Reduction of the Beam Hardening Artifacts in the X-Ray Computer Tomography: Energy Discrimination with a Photon-Counting Detector

The material identification is a pressing requirement for the sensitive security applications. Dual-energy X-ray computer tomography (DXCT) has been investigated for material identification in the medical and security fields. It requires two tomographic images at sufficiently different energies. To discriminate dangerous materials of light elements such as plastic bombs in luggage, it is needed to measure accurately with several tens of kilo electron volts where such materials exhibit significant spectral differences. However, CT images in that energy region often include artifacts from beam hardening. To reduce these artifacts, a novel reconstruction method has been investigated. It is an extension of the Al-gebraic Reconstruction Technique and Total Variation (ART-TV) method that reduces the artifacts in a lower-energy CT image by referencing it to an image obtained at higher energy. The CT image of a titanium sample was recon-structed using this method in order to demonstrate the artifact reduction capability.

Aflibercept combined with triamcinolone acetonide in the treatment of diabetic macular edema:optical coherence tomography and optical coherence tomography angiography

AIM:To analyze the relationship between optical coherence tomography(OCT)and OCT angiography(OCTA)imaging in patients with diabetic macular edema(DME)who are treated with a combination of aflibercept and triamcinolone acetonide(TA).METHODS:A total of 76 eyes newly diagnosed DME were included in this study.They were randomly assigned to receive either aflibercept or a combination of aflibercept and TA.Injections once a month for a total of three injections.Central macular thickness(CMT),number of hyperreflective foci(HRF),height of subretinal fluid(SRF),and area of foveal avascular zone(FAZ)were evaluated using OCT and OCTA at baseline and after each monthly treatment.RESULTS:Both groups showed improvement in best corrected visual acuity(BCVA)and reduction in macular edema after treatment,and the difference in BCVA between the two groups was statistically significant after each treatment(P<0.05).The difference in CMT between the two groups was statistically significant after the first two injections(P<0.01),but not after the third injection(P=0.875).The number of HRF(1mo:7.41±8.25 vs 10.86±7.22,P=0.027;2mo:5.33±6.13 vs 9.12±8.61,P=0.034;3mo:3.58±3.00 vs 6.37±5.97,P=0.007)and height of SRF(1mo:82.39±39.12 vs 105.77±42.26μm,P=0.011;2mo:36.84±10.02 vs 83.59±37.78μm,P<0.01;3mo:11.57±3.29 vs 45.43±12.60μm,P<0.01)in combined group were statistically significant less than aflibercept group after each injection,while the area of FAZ showed no significant change before and after treatment in both groups.CONCLUSION:The combination therapy of aflibercept and TA shows more significant effects on DME eyes with decreased HRF and SRF.However,both aflibercept and combination therapy show no significant change in the area of FAZ.

Computed tomography for prediction of esophageal variceal bleeding

This letter to the editor relates to the study entitled“The role of computed tomography for the prediction of esophageal variceal bleeding:Current status and future perspectives”.Esophageal variceal bleeding(EVB)is one of the most common and severe complications related to portal hypertension(PH).Despite marked advances in its management during the last three decades,EVB is still associated with significant morbidity and mortality.The risk of first EVB is related to the severity of both PH and liver disease,and to the size and endoscopic appearance of esophageal varices.Indeed,hepatic venous pressure gradient(HVPG)and esophagogastroduodenoscopy(EGD)are currently recognized as the“gold standard”and the diagnostic reference standard for the prediction of EVB,respectively.However,HVPG is an invasive,expensive,and technically complex procedure,not widely available in clinical practice,whereas EGD is mainly limited by its invasive nature.In this scenario,computed tomography(CT)has been recently proposed as a promising modality for the non-invasive prediction of EVB.While CT serves solely as a diagnostic tool and cannot replace EGD or HVPG for delivering therapeutic and physiological information,it has the potential to enhance the prediction of EVB more effectively when combined with liver disease scores,HVPG,and EGD.However,to date,evidence concerning the role of CT in this setting is still lacking,therefore we aim to summarize and discuss the current evidence concerning the role of CT in predicting the risk of EVB.

Tracking the phase transformation and microstructural evolution of Sn anode using operando synchrotron X-ray energy-dispersive diffraction and X-ray tomography

Tin(Sn)holds great promise as an anode material for next-generation lithium(Li)ion batteries but suffers from massive volume change and poor cycling performance.To clarify the dynamic chemical and microstructural evolution of Sn anode during lithiation and delithiation,synchrotron X-ray energydispersive diffraction and X-ray tomography are simultaneously employed during Li/Sn cell operation.The intermediate Li-Sn alloy phases during de/lithiation are identified,and their dynamic phase transformation is unraveled which is further correlated with the volume variation of the Sn at particle-and electrode-level.Moreover,we find that the Sn particle expansion/shrinkage induced particle displacement is anisotropic:the displacement perpendicular to the electrode surface(z-axis)is more pronounced compared to the directions(x-and y-axis)along the electrode surface.This anisotropic particle displacement leads to an anisotropic volume variation at the electrode level and eventually generates a net electrode expansion towards the separator after cycling,which could be one of the root causes of mechanical detachment and delamination of electrodes during long-term operation.The unraveled chemical evolution of Li-Sn and deep insights into the microstructural evolution of Sn anode provided here could guide future design and engineering of Sn and other alloy anodes for high energy density Li-and Na-ion batteries.

Seeing through Materials:X-Ray Imaging Using Computed Tomography

X-ray computed tomography(XCT)has recently emerged as a powerful tool for characterizing the evolution of microstructure during phase transformation in three dimensional(3D)such as dendritic solidification of alloys.This paper briefly reviews the recent advances in the in-situ observation of aluminium alloys,magnesium alloys and nickel-based superalloys during solidification using laboratory XCT and synchrotron X-ray sources.The focus is on the growth kinetics of dendrites,porosity and secondary phases.In addition,in-situ characterization during the loading and corrosion process is also discussed.

Importance of computed tomography in posterior malleolar fractures:Added information to preoperative X-ray studies

BACKGROUND Ankle fractures are common lesions of the lower limbs.Approximately 40%of ankle fractures affect the posterior malleolus(PM).Historically,PM osteosynthesis was recommended when PM size in X-ray images was greater than 25%of the joint.Currently,computed tomography(CT)has been gaining traction in the preoperative evaluation of ankle fractures.AIM To elucidate the similarity in dimensions and to correlate PM size in X-ray images with the articular surface of the affected tibial plafond in the axial view on CT(AXCT)of a PM fracture.METHODS Eighty-one patients(mean age:39.4±13.5 years)were evaluated(54.3%were male).Two independent examiners measured PM size in profile X-ray images(PMXR)and sagittal CT(SAGCT)slices.The correlation of the measurements between the examiners and the difference in the PM fragment sizes between the two images were compared.Next,the PM size in PMXR was compared with the surface of the tibial plafond involved in the fracture in AXCT according to the Haraguchi classification.RESULTS The correlation rates between the examiners were 0.93 and 0.94 for PMXR and SAGCT,respectively(P<0.001).Fragments were 2.12%larger in SAGCT than in PMXR(P=0.018).In PMXR,there were 56 cases<25%and 25 cases≥25%.When PMXR was<25%,AXCT corresponded to 10.13%of the tibial plafond.When PMXR was≥25%,AXCT was 24.52%(P<0.001).According to the Haraguchi classification,fracture types I and II had similar PMXR measurements that were greater than those of type III.When analyzing AXCT,a significant difference was found between the three types,with II>I>III(P<0.001).CONCLUSION PM fractures show different sizes using X-ray or CT images.CT showed a larger PM in the sagittal plane and allowed the visualization of the real dimensions of the tibial plafond surface.

Computed tomography-based nomogram of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction to predict response to docetaxel, oxaliplatin and S-1

BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.

Intravascular photoacoustic and optical coherence tomography imaging dual-mode system for detecting spontaneous coronary artery dissection: A feasibility study

In this work,we present an intravascular dual-mode endoscopic system capable of both intravascular photoacoustic imaging(IVPAI)and intravascular optical coherence tomography(IVOCT)for recognizing spontaneous coronary artery dissection(SCAD)phantoms.IVPAI provides high-resolution and high-penetration images of intramural hematoma(IMH)at different depths,so it is especially useful for imaging deep blood clots associated with imaging phantoms.IVOCT can readily visualize the double-lumen morphology of blood vessel walls to identify intimal tears.We also demonstrate the capability of this dual-mode endoscopic system using mimicking phantoms and biological samples of blood clots in ex vivo porcine arteries.The results of the experiments indicate that the combined IVPAI and IVOCT technique has the potential to provide a more accurate SCAD assessment method for clinical applications.

A deep learning model based on contrast-enhanced computed tomography for differential diagnosis of gallbladder carcinoma

Background:Gallbladder carcinoma(GBC)is highly malignant,and its early diagnosis remains difficult.This study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist radiologists in identifying GBC.Methods:We retrospectively enrolled 278 patients with gallbladder lesions(>10 mm)who underwent contrast-enhanced CT and cholecystectomy and divided them into the training(n=194)and validation(n=84)datasets.The deep learning model was developed based on ResNet50 network.Radiomics and clinical models were built based on support vector machine(SVM)method.We comprehensively compared the performance of deep learning,radiomics,clinical models,and three radiologists.Results:Three radiomics features including LoG_3.0 gray-level size zone matrix zone variance,HHL firstorder kurtosis,and LHL gray-level co-occurrence matrix dependence variance were significantly different between benign gallbladder lesions and GBC,and were selected for developing radiomics model.Multivariate regression analysis revealed that age≥65 years[odds ratios(OR)=4.4,95%confidence interval(CI):2.1-9.1,P<0.001],lesion size(OR=2.6,95%CI:1.6-4.1,P<0.001),and CA-19-9>37 U/mL(OR=4.0,95%CI:1.6-10.0,P=0.003)were significant clinical risk factors of GBC.The deep learning model achieved the area under the receiver operating characteristic curve(AUC)values of 0.864(95%CI:0.814-0.915)and 0.857(95%CI:0.773-0.942)in the training and validation datasets,which were comparable with radiomics,clinical models and three radiologists.The sensitivity of deep learning model was the highest both in the training[90%(95%CI:82%-96%)]and validation[85%(95%CI:68%-95%)]datasets.Conclusions:The deep learning model may be a useful tool for radiologists to distinguish between GBC and benign gallbladder lesions.

Gates joint locally connected network for accurate and robust reconstruction in optical molecular tomography

Optical molecular tomography(OMT)is a potential pre-clinical molecular imaging technique with applications in a variety of biomedical areas,which can provide non-invasive quantitative three-dimensional(3D)information regarding tumor distribution in living animals.The construction of optical transmission models and the application of reconstruction algorithms in traditional model-based reconstruction processes have affected the reconstruction results,resulting in problems such as low accuracy,poor robustness,and long-time consumption.Here,a gates joint locally connected network(GLCN)method is proposed by establishing the mapping relationship between the inside source distribution and the photon density on surface directly,thus avoiding the extra time consumption caused by iteration and the reconstruction errors caused by model inaccuracy.Moreover,gates module was composed of the concatenation and multiplication operators of three different gates.It was embedded into the network aiming at remembering input surface photon density over a period and allowing the network to capture neurons connected to the true source selectively by controlling three different gates.To evaluate the performance of the proposed method,numerical simulations were conducted,whose results demonstrated good performance in terms of reconstruction positioning accuracy and robustness.

Distal-scanning common path probe for optical coherence tomography

In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be able to effectively circumvent polarization and dispersion mismatch caused by fiber motion and is more robust to a variety of interfering factors during the imaging process,experimentally compared to a conventional noncommon path probe.Furthermore,our design counteracts the attenuation of backscattering with depth and the fall-off of the signal,resulting in a more balanced signal range and greater imaging depth.Spectral-domain OCT imaging of phantom and biological tissue is also demonstrated with a sensitivity of∼100dB and a lateral resolution of∼3μm.This low-cost probe offers simplified system configuration and excellent robustness,and is therefore particularly suitable for clinical diagnosis as one-off medical apparatus.

The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[^(18)F]fluoro-D-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology:A single centre retrospective study

Objective:To review the risk of prostate cancer(PCa)in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography(18F-FDG PET/CT)ordered at Department of Urology,The Wesley Hospital,Brisbane,QLD,Australia for non-PCa related pathology.Methods:Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F-FDG PET/CT for non-prostate related conditions was conducted.Men were classified as benign,indeterminate,or malignant depending of the results of prostate-specific antigen(PSA),PSA velocity,biopsy histopathology,and three-Tesla(3 T)multiparametric MRI(mpMRI)Prostate Imaging Reporting and Data System score,or gallium-68-prostate-specific membrane antigen(68Ga-PSMA)PET/CT results.Results:Three percent(273/9122)of men demonstrated 18F-FDG avidity within the prostate.Eighty-five percent(231/273)were further investigated,including with PSA tests(227/231,98.3%),3 T mpMRI(68/231,29.4%),68Ga-PSMA PET/CT(33/231,14.3%),and prostate biopsy(57/231,24.7%).Results were considered benign in 130/231(56.3%),indeterminate in 31/231(13.4%),and malignant in 70/231(30.3%).PCa was identified in 51/57(89.5%)of the men who proceeded to biopsy,including 26/27(96.3%)men with Prostate Imaging Reporting and Data System scores 4-5 mpMRI and six men with a positive 68Ga-PSMA PET/CT.The most common Gleason score on biopsy was greater than or equal to 4+5(14/51,27.5%).68Ga-PSMA PET/CT was concordant with the 18F-FDG findings in 26/33(78.8%).All 13 men with a positive concordant 18F-FDG,3 T mpMRI,and 68Ga-PSMA PET/CT had PCa on biopsy.There was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups(5.7 vs.6.1;p=0.580).Conclusion:In this study,after an incidental finding of an avid intraprostatic lesion on 18F-FDG PET/CT,70 of the 231 cases(30.3%;0.8%of the entire cohort)had results consistent with PCa,most commonly as Gleason score greater than or equal to 4+5 disease.Unless there is limited life expectancy due to competing medical co-morbidity,men with an incidental finding of intraprostatic uptake on 18F-FDG should be further investigated using principles of PCa detection.

Contribution of Computed Tomography to the Diagnosis of Urinary Lithiasis in a West African University Hospital

Introduction: Urinary lithiasis is defining as a condition characterized by the formation of concretions in the kidneys or urinary excretory tract. We aimed to study professional practice in CT urinary lithiasis at CHUYO. Materials and method: This was a descriptive cross-sectional study with retrospective data collection covering 3 years from January 2017 to December 2019. Results: In general, it was noted that CT scans in our environment provide all the elements needed by urologists to diagnose urinary lithiasis and its impact on the urinary system. However, there are shortcomings, particularly in terms of the accuracy of the shape and density of the stones in the CT scan reports, which does not make it easier for urologists to decide on treatment. Conclusion: Computed tomography plays a major role in the diagnosis and therapeutic management of urinary lithiasis, and its use needs to be improved in our context.

Triple-path feature transform network for ring-array photoacoustic tomography image reconstruction

Photoacoustic imaging(PAI)is a noninvasive emerging imaging method based on the photoacoustic effect,which provides necessary assistance for medical diagnosis.It has the characteristics of large imaging depth and high contrast.However,limited by the equipment cost and reconstruction time requirements,the existing PAI systems distributed with annular array transducers are difficult to take into account both the image quality and the imaging speed.In this paper,a triple-path feature transform network(TFT-Net)for ring-array photoacoustic tomography is proposed to enhance the imaging quality from limited-view and sparse measurement data.Specifically,the network combines the raw photoacoustic pressure signals and conventional linear reconstruction images as input data,and takes the photoacoustic physical model as a prior information to guide the reconstruction process.In addition,to enhance the ability of extracting signal features,the residual block and squeeze and excitation block are introduced into the TFT-Net.For further efficient reconstruction,the final output of photoacoustic signals uses‘filter-then-upsample’operation with a pixel-shuffle multiplexer and a max out module.Experiment results on simulated and in-vivo data demonstrate that the constructed TFT-Net can restore the target boundary clearly,reduce background noise,and realize fast and high-quality photoacoustic image reconstruction of limited view with sparse sampling.

Plasma current tomography for HL-2A based on Bayesian inference

An accurate plasma current profile has irreplaceable value for the steady-state operation of the plasma.In this study,plasma current tomography based on Bayesian inference is applied to an HL-2A device and used to reconstruct the plasma current profile.Two different Bayesian probability priors are tried,namely the Conditional Auto Regressive(CAR)prior and the Advanced Squared Exponential(ASE)kernel prior.Compared to the CAR prior,the ASE kernel prior adopts nonstationary hyperparameters and introduces the current profile of the reference discharge into the hyperparameters,which can make the shape of the current profile more flexible in space.The results indicate that the ASE prior couples more information,reduces the probability of unreasonable solutions,and achieves higher reconstruction accuracy.

The diagnostic yield for computed tomography pulmonary angiography in patients with anticoagulation

BACKGROUND:Patients who present to the emergency department(ED)for suspected pulmonary embolism(PE)are often on active oral anticoagulation(AC).However,the diagnostic yield of computed tomography pulmonary angiography(CTPA)in screening for PE in patients who present on AC has not been well characterized.We aim to investigate the diagnostic yield of CTPA in diagnosing PE depending on AC status.METHODS:We reviewed and analyzed the electronic medical records of patients who underwent CTPA for PE at a university hospital ED from June 1,2019,to March 25,2022.Primary outcome was the incidence of PE on CTPA depending on baseline AC status and indication for AC.RESULTS:Of 2,846 patients,242 were on AC for a history of venous thromboembolism(VTE),210 were on AC for other indications,and 2,394 were not on AC.The incidence of PE on CTPA was significantly lower in patients on AC for other indications(5.7%)when compared to patients on AC for prior VTE(24.3%)and patients not on AC at presentation(9.8%)(P<0.001).In multivariable analysis among the whole cohort,AC was associated with a positive CTPA(odds ratio[OR]0.26,95%confidence interval[CI]:0.15-0.45,P<0.001).CONCLUSION:The incidence of PE among patients undergoing CTPA in the ED is lower in patients previously on AC for indications other than VTE when compared to those not on AC or those on AC for history of VTE.AC status and indication for AC may affect pre-test probability of a positive CTPA,and AC status therefore warrants consideration as part of future diagnostic algorithms among patients with suspected PE.

Rim^(18)F-fluorodeoxyglucose uptake of hepatic cavernous hemangioma on positron emission tomography/computed tomography:A case report

BACKGROUND Peripheral FDG accumulation in a hepatic hemangioma presenting in a patient with prolonged fever is rare.Therefore,clinicians should pay close attention to patients with hepatic mass.CASE SUMMARY A 54-year-old woman with a 4-wk history of daily fevers was admitted to our hospital.A whole body^(18)-Fluordesoxyglucose(PET-FDG)positron emission tomography/computed tomography(PET/CT)was performed to elucidate the source of the fever.However,whole body^(18)-FDG PET/CT raised the suspicion of a malignant lesion because of peripheral FDG accumulation(SUVmax 3.5 g/mL)higher than that of the normal liver parenchyma(SUVmax 1.6 g/mL)surrounding a hypoactive area,and no other abnormalities were showed.Subsequently,the patient underwent liver mass resection.Histopathology showed a hepatic cavernous hemangioma with fatty infiltration around the lesion.The fever disappeared four days after surgery and the patient did not present any complications during follow-up.CONCLUSION Fatty infiltration in the peripheral parts of hepatic cavernous hemangioma may lead to subacute inflammation which further activate the Kupffer cells.This may cause prolonged fever and peripheral rim FDG accumulation on PET/CT.

Deep learning-based inpainting of saturation artifacts in optical coherence tomography images

Limited by the dynamic range of the detector,saturation artifacts usually occur in optical coherence tomography(OCT)imaging for high scattering media.The available methods are difficult to remove saturation artifacts and restore texture completely in OCT images.We proposed a deep learning-based inpainting method of saturation artifacts in this paper.The generation mechanism of saturation artifacts was analyzed,and experimental and simulated datasets were built based on the mechanism.Enhanced super-resolution generative adversarial networks were trained by the clear–saturated phantom image pairs.The perfect reconstructed results of experimental zebrafish and thyroid OCT images proved its feasibility,strong generalization,and robustness.

Micro-Computed Tomography Applications in Dentistry

Micro-computed tomography (MCT) encompasses two primary scanning options: ex-vivo and in-vivo imaging. Ex-vivo scanning involves the examination of extracted teeth or dental specimens, allowing for detailed analyses of the microarchitecture of mineralized tissue. By analyzing the microarchitecture of dental tissues, MCT can provide valuable information about bone density, porosity, and microstructural changes, contributing to a better understanding of disease progression and treatment outcomes. Moreover, MCT facilitates the quantification of dental parameters, such as bone volume, trabecular thickness, and connectivity density, which are crucial for evaluating the efficacy of dental interventions. This present study aims to comprehensively review and explore the applications of MCT in dentistry and highlight its potential in advancing research and clinical practice. The results depicted that the quantitative approach of MCT enhances the precision and reliability of dental research. Researchers and clinicians can make evidence-based decisions regarding treatment strategies and patient management, relying on quantifiable data provided by MCT. The applications of MCT in dentistry extend beyond research, with potential clinical implications in fields such as dental implantology and endodontics. MCT is expected to play an increasingly significant role in enhancing our understanding of dental pathologies, improving treatment outcomes, and ultimately, benefiting patient care in the field of dentistry.

The 2023 Turkey earthquake doublet: Earthquake relocation, seismic tomography, and stress field inversion

On February 6,2023,two earthquakes with magnitudes of M_(W) 7.8 and M_(W) 7.5 struck southeastern Turkey,causing significant casualties and economic losses.These seismic events occurred along the East Anatolian Fault Zone,a convergent boundary between the Arabian Plate and the Anatolian Subplate.In this study,we analyze the M_(W) 7.8 and M_(W) 7.5 earthquakes by comparing their aftershock relocations,tomographic images,and stress field inversions.The earthquakes were localized in the upper crust and exhibited steep dip angles.Furthermore,the aftershocks occurred either close to the boundaries of low and high P-wave velocity anomaly zones or within the low P-wave velocity anomaly zones.The East Anatolia Fault,associated with the M_(W) 7.8 earthquake,and the SürgüFault,related to the M_(W) 7.5 earthquake,predominantly experienced shear stress.However,their western sections experienced a combination of strike-slip and tensile stresses in addition to shear stress.The ruptures of the M_(W) 7.8 and M_(W) 7.5 earthquakes appear to have bridged a seismic gap that had seen sparse seismicity over the past 200 years prior to the 2023 Turkey earthquake sequence.