Browsing by Author "Pramod Kumar Singh"

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A novel method for automatic retinal detachment detection and estimation using ocular ultrasound image
(Springer, 2020) Rajeev Gupta; Vishal Gupta; Basant Kumar; Pramod Kumar Singh; Amit Kumar Singh
This paper presents a novel method for automated detection of retinal detachment from ocular ultrasound image using digital image processing and computational techniques. Retinal detachment (RD) is an ocular emergency in which retina gets detached from the tissues lying underneath it and often requires immediate intervention to prevent rapid, irreversible vision loss. Direct fundoscopy and visual field testing are most common methods for the detection of RD. These methods are difficult to perform and they do not completely rule out retinal detachment. Generally, Ophthalmologists use ocular ultrasound to enhance their clinical acumen in detecting RD. Sometimes it is difficult to extract diagnostic features from ultrasound (USG) images due to its poor quality. Also, noise present in the image would cause misinterpretation during visual inspection;this demands development of intelligent and automated techniques for detection of retinal detachment. Further, the paper proposes a novel frame work for accurate and automatic retinal detachment using image processing techniques and mathematical analysis of detached area contour detected within the ocular globe. Furthermore, the estimation of diagnostic parameters, indicative of retinal detachment is also computed. Based on the mathematical analysis, three such parameters, percentage area of detached retina (PADR) compared to the ocular globe, angular width of detachment (α) and maximum radial distance of detachment to choroid layer beneath it (β), are calculated. These estimated parameters are very useful in determining the exact location and extent of retinal detachment. Results obtained through the proposed retinal detachment detection scheme are validated by the radiologist. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
A Rare Cause of Acute Recurrent Pancreatitis in a Child
(Springer, 2024) Ishan Kumar; Sunil Meena; Pramod Kumar Singh; Priyanka Aggarwal; Ashish Verma
[No abstract available]
Automated Detection of Retinal Detachment from Ocular Ultrasound using Image Thresholding
(Institute of Electrical and Electronics Engineers Inc., 2018) Rajeev Gupta; Pramod Kumar Singh; Basant Kumar; Abhishek Singh; Ayushi Chandra
This paper presents a new method for automated detection of retinal detachment from ocular ultrasound (USG) image using digital image processing techniques. Retinal detachment (RD) is an ocular emergency in which retina gets detached from the tissues lying underneath it and often requires immediate intervention to prevent rapid, irreversible vision loss. For the detection of RD, manual methods like direct fundoscopy and visual field testing are difficult to perform and they do not completely rule out retinal detachment. Ophthalmologists use ocular ultrasound image to enhance their clinical acumen in detecting retinal detachment. Sometimes it is difficult to extract diagnostic features from ultrasound image due to its poor quality. Also, noise present in the image would cause misinterpretation during an eye examination; this demands pre-processing of the image followed by automated detection technique for detection of retinal detachment. A new technique for automatic detection of retinal detachment using ocular ultrasound image is presented here through appropriate image thresholding and segmentation methods. In this paper, enhancement of the ultrasound image is done initially and then region of interest (ROI) is fixed to locate vitreous region. In next stage, thresholding (Binarization) and inversion of ROI are performed. In last stage, morphological operations are performed for computing percentage of detached retina (PDR) and identification of the nature of detached retina (NDR). © 2018 IEEE.
Automatic Detection of Hard Exudates Shadow Region within Retinal Layers of OCT Images
(Hindawi Limited, 2022) Maninder Singh; Vishal Gupta; Pramod Kumar Singh; Rajeev Gupta; Basant Kumar; Fayadh Alenezi; Adi Alhudhaif; Sara A. Althubiti; Kemal Polat
The optical coherence tomography (OCT) is useful in viewing cross-sectional retinal images and detecting various forms of retinal disorders from those images. Image processing methods and computational algorithms underlying this paper try to detect the shadowing region beneath exudates automatically. This paper presents a novel method for detecting hard exudates from retinal OCT images, often associated with macular edema near or within the outer plexiform layer. In this paper, an algorithm can automatically detect the presence of hard exudates in retinal OCT images, and these exudates appear as highly reflective spots. Still, they do not appear as noticeable bright spots because of their minute sizes in predevelopment phases. In the proposed work, we are using a method to detect the presence of hard exudates by analyzing their shadowing effect instead of focusing on brightness spots. The raster scanning operation is performed by traversing the retina horizontally, and noting up any change in normalized summation of brightness intensity (summing up the intensity from top to bottom retinal layers and normalized concerning retinal width) leads to the detection of minute as well as the presence for the detection of large exudates detection by differentiating this brightness intensity graph. The shadow region helps identify the hard exudates; in our proposed method, the output for three input images has been shown. There is an excellent agreement between the results generated by the proposed algorithm and the diagnostic opinion made by the ophthalmologist. The proposed method automatically detects the hard exudates using shadow regions, and it does not need any parameter settings or manual intervention. It can yield significant results by giving the position of shadow regions, which indicates the presence of exudates. © 2022 Maninder Singh et al.
Comparative analysis of simultaneous integrated boost and sequential boost radiotherapy in node-positive cervical cancer: dosimetric and radiobiological considerations
(Springer Science and Business Media Deutschland GmbH, 2024) Ritusha Mishra; Shreya Singh; Ganesh Patel; Abhijit Mandal; Himanshu Mishra; Ankita Pandey; Bajarang Bahadur; Pramod Kumar Singh; Shikha Sachan; Mallika Tewari
For locally advanced cervical cancer, the standard therapeutic approach involves concomitant chemoradiation therapy, supplemented by a brachytherapy boost. Moreover, an external beam radiotherapy (RT) boost should be considered for treating gross lymph node (LN) volumes. Two boost approaches exist with Volumetric Intensity Modulated Arc Therapy (VMAT): Sequential (SEQ) and Simultaneous Integrated Boost (SIB). This study undertakes a comprehensive dosimetric and radiobiological comparison between these two boost strategies. The study encompassed ten patients who underwent RT for cervical cancer with node-positive disease. Two sets of treatment plans were generated for each patient: SIB-VMAT and SEQ-VMAT. Dosimetric as well as radiobiological parameters including tumour control probability (TCP) and normal tissue complication probability (NTCP) were compared. Both techniques were analyzed for two different levels of LN involvement – only pelvic LNs and pelvic with para-aortic LNs. Statistical analysis was performed using SPSS software version 25.0. SIB-VMAT exhibited superior target coverage, yielding improved doses to the planning target volume (PTV) and gross tumour volume (GTV). Notably, SIB-VMAT plans displayed markedly superior dose conformity. While SEQ-VMAT displayed favorable organ sparing for femoral heads, SIB-VMAT appeared as the more efficient approach for mitigating bladder and bowel doses. TCP was significantly higher with SIB-VMAT, suggesting a higher likelihood of successful tumour control. Conversely, no statistically significant difference in NTCP was observed between the two techniques. This study’s findings underscore the advantages of SIB-VMAT over SEQ-VMAT in terms of improved target coverage, dose conformity, and tumour control probability. In particular, SIB-VMAT demonstrated potential benefits for cases involving para-aortic nodes. It is concluded that SIB-VMAT should be the preferred approach in all cases of locally advanced cervical cancer. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
Contrastive Learning Embedded Siamese Neural Network for the Assessment of Fatty Liver
(Institute of Electrical and Electronics Engineers Inc., 2023) Kumar Mohit; Ankit Shukla; Rajeev Gupta; Pramod Kumar Singh; Kushagra Agarwal; Basant Kumar
This paper presents an self-supervised Siamese neural network (SNN) for identification and classification of fatty liver severity. SNN is used for self-supervision tasks for being influenced from model optimization property of supervised and manual annotation property of unsupervised learning. This technique is based on contrastive learning of the joint embedding network which can learn more subtle representations from the medical images for classification task, with just one or few number of labelled images required from each class for training. The efficiency of the proposed model is validated on our dataset of liver ultrasound to classify them into three stages of the fatty liver disease and normal liver. A two-class classifier (normal/grade-I, normal/grade-II and normal/grade-III fatty liver) and four-class classifier (normal, grade-I, grade-II, grade-III fatty liver disease) were trained by minimizing contrastive loss to obtain classification accuracy of 98.91% and 96.84% respectively. © 2023 IEEE.
COVID-19 Vaccines: A Radiological Review of the Good, the Bad, and the Ugly
(Thieme Medical Publishers, Inc., 2024) Ishan Kumar; Mohammad Sharoon Ansari; Ashish Verma; Pramod Kumar Singh; Sankha Shubhra Chakrabarti; Ram Chandra Shukla
The World Health Organization has declared “with great hope” an end to COVID-19 as a public health emergency. The vaccination drive that started in December 2020 played a crucial role in controlling the pandemic. However, the pace at which COVID-19 vaccines were developed and deployed for general population use led to vaccine hesitancy, largely owing to concerns regarding the safety and efficacy of the vaccines. Radiology has been instrumental in demonstrating the extent of pulmonary involvement and identification of the complications of COVID-19, and the same holds true for vaccine-related complications. This review summarizes the existing body of radiological literature regarding the efficacy, adverse events, and imaging pitfalls that accompany the global rollout of various COVID-19 vaccines. © 2024. Indian Radiological Association. All rights reserved.
Cross talk signalling: An emerging defense strategy in plants
(2011) Pramod Kumar Singh; Varun Kumar Chaturvedi; Harikesh Bahadur Singh
Important suites of plant responses to foreign attack are mediated by plant hormones such as jasmonate, salicylate, abscisic acid and brassinosteroids, which independently provide resistance to herbivorous insects, pathogens and other environmental challenges. This biochemical link of general plant defense strategies is regulated by both positive and negative interaction between phytohormones. Here we consider the mechanistic perspective of plants against pathogens, insects and osmotic adaptations. ABA-JA and salicylic acid mediated signalling pathways provide possible responses to biotic and abiotic stresses in plants. Phytohormonal ecology is attempting to link organisms and stress factors to develop a predictive framework for how and why plants coordinate with the environment.
Demystifying the Radiography of Age Estimation in Criminal Jurisprudence: A Pictorial Review
(Thieme Medical Publishers, Inc., 2024) Vritika Bhardwaj; Ishan Kumar; Priyanka Aggarwal; Pramod Kumar Singh; Ram C. Shukla; Ashish Verma
Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not available. Wrist and hand radiographs are the most common skeletal radiograph considered for age estimation. Other parts imaged are elbow, shoulder, knee, and hip according to suspected age categories. Age estimation by wrist radiographs is usually done by the Tanner-Whitehouse method where the maturity level of each bone is categorized into stages and a final total score is calculated that is then transformed into the bone age. Careful assessment and interpretation at multiple joints are needed to minimize the error and categorize into age-group. In this article, we aimed to summarize a suitable radiographic examination and interpretation for bone age estimation in living children, adolescents, young adults, and adults for medicolegal purposes. © 2024 Thieme Medical Publishers, Inc.. All rights reserved.
Duodenojejunal junction web masquerading as Wilkie's syndrome: Report of a case
(2011) Somprakas Basu; Vivek Srivastava; Pramod Kumar Singh; Arvind Srivastava; Vijay Kumar Shukla
Wilkie's syndrome (superior mesenteric artery syndrome) is a rare cause of obstruction to the third part of duodenum due to compression between the superior mesenteric artery and the abdominal aorta. Pathologies like malignant growth in the mesenteric root, the presence of a lymph nodal mass compressing the terminal duodenum, dissecting aortic aneurysm, and intestinal malrotation may mimic the condition, but are not true etiologies of the syndrome. A duodenojejunal web causing narrowing of the duodenojejunal junction and mimicking Wilkie's syndrome has not been described before in the literature. We herein report a case of gastroduodenal obstruction due to a web in the duodenojejunal junction in a young female patient, which closely mimicked Wilkie's syndrome but was finally diagnosed postoperatively. We highlight the first case of its kind in an adult and discuss the challenges in both the diagnosis and management. © Springer 2011.
Evaluation of Uterocervical Angle and Cervical Length as Predictors of Spontaneous Preterm Birth
(Georg Thieme Verlag, 2022) Pramod Kumar Singh; Resham Srivastava; Ishan Kumar; Sangeeta Rai; Saurabh Pandey; Ram C. Shukla; Ashish Verma
Aim The aim of this article was to evaluate uterocervical angle (UCA) and cervical length (CL) measured at 16 to 24 weeks of gestation using transvaginal sonography (TVS) as predictors of spontaneous preterm birth. Methods In this prospective study, TVS was performed in 159 primigravidas with a singleton, uncomplicated pregnancy at 16 to 24 weeks of gestation to measure the anterior UCA and CL. All the cases were followed until labor to document gestational age at delivery. Results The risk of spontaneous preterm birth was higher in women with obtuse UCA (>95 degrees) with sensitivity of 86.7%, specificity of 93.0%, positive predictive value of 83.0%, negative predictive value of 94.6%, and p -value of <0.001. The difference between the means was statistically significant (p -value < 0.001). UCAs ≥105degrees and 95 to 105 degrees were found to be significantly associated with spontaneous preterm births at <34 weeks and 34 to 37 weeks, respectively. CL <2.5 cm was found to predict spontaneous preterm births at <37 weeks with sensitivity of 31.1%, specificity of 95.6%, and p -value of <0.001. UCA was found to be a better predictor of spontaneous preterm birth with a higher coefficient of variation (56.4%) when compared with CL (16.9%). Conclusions UCA proved to be a novel ultrasound parameter that can serve as a better predictor of spontaneous preterm births in comparison to CL. A strong correlation exists between obtuse UCA and a risk of spontaneous preterm birth. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Gastrointestinal Tract (GIT) Tumors
(Springer Science+Business Media, 2025) Ishan Kumar; Pramod Kumar Singh; Ashish Verma
Tumors of the gastrointestinal (GI) tract are rare in children with less than 5% of childhood tumors arising from the GI tract [1]. Due to non-specific presentation and low degree of clinical suspicion, the diagnosis is often delayed. The most common GI tumors of childhood are lymphoma, gastrointestinal stromal tumor (GIST), carcinoma, carcinoid, and other benign tumors [2]. Both malignant and benign tumors of GIT in the pediatric age group may have an underlying genetic disorder, and it is essential for a radiologists to be familiar with the imaging findings as well as the associations. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Genetic diversity in Indian bean (Lablab purpureus) germplasm based on morphological traits and RAPD markers
(2011) Nagendra Rai; Pramod Kumar Singh; Avinash Chandra Rai; Ved Prakash Rai; Major Singh
The genetic diversity among 48 Indian bean (Lablab purpureus L. Sweet) genotypes, collected from various parts of India, was analyzed based on morphological traits and randomly amplified polymorphic DNA (RAPD) markers. All the genotypes, grown in randomized block design with three replications over two consecutive years, were used to record the 15 morphological traits. Twentyfive RAPD primers amplified 6-12 banding patterns for a total of 215 scorable and 178 polymorphic bands. In cluster analysis based on morphological traits and molecular markers, the genotypes were grouped in three and two clusters, respectively. Result of cluster analysis based on RAPD data showed positive correlation with morphological characters based on Mantel's test (r = 0.1417). The wide genetic variation observed for L. purpureus in India indicates that India has a rich genetic diversity for this species and that there is an ample scope for its genetic improvement.
Geochemical evolution of geothermal waters in Trans-Himalayas: Implications for critical mineral deposition
(Elsevier GmbH, 2025) Archisman Dutta; Parashar Mishra; Abhijit Mukherjee; Vivek P. Malviya; Sanjeet K. Verma; Pramod Kumar Singh; Biswajit Ray
The hydrothermal fluids of the Trans-Himalayan region host rich deposits of critical elements (e.g. Li, Cs, B, W, etc.), that forms critical energy minerals. We characterize geochemical evolution of hydrothermal waters in Trans-Himalayan region, delineating the origin and dissemination of critical energy minerals as epithermal deposits in the region. Thermal fluids exhibit enrichment in W with maximum value of 1603 μg/L and rare alkalis like Cs and Li, whose peak concentrations reach upto 6976 μg/L, and 6.8 mg/L, respectively. Similarly, soils/altered rocks are characterized by significant levels of Li (116–911 mg/kg), Cs (632.56–3317 mg/kg), Cu (181–343 mg/kg), Hg (11–2540 μg/kg), Sb (108.94–6602 mg/kg), BaSO4 (27.49–71.13 %), S (37.3 %), and F (84–3848 mg/kg). This study identifies Li-bearing mica minerals in considerable concentrations, alongside epithermal minerals attributing to a paleo-high-temperature regime in the Himalayan geothermal field. A conceptual model has been developed to trace the origin of critical minerals in thermal fluids and spring deposits, suggesting that metals and metalloids degas from felsic magmatic melts, through less-denser geological vapours, primarily as vapour-soluble chloride and sulfide complexes, which mixes with genetically evolved secondary fluids undergoing gas-solution-rock interactions and gets enriched in liquid phase after steam segregation, mainly due to decompression boiling. © 2025 Elsevier GmbH
Geological setup and physicochemical characteristics of Munger Groups of thermal springs along Munger–Saharsa Ridge Fault, Bihar, India: A conceptual hydrogeochemical model
(Springer, 2023) Archisman Dutta; Ayodhaya Prasad Thapliyal; Pramod Kumar Singh; Sandeep Rohilla; Ramesh Kumar Gupta
The hydrogeochemistry of hot springs located along the vast stretch of Munger–Saharsa Ridge Fault (MSR) zone in the Rajgir–Munger metasedimentary belt of eastern peninsular India is investigated. The temperature of springs lies between 25° and 65°C, with the highest surface manifestation in Bhimband. The thermal springs are issued from joints and fractures along MSR, East/West Patna faults of Precambrian quartzites and phyllites. The major ion composition elucidates that majority of waters are Ca–Mg–HCO3 type. The mechanisms controlling rock dominance origin of cations and both precipitation and rock dominance origin of anions in thermal waters are silicate rock weathering and ion-exchange processes between aquifer-rock and water. The mixing models illustrate that cold water causes intense dilution of geothermal fluids before discharge, with highest contribution in Bhaduria Bhar (76.6%) and lowest in Bhimband (55.4%) springs. The reservoir temperature as estimated based on quartz geothermometry ranges ~100°C grading springs as low enthalpic geothermal resources. Near-surface dilution disturbs Na/K-geochemical equilibrium and thus multi-component geothermometry furnish inaccurate results. Mineral phase saturation studies depict near equilibration of quartz and chalcedony with thermal waters. With all evidences of hydrogeochemical modelling, a conceptual model of recharge-mixing-discharge of thermal springs is proposed in the study. © 2023, Indian Academy of Sciences.
Hiccups: An atypical side effect experienced during chemo-radiotherapy in carcinoma nasopharynx
(Wolters Kluwer Medknow Publications, 2023) Ankita Pandey; Himanshu Mishra; Pramod Kumar Singh; Ritusha Mishra
Nasopharyngeal carcinoma is an uncommon cancer but has a distinct racial and geographic distribution. Patient presents with constellation of signs and symptoms due to its vicinity to critical structures and are best treated by conformal concurrent chemo-radiotherapy. We present a case of 45-year-old male diagnosed with carcinoma nasopharynx, referred to us for radiotherapy after three cycles of neoadjuvant chemotherapy. As per the prevailing standard of care, patient was planned for radiotherapy by volumetric arc technique with concurrent cisplatin. Initial days of treatment were uneventful. After fourth week of treatment, patient developed persistent hiccup which was not relieved on conservative medications. Plan was re-evaluated and it revealed maximum dose of 54.6 Gy to the brainstem. Radiotherapy induced edema that could have stimulated vagus nerve leading to hiccups was suspected. Patient was started on injectable steroid and chlorpromazine. There was prompt recovery from the symptom within five days of conservative treatment. Copyright © 2023 Journal of Cancer Research and Therapeutics.
Importance of seasonal regimen with special reference to impact on physiological parameters
(2012) Pramod Kumar Singh; P.S. Byadgi; N.S. Tripathi
Season is divided into six parts and each part consists of two months. Seasons also classified to eliminate the morbidity of Doshas in the respective seasons. Strength of the person is highest in visarga kala in comparison to adana kala. Different life style and dietetic regimen advised for each seasons. Time of seven days at the end and commencement of the season is known as ritusandhi. It is critical period in which previous regimen should be discontinued gradually and that of subsequent season should be adopted gradually. Seasons influences on body humours resulting into aggravation, accumulation and pacification. Hence one should prescribe appropriate biopurificatory procedures, collect drugs etc. to lead a healthy life.
Initial comparative analysis of pulmonary involvement on HRCT between vaccinated and non-vaccinated subjects of COVID-19
(Springer Science and Business Media Deutschland GmbH, 2022) Ashish Verma; Ishan Kumar; Pramod Kumar Singh; Mohammad Sharoon Ansari; Harsh Anand Singh; Shashank Sonkar; Adity Prakash; Ritu Ojha; Ram Chandra Shukla
Objectives: To compare the high-resolution computed tomography (HRCT)–derived severity score in COVID-19 patients between those who had earlier received the vaccine against the SARS-CoV-2 and those who did not. Methods: A retrospective cross-sectional analysis of HRCT of the chest was done in correlation with the vaccination status of clinically diagnosed COVID-19 patients. The variable under evaluation was the CT severity score, whereby differential analysis of the variability on this parameter between incompletely (single dose) vaccinated, completely (both doses) vaccinated, and non-vaccinated individuals was the outcome. Results: The analysis included 826 patients of which 581 did not receive any vaccination whereas 196 patients received incomplete (single dose) vaccination and 49 received complete vaccination. Mean CT severity score was lower in completely vaccinated patients (3.5 ± 6.3) vis-à-vis incompletely vaccinated (10.1 ± 10.5) and non-vaccinated (10.1 ± 11.4) individuals. The mean CT score was significantly lower in completely vaccinated patients of lower ages (≤ 60 years) compared to patients above that age. The incidence of severe disease (CT score ≥ 20) was significantly higher in the incompletely vaccinated and non-vaccinated patients compared to that in the completely vaccinated group. Conclusions: CT severity scores in individuals receiving both doses of SARS-CoV-2 vaccination were less severe in comparison to those receiving a single dose of vaccine or no vaccine at all. Key Points: • Patients who received complete two doses of vaccination had significantly low mean CT scores compared to the partially vaccinated patients and non-vaccinated patients. • The mean CT scores were significantly lower in completely vaccinated patients of lower ages (< 60 years) while patients > 60 years did not show significantly different CT scores between the vaccinated and non-vaccinated groups. • Consolidations and ground-glass opacities were significantly lower in the group receiving complete vaccination as compared to the unvaccinated and incompletely vaccinated patients. © 2022, The Author(s), under exclusive licence to European Society of Radiology.
Integrated use of contrast-enhanced and grey-scale ultrasound in assigning American College of Radiology Thyroid Imaging–Reporting and Data System scores for characterisation of thyroid nodules: A prospective observational study
(SAGE Publications Ltd, 2024) Ashish Verma; Adith Krishna K; Ishan Kumar; Pramod Kumar Singh; Amrita Ghosh Kar; Neeraj Kumar Agrawal
Background: The advent and increased use of high-resolution ultrasonography has resulted in improved detection of thyroid nodules. Even with the use of various Thyroid Imaging–Reporting and Data System, accurate imaging diagnosis of malignant thyroid nodules has been suboptimal, which necessitated use of newer modalities like contrast-enhanced ultrasonography alone and in combination for this purpose. Although the combined use of various Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography has turned out to be accurate in many studies, the ideal way to integrate contrast-enhanced ultrasonography into the Thyroid Imaging–Reporting and Data System algorithm is under-investigated. Purpose: To estimate and compare the diagnostic accuracy of American College of Radiology Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography in differentiating benign and malignant nodules alone and in combination. To estimate the diagnostic accuracy of contrast-enhanced ultrasonography in re-categorisation of Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 thyroid nodules. Materials and methods: This was a prospective cohort study performed in a tertiary care university–based hospital for 3 years. Adult patients with clinical or previous sonographic diagnosis of thyroid nodules were selected. Each of the nodules were assessed using ultrasonography and categorised using American College of Radiology Thyroid Imaging–Reporting and Data System criteria. The lesion was then assessed for contrast-enhanced ultrasonography features. The final diagnosis of the nodules was made using fine needle aspiration cytology. The diagnostic accuracy in diagnosis of malignant thyroid nodules for each of the American College of Radiology Thyroid Imaging–Reporting and Data System and contrast-enhanced ultrasonography alone and in combination was assessed. The diagnostic accuracy of contrast-enhanced ultrasonography in diagnosis of malignant thyroid nodules categorised as Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 was also assessed. Results: American College of Radiology Thyroid Imaging–Reporting and Data System had a sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 86.6%, 54.5%, 17.4%, 97.3% and 57.7%, respectively, in diagnosis of malignant thyroid nodules. Contrast-enhanced ultrasonography had a sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 86.6%, 95.4%, 67.9%, 98.4% and 94.4%, respectively, in diagnosis of malignant thyroid nodules. Contrast-enhanced ultrasonography had sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 93.3%, 100.0%, 100.0%, 99.2% and 99.3%, respectively, in re-categorisation of Thyroid Imaging–Reporting and Data System 3 and Thyroid Imaging–Reporting and Data System 4 nodules. Conclusion: Contrast-enhanced ultrasonography can play a key role in diagnosis of malignant thyroid nodules which are categorised as indeterminate on grey-scale ultrasound. © The Author(s) 2024.
Magnetic resonance imaging spectrum of COVID-associated rhino-orbital-cerebral mucormycosis and assessment of anatomical severity
(SAGE Publications Inc., 2023) Ishan Kumar; Ashish Verma; Jyoti Dangwal; Pramod Kumar Singh; Ram Chandra Shukla; Jaya Chakravarty
Objectives: To describe the extent and imaging findings of COVID-associated rhino-orbital-cerebral mucormycosis on magnetic resonance imaging and to evaluate the value of MRI severity score in grading the extent of involvement. Methods: Proven cases of ROCM with a history of concurrent or recently (<6 weeks) treated COVID-19 underwent MRI at the initial presentation. Findings were charted for each anatomical structure and the extent of involvement was scored for sinonasal, extra-sinus soft tissues, orbits, and brain. MR severity score was defined by summing up the individual scores of each compartment (sinonasal 20, orbital 20, soft tissue 10, and brain 10) and a total score out of 60 was assigned. Results: A total of 47 patients were included in our study with variable involvement of sinonasal compartment (n = 43), extra-sinus soft tissue (n = 25), orbits (n = 23), and brain (n = 17). In the sinonasal compartment, T2, DWI, and post-contrast T1 were the most useful sequences. A significantly higher mean sinonasal score was associated with mortality (p = 0.007). In the orbits, a combination of STIR (orbital fat and extraconal muscles), DWI (optic nerves), and post-contrast images (superior ophthalmic vein) were the most accurate sequences. A higher mean orbital score was associated with vision loss (p = 0.001). Patients with uncontrolled diabetes had greater extent of cranial involvement. Conclusion: A combination of magnetic resonance sequences is required to correctly evaluate the involvement of individual structures and thus to assign the correct MR scoring. The proposed MR severity score can effectively and objectively evaluate the severity of COVID-associated ROCM. © The Author(s) 2022.