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MRI texture analysis features were significantly associated with ground-truth subchondral bone histomorphometry at the tibial plateau.

2 ABSTRACT PurposeTo determine the feasibility of MRI texture analysis as a method of quantifying subchondral bone architecture in knee osteoarthritis (OA). MethodsAsymptomatic subjects aged 20-30 (group 1, n=10), symptomatic patients aged 40-50 (group 2, n=10) and patients scheduled for knee replacement aged 55-85 (group 3, n=10) underwent high spatial resolution T1 weighted coronal 3T knee MRI.Regions of interest were created in the medial (MT) and lateral (LT) tibial subchondral bone from which 20 texture parameters were calculated. T2 mapping of the tibial cartilage was performed in groups 1 & 2. Mean parameter values were compared between groups using ANOVA. Linear discriminant analysis (LDA) was used to evaluate the ability of texture analysis to classify subjects correctly. ResultsSignificant differences in 18/20 and 12/20 subchondral bone texture parameters were demonstrated between groups at the MT and LT respectively. There was no significant difference in mean MT or LT cartilage T2 values between group 1 and group 2.LDA demonstrated subject classification accuracy of 97% (95% CI 91-100%). ConclusionMRI texture analysis of tibial subchondral bone may allow detection of alteration in subchondral bone architecture in OA. This has potential applications in understanding OA pathogenesis and assessing response to treatment.

PURPOSETo compare two different methods of quantitative assessment of tibial subchondral bone in osteoarthritis (OA): statistical texture analysis (sTA) and trabecular microarchitecture analysis (tMA). METHODSAsymptomatic controls aged ͮͬ-ͯͬ (n=ͭͬ), patients aged Ͱͬ-ͱͬ with chronic knee pain but without established OA (n=ͭͬ) and patients aged ͱͱ-ʹͱ with advanced OA scheduled for knee replacement (n=ͭͬ) underwent knee MR imaging at ͯT with a ͯD gradient echo (GRE) sequence to allow sTA and tMA.tMA and sTA features were calculated using ROI creation in the medial (MT) and lateral (LT) tibial subchondral bone. Features were compared between groups using one-way ANOVA.The two most discriminating tMA and sTA features were used to construct exploratory discriminant functions to assess the ability of the two methods to classify participants. RESULTSNo tMA features were significantly different between groups at either MT or LT. ͭͳ/ͮͬ and ͭͭ/ͮͬ sTA features were significantly different between groups at the MT/LT respectively (p<ͬ.ͬͬͭ).Discriminant functions created using tMA features classified ͭͮ/ͯͬ participants correctly (Ͱͬ% accuracy, ͵ͱ% CI ͮͮ-ͱʹ%) based on MT data and ͵/ͯͬ correctly (ͯͬ%, ͭͰ-ͰͲ) based on

In the UK, breast cancer represents the most commonly diagnosed cancer in females and carries with it a significant morbidity and mortality. An established national screening programme is in place to identify those with the disease at an early stage in order to optimise treatment and prognosis. This article provides an overview for the non-breast specialist clinician whose practice regularly deals with women who may be the subject of the screening programme. It outlines the diagnostic methods employed in the screening programme, the controversies that have surrounded it and the evolving technologies that will improve detection and diagnostic accuracy.

A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed whether endovascular treatment improved peri-operative outcomes when compared to an open approach to restore arterial perfusion in acute mesenteric occlusive disease. Four hundred and ninety seven papers were identified using the reported search; of which 4 represented the best evidence to answer the question and are discussed. The evidence on this subject is limited, comprising largely of non-randomised retrospective cohort studies. The evidence suggests that endovascular treatment is associated with reduced mortality and has better short-term peri-operative outcomes, as well as longer-term survival - however many endovascular cases require subsequent open surgery. There is also conflicting evidence to suggest endovascular therapy is associated with longer ICU stays. Aside from procedural complications, factors such as patient status, time delay to diagnosis and treatment may play a greater role in determining mortality rates. In summary, endovascular therapy appears to be a feasible treatment option with post-operative complications and inpatient mortality rates lower than those seen in open surgery.

Breast cancer is the most commonly diagnosed cancer in women with a lifetime risk of 1 in 8 in the UK. The disease is associated with considerable morbidity and mortality. The UK breast screening program has been in place for almost 30 years and has evolved with improved diagnostic imaging. The overall benefits of the screening program are subject to continued heated debate with multiple potential harms. The aim of this review is to provide the non-breast specialist health-care professional an overview of the evolution of the breast screening program, a summary of the evidence of the benefits, and a description of the harms. In addition, the diagnostic methods currently employed as well as potential future changes to the screening program and imaging techniques will be covered.