Journal of X-Ray Science and Technology - Volume 28, issue 1

Authors: Jiang, Chuanjie | Yang, Yongjun | Zhou, Jiping | Yang, Kai | Yao, Shuqiang | Jiang, Zewei | Wu, Rui

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the accuracy of a novel guidance method of pedicle screw implantation determined by spinal stress. METHODS: We retrospectively analyzed patients underwent pedicle screw internal fixation between January 2015 and August 2018 in our hospital. Patients were divided into two groups according to the methods of pedicle screw implantation namely, the conventional nail placement and novel guidance method of pedicle screw implantation determined by spinal stress. Accuracy of spinal pedicle screw placements was evaluated using intraoperative and postoperative X-ray computed tomography (CT) examination and intraoperative touch of nerve root dissection pedicle bone. The success rate of …intraoperative one-time screw placement was calculated according to Heary classification I. RESULTS: A total of 785 patients underwent pedicle screw internal fixation were retrospectively analyzed. Among them 384 patients were treated using conventional nail placement (Group A) and 401 patients were treated using the technique according to analysis of spinal stress (Group B). There was no significant difference in terms of the characteristics between two groups. There were significant differences in terms of the success rate of total of screw placement (88.7% vs. 96.2%, P  < 0.001) including thoracic screw placement (87.8% vs. 94.5%, P  = 0.003) and lumbar screw placement (88.8% vs. 96.5%, P  = 0.001) for Group A and Group B, respectively. CONCLUSIONS: Using the novel guidance method of pedicle screw implantation determined by spinal stress might improve the accuracy of pedicle screw implantation. Show more

Keywords: Pedicle screw implantation, free-hand, stress conduction, thoracolumbar spine

DOI: 10.3233/XST-190566

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 147-155, 2020

Authors: Zhou, Wei-Ping | Zan, Xing-You | Hu, Xiao-Yun | Liu, Xiao | Sudarshan, Sanjeev Kumar Pitla | Yang, Shu-Dong | Guo, Yu-Jiang | Fang, Xiang-Ming

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the characterization of breast lesions using diffusion kurtosis model-based imaging. METHODS: This prospective study included 120 consecutive patients underwent preoperative DCE-MRI examinations and multi-b-value diffusion-weighted imaging (DWI). Among them, 88 malignant lesions and 44 benign lesions were detected, 56 normal fibroglandular breast tissue were selected as normal control. Conventional apparent diffusion coefficient (ADC), DKI-based parameters mean kurtosis (MK) and mean diffusivity (MD) were analyzed by lesions types and histological subtypes using one-way ANOVA and receiver operating characteristic (ROC) curve. RESULTS: (1) The malignant group showed significantly lower ADC and MD (1.07±0.32×10-3 mm2 …/s and 1.30±0.40×10-3 mm2 /s, respectively) and higher MK (0.87±0.18) than those in the benign group (1.29±0.26×10-3 mm2 /s, 1.62±0.31×10-3 mm2 /s and 0.67±0.18) and control group (1.67±0.33×10-3 mm2 /s, 2.24±0.28×10-3 mm2 /s and 0.52±0.08) with all P  < 0.001. (2) Areas under ROC curve (AUC) for diagnosing malignant lesions were 0.936 for MD, 0.911 for MK and 0.897 for ADC, respectively. AUC for MD was significantly higher than that for ADC (P  = 0.015). The optimal cut-off value, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were as follow: ADC = 1.18×10-3 mm2 /s, 78.3%, 93.2%, 81.2%, 81.6%, 81.4%; MD = 1.48×10-3 mm2 /s, 82.2%, 98.3%, 84.4%, 87.8%, 86.2%; MK = 0.78, 91.5%, 85.3%, 89.0%, 85.8%, 87.2%. (3) Invasive ductal carcinoma (IDC), ductal carcinoma in situ (DCIS) and mucinous adenocarcinoma also showed significant differences among ADC, MD and MK (with P  < 0.05). CONCLUSIONS: MR-DKI parameters enable to improve breast lesion characterization and have diagnostic potential applying to different pathological subtypes of breast cancers. Show more

Keywords: Diffusion weighted imaging, diffusion kurtosis imaging, breast lesions, pathological subtypes

DOI: 10.3233/XST-190590

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 157-169, 2020

Authors: Li, Shuo | Mi, Shijun | Guo, Ruijun | Ma, Xiuqing | Han, Mei

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate application of a computed tomography (CT)-ultrasound fusion imaging technique to unilateral percutaneous vertebroplasty (PVP) for treating patients with osteoporotic thoracolumbar compression fracture. METHODS: Fourteen patients with osteoporotic thoracolumbar compression fractures were included, randomly divided into CT-ultrasound fusion imaging (n  = 7) and traditional X-ray fluoroscopy groups (n  = 7). Patients in the first group underwent unilateral PVP using real-time CT-ultrasound fusion imaging. A body surface locator was placed on the side contralateral to the scheduled puncture site (2–3 cm from the spinous process). Patient CT image information was recorded in the ultrasound system for registration during real-time ultrasound …and CT fusion imaging, and one-click automatic registration was then performed. The puncture point and target point at which the puncture needle arrived were determined on CT images, with the puncture being performed under ultrasound guidance. Patients in the second group underwent X-ray fluoroscopy-guided PVP. Bone cement injection was injected under monitoring using a C-arm X-ray system. Patients’ X-ray exposure and puncture times were recorded and compared between the two groups. RESULTS: The average puncture times in the CT-ultrasound fusion imaging and traditional X-ray fluoroscopy groups were 2.50±0.31 min (without exposing patients and operators to radiation) and 5.00±0.65 min (with the same duration of radiation exposure), respectively. The average times for bone cement injection were 3.29±0.81 min and 3.50±0.86 min, respectively. The mean visual analog scale (VAS) scores were 2.10±0.11 and 2.20±0.21, respectively. The bone cement was evenly distributed without cement leakage in patients in the CT-ultrasound fusion imaging group, but a poor distribution of bone cement and bone cement leakage were found in one patient in the traditional X-ray fluoroscopy group. CONCLUSIONS: Real-time CT-ultrasound fusion imaging is easy to perform, and provides precise localization of the puncture point, path, and target point. The selected puncture path was reasonable, and the needle had reached the target point accurately, which increased the success rate of puncture without radiation exposure. Show more

Keywords: Ultrasound fusion imaging technique, unilateral percutaneous vertebroplasty, osteoporotic thoracolumbar compression fracture

DOI: 10.3233/XST-190563

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 171-183, 2020

Authors: Khan, Sajid Ullah | Ullah, Imran | Ahmed, Imran | Imran, Ali | Ullah, Najeeb

Article Type: Correction

DOI: 10.3233/XST-200001

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 185-185, 2020