ObjectivesNewly diagnosed focal epilepsy (NDfE) is rarely studied, particularly using advanced neuroimaging techniques. Many patients with NDfE experience cognitive impairments, particularly with respect to memory, sustained attention, mental flexibility, and executive functioning. Cognitive impairments have been related to alterations in resting‐state functional brain networks in patients with neurological disorders. In the present study, we investigated whether patients with NDfE had altered connectivity in large‐scale functional networks using resting‐state functional MRI.MethodsWe recruited 27 adults with NDfE and 36 age‐ and sex‐matched healthy controls. Resting‐state functional MRI was analyzed using the Functional Connectivity Toolbox (CONN). We investigate reproducibly determined large‐scale functional networks, including the default mode, salience, fronto‐parietal attention, sensorimotor, and language networks using a seed‐based approach. Network comparisons between patients and controls were thresholded using a FDR cluster‐level correction approach.ResultsWe found no significant differences in functional connectivity between seeds within the default mode, salience, sensorimotor, and language networks and other regions of the brain between patients and controls. However, patients with NDfE had significantly reduced connectivity between intraparietal seeds within the fronto‐parietal attention network and predominantly frontal and temporal cortical regions relative to controls; this finding was demonstrated including and excluding the patients with brain lesions. No common alteration in brain structure was observed in patients using voxel‐based morphometry. Findings were not influenced by treatment outcome at 1 year.ConclusionsPatients with focal epilepsy have brain functional connectivity alterations at diagnosis. Functional brain abnormalities are not necessarily a consequence of the chronicity of epilepsy and are present when seizures first emerge.

Robot-assisted ultrasound-guided breast biopsy combines ultrasound (US) imaging with a robotic system for medical interventions. This study was designed to provide a literature review of a robotic US-guided breast biopsy system to delineate its efficacious impact on current medical practice. In addition, the strengths and limitations of this approach were also addressed. Articles published in the English language between 2000 and 2016 were appraised in this review. A wide range of systems that bind robotics with US imaging and guided breast biopsy were examined in this article. The fundamental safety and real-time imaging capabilities of US, together with the accuracy and maneuverability of robotic devices, is clearly an effective association with unmatched capabilities. Numerous experimental systems have obvious benefits over old-fashioned techniques, and the future of robot-assisted US-guided breast biopsy will be characterized by increasing levels of automation, and they hold tremendous possibility to impact doctor achievement, patient recovery, and clinical management.

The aims of the present work were to quantify radiation doses arises from patients' exposure in mammographic X-ray imaging procedures and to estimate the radiation induced cancer risk. Sixty patients were evaluated using a calibrated digital mammography unit at King Khaled Hospital and Prince Sultan Center, Alkharj, Saudi Arabia. The average patient age (years) was 44.4 ± 10 (26–69). The average and range of exposure parameters were 29.1 ± 1.9 (24.0–33.0) and 78.4 ± 17.5 (28.0–173.0) for X-ray tube potential (kVp) and current multiplied by the exposure time (s) (mAs), respectively. The MGD (mGy) per single projection for craniocaudal (CC), Medio lateral oblique (MLO) and lateromedial (LM) was 1.02 ± 0.2 (0.4–1.8), 1.1 ± 0.3 (0.5–1.8), 1.1 ± 0.3 (0.5–1.9) per procedure, in that order. The average cancer risk per projection is 177 per million procedures. The cancer risk is significant during multiple image acquisition. The study revealed that 80% of the procedures with normal findings. However, precise justification is required especially for young patients.

PurposeTo calculate the frequencies of incidental extraspinal findings and incidentally detected congenital anomalies or anatomical differences in the lumbar spine on magnetic resonance imaging (MRI) scans of intervertebral discs.Materials and methodsA total of 379 lumbar spine MRI cases were prospectively investigated in the period spanning from August 2016 to January 2018. Both 1.5 and 0.35 Tesla MRI units (Toshiba and Siemens Medical Systems) were used to examine patients with clinically suspected intervertebral disc abnormalities at three MRI diagnostic centers in Khartoum State, Sudan.ResultsOf the 379(100%) patients, 90(23.7%) patients were presented with incidental findings. Among the incidental findings, 39(10.3%) were renal cysts, 10(2.6%) were retroverted uteri, 5(1.3%) were Nabothian cysts, 4(1.1%) were ovarian cysts, 10(2.6%) were uterine fibroids, 3(0.8%) were endometrial thickening, 11(2.9%) were indicative of hydronephrosis, 4(1.1%) were uncovered prostatic enlargement, 2(0.5%) were atrophic kidney, and 1(0.3%) each was of an ectopic kidney and bladder wall thickening, respectively.ConclusionsA high percentage of extraspinal pathological findings were detected during MRI lumbar spine scans of intervertebral discs. Thus, it is important to be aware of the high percentage of patients who undergo further evaluation given the presence of unexpected findings, but for whom clinical confirmation of these abnormalities is not obtained.

PurposeTo determine the causes of low vision among Sudanese patients with diabetic retinopathy (DR) by using ophthalmic B-scan ultrasonography.Materials and methodsA total of 100 patients with DR at different grades, were recruited prospectively between September 2016 and January 2018. Nidek (Echoscan US-4000) ultrasound unit was used to determine the causes of low vision in diabetic patients according to their glycated haemoglobin (HbA1c) and early treatment of diabetic retinopathy scale (ETDRS) severity levels.ResultsVitreous hemorrhage (VH) 42(66.6%), asteroid hyalosis (AH) 12(14.3%), and partial retinal detachment (PRD) 9(19%) were the main cause of low vision in patients presenting with moderately regulated HbA1c and graded with either minimal or mild nonproliferative retinopathy (NPDR). While VH 15(40.5%), total retinal detachment (TRD) 12(32.4%), posterior vitreous detachment (PVD) 7(19%), and choroidal detachment (CD) 3(8.1%), were dominant in patients with poorly regulated HbA1c and graded either as moderate NPDR; severe NPDR; and proliferative retinopathy (PR).ConclusionsOphthalmic B-mode ultrasound is a rapid, noninvasive imaging technique that can be used with minimum discomfort in ophthalmological practice for the detection and evaluation of DR complications that predict the visual outcome.

The purpose of this study was to describe, analyze and characterize computed tomography (CT) and magnetic resonance imaging (MRI) scan of glioblastoma multiforme (GBM) patients. One hundred and three clinically definite GBM patient information, CT and MRI images along with clinical records and demographic data were retrospectively collected from the radiology information system (RIS) database of the Radiology and Medical Imaging Department of King Fahd Medical City between January 2012 to March 2019. Based on our analysis, 70.9% and 29.1% were males and females patients with a mean age of 49.05 ± 14.77 years. The majority of patients (98.1%) were diagnosed with GBM by MRI T2-weighted fluid attenuation inversion recovery (FLAIR) hyperintense scanning protocols, 97.1% diagnosed by MRI T2-weighted hyperintense and 93.2% were diagnosed by an MRI T1-weighted hypointense. About 98.1% of patients had MRI contrast enhancement while 88.1% and 6.8% had a CT hypodense and heterogeneous appearance, respectively. GBM shape in 100% of patients was irregular and the majority (41.8%) of GBM were located in the frontal lobe. In conclusion, this study manages to describe, analyze and characterize the radiological features of GBM in CT and MRI examination.

Highlights Patients showed showed widespread connectome alterations relative to controls. Relative to controls, patients /w seizure-freedom (SF) had increased diffusivity. Patients /w persistent seizures (PS) had increased diffusivity relative to controls. Subgroup-specific connectomes were found for both patient groups (SF vs PS). Patients with generalized seizures and those without had altered connectomes.

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