 1.45 h. Pearson’s correlation analysis revealed a significant association between Ft and both TcUR and RR (p < 0.05), while Tet correlated with renal function and BMI (p < 0.05). Conclusion: This novel and practical method assessing RAI biokinetics demonstrates consistency with other parameters and related studies, enhancing the model reliability. It shows promise in predicting an appropriate discharge time and estimating radiation exposure to caregivers, allowing for modifications to radiation protection precautions to follow ALARA principle and minimize the potential risks from radiation exposure.
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(This article belongs to the Section Medical Imaging and Theranostics)
Open AccessArticle
Radiographical Diagnostic Evaluation of Mandibular Cortical Index Classification and Mandibular Cortical Width in Female Patients Prescribed Antiosteoporosis Medication: A Retrospective Cohort Study
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Keisuke Seki, Maki Nagasaki, Tona Yoshino, Mayuko Yano, Aki Kawamoto and Osamu Shimizu
Diagnostics 2024, 14(10), 1009; https://doi.org/10.3390/diagnostics14101009 - 13 May 2024
Abstract
Osteoporosis is often detected late and becomes severe because of a lack of subjective symptoms. Digital panoramic radiography (DPR) has been reported to be useful for osteoporosis screening based on the morphological classification of the mandibular inferior cortex. The purpose of this study
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Osteoporosis is often detected late and becomes severe because of a lack of subjective symptoms. Digital panoramic radiography (DPR) has been reported to be useful for osteoporosis screening based on the morphological classification of the mandibular inferior cortex. The purpose of this study was to evaluate the sensitivity and specificity of the mandibular cortical index (MCI) in the diagnosis of osteoporosis in a group of patients who were and were not using antiosteoporosis medication (AOM). Three hundred and fifty female patients aged 40 years or older who had DPR imaging performed during a 6-year period from December 2015 to February 2022 met the selection criteria. Two examiners recorded mandibular cortical width and MCI from the images. These results were statistically examined together with the patients’ demographic data. Forty-nine patients were using AOM (13 nonbisphosphonate/denosumab and 36 bisphosphonate/denosumab). MCI type 3 was the most common in the AOM group. In the MCI classification, DPR imaging among the AOM group was more sensitive (0.95) than that of the control group. This method of estimating osteoporosis based on MCI classification using DPR images has high sensitivity, especially in patients using AOM, suggesting that this method is useful as a screening test.
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(This article belongs to the Section Medical Imaging and Theranostics)
Open AccessArticle
Novel Feature Generation for Classification of Motor Activity from Functional Near-Infrared Spectroscopy Signals Using Machine Learning
by
V. Akila, J. Anita Christaline and A. Shirly Edward
Diagnostics 2024, 14(10), 1008; https://doi.org/10.3390/diagnostics14101008 - 13 May 2024
Abstract
Recent research in the field of cognitive motor action decoding focuses on data acquired from Functional Near-Infrared Spectroscopy (fNIRS) and its analysis. This research aims to classify two different motor activities, namely, mental drawing (MD) and spatial navigation (SN), using fNIRS data from
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Recent research in the field of cognitive motor action decoding focuses on data acquired from Functional Near-Infrared Spectroscopy (fNIRS) and its analysis. This research aims to classify two different motor activities, namely, mental drawing (MD) and spatial navigation (SN), using fNIRS data from non-motor baseline data and other motor activities. Accurate activity detection in non-stationary signals like fNIRS is challenging and requires complex feature descriptors. As a novel framework, a new feature generation by fusion of wavelet feature, Hilbert, symlet, and Hjorth parameters is proposed for improving the accuracy of the classification. This new fused feature has statistical descriptor elements, time-localization in the frequency domain, edge feature, texture features, and phase information to detect and locate the activity accurately. Three types of independent component analysis, including FastICA, Picard, and Infomax were implemented for preprocessing which removes noises and motion artifacts. Two independent binary classifiers are designed to handle the complexity of classification in which one is responsible for mental drawing (MD) detection and the other one is spatial navigation (SN). Four different types of algorithms including nearest neighbors (KNN), Linear Discriminant Analysis (LDA), light gradient-boosting machine (LGBM), and Extreme Gradient Boosting (XGBOOST) were implemented. It has been identified that the LGBM classifier gives high accuracies—98% for mental drawing and 97% for spatial navigation. Comparison with existing research proves that the proposed method gives the highest classification accuracies. Statistical validation of the proposed new feature generation by the Kruskal–Wallis H-test and Mann–Whitney U non-parametric test proves the reliability of the proposed mechanism.
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(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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Open AccessArticle
Evaluation of PD-L1 Expression in Colorectal Carcinomas by Comparing Scoring Methods and Their Significance in Relation to Clinicopathologic Parameters
by
Mirela Frančina, Mislav Mikuš, Marin Mamić, Tihomir Jovanović, Mario Ćorić, Božica Lovrić, Ivan Vukoja, Goran Zukanović, Kristijan Matković, Jasmina Rajc, Ferdinand Slišurić, Mateja Jurić-Marelja, Goran Augustin and Ilijan Tomaš
Diagnostics 2024, 14(10), 1007; https://doi.org/10.3390/diagnostics14101007 - 13 May 2024
Abstract
Background: This study aims to evaluate PD-L1 expression in colorectal carcinomas (CRCs) by using the tumor proportion score (TPS) and the combined positive score (CPS), and to investigate whether there is a correlation with clinicopathologic features. Methods: A cross-sectional study was conducted that
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Background: This study aims to evaluate PD-L1 expression in colorectal carcinomas (CRCs) by using the tumor proportion score (TPS) and the combined positive score (CPS), and to investigate whether there is a correlation with clinicopathologic features. Methods: A cross-sectional study was conducted that included samples from patients with colorectal adenocarcinoma treated with colon resection and rectal resection after neoadjuvant radio- and chemotherapy at the Department of Abdominal Surgery at Požega Hospital in the period from 2017 to 2022. The study included 102 tumor tissue samples from patients after resection and the pathohistological diagnosis of adenocarcinoma. Results: In our study, the PD-L1 positivity rate after the TPS was 42 (41%) samples, and after the CPS, 97 (95%) of them (p < 0.001). The positive expression of PD-L1 in tumor cells using the TPS method showed a statistically significant association with adenocarcinoma (TPS ≥ 10–50% and ≥50%). There were significantly more that were moderately differentiated, with TPS ≥ 50%, and those poorly differentiated had values ≥ 10–50%. There were significantly more patients with a status of more than one positive lymph node with TPS values ≥ 10–50%. Patients without metastases in the lymph nodes are significantly more likely to have CPS values > 50%, compared with other lymph node statuses. Conclusions: These results suggest that the total number of PD-L1-expressing cells, including tumor and immune cells, is a more sensitive biomarker than the number of PD-L1-expressing tumor cells alone in CRC.
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(This article belongs to the Section Pathology and Molecular Diagnostics)
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Open AccessArticle
In Vivo Classification and Characterization of Carotid Atherosclerotic Lesions with Integrated 18F-FDG PET/MRI
by
Fan Yu, Yue Zhang, Heyu Sun, Xiaoran Li, Yi Shan, Chong Zheng, Bixiao Cui, Jing Li, Yang Yang, Bin Yang, Yan Ma, Yabing Wang, Liqun Jiao, Xiang Li and Jie Lu
Diagnostics 2024, 14(10), 1006; https://doi.org/10.3390/diagnostics14101006 - 13 May 2024
Abstract
Background: The aim of this study was to exploit integrated PET/MRI to simultaneously evaluate the morphological, component, and metabolic features of advanced atherosclerotic plaques and explore their incremental value. Methods: In this observational prospective cohort study, patients with advanced plaque in the carotid
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Background: The aim of this study was to exploit integrated PET/MRI to simultaneously evaluate the morphological, component, and metabolic features of advanced atherosclerotic plaques and explore their incremental value. Methods: In this observational prospective cohort study, patients with advanced plaque in the carotid artery underwent 18F-FDG PET/MRI. Plaque morphological features were measured, and plaque component features were determined via MRI according to AHA lesion-types. Maximum standardized uptake values (SUVmax) and tissue to background ratio (TBR) on PET were calculated. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of FDG uptake when added to AHA lesion-types for symptomatic plaque classification. Results: A total of 280 patients with advanced plaque in the carotid artery were recruited. A total of 402 plaques were confirmed, and 87 of 402 (21.6%) were symptomatic plaques. 18F-FDG PET/MRI was performed a mean of 38 days (range 1–90) after the symptom. Increased stenosis degree (61.5% vs. 50.0%, p < 0.001) and TBR (2.96 vs. 2.32, p < 0.001) were observed in symptomatic plaques compared with asymptomatic plaques. The performance of the combined model (AHA lesion type VI + stenosis degree + TBR) for predicting symptomatic plaques was the best among all models (AUC = 0.789). The improvement of the combined model (AHA lesion type VII + stenosis degree + TBR) over AHA lesion type VII model for predicting symptomatic plaques was the highest (AUC = 0.757/0.454, combined model/AHA lesion type VII model), and the NRI was 50.7%. Conclusions: Integrated PET/MRI could simultaneously evaluate the morphological component and inflammation features of advanced atherosclerotic plaques and provide supplementary optimization information over AHA lesion-types for identifying vulnerable plaques in atherosclerosis subjects to achieve further stratification of stroke risk.
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(This article belongs to the Special Issue Recent Advances in Radiomics in Medical Imaging)
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The Fate of RPE Cells Following hESC-RPE Patch Transplantation in Haemorrhagic Wet AMD: Pigmentation, Extension of Pigmentation, Thickness of Transplant, Assessment for Proliferation and Visual Function—A 5 Year-Follow Up
by
Lyndon da Cruz, Taha Soomro, Odysseas Georgiadis, Britta Nommiste, Mandeep S. Sagoo and Peter Coffey
Diagnostics 2024, 14(10), 1005; https://doi.org/10.3390/diagnostics14101005 - 13 May 2024
Abstract
(1) Background: We reviewed a stem cell-derived therapeutic strategy for advanced neovascular age-related macular degeneration (nAMD) using a human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE) monolayer delivered on a coated, synthetic basement membrane (BM)—the patch—and assessed the presence and distribution of hESC-RPE
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(1) Background: We reviewed a stem cell-derived therapeutic strategy for advanced neovascular age-related macular degeneration (nAMD) using a human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE) monolayer delivered on a coated, synthetic basement membrane (BM)—the patch—and assessed the presence and distribution of hESC-RPE over 5 years following transplantation, as well as functional outcomes. (2) Methods: Two subjects with acute vision loss due to sub-macular haemorrhage in advanced nAMD received the hESC-RPE patch. Systematic immunosuppression was used peri-operatively followed by local depot immunosuppression. The subjects were monitored for five years with observation of RPE patch pigmentation, extension beyond the patch boundary into surrounding retina, thickness of hESC-RPE and synthetic BM and review for migration and proliferation of hESC-RPE. Visual function was also assessed. (3) Results: The two study participants showed clear RPE characteristics of the patch, preservation of some retinal ultrastructure with signs of remodelling, fibrosis and thinning on optical coherence tomography over the 5-year period. For both participants, there was evidence of pigment extension beyond the patch continuing until 12 months post-operatively, which stabilised and was preserved until 5 years post-operatively. Measurement of hESC-RPE and BM thickness over time for both cases were consistent with predefined histological measurements of these two layers. There was no evidence of distant RPE migration or proliferation in either case beyond the monolayer. Sustained visual acuity improvement was apparent for 2 years in both subjects, with one subject maintaining the improvement for 5 years. Both subjects demonstrated initial improvement in fixation and microperimetry compared to baseline, at year 1, although only one maintained this at 4 years post-intervention. (4) Conclusions: hESC-RPE patches show evidence of continued pigmentation, with extension, to cover bare host basement membrane for up to 5 years post-implantation. There is evidence that this represents functional RPE on the patch and at the patch border where host RPE is absent. The measurements for thickness of hESC-RPE and BM suggest persistence of both layers at 5 years. No safety concerns were raised for the hypothetical risk of RPE migration, proliferation or tumour formation. Visual function also showed sustained improvement for 2 years in one subject and 5 years in the other subject.
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(This article belongs to the Special Issue Advances in Diagnostic Techniques in Retinal Diseases)
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