ORCID Profile
0000-0001-5998-8648
Current Organisations
Royal Brisbane and Women's Hospital
,
University of Queensland
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Publisher: Springer Science and Business Media LLC
Date: 27-04-2023
DOI: 10.1007/S13246-023-01261-4
Abstract: Distal radius fractures (DRFs) are one of the most common types of wrist fracture and can be sub ided into intra- and extra-articular fractures. Compared with extra-articular DRFs which spare the joint surface, intra-articular DRFs extend to the articular surface and can be more difficult to treat. Identification of articular involvement can provide valuable information about the characteristics of fracture patterns. In this study, a two-stage ensemble deep learning framework was proposed to differentiate intra- and extra-articular DRFs automatically on posteroanterior (PA) view wrist X-rays. The framework firstly detects the distal radius region of interest (ROI) using an ensemble model of YOLOv5 networks, which imitates the clinicians’ search pattern of zooming in on relevant regions to assess abnormalities. Secondly, an ensemble model of EfficientNet-B3 networks classifies the fractures in the detected ROIs into intra- and extra-articular. The framework achieved an area under the receiver operating characteristic curve of 0.82, an accuracy of 0.81, a true positive rate of 0.83 and a false positive rate of 0.27 (specificity of 0.73) for differentiating intra- from extra-articular DRFs. This study has demonstrated the potential in automatic DRF characterization using deep learning on clinically acquired wrist radiographs and can serve as a baseline for further research in incorporating multi-view information for fracture classification.
Publisher: Springer Science and Business Media LLC
Date: 13-05-2022
DOI: 10.1007/S00261-022-03528-Y
Abstract: To establish if virtual non-contrast (VNC) images generated from contrast-enhanced detector-based spectral CT could replace true non-contrast (TNC) imaging for the characterisation of adrenal masses. TNC and VNC images were retrospectively reviewed for 39 patients with one or more adrenal lesions who underwent contrast-enhanced spectral CT of the upper abdomen. Lesions were categorised as either 'adenoma' or 'indeterminate/other lesion' based on current reference standards. The CT density of each lesion was measured on both image sets by two readers and compared using Wilcoxon signed-rank test. ROC analysis with Youden's J index method was performed to determine the optimal attenuation cut-off for diagnosing benign adenoma on VNC images. Forty-four lesions were included, 37 of which were diagnosed as adenomas. There were significant differences between TNC and VNC measurements for both readers (mean difference 9.1 HU for reader 1 9.8 HU for reader 2 p < 0.01). Optimal attenuation thresholds for diagnosing adenomas on VNC were 25.3 HU (reader 1) and 23.9 HU (reader 2) for the entire population, and 18.3 HU (reader 1) and 19.7 HU (reader 2) for lipid-rich adenomas < 10 HU on TNC imaging. There is insufficient evidence to support the use of VNC as a substitute for TNC images in the characterisation of adrenal lesions. VNC using a detector-based spectral CT scanner shows a predictable increase in attenuation values compared to TNC. Thus, future studies might be better directed towards finding a new threshold value for diagnosing benign adrenal adenomas on VNC imaging.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Wiley
Date: 26-09-2023
DOI: 10.1002/BCO2.192
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2008
Publisher: Wiley
Date: 05-02-2018
Abstract: Computed tomographic (CT) imaging is widely available in Australian rural and remote hospitals and is often performed prior to patient transfer to definitive tertiary hospital care. We hypothesised that critically ill trauma and neurosurgical patients might have CT scans repeated after interhospital transfer and that the utility of this practice might be low in relation to the additional financial cost and radiation exposure. We conducted a retrospective review of clinical records to determine the proportion of trauma and neurosurgical patients transferred to our tertiary ICU from other hospitals between 1 June 2013 and 30 June 2014 who underwent a repeat CT scan. The additional effective radiation dose was estimated using the dose length product method and the Australian Medicare Benefits Schedule was used to estimate the associated cost. Of the 247 patients transferred for trauma and neurosurgical indications, many (144 58%) had undergone CT imaging at the referring hospital. Repeat scans were performed in 60 (42%) already imaged patients (24% of all transferred patients), most frequently for changed clinical indications. While in 11 (18%) of those 60 already imaged patients the repeat scan led to an identifiable change in management, for another 13 (22%) patients the repeat scans appeared to be potentially avoidable. The median cost of a repeat scan was AU$250 and the median additional effective radiation dose was 2.74 mSv per patient. Repeat CT scans for patients already imaged prior to transfer were relatively common, occurring mostly for apparently valid clinical reasons. However, the additional radiation risk and financial cost of these repeat scans appeared on retrospective audit to be potentially avoidable in approximately one in five cases.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2018
DOI: 10.1007/S10140-018-1591-1
Abstract: The purpose of this study was to review and compare the image quality and radiation dose of split-bolus single-pass computed tomography(CT) in the assessment of trauma patients in comparison to standard multi-phase CT techniques. An online electronic database was searched using the MESH terms "split-bolus," "dual phase," and "single pass." Inclusion criteria required the research article to compare a split contrast bolus protocol in a single-pass scan in the assessment of trauma patients. Studies using split-bolus CT technique in non-traumatic injury assessment were excluded. Six articles met the inclusion criteria. Parenchymal and vascular image qualities, as well as subjective image quality assessments, were equal or superior in comparison to non-split-bolus multi-phase trauma CT protocols. Split-bolus single-pass CT decreased radiation exposure in all studies. Further research is required to determine the superior split-bolus protocol and the specificity and sensitivity of detecting blunt cerebrovascular injury screening, splenic parenchymal vascular lesions, and characterization of pelvic vascular extravasation.
Publisher: BMJ
Date: 12-05-2017
Publisher: FSFEI HE Don State Technical University
Date: 25-12-2020
DOI: 10.23947/2687-1653-2020-20-4-350-359
Abstract: Introduction. When developing ocular prostheses, a number of problems arise, one of which is the construction of the connection between the hard optical part and the soft corneal tissue. Their Young's modules can differ by three orders of magnitude. In this case, the problem arises of creating an intermediate layer, possibly with gradient properties, whose purpose is to exclude injury to soft biological tissues. Two types of keratoprostheses are considered: the first type with a support plate and the second type with an intermediate functionally gradient layer. The stress-strain state of the prosthesis is calculated for the first type. For the second type, analytical and finite element modeling of the interaction of a cylindrical optical prosthesis, an intermediate inhomogeneous layer, and the cornea was carried out in the elastic media. Two versions are considered: discounting the curvature (circular plate or plate) and with account of the curvature (spherical dome or shell). The work objective is to study the stress-strain state of the keraprosthesis and cornea in the contact area. Materials and Methods. Mathematical models of the structures under consideration are the boundary value problems of the linear elasticity theory. The analytical solution is constructed for a simplified model in the form of a composite circular plate. Spatial three-dimensional problems and axisymmetric problems are solved by the finite element method. Finite element modeling of the considered structures was performed in the CAE package ANSYS and ACELAN. Results. CAD models of keratoprostheses with conditions of fixing and loading are constructed. The load acting on the keraprosthesis under the effect of intraocular pressure was determined. The stress-strain state of the keratoprosthesis and cornea elements was calculated. Special attention was paid to the area of its contact with the keratoprosthesis. Discussion and Conclusions. The results of calculating the axial displacements and mechanical stresses in the first type of keratoprosthesis show that the selected geometric parameters meet the kinematic and strength requirements. The proposed models of the deformed state of soft biological tissues provide assessing their injury when using a keratoprosthesis of the second type, as well as selecting the geometric parameters and gradient properties of the intermediate layer.
Publisher: Wiley
Date: 23-06-2010
DOI: 10.1111/J.1445-2197.2010.05346.X
Abstract: The objective of routine outpatient assessment of well-functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow-up of patients after THA. A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a four-year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow-up information were recorded and cross-referenced with Australian Orthopaedic Association National Joint Replacement Registry data. One hundred ten THAs in 104 patients (average age 70.4 (SD 9.8 years)). There were 70 (63.6%) in total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri-prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only four (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3)) follow-up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years. We conclude that patients with prostheses with excellent long-term clinical results as validated by joint registries, routine follow-up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow-up of asymptomatic THA may be excessively costly and unnecessary, and a less resource-intensive review method may be more appropriate.
Publisher: Springer Science and Business Media LLC
Date: 13-08-2015
Publisher: Elsevier BV
Date: 04-2020
No related grants have been discovered for Craig HACKING.