Introduction: Coronary artery disease (CAD) is a leading cause of death worldwide. Accurate diagnosis and management are critical. Non-invasive imaging, such as coronary computed tomography angiography (CCTA), is vital for early diagnosis and treatment planning. This study evaluates the accuracy of CAD-Reporting and Data System (CAD-RADS) scoring and the compatibility between CCTA and invasive coronary angiography (ICA) in patients suspected of having CAD. Materials and methods: From January 1, 2022 to January 15, 2024, 214 patients suspected of CAD underwent both CCTA and ICA. CCTA artifacts led to the exclusion of 32 patients and 128 vessels, leaving 586 vessels for analysis. CAD-RADS scoring categorized coronary stenosis. Diagnostic performance was measured by specificity, sensitivity, accuracy, positive and negative predictive value (NPV). Extracardiac findings were analyzed with a wide field of view (FOV) during CCTA. Results: A total of 214 patients (67.3% male, median age 56) were examined. Hypertension, smoking, calcium score, and high-risk plaques correlated with CCTA and ICA CAD-RADS scores; calcium score also related to hypertension, smoking, diabetes, and dyslipidemia (p < 0.05). CCTA showed a sensitivity of 80.8% and NPV of 90.3% for detecting stenosis of 70% or more; for 50% stenosis, sensitivity was 93.5% and NPV 92.1%. Agreement between CCTA and ICA was excellent in bypass patients; stenosis detection in stented patients had 85.7% sensitivity and 96.2% NPV. Conclusion: This study highlights the importance of CAD-RADS and CCTA in CAD diagnosis and treatment planning. CCTA effectively evaluates stents and grafts, emphasizing the benefits of extracardiac findings and a wide FOV.

Objective: High anxiety during coronary computed tomography angiography (CCTA) can compromise imaging quality, increase radiation exposure, and elevate medication use. Therefore, optimizing waiting room environments to reduce patient anxiety is important for clinical outcomes. This study examines the effects of music and visual stimuli in the waiting rooms on patients’ anxiety levels, heart rate, radiation dose, and beta-blocker use prior to CCTA. Methods: This study, designed as a prospective and randomized trial, was conducted between April 15 and August 15, 2024, with 216 patients randomized into two groups: a standard waiting room (SWR) and a designed waiting room (DWR) featuring music and visual objects. Anxiety and depression levels were measured using the Hospital Anxiety and Depression Scale (HADS) and the State-Trait Anxiety Inventory (STAI). Additional parameters, such as heart rate, radiation dose, and beta-blocker requirement, were also recorded. Results: In the DWR group, anxiety scores and heart rates were significantly lower compared to the SWR group (p < 0.001). Additionally, a notable reduction in radiation dose and beta-blocker use was observed in the DWR group (p < 0.05). In the general patient population, higher anxiety scores were associated with poorer imaging quality. Imaging quality was significantly better in the DWR group (p < 0.001). Conclusion: It has been demonstrated that waiting room designs enriched with music and visual stimuli reduce anxiety during CCTA scanning, enhancing patient comfort, improving imaging quality, and enabling imaging with lower radiation doses. The design of such waiting rooms can improve patient experience while optimizing outcomes. Key Points: Question Can a waiting room with music and visual stimuli reduce anxiety and heart rate in CCTA patients, improving imaging quality and reducing beta-blocker use? Findings Music and visual stimuli reduced anxiety and heart rate, lowering beta-blocker use and radiation doses while improving imaging quality in CCTA. Clinical relevance Integrating music and visual stimuli in waiting rooms helps reduce anxiety and heart rate, leading to less medication use and radiation exposure while enhancing imaging quality. This simple, cost-effective approach improves patient comfort and optimizes outcomes in CCTA procedures. Graphical

Introduction: The lamina papyracea is the thin line between the ethmoid sinus and the medial orbital wall. Knowledge of the presence of the lamina papyracea dehiscence (LPD) bears critical importance to prevent misdiagnosis of fractures at this level and to define the anatomy before sinonasal surgery, including Functional Endoscopic Sinus Surgery (FESS). The present study is therefore intended to determine the incidence of LPD in paranasal computed tomography, to identify its imaging characteristics in CT, and to compare with the literature. Materials and methods: The current study included patients who underwent paranasal CT scanning for any reason in our clinic between January 2018 and January 2022. Patients were evaluated in terms of age, gender, and presence of LPD. Patients with dehiscence were evaluated in terms of age, gender, dehiscence localization (right, left), tissue at the level of dehiscence, dehiscence size, and dehiscence grade. Results: 1000 patients with a mean age of 32. ± 16.3 (min = 18-max = 79) were included in the study. 20 patients (2%) were found to have LPD. Of those with LPD, 14 (70%) were grade 1, 4 (20%) were grade 2 and 2 (10%) were grade 3. Again of those with LPD, 14 (70%) had LPD localized on the right and 6 (30%) had LPD on the left. In 12 (60%) of the patients with LPD, herniated tissue was detected. Among these patients with herniation, fatty tissue herniation was observed in 10 (83.3%) and medial rectus muscle herniation was observed in 2 (16.7%). Discussion and Conclusion: Comprehensive evaluation for and identification of LPD are very important before possible sinus surgery.

The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and dynamic breast MRI techniques for diagnosing breast lesions, assess the diagnostic accuracy of CEM’s using histopathological findings, and compare lesion size measurements obtained from both methods with pathological size.Materials and methods: This prospective study included 120 lesions, of which 70 were malignant, in 104 patients who underwent CEM and MRI within a week. Two radiologists independently evaluated the MR and CEM images in separate sessions, using the BI-RADS classification system. Additionally, the maximum sizes of lesion were measured. Diagnostic accuracy parameters and the receiver operating characteristics (ROC) curves were constructed for the two modalities. The correlation between the maximum diameter of breast lesions observed in MRI, CEM, and pathology was analyzed.Results: The overall diagnostic values for MRI were as follows: sensitivity 97.1%, specificity 60%, positive predictive value (PPV) 77.3%, negative predictive value (NPV) 93.8%, and accuracy 81.7%. Correspondingly, for CEM, the sensitivity, accuracy, specificity, PPV, and NPV were 97.14%, 81.67%, 60%, 77.27%, and 93.75%, respectively. The ROC analysis of CEM revealed an area under the curve (AUC) of 0.907 for observer 1 and 0.857 for observer 2, whereas MRI exhibited an AUC of 0.910 for observer 1 and 0.914 for observer 2. Notably, CEM showed the highest correlation with pathological lesion size (r = 0.660 for observer 1 and r = 0.693 for observer 2, p < 0.001 for both).Conclusion: CEM can be used with high sensitivity and similar diagnostic performance comparable to MRI for diagnosing breast cancer. CEM proves to be a successful diagnostic method for precisely determining tumor size.