Precise and reproducible hippocampus outlining is important to quantify hippocampal atrophy caused by neurodegenerative diseases and to spare the hippocampus in whole brain radiation therapy when ...performing prophylactic cranial irradiation or treating brain metastases. This study aimed to quantify systematic differences between methods by comparing regional volume and outline reproducibility of manual, FSL-FIRST and FreeSurfer hippocampus segmentations.
This study used a dataset from ADNI (Alzheimer's Disease Neuroimaging Initiative), including 20 healthy controls, 40 patients with mild cognitive impairment (MCI), and 20 patients with Alzheimer's disease (AD). For each subject back-to-back (BTB) T1-weighted 3D MPRAGE images were acquired at time-point baseline (BL) and 12 months later (M12). Hippocampi segmentations of all methods were converted into triangulated meshes, regional volumes were extracted and regional Jaccard indices were computed between the hippocampi meshes of paired BTB scans to evaluate reproducibility. Regional volumes and Jaccard indices were modelled as a function of group (G), method (M), hemisphere (H), time-point (T), region (R) and interactions.
For the volume data the model selection procedure yielded the following significant main effects G, M, H, T and R and interaction effects G-R and M-R. The same model was found for the BTB scans. For all methods volumes reduces with the severity of disease. Significant fixed effects for the regional Jaccard index data were M, R and the interaction M-R. For all methods the middle region was most reproducible, independent of diagnostic group. FSL-FIRST was most and FreeSurfer least reproducible.
A novel method to perform detailed analysis of subtle differences in hippocampus segmentation is proposed. The method showed that hippocampal segmentation reproducibility was best for FSL-FIRST and worst for Freesurfer. We also found systematic regional differences in hippocampal segmentation between different methods reinforcing the need of adopting harmonized protocols.
The objective is to present a proof-of-concept of a semi-automatic method to reduce hippocampus segmentation time on magnetic resonance images (MRI).
FAst Segmentation Through SURface Fairing ...(FASTSURF) is based on a surface fairing technique which reconstructs the hippocampus from sparse delineations. To validate FASTSURF, simulations were performed in which sparse delineations extracted from full manual segmentations served as input. On three different datasets with different diagnostic groups, FASTSURF hippocampi were compared to the original segmentations using Jaccard overlap indices and percentage volume differences (PVD). In one data set for which back-to-back scans were available, unbiased estimates of overlap and PVD were obtained. Using longitudinal scans, we compared hippocampal atrophy rates measured by manual, FASTSURF and two automatic segmentations (FreeSurfer and FSL-FIRST).
With only seven input contours, FASTSURF yielded mean Jaccard indices ranging from 72(±4.3)% to 83(±2.6)% and PVDs ranging from 0.02(±2.40)% to 3.2(±3.40)% across the three datasets. Slightly poorer results were obtained for the unbiased analysis, but the performance was still considerably better than both tested automatic methods with only five contours.
FASTSURF segmentations have high accuracy and require only a fraction of the delineation effort of fully manual segmentation. Atrophy rate quantification based on completely manual segmentation is well reproduced by FASTSURF. Therefore, FASTSURF is a promising tool to be implemented in clinical workflow, provided a future prospective validation confirms our findings.
Objectives
The objectives of this cross-sectional survey were to determine the prevalence of secondary caries (SC) in general population, to identify patient- and material-related factors which may ...affect the prevalence, and to describe some clinical characteristics of SC lesions.
Materials and methods
A total of 4036 restorations in 450 patients, who visited the university dental clinic for a regular (half) yearly checkup, were examined clinically (and radiographically) for the presence of SC. Clinical characteristics of the detected SC lesions (size, activity, and location) and the planned treatment were recorded. In addition, patients’ caries-risk status was assessed according to the modified “cariogram” model.
Results
In total, 146 restorations were diagnosed with SC, which gives an overall prevalence of 3.6%. Restorative material, restoration class, patient’s caries risk, and smoking habits were shown to be important factors, as SC prevalence was significantly higher with composites, class II restorations, high-caries-risk patients, and smokers. Restorations’ gingival margins were most frequently affected by SC. The largest number of restorations with SC (72%) was scheduled for the replacement.
Conclusions
Prevalence of SC was higher with composite than with amalgam restorations, irrespective of the patient’s caries-risk status. Gingival margins of class II, including MOD restorations, seem to be the place of less resistance to SC development. Management of SC seems to place a considerable burden on the health care workforce and expenditure.
Clinical relevance
Secondary caries (SC) is considered to be the main cause of dental restoration failure and one of the biggest clinical challenges related to dental composites. Nevertheless, its prevalence in daily practice is still not clear, which impedes an accurate estimation of its impact on health care costs.
To assess light irradiance (LI) delivered by two light-curing units (LCU’s) and to measure the degree of conversion (DC) of three composite cements, when cured through different thicknesses of two ...novel CAD–CAM block materials.
100-μm-thick films of a dual-curable composite cement (G-CEM LinkAce, GC), a light-curable flowable resin-based composite (RBC) (G-ænial Universal Flo, GC) and a micro-hybrid RBC (G-ænial Posterior, GC) were investigated as luting agents. Two ‘polymer–ceramic’ CAD–CAM blocks (Cerasmart, GC; Enamic, Vita Zahnfabrik) were sectioned in slabs with different thicknesses (1, 3 and 5mm). LI at the bottom of the specimens was measured using a calibrated spectrometer, while being light-cured through the CAD–CAM block slabs for 40s with a low- (±500mW/cm2) or high- (±1,600mW/cm2) irradiance LCU (n=5). After light-curing, micro-Raman spectra of the composite films were acquired to determine DC at 5min, 10min, 1h and 24h. LI data were statistically analyzed by Kruskal–Wallis followed by post-hoc comparisons, while a linear mixed-effect model was applied for the DC analysis. In addition, the CAD–CAM blocks ultrastructure was characterized upon argon-ion slicing using scanning transmission electron microscopy (STEM). Finally, light transmission (LT) through each CAD–CAM block material was assessed using a spectrophotometer.
Curing-light attenuation and DC were significantly influenced by thickness and type of the overlying material. LCU only had a significant effect on DC of the micro-hybrid RBC. DC significantly increased over time for all composite cements. CAD–CAM block structural analysis revealed a relatively small and homogenous filler configuration (mean filler size of 0.2–0.5μm) for Cerasmart, while Enamic contained ceramic grains varying in shape and size (1–10μm), which were interconnected by the polymer-based network. LT was much higher at a wavelength range of 300–800nm for Cerasmart than for Enamic.
Light-curable composite cements can be cured through a restoration up to 2.7-mm thickness, depending on the kind of CAD–CAM material. A high-irradiance LCU only has a limited effect on the maximum thickness of the polymer–ceramic CAD–CAM material that can be cured through.
To evaluate the effect of the kind and concentration of photo-initiator on the degree of conversion (DC) of adhesives on dentin/glass substrates and their mini-interfacial fracture toughness ...(mini-iFT) to dentin.
We tested the adhesive Clearfil S3 Bond Plus and 4 derived experimental ‘LUB’ (‘Leuven Univesity Bond’) adhesives (all from Kuraray Noritake), namely ‘LUB-CQ/amine_high’, ‘LUB-CQ/amine_low’, ‘LUB-TPO_high’, and ‘LUB-TPO_low’, respectively containing 2.0wt% camphorquinone (CQ) and 2.0wt% EDMAB (amine), 0.35wt% CQ and 0.35wt% amine, 2.0wt% TPO, and 0.35wt% TPO. For DC, each adhesive was applied onto glass or dentin prior to being cured (Bluephase 20i; Ivoclar Vivadent: “high mode”) for 10s. DC was measured at 5min, 10min, 1h, 24h and 1 week using micro-Raman spectroscopy (SENTERRA; BrukerOptik). For mini-iFT, each adhesive was bonded to 320-grit SiC-paper ground dentin and covered with composite (Z100; 3M ESPE). The restored teeth were cut in sticks (1.5×2.0×16mm), after which a single-gradient notch was prepared at the adhesive-dentin interface using a 150-μm diamond blade. The micro-specimens were loaded until failure in a 4-point bending test and the mini-iFT in term of KQvM was calculated.
DC was higher on dentin than on glass. All adhesives were adequately polymerized at 1 week, except for LUB-TPO_low. DC at 5min was significantly higher for LUB-TPO_high than for both CQ/amine-based adhesives. The highest and most reliable mini-iFT was measured for LUB-CQ/amine_high, despite its 5-min DC was relatively low. No correlation between DC and mini-iFT was found.
Curing of TPO-based adhesives is faster, but the dark cure of the CQ/amine-containing adhesives is more efficient. The differences in curing profiles do affect the mechanical properties of the resultant interfaces at dentin.
The morphologies contained in 3D third harmonic generation (THG) images of human brain tissue can report on the pathological state of the tissue. However, the complexity of THG brain images makes the ...usage of modern image processing tools, especially those of image filtering, segmentation and validation, to extract this information challenging.
We developed a salient edge-enhancing model of anisotropic diffusion for image filtering, based on higher order statistics. We split the intrinsic 3-phase segmentation problem into two 2-phase segmentation problems, each of which we solved with a dedicated model, active contour weighted by prior extreme. We applied the novel proposed algorithms to THG images of structurally normal ex-vivo human brain tissue, revealing key tissue components-brain cells, microvessels and neuropil, enabling statistical characterization of these components. Comprehensive comparison to manually delineated ground truth validated the proposed algorithms. Quantitative comparison to second harmonic generation/auto-fluorescence images, acquired simultaneously from the same tissue area, confirmed the correctness of the main THG features detected.
The software and test datasets are available from the authors.
z.zhang@vu.nl.
Supplementary data are available at Bioinformatics online.
To summarize the distribution of glioma location within a patient population, registration of individual MR images to anatomical reference space is required. In this study, we quantified the accuracy ...of MR image registration to anatomical reference space with linear and non-linear transformations using estimated tumor targets of glioblastoma and lower-grade glioma, and anatomical landmarks at pre- and post-operative time-points using six commonly-used registration packages (FSL, SPM5, DARTEL, ANTs, Elastix, and NiftyReg). Routine clinical pre- and post-operative, post-contrast T1-weighted images of 20 patients with glioblastoma and 20 with lower-grade glioma were collected. The 2009a Montreal Neurological Institute brain template was used as anatomical reference space. Tumors were manually segmented in the patient space and corresponding healthy tissue was delineated as a target volume in the anatomical reference space. Accuracy of the tumor alignment was quantified using the Dice score and the Hausdorff distance. To measure the accuracy of general brain alignment, anatomical landmarks were placed in patient and in anatomical reference space, and the landmark distance after registration was quantified. Lower-grade gliomas were registered more accurately than glioblastoma. Registration accuracy for pre- and postoperative MR images did not differ. SPM5 and DARTEL registered tumors most accurate, and FSL least accurate. Non-linear transformations resulted in more accurate general brain alignment than linear transformations, but tumor alignment was similar between linear and non-linear transformation. We conclude that linear transformation suffices to summarize glioma locations in anatomical reference space.
Besides micro-mechanical interlocking through hybrid-layer formation, self-etch adhesives may benefit from additional chemical interaction between the functional monomer and residual hydroxyapatite. ...One-step adhesives are commonly associated with lower bonding effectiveness, which must be attributed in part to the dissolution of hydrophilic and hydrophobic monomers in a relatively highly concentrated solvent. In this ‘difficult’ mixture, also water is essential as ionization medium to enable self-etching activity. Due to the high hydrophilicity, one-step self-etch adhesives have been reported to behave as semi-permeable membranes, allowing fluids to pass through and seriously jeopardizing bond durability. Recent research has also revealed that HEMA-free one-step adhesives are prone to phase-separation, which may also account for their lower bonding effectiveness. Employing an appropriate air-drying technique may, however, improve the bonding effectiveness of such phase-separating adhesives by getting rid of substantially more interfacial water than HEMA-containing adhesives, of which water might be more difficult to remove from.
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