Purpose: Defining normal anthropometric ranges of proximal femur and femoral head for each age group in children/adolescents is a necessity when differentiating normal anatomical variants from pathological deformities. Aim of this study is to define a set of normal anthropometric parameters based on 3D-CT measurements in normal asymptomatic children/adolescents and analyse the variations arising depending on age, side, and/or gender.Methods: Morphology of the proximal femur was retrospectively assessed in 170 hips (85 children, < 15 years). Measurements included covered femoral head volume (CFHV), femoral head diameter (FHD), femoral head extrusion index (FHEI), coronal alpha angle (CAA), lateral centre-edge angle (LCEA), anterior (AOS) and posterior head-neck offset (POS) and femoral neck-shaft angle (FNSA). Correlation analyses as well as inter- and intra-rater reliability were performed.Results: CFHV, LCEA, FHD and AOS/POS increased with age and FHEI, CAA, and FNSA decreased with age. None of the measurements correlated with the side. AOS showed a poor correlation with gender. Rapid growth phases were observed at the age of 1, 7 and 11. The inter- and intra-rater reliability was high (range ICC 0.8–0.99 Cronbach alpha 0.86–0.99).Conclusion: This data delivers a description of growth phases as well as gender and age-correlated reference values of the proximal femoral morphology that could be used by paediatricians and orthopaedic/paediatric surgeons to early diagnose proximal femur deformities and provide guidance in the planning of possible operations.

This study evaluates ultra-low-dose computed tomography (ULDCT) protocols concerning the detectability of pulmonary nodules. The influence of tube current settings, kernels, strength levels of third-generation iterative reconstruction algorithms, and pitch was investigated. A chest phantom with artificial spherical nodules of different densities and diameters was examined with a third-generation dual-source CT. Scanning and post-processing protocols, tube current levels, and ultra-high and non-high pitch modes were applied. Images were reconstructed with filtered back-projection (FBP) or advanced model-based iterative reconstruction (ADMIRE) algorithms. Sharp (Bl57) or medium-soft (Br36) convolution kernels were applied. The reading was performed by an experienced and an inexperienced reader. The highest observer sensitivity was found using a non-high pitch protocol at tube currents of 120 mAs and 90 mAs with the sharp kernel and iterative reconstruction level of 5. Non-high pitch protocols showed better detectability of solid nodules. Combinations with the medium-soft kernel achieved slightly higher observer sensitivity than with the sharp kernel. False positives (FP) occurred more often for subsolid nodules, at a tube current level of 120 mAs, and with the sharp kernel. A tube current level of 90 mAs combined with the highest iterative reconstruction level achieved the highest accuracy in lung nodule detection regardless of size, density, and reader experience.

The aim was to prospectively evaluate the diagnostic and prognostic value of different quantitative analysis methods assessing adrenal gland parameters on contrast-enhanced CT scans in patients with septic conditions. Seventy–six patients (49 men, 27 women) received CT scans for focus search. Adrenal glands were analyzed by means of three different methods: subjective region of interest (ROI) measurement, organ segmentation and histogram analysis using semi-automated software. Univariate analyses with multiple testing thresholds and receiver operating characteristic curves were performed. Clinical endpoints were 8-days, 28-days and 6-months mortality. Forty-four CT scans were analyzed (ground truth: patients with no sepsis: n = 6; patients with sepsis: n = 15; patients in septic shock: n = 21). Left adrenal gland (LAG) values were analyzed and compared, as data variation was lower than in the right adrenal glands. In patients with septic conditions, the combination of high LAG and Inferior Vena Cava (IVC) density values was highly specific for septic shock with all three methods. Only segmentation values were significantly different between the sepsis and septic shock groups after confounder correction (p = 0.048). Total adrenal gland volume was 20% higher in the septic shock patients while a relatively small LAG volume within the septic shock subgroup was associated with higher mortality at day 8 (AUC = 0.8; p = 0.006) and at 6 months (AUC = 0.7; p = 0.035). However, time-consuming density analysis methods assessing adrenal glands do not provide additional diagnostic value in patients with septic conditions. The combination of high LAG and IVC attenuation values seems to be highly specific for septic shock, regardless of the analysis type. Adrenal gland volume reveals short- and long-term prognostic capacity.