Publications by authors named "Eleni P Kariki"

5 Publications

  • Page 1 of 1

Opportunistic diagnosis of osteoporosis, fragile bone strength and vertebral fractures from routine CT scans; a review of approved technology systems and pathways to implementation.

Ther Adv Musculoskelet Dis 2021 10;13:1759720X211024029. Epub 2021 Jul 10.

University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK.

Osteoporosis causes bones to become weak, porous and fracture more easily. While a vertebral fracture is the archetypal fracture of osteoporosis, it is also the most difficult to diagnose clinically. Patients often suffer further spine or other fractures, deformity, height loss and pain before diagnosis. There were an estimated 520,000 fragility fractures in the United Kingdom (UK) in 2017 (costing £4.5 billion), a figure set to increase 30% by 2030. One way to improve both vertebral fracture identification and the diagnosis of osteoporosis is to assess a patient's spine or hips during routine computed tomography (CT) scans. Patients attend routine CT for diagnosis and monitoring of various medical conditions, but the skeleton can be overlooked as radiologists concentrate on the primary reason for scanning. More than half a million CT scans done each year in the National Health Service (NHS) could potentially be screened for osteoporosis (increasing 5% annually). If CT-based screening became embedded in practice, then the technique could have a positive clinical impact in the identification of fragility fracture and/or low bone density. Several companies have developed software methods to diagnose osteoporosis/fragile bone strength and/or identify vertebral fractures in CT datasets, using various methods that include image processing, computational modelling, artificial intelligence and biomechanical engineering concepts. Technology to evaluate Hounsfield units is used to calculate bone density, but not necessarily bone strength. In this rapid evidence review, we summarise the current literature underpinning approved technologies for opportunistic screening of routine CT images to identify fractures, bone density or strength information. We highlight how other new software technologies have become embedded in NHS clinical practice (having overcome barriers to implementation) and highlight how the novel osteoporosis technologies could follow suit. We define the key unanswered questions where further research is needed to enable the adoption of these technologies for maximal patient benefit.
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http://dx.doi.org/10.1177/1759720X211024029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274099PMC
July 2021

Increased prevalence of fractures in inadequately transfused and chelated Indian children and young adults with beta thalassemia major.

Bone 2021 02 18;143:115649. Epub 2020 Sep 18.

Growth and Pediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra 411 001, India; School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Rd, Ganeshkhind, Pune, Maharashtra 411007, India. Electronic address:

Introduction: In patients with beta thalassemia major, inadequate transfusion and chelation may compromise bone health and increase risk of fractures. The objective of this study was to describe the prevalence of fractures in Indian inadequately transfused and chelated children, adolescents and young adults with beta thalassemia major.

Methods: We studied 179 patients with beta thalassemia (3.6-28.3 years; 105 boys). Medical, transfusion, chelation and fracture history were recorded. Vertebral fracture assessment (VFA) was performed using lateral spine images acquired using the GE Lunar iDXA (Wisconsin, MD). Fractures were classified according to an adapted semi-quantitative method.

Results: History of non-traumatic long bone fractures was observed in 21% patients (n = 37); there were significantly greater (p < 0.05) number of males (n = 30) than females (n = 15). The 21% fracture prevalence in the present study is higher than the reported fractures of 9% in healthy Indian children and adolescents. The prevalence of vertebral fractures was 4.5% (n = 8) in the study group. Of those with fractures, four patients had both long bone and vertebral fractures, and (any, long bone or vertebral fractures) sixteen patients had more than 1 fracture; eleven patients had 2 fractures, four patients had 3 fractures and one patient had 5 fractures. Thus, in 179 patients, there were a total of 68 single fractures which translates to 307 fractures per 10,000 patient years.

Conclusion: This study found increased prevalence of non-traumatic long bone and vertebral fractures in children and adolescents with thalassemia major.
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http://dx.doi.org/10.1016/j.bone.2020.115649DOI Listing
February 2021

The rare sprengel deformity: our experience with three cases.

J Clin Imaging Sci 2014 27;4:55. Epub 2014 Oct 27.

Department of Radiology, Papageorgiou General Hospital, Thessaloniki, Greece.

Sprengel shoulder is a rare congenital deformity of one or both scapulae that is usually detected at birth. It occurs due to failure of the scapula to descend during intrauterine development and its cause is still unknown. Although the deformity appears randomly most of the time, familial cases have been reported. Sprengel shoulder is often associated with Klippel-Feil syndrome and other congenital skeletal deformities. Anteroposterior X-ray imaging can accurately diagnose Sprengel deformity. However, computed tomography and magnetic resonance scans with three-dimensional reconstruction are nowadays used in everyday practice in order to diagnose concomitant abnormalities, study in detail the anatomy of the affected shoulder(s), and plan appropriate management. We present here our imaging experience from three pediatric cases with Sprengel shoulder and take the opportunity to discuss this rare entity, which is, nevertheless, the commonest congenital defect of the scapula.
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http://dx.doi.org/10.4103/2156-7514.143407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220418PMC
November 2014

Eleven patients with testicular leydig cell tumors: clinical, imaging, and pathologic correlation.

J Ultrasound Med 2014 Oct;33(10):1855-64

Department of Radiology, Papageorgiou General Hospital, Thessaloniki, Greece.

We present the sonographic and magnetic resonance imaging findings of Leydig cell tumors in a series of patients, along with a brief review of the literature. We evaluated the sonographic features of 11 cases of Leydig cell tumors, including echogenicity, size, margins, and patterns of vascularity. The magnetic resonance imaging characteristics of 9 patients were also assessed, with special attention to the appearance of the tumors on T2-weighted imaging and postcontrast T1-weighted imaging. Seven tumors were hypoechoic, and 4 were almost isoechoic. Ten patients showed various patterns of hypervascularity in the tumors, combined in some cases with feeding vessels. One case presented with a single feeding vessel. The tumors showed homogeneous or heterogeneous low signal intensity on T2-weighted imaging and marked enhancement on postcontrast T1-weighted imaging. The small size of these tumors, the various patterns of vascularity on color and power Doppler sonography, and the marked enhancement on postcontrast T1-weighted imaging are considered valuable but generally nonspecific for identification of these tumors.
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http://dx.doi.org/10.7863/ultra.33.10.1855DOI Listing
October 2014

Adult type granulosa cell tumor of the testis: Radiological evaluation and review of the literature.

Turk J Urol 2014 Jun;40(2):115-9

Department of Radiology, "Papageorgiou" General Hospital, Thessaloniki, Greece.

A testicular granulosa cell tumor of the adult type is very rare. Isolated case reports and small series have been published in the English literature. Here, we analyze an incidentally discovered testicular granulosa cell tumor in a 29-year-old man to discuss the radiological evaluation of this entity and review the literature.
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http://dx.doi.org/10.5152/tud.2014.70446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548378PMC
June 2014
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