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Cerebral White Matter Hyperintensity (WMH) lesions have been identified as markers of cerebrovascular diseases and they are associated with increased risk of cognitive impairment. In this study, we investigated the relationship between midlife cardiovascular risk factors and late life WMH volumes two decades later, and examined their association with cognitive performance. 135 participants from the Women’s Healthy Ageing Project had completed midlife cardiovascular risk measurement in 1992 and late life brain MRI scan and cognitive assessment in 2012. In these community-dwelling normal aging women, we found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater WMH volume two decades later, and was predominantly driven by the impact of HDL cholesterol level, controlling for age, education and APOE ε4 status. Structural equation modelling demonstrated that the relationship between midlife FCRP score and late life executive function was mediated by WMH volume. These findings suggest intervention strategies that target major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late life cognitive decline.

Introduction: Doctors can play a significant role in attributing to patient safety concerning exposure to ionizing radiation. Therefore, healthcare professionals should have adequate knowledge about radiation risk and protection of different medical imaging examinations. This study aims to evaluate the knowledge about radiation protection (RP) and applications of different imaging modalities (IMs) among medical students in their clinical years and intern, in Jeddah, Saudi Arabia. Materials and Methods: A cross‐sectional study based on an online questionnaire was performed in Jeddah, Saudi Arabia, on 170 medical students during January 2024; the study participants included clinical years medical students (from Years 4 to 6) and interns of both gender and basic year medical students, and specialists and consultants were excluded. For each participant, the percentage of correct answers was calculated for the knowledge RP and knowledge in IMs separately, and each participant will have two scores, RP knowledge score (RPKS) and IM knowledge score (IMKS). Results: A total of 170 medical students responded and completed the questionnaire. The overall levels of awareness and knowledge of the students was determined through calculations of their scores in answering the questionnaire; students in this study group have low average knowledge score in RP, which is 43, while they have moderate–high knowledge score in IMs, which is 68. Regarding the knowledge score, for the RPKS, the best participant scored 82, while the worst scored 0, whereas for IMKS, the best participant score 100, while the worst scored 0. However, according to the SD, participants generally differ between each other by 19 in RPKS and 31 in IMKS. Conclusions: The assessments of medical students’ knowledge regarding radiation exposure in diagnostic modalities reveal a low level of confidence in their knowledge of ionizing radiation dose parameters. Furthermore, the mean scores on overall knowledge assessments indicate a need for improvement in RP knowledge for medical students. To address this gap, a comprehensive modification of the undergraduate medical curriculum’s radiology component is required by enhancing active learning approaches and integrating radiation safety courses early in the medical curriculum. Medical education institutions could implement ongoing workshops, online modules, and certification programs to reinforce radiation safety principles.

Coronavirus disease (COVID-19) is a serious infectious disease that causes severe respiratory illness. This pandemic represents a serious public health risk. Therefore, early and accurate diagnosis is essential to control disease progression. Radiological examination plays a crucial role in the early identification and management of infected patients. The aim of this review was to identify the diagnostic value of different imaging modalities used for diagnosis of COVID-19. A comprehensive literature search was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases. The keywords diagnostic imaging, radiology, respiratory infection, pneumonia, coronavirus infection and COVID-19 were used to identify radiology articles focusing on the diagnosis of COVID-19 and to determine the diagnostic value of various imaging modalities, including x-ray, computed tomography (CT), ultrasound, and nuclear medicine for identification and management of infected patients. We identified 50 articles in the literature search. Studies that investigated the diagnostic roles and imaging features of patients with COVID-19, using either chest CT, lung ultrasound, chest x-ray, or positron emission topography/computed tomography (PET/CT) scan, were discussed. Of these imaging modalities, chest x-ray and CT scan are the most commonly used for diagnosis and management of COVID-19 patients, with chest CT scan being more accurate and sensitive in identifying COVID-19 at early stages. Only a few studies have investigated the roles of ultrasound and PET/CT scan in diagnosing COVID-19. Chest CT scan remains the most sensitive imaging modality in initial diagnosis and management of suspected and confirmed patients with COVID-19. Other diagnostic imaging modalities could add value in evaluating disease progression and monitoring critically ill patients with COVID-19.

Background: Breast cancer has a 14.8% incidence rate and an 8.5% fatality rate in Saudi Arabia. Mammography is useful for the early detection of breast cancer. Researchers have been developing artificial intelligence (AI) algorithms for early breast cancer diagnosis and reducing false-positive mammography results. The aim of this study was to examine the performance and accuracy of an AI system in breast cancer screening among Saudi women. Materials and Methods: This is a retrospective cross-sectional study that included 378 mammograms collected from 2017 to 2021 from government hospitals in Jeddah, Saudi Arabia. The patients’ demographic and clinical information were collected from files and electronic medical records. The radiologists’ assessments of the mammograms were based on Breast Imaging Reporting and Data System (BIRADS) scores. Follow-up or biopsy reports verified the radiologists’ findings. The MammoScreen system was the AI tool used in this study. Data were analyzed using SPSS Version 25. Results: The patients’ mean age was 50.31 years. Most patients had breast density B (42.3%) followed by A (27.2%) and C (25.9%). Most malignant cases were invasive ductal carcinomas (37.3%). Of the 181 cancer cases, 36.9% were BIRADS category V. The area under the curve for the AI detection (0.923; 95% confidence interval [CI], 0.893–0.954) was greater than that for the radiologists’ interpretation (0.838; 95% CI, 0.796–0.881). The AI detection agreed with the histopathological result in 167 positive (91.3%) and 182 negative cases (93.3%). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the AI system were 92.8%, 91.9%, 91.3%, 93.3%, and 92.3%, respectively. The radiologist’s interpretation agreed with the pathology report in 180 positive (73.8%) and 134 negative cases (100%). Its sensitivity, specificity, PPV, NPV, and accuracy were 100%, 67.7%, 73.8%, 100%, and 83.1%, respectively. Conclusions: The AI system tested in this study had better accuracy and diagnostic performance than the radiologists and thus could be used as a support diagnostic tool for breast cancer detection in clinical practice and to reduce false-positive recalls.

Medical ionizing radiation is widely used in hospitals, in particular dental clinics, and in medical research to facilitate the diagnosis and treatment of patients. The awareness, attitude, and perception of ionizing radiation exposure among dental undergraduate students and interns in radiological investigations and dental care clinics were investigated. A cross-sectional study was conducted; 17 questions were designed online using the software “QuestionPro,” which was licensed to the University of Imam Abdulrahman Bin Faisal. Participants included senior medical dental students from Imam Abdulrahman Bin Faisal University in their third to fifth years, as well as interns from King Fahad University Hospital and private dental care clinics. A total of 855 participants viewed, 360 started the questionnaire, and 258 (72%) completed it online. Overall, knowledge was lacking; 32% of respondents incorrectly believed that magnetic resonance imaging and ultrasound used ionizing radiation, while 38% were unsure. Dental X-rays were deemed harmful by 40% (n = 104) of respondents. According to 33% (n = 85) of participants, there is no radiation scatter during an X-ray or CT scan, while 30% (n = 76) are unsure. Respondents (44%; n = 104) were unaware of the radiation dose from a chest radiograph and (45%; n = 116) overestimated the radiation dose. The effects of ionizing radiation on healthy tissue are known to more than half of the participants (54%). According to 39% of respondents, digital radiography exposes them to less radiation than traditional radiography. In terms of radiation protection and hazard, 46% said personal monitoring badges should be always worn and 58% (n = 150) said lead aprons should be used on a regular basis. 63% of the subjects had received radiation protection education, such as formal lectures, tutorials, or workshops, while 37% (n = 95) had not. 53% of the respondents were not aware of the international recommendations from the International Commission on Radiological Protection. When asked if they would follow radiation protection protocols if they opened a private dental clinical practice in the future, 50% (n = 129) said they would.

Lack of physical activity is a risk factor for dementia, however, the utility of interventional physical activity programs as a protective measure against brain atrophy and cognitive decline is uncertain. Here we present the effect of a randomized controlled trial of a 24-month physical activity intervention on global and regional brain atrophy as characterized by longitudinal voxel-based morphometry with T1-weighted MRI images. The study sample consisted of 98 participants at risk of dementia, with mild cognitive impairment or subjective memory complaints, and having at least one vascular risk factor for dementia, randomized into an exercise group and a control group. Between 0 and 24 months, there was no significant difference detected between groups in the rate of change in global, or regional brain volumes.

Computed tomography (CT) has had a massive impact on diagnostic radiology over the past few decades. Serious concerns exist because of the increase in the effective radiation dose associated with CT scans, which could pose significant health risks. In CT, the effective dose can be estimated by Monte Carlo simulations. The aim of the study was to estimate and compare the effective doses for CT from organ dose-based calculations using the tissue weighting factors of the International Commission on Radiological Protection publications (ICRP 60, 103), Monte Carlo CT-Expo v2.6, and dose-length product (DLP)-based estimates. For 165 CT scans, the effective doses (Ed) of the most common routine radiological investigations were assessed. There were 112 male patients (68%) and 53 female patients (32%). When compared to organ dose-based estimates, the DLP-based estimates of the effective dose produced by applying ICRP 60 coefficients were less than 55–57% (head) and more than 18.1% (chest) and 20% (abdomen). The ICRP 103 values of the Ed were less than 79% (head) and more than 17% (chest), and they changed randomly with the tissue weighting factors for the abdomen. For Monte Carlo CT-Expo, the Ed values were lower by 54% (head), 6% (abdomen), and more than 2% (chest) compared to organ dose-based estimates. Effective doses calculated using the tissue-weighting factors of ICRP 103 values comparable to ICRP 60 differ greatly by an average of 2.3, 2.9, and 4.5 mSv for the head, chest, and abdomen, respectively. In conclusion, all estimates of Ed are subject to the biases inflicted by the assumptions in the methods used; therefore, no significant agreement should be expected. The reason for evaluating ICRP 60 is to make a point that ICRP’s update is indeed more accurate. The variability associated with the use of various methodologies to estimate and compare the effective dose Ed in CT scans was shown to be significant in this study.

Computerised tomography (CT) continues to be a corner stone medical and radiologic imaging modalities in radiology and radiotherapy departments. Its importance lies in its efficiency in low contrast detectability (LCD). The assessment of such capabilities requires rigorous image quality analysis using special designed phantoms with different densities as well as variation in atomic mass numbers (A) of the material. Absence of such ranges of densities and atomic mass numbers, limits the dynamic range of assessment. An example is Catphan phantom which represents only three subject contrast levels 0.3, 0.5 and 1 per cent. This project aims to present a phantom with extended range of available subject contrast to include very low-level values and to increase its dynamic scale. With this design, a relatively large number of different contrast objects (holes) can be presented for imaging by a CT scanner to assess its LCD ability. We shall thus introduce another LCD phantom to complement the existing ones, such as Catphan. The cylindrical phantom is constructed using Poly (methyl methacrylate) (PMMA), with craters (holes) having dimensions that gradually increase from 1.0 to 12.5 mm penetrated in configuration that extend from the centre to the corner. Each line of the drilled holes in the phantom is filled with contrast material of specific concentrations. As opposed to the phantom of low detail contrast used in planar imaging, the iodine (contrast material) in this phantom replaces the depth of the phantom holes. The iodine could be reduced to 0.2 l milli-Molar (mM) and can be varied for the next line of holes by a small increment depending on the required level of contrast detectability assessment required.

Brain atrophy can occur several decades prior to onset of cognitive impairments. However, few longitudinal studies have examined the relationship between brain volume changes and cognition over a long follow-up period in healthy elderly women. In the present study we investigate the relationship between whole brain and hippocampal atrophy rates and longitudinal changes in cognition, including verbal episodic memory and executive function, in older women. We also examine whether baseline brain volume predicts subsequent changes in cognitive performance over a 10-year period. A total of 60 individuals from the population-based Women’s Healthy Ageing Project with a mean age at baseline of 59 years underwent 3T MRI. Of these, 40 women completed follow-up cognitive assessments, 23 of whom had follow-up MRI scans. Linear regression analysis was used to examine the relationship between brain atrophy and changes in verbal episodic memory and executive function over a 10-year period. The results show that baseline measurements of frontal and temporal grey matter volumes predict changes in verbal episodic memory performance, whereas hippocampal volume at baseline is associated with changes in executive function performance over a 10-year period of follow-ups. In addition, higher whole brain and hippocampal atrophy rates are correlated with a decline in verbal episodic memory. These findings indicate that in addition to atrophy rate, smaller regional grey matter volumes even 10 years prior is associated with increased rates of cognitive decline. This study suggests useful neuroimaging biomarkers for the prediction of cognitive decline in healthy elderly women.

Radiation protection for pediatric patients is the main concern in pediatric computed tomography (CT) due to their sensitive organs, such as the brain and the thyroid glands. Accordingly, an optimization of pediatric CT practices is vital to minimize the radiation dose for this population. To assess the pediatric CT practices of radiologists and technologists in a CT unit. The study was conducted among 26 hospitals, located in various regions in Saudi Arabia. A total of 200 hard copies of the questionnaire were distributed manually and were collected for analysis. In total, 117 completed surveys were gathered from technologies, while 49 were gathered from radiologists. In the case of infants with hydrocephalus, 65% of the radiologists ordered an ultrasound (US), 24% ordered a head CT scan, and 10% ordered a magnetic resonance imaging (MRI) and general X-ray for diagnosis. For pediatric patients complaining of persistent headache, 59% and 27% of the radiologists recommended CT and MRI, respectively, for diagnosis. Most of the radiologists utilize CT head scan to diagnose persistent headache (by 59%) and ventriculoperitoneal shunt (VPS) malfunction (by 41%) in pediatric patients compared with the other modalities. The use of CT can increase the risk of later malignancy among pediatric patients due to radiation exposure. Alternative imaging modalities such as US and MRI (non-ionized radiation) should be considered to reduce the ionizing radiation hazards and optimize the current practices of radiologists. Most of the technologists follow radiation protection protocols in this study as 63% of the technologists used lead apron for pediatric patient's protection. Radiation awareness training for the technologists could improve the knowledge about the benefits of using lead apron and reduce the radiation risks in pediatric patients.