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[...]owing to time consuming offsite calculations, the clinical impact of this innovative approach remains unclear. [...]a solution for physician-driven CT-FFR derivation using regular onsite workstations was developed, as noted by the first results produced by our research group2 and Coenen et al.3 This new CT-FFR algorithm applies reduced order models for more expeditious calculations.

Objectives To determine the optimal window setting for displaying virtual monoenergetic reconstructions of third generation dual-source, dual-energy CT (DECT) angiography of the abdomen. Methods Forty-five patients were evaluated with DECT angiography (90/150 kV, 180/90 ref. mAs). Three datasets were reconstructed: standard linear blending (M_0.6), 70 keV traditional virtual monoenergetic (M70), and 40 keV advanced noise-optimized virtual monoenergetic (M40+). The best window setting (width and level, W/L ) was assessed by two blinded observers and was correlated with aortic attenuation to obtain the Optimized W/L setting (O- W/L ). Subjective image quality was assessed, and vessel diameters were measured to determine any possible influences between different W/L settings. Repeated measures of variance were used to evaluate comparison of W/L values, image quality, and vessel sizing between M_0.6, M70, and M40+. Results The Best W/L (B- W/L ) for M70 and M40+ was 880/280 and 1410/450, respectively. Results from regression analysis inferred an O- W/L of 850/270 for M70 and 1350/430 for M40+. Significant differences for W and L were found between the Best and the Optimized W/L for M40+, and between M70 and M40+ for both the Best and Optimized W / L . No significant differences for vessel measurements were found using the O- W / L for M40+ compared to the standard M_0.6 ( p  ≥ 0.16), and significant differences were observed when using the B- W / L with M40+ compared to M_0.6 ( p  ≤ 0.04). Conclusion In order to optimize virtual monoenergetic imaging with both traditional M70 and advanced M40+, adjusting the W / L settings is necessary. Our results suggest a W / L setting of 850/270 for M70 and 1350/430 for M40+.

The purpose of this study was to investigate patterns in the amygdala-based emotional processing circuit of hemodialysis patients using resting-state functional MR imaging (rs-fMRI). Fifty hemodialysis patients (25 with depressed mood and 25 without depressed mood) and 26 healthy controls were included. All subjects underwent neuropsychological tests and rs-fMRI, and patients also underwent laboratory tests. Functional connectivity of the bilateral amygdala was compared among the three groups. The relationship between functional connectivity and clinical markers was investigated. Depressed patients showed increased positive functional connectivity of the left amygdala with the left superior temporal gyrus and right parahippocampal gyrus (PHG) but decreased amygdala functional connectivity with the left precuneus, angular gyrus, posterior cingulate cortex (PCC), and left inferior parietal lobule compared with non-depressed patients ( P  < 0.05, AlphaSim corrected). Depressed patients had increased positive functional connectivity of the right amygdala with bilateral supplementary motor areas and PHG but decreased amygdala functional connectivity with the right superior frontal gyrus, superior parietal lobule, bilateral precuneus, and PCC ( P  < 0.05, AlphaSim corrected). After including anxiety as a covariate, we discovered additional decreased functional connectivity with anterior cingulate cortex (ACC) for bilateral amygdala ( P  < 0.05, AlphaSim corrected). For the depressed, neuropsychological test scores were correlated with functional connectivity of multiple regions ( P  < 0.05, AlphaSim corrected). In conclusion, functional connectivity in the amygdala-prefrontal-PCC-limbic circuits was impaired in depressive hemodialysis patients, with a gradual decrease in ACC between controls, non-depressed, and depressed patients for the right amygdala. This indicates that ACC plays a role in amygdala-based emotional regulatory circuits in these patients.

Objectives To evaluate the use of dual-energy CT imaging of the lung perfused blood volume (PBV) for the detection of pulmonary fat embolism (PFE). Methods Dual-energy CT was performed in 24 rabbits before and 1 hour, 1 day, 4 days and 7 days after artificial induction of PFE via the right ear vein. CT pulmonary angiography (CTPA) and lung PBV images were evaluated by two radiologists, who recorded the presence, number, and location of PFE on a per-lobe basis. Sensitivity, specificity, and accuracy of CTPA and lung PBV for detecting PFE were calculated using histopathological evaluation as the reference standard. Results A total of 144 lung lobes in 24 rabbits were evaluated and 70 fat emboli were detected on histopathological analysis. The overall sensitivity, specificity and accuracy were 25.4 %, 98.6 %, and 62.5 % for CTPA, and 82.6 %, 76.0 %, and 79.2 % for lung PBV. Higher sensitivity ( p  < 0.001) and accuracy ( p  < 0.01), but lower specificity ( p  < 0.001), were found for lung PBV compared with CTPA. Dual-energy CT can detect PFE earlier than CTPA (all p  < 0.01). Conclusion Dual-energy CT provided higher sensitivity and accuracy in the detection of PFE as well as earlier detection compared with conventional CTPA in this animal model study. Key points • Fat embolism occurs commonly in patients with traumatic bone injury . • Dual - energy CT improves diagnostic performance for pulmonary fat embolism detection . • Dual - energy CT can detect pulmonary fat embolism earlier than CTPA .

Atherosclerosis and its related complications represent a major cause of morbidity and mortality worldwide. Morbidity and mortality rates for cardiovascular disease actually increase with age, which is an issue considering the growing geriatric population. In recent years, non-invasive diagnostic imaging—mainly CT and MRI—has seen an increasingly important role in diagnosing atherosclerosis early, improving risk assessment, and preventing complications. These findings are mainly from studies focusing on adult populations. Furthermore, as these techniques evolve and prove themselves to be extremely useful in this regard, the knowledge gap specific to geriatric patients remains significant. We provide an overview on the techniques and applications of MRI and CT in the diagnosis of atherosclerosis both in general, and for geriatric populations, in particular.