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Kiani P, Vatankhahan H, Zare-Hoseinabadi A, Ferdosi F, Ehtiati S, Heidari P, Dorostgou Z, Movahedpour A, Baktash A, Rajabivahid M, Khatami SH. Electrochemical biosensors for early detection of breast cancer. Clin Chim Acta 2025; 564:119923. [PMID: 39153652 DOI: 10.1016/j.cca.2024.119923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
Breast cancer continues to be a significant contributor to global cancer deaths, particularly among women. This highlights the critical role of early detection and treatment in boosting survival rates. While conventional diagnostic methods like mammograms, biopsies, ultrasounds, and MRIs are valuable tools, limitations exist in terms of cost, invasiveness, and the requirement for specialized equipment and trained personnel. Recent shifts towards biosensor technologies offer a promising alternative for monitoring biological processes and providing accurate health diagnostics in a cost-effective, non-invasive manner. These biosensors are particularly advantageous for early detection of primary tumors, metastases, and recurrent diseases, contributing to more effective breast cancer management. The integration of biosensor technology into medical devices has led to the development of low-cost, adaptable, and efficient diagnostic tools. In this framework, electrochemical screening platforms have garnered significant attention due to their selectivity, affordability, and ease of result interpretation. The current review discusses various breast cancer biomarkers and the potential of electrochemical biosensors to revolutionize early cancer detection, making provision for new diagnostic platforms and personalized healthcare solutions.
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Affiliation(s)
- Pouria Kiani
- Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Vatankhahan
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Zare-Hoseinabadi
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Felora Ferdosi
- Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sajad Ehtiati
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parasta Heidari
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zahra Dorostgou
- Department of Biochemistry, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
| | | | - Aria Baktash
- Department of Medicine, Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Mansour Rajabivahid
- Department of Internal Medicine, Valiasr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Seyyed Hossein Khatami
- Student Research Committee, Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Alzaabi AN, Chaggar G, Hussain MW, Daniels VJ, Beecher G. Education Research: Feasibility, Reliability and Educational Value of Neuromuscular Ultrasound Training in a Canadian Neurology Residency Program: A Pilot Study. NEUROLOGY. EDUCATION 2024; 3:e200166. [PMID: 39391798 PMCID: PMC11466532 DOI: 10.1212/ne9.0000000000200166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 09/06/2024] [Indexed: 10/12/2024]
Abstract
Background and Objectives Point-of-care neuromuscular ultrasound (NMUS) is increasingly used in the evaluation of peripheral nervous system disorders; however, there remains a gap in education and training for neurology residents. We evaluated whether neurology residents can feasibly be trained in basic NMUS skills and nerve cross-sectional area (CSA) measurement and whether they value incorporation of this training into their curriculum. Methods Participants included neurology residents (postgraduate years 1-5) at the University of Alberta (Edmonton, Alberta, Canada). All completed pretraining and posttraining surveys using a Likert scale, rating their confidence in independently performing NMUS and their degree of agreement regarding the educational value of NMUS training. Residents underwent training (7 hours) comprising 1 didactic and 2 hands-on sessions, detailing NMUS of median, ulnar, and fibular nerves. Participants could then opt-in to a posttraining testing session where CSA measurements (mm2) of the median, ulnar, and fibular nerve at multiple sites were independently performed on 3 healthy volunteers and compared with measurements obtained by the trainer. Results Eighteen residents participated in training and pretraining/posttraining surveys. Nine completed the testing component. Nerve CSA measurement reliability between the trainer and trainees across all nerve sites combined was very good (intraclass correlation coefficient [ICC] 0.93, 95% CI 0.83-0.96) but varied by nerve and site. ICC was good to very good (0.62-0.95) except for the ulnar nerve-distal forearm/wrist (0.39-0.58) and fibular nerve-fibular head (0.12) sites. The coefficient of variation (CoV) across all sites was 19.6% (95% CI 17.3-21.8) and best for the median nerve-wrist site at 15.5% (9.8-20.8). The mean absolute difference between trainer and trainee measurements was low (<0.5 mm2 across all sites). Comparing pretraining and posttraining survey responses, there was a significant increase in agreement that basic NMUS operational skills were obtained and in confidence in independently measuring each nerve. NMUS training was considered a valuable component of a neurology residency program curriculum (median rating: strongly agree). Discussion Neurology residents across stages of training can acquire basic NMUS and CSA measurement skills of the median and ulnar nerves after 2 half-days of training and value incorporation of NMUS training in their educational curriculum.
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Affiliation(s)
- Ahmed N Alzaabi
- From the Division of Neurology, Department of Medicine (A.N.A., G.C., M.W.H., G.B.), Department of Medicine (V.J.D.), and Neuroscience and Mental Health Institute (NMHI) (G.B.), University of Alberta, Edmonton, Canada
| | - Gurpreet Chaggar
- From the Division of Neurology, Department of Medicine (A.N.A., G.C., M.W.H., G.B.), Department of Medicine (V.J.D.), and Neuroscience and Mental Health Institute (NMHI) (G.B.), University of Alberta, Edmonton, Canada
| | - Mohammed Wasif Hussain
- From the Division of Neurology, Department of Medicine (A.N.A., G.C., M.W.H., G.B.), Department of Medicine (V.J.D.), and Neuroscience and Mental Health Institute (NMHI) (G.B.), University of Alberta, Edmonton, Canada
| | - Vijay J Daniels
- From the Division of Neurology, Department of Medicine (A.N.A., G.C., M.W.H., G.B.), Department of Medicine (V.J.D.), and Neuroscience and Mental Health Institute (NMHI) (G.B.), University of Alberta, Edmonton, Canada
| | - Grayson Beecher
- From the Division of Neurology, Department of Medicine (A.N.A., G.C., M.W.H., G.B.), Department of Medicine (V.J.D.), and Neuroscience and Mental Health Institute (NMHI) (G.B.), University of Alberta, Edmonton, Canada
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Feng YT, Pei JY, Wang YP, Feng XF. Association between depression and vascular aging: a comprehensive analysis of predictive value and mortality risks. J Affect Disord 2024; 367:632-639. [PMID: 39216647 DOI: 10.1016/j.jad.2024.08.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/17/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Depression is a significant global health concern, projected to become the leading disease burden. Vascular burden has been implicated in the pathogenesis of depression. Conversely, whether depression independently influences the process of vascular aging is unknown. This study aims to investigate the mutual relationship between vascular age and depression. METHODS Utilizing data from the National Health and Nutrition Examination Survey (NHANES), the study included 27,764 participants after exclusions. Depression was assessed using the Patient Health Questionnaire (PHQ-9). Vascular aging was assessed by estimated pulse wave velocity (ePWV) and the heart age/vascular age (HVA) based on Framingham Risk Score (FRS). The study employed weighted logistic regression and Cox proportional hazards models to analyze the association between vascular age and depression as well as its mortality risk. Mendelian randomization was utilized to explore the causal associations. RESULTS Individuals with depression exhibited a higher risk of an advanced vascular age over their chronological age. Mendelian randomization analysis indicated a causal relationship between depression and arterial stiffness. A significant association was found between vascular age and depression incidence with odds ratios ranging from 1.10 to 1.38. As vascular age increased, the risk of mortality in individuals with depression increased by 22 % and 46 %, respectively. LIMITATIONS The study design limits the exploration of the dynamic relationship between changes in vascular age and depression due to the single timepoint measurement. CONCLUSION This study highlights the bidirectional relationship between depression and vascular age. Vascular age is a significant biomarker for the risk and prognosis of depression, while depression may contribute to vascular aging, which underscores the importance of integrated strategies for managing both vascular health and depression.
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Affiliation(s)
- Yun-Tao Feng
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Jing-Yin Pei
- School of Computer, Electronics and Information, Guangxi University, Nanning 530004, China
| | - Yue-Peng Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
| | - Xiang-Fei Feng
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
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Xu J, Du X, Zhang S, Zang X, Xiao Z, Su R, Huang X, Liu L. Diagnostic value of uric acid to high-density lipoprotein cholesterol ratio in abdominal aortic aneurysms. Ann Med 2024; 56:2357224. [PMID: 38779715 PMCID: PMC11123539 DOI: 10.1080/07853890.2024.2357224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/05/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Abdominal aortic aneurysm (AAA) is highly lethal upon onset of acute aortic diseases (AAD) or rupture. Dyslipidaemia and hyperuricaemia are important risk factors for the development of AAA and AAD as well as aortic disease-related death. The aim of this study was to explore whether uric acid (UA) to high-density lipoprotein cholesterol (HDL-C) ratio (UHR) can be used as an independent predictor of the presence of AAA or AAD. METHODS Three hundred subjects, including 100 AAA patients (AAA group), 100 AAD patients (AAD group) and 100 controls (CON group), were recruited in this study. UHR and other serum samples were obtained upon the patients' admission before any medical treatment. The optimal cut-off points of UHR were determined using receiver operating characteristic (ROC) curve analysis. RESULTS The UHR in AAA group was significantly higher than that in CON group, but there was no significant difference between AAD group and CON group. The optimal cut-off point of UHR for AAA was 7.78 (sensitivity 84.7%, specificity 62.4%, and AUC 0.811; p < 0.001), and UHR (OR: 1.122, 95%CI: 1.064-1.184; p < 0.001) was found to be an independent factor for predicting AAA after adjusting for traditional AAA risk factor. CONCLUSION UHR can be widely used in clinical practice as an auxiliary tool for screening AAA. The optimal cut-off point for UHR to AAA was determined for the first time in Chinese subjects.
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Affiliation(s)
- Jin Xu
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
| | - Xiao Du
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shilan Zhang
- Department of Cardiovascular Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine
| | - Xueyan Zang
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
| | - Zixi Xiao
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
| | - Rongkai Su
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
| | - Xiadie Huang
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
| | - Ling Liu
- Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Hunan, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Hunan, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Hunan, China
- Cardiovascular Disease Research Center of Hunan Province, Hunan, China
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Zhou X, Daniel BL, Hargreaves BA, Lee PK. Distortion-free water-fat separated diffusion-weighted imaging using spatiotemporal joint reconstruction. Magn Reson Med 2024; 92:2343-2357. [PMID: 39051729 DOI: 10.1002/mrm.30221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/03/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE Diffusion-weighted imaging (DWI) suffers from geometric distortion and chemical shift artifacts due to the commonly used Echo Planar Imaging (EPI) trajectory. Even with fat suppression in DWI, severe B0 and B1 variations can result in residual fat, which becomes both a source of image artifacts and a confounding factor in diffusion-weighted contrast in distinguishing benign and malignant tissues. This work presents a method for acquiring distortion-free diffusion-weighted images using spatiotemporal acquisition and joint reconstruction. Water-fat separation is performed by chemical-shift encoding. METHODS Spatiotemporal acquisition is employed to obtain distortion-free images at a series of echo times. Chemical-shift encoding is used for water-fat separation. Reconstruction and separation are performed jointly in the spat-spectral domain. To address the shot-to-shot motion-induced phase in DWI, an Fast Spin Echo (FSE)-based phase navigator is incorporated into the sequence to obtain distortion-free phase information. The proposed method was validated in phantoms and in vivo for the brain, head and neck, and breast. RESULTS The proposed method enables the acquisition of distortion-free diffusion-weighted images in the presence of B0 field inhomogenieties commonly observed in the body. Water and fat components are separated with no obvious spectral leakage artifacts. The estimated Apparent Diffusion Coefficient (ADC) is comparable to that of multishot DW-EPI. CONCLUSION Distortion-free, water-fat separated diffusion-weighted images in body can be obtained through the utilization of spatiotemporal acquisition and joint reconstruction methods.
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Affiliation(s)
- Xuetong Zhou
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Bruce L Daniel
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Philip K Lee
- Department of Radiology, Stanford University, Stanford, California, USA
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Liu Y, Teng J, Mei J, Chen C, Xu QQ, Zhou C, Deng KL, Wang HW. Analysis of airway structural parameters in Han Chinese adults: a prospective cross-sectional study. Ann Med 2024; 56:2316258. [PMID: 38364214 PMCID: PMC10878341 DOI: 10.1080/07853890.2024.2316258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/13/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Establishing reference ranges for central airway parameters and exploring their influencing factors in Han Chinese non-smoking adults. METHODS This prospective cross-sectional study was conducted on Han Chinese non-smoking adults who underwent chest CT scans at the Tongzhou Campus of Dongzhimen Hospital Affiliated with the Beijing University of Chinese Medicine between September 2022 and November 2022. The SYNAPSE 3D image analysis software was utilized, enabling the extraction of critical parameters such as central airway length, airway wall thickness (AWT), airway lumen area (ALA), and subcarinal angle (SCA). Pearson's correlation coefficient analysis and multiple linear regression analysis methods were employed to evaluate the relationship between central airway parameters and age, sex, weight, and height. RESULTS The study encompassed 888 Han Chinese non-smoking adults, comprising 456 females and 432 males. Significant sex differences were noted in central airway length, AWT, and ALA, with measurements in males exceeding those in females (p < 0.01) with no significant difference in SCA. Correlation analyses unveiled relationships between central airway parameters and age, sex, weight, and height. During multiple linear regression analyses, no conclusive evidence emerged to demonstrate the independent or combined explanatory or predictive capacity of the aforementioned variables for central airway length and SCA. Although sex has a significant impact on AWT and ALA, its capability in explanation or prediction remains limited. The conclusions drawn from the primary analysis receive reinforcement from the outcomes of sensitivity analyses. CONCLUSION Establishing the distribution range of central airway parameters in non-smoking Han Chinese adults. It observed significant sex differences in these parameters, except for the SCA. However, the study found that the predictive or explanatory power of age, sex, weight, and height for central airway parameters was either limited or non-significant.
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Affiliation(s)
- Yan Liu
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jun Teng
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Jian Mei
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chao Chen
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qian-qian Xu
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cui Zhou
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Quality Control Office, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kang-li Deng
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-wu Wang
- Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Abstract
PURPOSE OF REVIEW 3D cone beam imaging (CBCT) has allowed clinicians to better understand the anatomical variations of cranial anatomy. One crucial aspect of this technology plays is the understanding of alveolar bone morphology and remodeling. Variations in cortical bone thickness between individuals have been reported. No published study has analyzed the relationship between cortical bone thickness and rate of tooth movement. The aim of this study is to begin answering the question: is there an association between rate of tooth movement and cortical bone thickness? RECENT FINDINGS Twenty-three patients underwent extraction of a single premolar in each of the four quadrants prior to orthodontic therapy. Routine clinical records including 3D CBCT images were acquired of all patients prior to first premolar extractions. Rate of tooth movement in each quadrant for each patient was determined via mesiodistal millimetric measurements obtained by a single calibrated operator. With CBCT images, cortical bone thickness was measured at various levels from the alveolar crest along the long axis of the to-be-extracted first premolars. The association between cortical bone thickness and rate of tooth movement was analyzed. Statistically significant associations were found between rate of tooth movement and cortical bone thickness at levels 2 mm, 5 mm, and 8 mm, apical to the alveolar crest in both the right and left maxillary quadrants (p < 0.05). Statistically significant associations were found between rate of tooth movement and cortical bone thickness at levels 5 mm and 8 mm apical to the alveolar crest in both mandibular quadrants (p < 0.05). Increased cortical bone thickness was associated with decreased rate of tooth movement. There was no statistically significant association between rate of tooth movement and cortical bone thickness 2 mm apical to the alveolar crest of the to-be-extracted first premolars in the mandibular left nor right quadrants (p > 0.05). Results suggest an inverse relationship may exist between cortical bone thickness and rate of tooth movement in both the maxilla and mandible. Cortical bone thickness may have the potential to serve as a predictive tool for rate of orthodontic tooth movement.
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Affiliation(s)
- Chung How Kau
- Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - David A Cruz Wilma
- Structural Genomics Consortium, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
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Hannum AJ, Cork TE, Setsompop K, Ennis DB. Phase stabilization with motion compensated diffusion weighted imaging. Magn Reson Med 2024; 92:2312-2327. [PMID: 38997801 PMCID: PMC11444045 DOI: 10.1002/mrm.30218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/03/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE Diffusion encoding gradient waveforms can impart intra-voxel and inter-voxel dephasing owing to bulk motion, limiting achievable signal-to-noise and complicating multishot acquisitions. In this study, we characterize improvements in phase consistency via gradient moment nulling of diffusion encoding waveforms. METHODS Healthy volunteers received neuro (N = 10 $$ N=10 $$ ) and cardiac (N = 10 $$ N=10 $$ ) MRI. Three gradient moment nulling levels were evaluated: compensation for position (M 0 $$ {M}_0 $$ ), position + velocity (M 1 $$ {M}_1 $$ ), and position + velocity + acceleration (M 1 + M 2 $$ {M}_1+{M}_2 $$ ). Three experiments were completed: (Exp-1) Fixed Trigger Delay Neuro DWI; (Exp-2) Mixed Trigger Delay Neuro DWI; and (Exp-3) Fixed Trigger Delay Cardiac DWI. Significant differences (p < 0 . 05 $$ p<0.05 $$ ) of the temporal phase SD between repeated acquisitions and the spatial phase gradient across a given image were assessed. RESULTS M 0 $$ {M}_0 $$ moment nulling was a reference for all measures. In Exp-1, temporal phase SD forG z $$ {G}_z $$ diffusion encoding was significantly reduced withM 1 $$ {M}_1 $$ (35% of t-tests) andM 1 + M 2 $$ {M}_1+{M}_2 $$ (68% of t-tests). The spatial phase gradient was reduced in 23% of t-tests forM 1 $$ {M}_1 $$ and 2% of cases forM 1 + M 2 $$ {M}_1+{M}_2 $$ . In Exp-2, temporal phase SD significantly decreased withM 1 + M 2 $$ {M}_1+{M}_2 $$ gradient moment nulling only forG z $$ {G}_z $$ (83% of t-tests), but spatial phase gradient significantly decreased with onlyM 1 $$ {M}_1 $$ (50% of t-tests). In Exp-3,M 1 + M 2 $$ {M}_1+{M}_2 $$ gradient moment nulling significantly reduced temporal phase SD and spatial phase gradients (100% of t-tests), resulting in less signal attenuation and more accurate ADCs. CONCLUSION We characterized gradient moment nulling phase consistency for DWI. Using M1 for neuroimaging and M1 + M2 for cardiac imaging minimized temporal phase SDs and spatial phase gradients.
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Affiliation(s)
- Ariel J Hannum
- Department of Radiology, Stanford University, Stanford, California, USA
- Division of Radiology, Veterans Administration Health Care System, Palo Alto, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Tyler E Cork
- Department of Radiology, Stanford University, Stanford, California, USA
- Division of Radiology, Veterans Administration Health Care System, Palo Alto, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Kawin Setsompop
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Stanford, California, USA
- Division of Radiology, Veterans Administration Health Care System, Palo Alto, California, USA
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Lodeiro G, Bokwa-Dąbrowska K, Miron A, Szaro P. Impact of diffusion-weighted imaging on agreement between radiologists and non-radiologist in musculoskeletal tumor imaging using magnetic resonance. Eur J Radiol Open 2024; 13:100590. [PMID: 39104462 PMCID: PMC11298833 DOI: 10.1016/j.ejro.2024.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 08/07/2024] Open
Abstract
Background Diffusion-weighted imaging (DWI) is widely used in neuroradiology or abdominal imaging but not yet implemented in the diagnosis of musculoskeletal tumors. Aim This study aimed to evaluate how including diffusion imaging in the MRI protocol for patients with musculoskeletal tumors affects the agreement between radiologists and non-radiologist. Methods Thirty-nine patients with musculoskeletal tumors (Ewing sarcoma, osteosarcoma, and benign tumors) consulted at our institution were included. Three raters with different experience levels evaluated examinations blinded to all clinical data. The final diagnosis was determined by consensus. MRI examinations were split into 1) conventional sequences and 2) conventional sequences combined with DWI. We evaluated the presence or absence of diffusion restriction, solid nature, necrosis, deep localization, and diameter >4 cm as known radiological markers of malignancy. Agreement between raters was evaluated using Gwet's AC1 coefficients and interpreted according to Landis and Koch. Results The lowest agreement was for diffusion restriction in both groups of raters. Agreement among all raters ranged from 0.51 to 0.945, indicating moderate to almost perfect agreement, and 0.772-0.965 among only radiologists indicating substantial to almost perfect agreement. Conclusion The agreement in evaluating diffusion-weighted MRI sequences was lower than that for conventional MRI sequences, both among radiologists and non-radiologist and among radiologists alone. This indicates that assessing diffusion imaging is more challenging, and experience may impact the agreement.
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Affiliation(s)
- Gustav Lodeiro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katarzyna Bokwa-Dąbrowska
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andreia Miron
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Xie Y, Huang Y, Hossack JA. SELFNet: Denoising Shear Wave Elastography Using Spatial-temporal Fourier Feature Networks. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1821-1833. [PMID: 39317627 PMCID: PMC11490379 DOI: 10.1016/j.ultrasmedbio.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/31/2024] [Accepted: 08/05/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVE Ultrasound-based shear wave elastography offers estimation of tissue stiffness through analysis of the propagation of a shear wave induced by a stimulus. Displacement or velocity fields during the process can contain noise as a result of the limited number of acquisitions. With advances in physics-informed deep learning, neural networks can approximate a physics field by minimizing the residuals of governing physics equations. METHODS In this research, we introduce a shear wave elastography Fourier feature network (SELFNet) using spatial-temporal random Fourier features within a physics-informed neural network framework to estimate and denoise particle displacement signals. The network uses a sparse mapping to increase robustness and incorporates the governing equations for regularization while simultaneously learning the mapping of the shear modulus. The method was evaluated in datasets from tissue-mimicking phantom of lesions and ex vivo tissue. RESULTS The findings indicate that SELFNet is capable of smoothing out the noise in phantom lesions with different stiffness and sizes, outperforming a reference Gaussian filtering method by 17% in relative ℓ2 error, 45% in reconstruction root-mean-square error. Furthermore, the ablation study suggested that SELFNet can prevent over-fitting through the Fourier feature mapping module. An ex vivo study confirmed its applicability to different types of tissue. CONCLUSION The implementation of SELFNet shows promise for shear wave elastography with limited acquisitions. In this context, subject to successful translation, it has the potential to be extended to clinical applications, such as the diagnosis of cancer or liver disease.
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Affiliation(s)
- Yanjun Xie
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Yi Huang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - John A Hossack
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
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11
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Cushman CJ, Ibrahim AF, Callahan T. Large gastroduodenal artery pseudoaneurysm and arterioportal fistula in chronic pancreatitis. Radiol Case Rep 2024; 19:5612-5618. [PMID: 39296759 PMCID: PMC11406347 DOI: 10.1016/j.radcr.2024.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 09/21/2024] Open
Abstract
Visceral artery pseudoaneurysms, particularly those in the gastroduodenal artery (GDA), are rare but serious complications associated with chronic pancreatitis, posing a significant risk of rupture due to their structural fragility. In this case, a 61-year-old male with a history of chronic pancreatitis, alcohol cirrhosis, duodenal ulcer, and COPD presented with persistent abdominal pain and recurrent fevers. Imaging revealed a 7 cm pseudoaneurysm between the GDA and superior mesenteric vein, which was successfully treated with coil embolization. This case highlights the importance of prompt recognition and intervention in managing GDA pseudoaneurysms, particularly when complicated by an arterioportal fistula, and demonstrates the efficacy of endovascular therapy as a minimally invasive treatment option that can significantly improve patient outcomes in complex vascular complications associated with chronic pancreatitis.
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Affiliation(s)
- Caroline J Cushman
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Andrew F Ibrahim
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Thomas Callahan
- Department of Interventional Radiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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12
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Hashim HT, Alhatemi AQM, Al-Obaidi AD, Al-Fatlawi N, Almusawi M, Al-Ghuraibawi MA, Al-Obiade R, Sulaiman FA, Al-Obaidi MN, Al-Awad A. Pulmonary hydatid cyst emergence post laparoscopic ovarian drilling in a clear preoperative chest: A novel case report. Radiol Case Rep 2024; 19:6542-6546. [PMID: 39391036 PMCID: PMC11465097 DOI: 10.1016/j.radcr.2024.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 10/12/2024] Open
Abstract
Echinococcus granulosus is the parasite that causes hydatid disease. The liver is the most often affected organ, followed by the lungs and other organs. We present the case of a 24-year-old woman who had no notable medical history prior to the presentation of a persistent cough and mild chest discomfort 3 weeks after laparoscopic ovarian drilling surgery. There were upper lobe opacities on the right side of the chest X-ray. Serology was used to confirm the diagnosis of a hydatid cyst, with computed tomography (CT) providing additional supporting evidence. This case demonstrated that, especially in endemic areas, patients presenting with atypical respiratory symptoms should have rare infectious etiologies taken into consideration during the postoperative period. After the cyst was successfully surgically removed, the patient received albendazole for antiparasitic treatment. She experienced an uneventful recovery and exhibited no clinical symptoms at follow-up.
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Affiliation(s)
- Hashim Talib Hashim
- Research Department, University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq
| | | | | | - Nabeel Al-Fatlawi
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | - Mustafa Almusawi
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | - Reem Al-Obiade
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | | | - Abdullah Al-Awad
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
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13
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Al Mazrouai RA, Al Shizawi A, Al Qassabi B, Al Aghbari S. Pseudoaneurysm formation following core needle biopsy in a patient diagnosed with breast cancer: A case report. Radiol Case Rep 2024; 19:5858-5862. [PMID: 39314662 PMCID: PMC11418121 DOI: 10.1016/j.radcr.2024.08.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 08/17/2024] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
Core needle biopsy is a common diagnostic procedure in breast cancer patients, but it can occasionally lead to serious complications. We report a rare case of pseudoaneurysm formation following a core needle biopsy in a 54-year-old female patient diagnosed with breast cancer. Despite the routine nature of the procedure, the patient developed a palpable mass at the biopsy site, which prompted further diagnostic imaging and interventions. The pseudoaneurysm was effectively treated using a percutaneous approach with ultrasound-guided thrombin injection, demonstrating a minimally invasive solution that promptly addressed the complication without the need for surgical intervention. This case highlights the critical importance of detecting complications early in the biopsy process, as they have significant implications for disease staging and treatment initiation. It also underscores the importance of being prepared for immediate intervention in case of biopsy-related complications like pseudoaneurysms, to prevent severe consequences.
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Affiliation(s)
| | | | - Badriya Al Qassabi
- Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Oman, Muscat
| | - Suaad Al Aghbari
- Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Oman, Muscat
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14
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Di Ludovico A, La Bella S, Ciarelli F, Chiarelli F, Breda L, Mohn A. Skeletal muscle as a pro- and anti-inflammatory tissue: insights from children to adults and ultrasound findings. J Ultrasound 2024; 27:769-779. [PMID: 38907089 DOI: 10.1007/s40477-024-00917-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/11/2024] [Indexed: 06/23/2024] Open
Abstract
Previously regarded as a movement and posture control agent, the skeletal muscle is now recognized as an endocrine organ that may affect systemic inflammation and metabolic health. The discovery of myokines such as IL-6, released from skeletal muscle in response to physical exercise, is now one of the most recent insights. Myokines are the mediators of the balance between the pro-inflammatory and anti-inflammatory responses. This underscores the muscle function as a determinant of good health and prevention of diseases. Advances in ultrasound technology improved evaluation of muscle thickness, composition, and determining fat distribution. Combining imaging with molecular biology, researchers discovered the complicated interplay between muscle function, cytokine production and general health effects.The production of myokines with exercise showcasing the adaptability of muscles to high-stress conditions and contributing to metabolism and inflammation regulation. These findings have significant implications in order to provide improvement in metabolic and inflammatory diseases.
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Affiliation(s)
| | | | | | | | - Luciana Breda
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Angelika Mohn
- Department of Pediatrics, University of Chieti, Chieti, Italy
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15
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Damani A, Nathe C, Thomas P, Van Brummen A, Rezaei KA, Feng S. Use of a handheld ultrasound device for detecting orbital inflammation. Am J Ophthalmol Case Rep 2024; 36:102160. [PMID: 39290998 PMCID: PMC11405627 DOI: 10.1016/j.ajoc.2024.102160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/06/2024] [Accepted: 08/29/2024] [Indexed: 09/19/2024] Open
Abstract
Purpose Orbital inflammatory disease has been historically diagnosed with computed tomography (CT) and magnetic resonance imaging (MRI). Orbital ultrasound has served as a non-radiation alternative that has been successful at diagnosing many orbital pathologies but is not commonly used in clinical practice due to need for specialized ultrasound training and equipment needs. We demonstrate use of handheld ultrasound for detecting orbital inflammation. Observations We present five patients with orbital inflammation where a handheld ultrasound probe was able to capture features consistent with concurrent CT scans. Conclusions and importance Handheld ultrasound is an accessible and portable method that can assist in the diagnosis and monitoring of orbital pathology.
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Affiliation(s)
- Aashka Damani
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
| | - Connor Nathe
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
| | - Preston Thomas
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
| | - Alexa Van Brummen
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
| | - Kasra Attaran Rezaei
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
| | - Shu Feng
- Department of Ophthalmology, University of Washington, 325 9th Ave Box 359608, Seattle, WA, USA
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16
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Dong X, Chen G, Zhu Y, Ma B, Ban X, Wu N, Ming Y. Artificial intelligence in skeletal metastasis imaging. Comput Struct Biotechnol J 2024; 23:157-164. [PMID: 38144945 PMCID: PMC10749216 DOI: 10.1016/j.csbj.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/26/2023] Open
Abstract
In the field of metastatic skeletal oncology imaging, the role of artificial intelligence (AI) is becoming more prominent. Bone metastasis typically indicates the terminal stage of various malignant neoplasms. Once identified, it necessitates a comprehensive revision of the initial treatment regime, and palliative care is often the only resort. Given the gravity of the condition, the diagnosis of bone metastasis should be approached with utmost caution. AI techniques are being evaluated for their efficacy in a range of tasks within medical imaging, including object detection, disease classification, region segmentation, and prognosis prediction in medical imaging. These methods offer a standardized solution to the frequently subjective challenge of image interpretation.This subjectivity is most desirable in bone metastasis imaging. This review describes the basic imaging modalities of bone metastasis imaging, along with the recent developments and current applications of AI in the respective imaging studies. These concrete examples emphasize the importance of using computer-aided systems in the clinical setting. The review culminates with an examination of the current limitations and prospects of AI in the realm of bone metastasis imaging. To establish the credibility of AI in this domain, further research efforts are required to enhance the reproducibility and attain robust level of empirical support.
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Affiliation(s)
- Xiying Dong
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing 100730, China
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing, China
| | - Guilin Chen
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing 100730, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Yuanpeng Zhu
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing 100730, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Boyuan Ma
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
| | - Xiaojuan Ban
- School of Intelligence Science and Technology, University of Science and Technology Beijing, Beijing, China
| | - Nan Wu
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
- Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing 100730, China
- Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing 100730, China
| | - Yue Ming
- Department of Nuclear Medicine (PET-CT Center), National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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17
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Otero Sanchez L, Moreno C. Noninvasive Tests in Assessment of Patients with Alcohol-Associated Liver Disease. Clin Liver Dis 2024; 28:715-729. [PMID: 39362717 DOI: 10.1016/j.cld.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Alcohol-associated liver disease (ALD) remains a significant public health concern, accounting for at least half of cirrhosis cases in Europe. Historically, liver biopsy has been considered the gold standard method for both diagnosing and staging ALD. However, in the past 3 decades, there has been a growing interest in developing noninvasive biomarkers for identifying high-risk patients prone to develop liver-related complications, including elastography methods or blood-based biomarkers. This review aims to summarize currently available noninvasive testing methods that are clinically available for assessing patients with ALD, including notably steatosis and fibrosis.
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Affiliation(s)
- Lukas Otero Sanchez
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Universitaire de Bruxelles, C.U.B. Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium.
| | - Christophe Moreno
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Universitaire de Bruxelles, C.U.B. Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium.
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18
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Mukund A, Kubihal V, Kumar N, Pandey Y, Vashistha C, Patidar Y, Sarin SK. Budd Chiari Syndrome: Radiological Aspects of the Disease Pertaining to Infertility and Role of Interventional Radiology in Successful Conception. J Clin Exp Hepatol 2024; 14:101473. [PMID: 39070155 PMCID: PMC11283212 DOI: 10.1016/j.jceh.2024.101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 06/19/2024] [Indexed: 07/30/2024] Open
Abstract
Background/Aims To study the association of infertility in patients with Budd Chiari syndrome, radiological aspects of the disease determining infertility and to see if there are improved chances of conception following radiological intervention. Methods Retrospective search of the hospital records was done and patients with Budd Chiari syndrome, who underwent radiological intervention between January 2016 till October 2021 were initially included. Patients outside the reproductive age group, unmarried patients, patients who did not attempt conception or attempted for less than 1 year and patients having other causes of infertility were excluded. 90 patients were assessed for presence of primary or secondary infertility using infertility questionnaire. In patients with infertility, conception during 1-year follow-up period following radiological intervention, was assessed. Results 146 patients underwent radiological intervention for Budd Chiari syndrome in the study period. 56 patients meeting the exclusion criteria were excluded from the study and subsequently 90 patients were assessed for infertility. 16.7% (15/90) of our patients with Budd Chiari syndrome had infertility, of which 7 were male, and 8 were female. Infertility is more common in younger age group (mean - 28.8 ± 4.2 years) (P < 0.001). In females, presence of pelvic venous congestion on preprocedural imaging showed significant association with infertility (P < 0.001). 6 (40%) out of 15 of patients with infertility conceived during a 1-year follow-up period after radiological intervention. Conclusion Infertility is a common in patients with Budd Chiari syndrome, with a prevalence of 16.7%. Pelvic venous congestion is associated with women having infertility. Radiological interventions play important role in management of Budd Chiari and may help to overcome infertility in these patients.
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Affiliation(s)
- Amar Mukund
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
| | - Vijay Kubihal
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
| | - Niraj Kumar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
| | - Yasha Pandey
- Indira IVF Fertility Center, New Delhi 110008, India
| | - Chitranshu Vashistha
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
| | - Yashwant Patidar
- Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India
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19
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Hu H, Hu X, Liang Z, Yang W, Li S, Li D, Cai J. Diagnostic performance of 18F‑FDG PET/CT vs. 18F‑NaF PET/CT in breast cancer with bone metastases: An indirect comparative meta‑analysis. Oncol Lett 2024; 28:546. [PMID: 39319212 PMCID: PMC11420642 DOI: 10.3892/ol.2024.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/20/2024] [Indexed: 09/26/2024] Open
Abstract
Breast cancer remains the leading cause of cancer-related death in women, with 5-year survival rates of as high as 90% for patients with early-stage breast cancer without metastasis, falling to 10% once bone metastases (BM) occur. Currently, there is no cure for breast cancer with BM. However, appropriate treatment can extend survival and improve patients' quality of life. Therefore, it is important to accurately evaluate the presence of BM in patients with breast cancer. The present meta-analysis evaluated the diagnostic performance of 18F-FDG and 18F-NaF as PET/CT tracers for breast cancer-associated BM. The present study aimed to compare the diagnostic performance of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomographs (PET/CT) and 18F-sodium fluoride (18F-NaF) PET/CT in patients with breast cancer and BM. The PubMed and Embase databases were searched for English literature on the diagnostic performance of 18F-FDG PET/CT and 18F-NaF PET/CT for breast cancer BM, and two authors independently extracted data. All included studies presented data that could be used to construct a 2×2 contingency table. The methodological quality of the selected studies was assessed using QUADAS-2, and forest plots were generated based on the sensitivity and specificity of 18F-FDG PET/CT and 18F-NaF PET/CT in the diagnosis of BM associated with breast cancer. A total of 14 articles were identified, including eight on the analysis of 18F-FDG PET/CT, five on 18F-NaF PET/CT and one on both. The studies on 18F-FDG PET/CT and 18F-NaF PET/CT included 530 and 270 patients, respectively. The pooled sensitivities were 0.88 [95% confidence interval (95% CI), 0.76-0.94] for 18F-FDG PET/CT and 0.98 (95% CI, 0.92-1.00) for 18F-NaF PET/CT, and the pooled specificities were 0.99 (95% CI, 0.97-1.00) and 0.91 (95% CI: 0.76-0.97), respectively. The area under the summary receiver operating characteristic curve for both 18F-FDG PET/CT and 18F-NaF PET/CT was 0.99 (95% CI, 0.98-1.00). Lesion-based analysis using 18F-FDG PET/CT was performed for 909 lesions, with a sensitivity of 0.84 (95% CI, 0.67-1.00) and specificity of 1.00 (95% CI, 0.98-1.00). Compared with 18F-FDG PET/CT, 18F-NaF PET/CT showed higher sensitivity (98 vs. 88%) but lower specificity (91 vs. 99%), although the difference between methods was not statistically significant. In conclusion, the results of the present study indicated that 18F-NaF PET/CT and 18F-FDG PET/CT are both accurate methods for the detection of BM in patients with breast cancer, and have comparable diagnostic accuracy.
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Affiliation(s)
- Hongyu Hu
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Xianwen Hu
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Zhigang Liang
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Wenbi Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Song Li
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Dandan Li
- Department of Gynecology, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, Guizhou 563000, P.R. China
| | - Jiong Cai
- Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
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20
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El-Masri S, Zeng A, Kusuma Y, Ma H, Williams C, Dowling R, Bush S, Mitchell P, Yan B. Adjunctive rescue therapy in acute large vessel occlusion secondary to underlying intracranial atherosclerotic disease. J Stroke Cerebrovasc Dis 2024; 33:107907. [PMID: 39116961 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/14/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The optimal treatment for patients with acute large vessel occlusion (LVO) secondary to intracranial atherosclerotic disease (ICAD) is unclear. Adjunctive rescue therapy with balloon angioplasty or stenting may be necessary to ensure vessel patency. We aimed to compare the safety and clinical outcomes of adjunctive rescue therapy vs lone thrombectomy for ICAD-related-LVO. METHODS A retrospective propensity score matching analysis was performed in acute stroke patients who had endovascular thrombectomy between 2008 and 2021. We included patients with acute ICAD-related-LVO. The location of ICAD and exposure to thrombolysis were used to generate propensity score matching to estimate the likelihood of treatment by adjunctive rescue therapy. The primary clinical outcome (90-day modified rankin scale 0-2) and safety outcomes (symptomatic intracerebral hemorrhage) were assessed between the two groups. RESULTS One-hundred and forty-four patients were included. The median (IQR) age was 68(59-76) and 52(36 %) were females. The baseline NIHSS was 12.5(8-19). Sixty-seven (47 %) patients had ICAD in M1 or M2 segments. Forty-six patients (67 %) had lone thrombectomy and twenty-one (28 %) had adjunctive rescue therapy. Propensity score matching did not demonstrate significant differences in 90-day modified Rankin Score 0-2 between lone thrombectomy (38.8 %) and adjunctive rescue therapy (39.3 %) (p = 0.3). Lone thrombectomy, compared to adjunctive rescue therapy, did not result in significantly more symptomatic intracerebral hemorrhages (2.8 % vs 8.3 %, p = 0.6), nor progressive occlusion (17 % vs 19 %, p = 0.8). CONCLUSION We did not find significant differences in clinical outcomes and safety between lone thrombectomy and adjunctive rescue therapy. Randomized controlled studies are required to resolve the equipoise in treatment of ICAD-related-LVO.
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Affiliation(s)
- Shaddy El-Masri
- Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
| | - Angela Zeng
- Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Yohanna Kusuma
- Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Henry Ma
- Department of Neurology, Monash Hospital, Melbourne, Australia
| | - Cameron Williams
- Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Richard Dowling
- Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Steven Bush
- Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Peter Mitchell
- Department of Radiology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Bernard Yan
- Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
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21
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Kim H, Jeon MJ, Seong G, Jung YC, Park JY, Lee D. Functional connectivity of the amygdala in relation to high stress and low mindfulness. Neurosci Lett 2024; 842:137985. [PMID: 39255895 DOI: 10.1016/j.neulet.2024.137985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/15/2024] [Accepted: 09/06/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND High psychological stress has been associated with several brain functional changes, including functional connectivity (FC) alterations in regions such as the prefrontal cortex and the amygdala. This study explored FC alterations associated with high perceived stress, and also investigated whether these neuroimaging features were correlated with low levels of mindfulness. METHODS This study included 29 adults (12 males and 17 females; mean age: 27.6 ± 3.2) who complained of moderate or higher perceived stress and 31 adults (17 males and 14 females; mean age: 29.2 ± 7.2) who complained of low-level stress on the questionnaire scale. Seed-based resting-state FC analysis was conducted to compare between high and low stress groups. The dorsolateral prefrontal cortex (DLPFC), the ventromedial prefrontal cortex (VMPFC) and the amygdala were selected as seeds. RESULTS High stress group showed weaker left amygdala-based FC in the left cerebellum crus II and the left orbitofrontal cortex compared with low stress group. High stress group had weaker FC between the left DLPFC and the left inferior parietal lobule. On the contrary, high stress group had stronger FC between the left VMPFC and the left caudate compared with low stress group. Weaker FC between the amygdala and the cerebellum crus II was correlated with lower level of awareness facet of mindfulness. CONCLUSIONS Those with high perceived stress showed low levels of mindfulness and several FC alterations centered on the prefrontal cortex and amygdala. Our findings also suggest that weak amygdala-based FC alterations associated with high psychological stress are related to low-level awareness facet of mindfulness.
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Affiliation(s)
- Heeyeon Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Min-Jeong Jeon
- Department of Clinical Psychology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, South Korea
| | - Goeun Seong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Young-Chul Jung
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, South Korea; Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea; Institute for Innovation in Digital Healthcare, Yonsei University, Seoul 03722, South Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, South Korea.
| | - Deokjong Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, South Korea; Yongin Empathy Psychiatry Clinic, Seoul 07008, South Korea.
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22
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Elmadağ NM, Kara D, Pulatkan A, Uçan V, Cesme DH, Aliyev O, Doğu H, Demirel N, Abdallah A. Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study. J Neurol Surg A Cent Eur Neurosurg 2024; 85:539-548. [PMID: 37257840 DOI: 10.1055/a-2103-7519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Surgical site infection (SSI) is one of the most severe complications of spinal fusion surgery that lead to increased morbidity and mortality rates. Prophylactic antibiotic usage is one of the methods that reduce the possibility of SSI in this procedure. The aim of this study was to determine the effect of local subfascial teicoplanin usage on radiologic and functional outcomes and compare it to the effect of vancomycin on surgical outcomes in patients who underwent decompression with posterior instrumentation (DPI) for lumbar spinal stenosis (LSS). METHODS Medical charts of patients with LSS who received DPI and met the study criteria were divided into three groups: the teicoplanin group included patients who underwent DPI with local teicoplanin before closure, the vancomycin group included patients who underwent DPI with local vancomycin, and the control group included patients who underwent DPI without any local prophylactic antibiotics. RESULTS A total of 101 patients were included in the study. No significant differences were found among groups regarding demographics, follow-up, and clinical and functional outcomes. No significant differences were observed among groups regarding postoperative improvements in SF-36-MCS, SF-36-PCS, Oswestry Disability Index, and Visual Analog Scale (VAS; p > 0.05). In the teicoplanin and vancomycin groups, the SSI rate was lower than that in the control group (2/35, 1/34, and 5/32, respectively, p = 0.136) without statistical significance; however, the postoperative fusion volume was significantly higher in the teicoplanin group when compared to the other groups (3.35 ± 1.08, 2.68 ± 1.17, and 2.65 ± 1.28 cm3, respectively, p = 0.007). CONCLUSIONS Although its cost is relatively higher, teicoplanin was a good alternative to vancomycin in preventing SSIs with a higher fusion rate, but no superiority was observed regarding other outcomes.
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Affiliation(s)
- Nuh Mehmet Elmadağ
- Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Deniz Kara
- Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Anil Pulatkan
- Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Vahdet Uçan
- Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Dilek Hacer Cesme
- Department of Radiology, Acıbadem Taksim Hastanesi, Istanbul, Turkey
| | - Orkhan Aliyev
- Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
| | - Hüseyin Doğu
- Department of Neurosurgery, Atlas University-Medicine Hospital, Bağcılar-Istanbul, Turkey
| | - Nail Demirel
- Department of Neurosurgery, University of Health Sciences-Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey
| | - Anas Abdallah
- Department of Neurosurgery, University of Health Sciences-Istanbul Training and Research Hospital, Samatya-Istanbul, Turkey
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Wernz MM, Voskrebenzev A, Müller RA, Zubke M, Klimeš F, Glandorf J, Czerner C, Wacker F, Olsson KM, Hoeper MM, Hohlfeld JM, Vogel-Claussen J. Feasibility, Repeatability, and Correlation to Lung Function of Phase-Resolved Functional Lung (PREFUL) MRI-derived Pulmonary Artery Pulse Wave Velocity Measurements. J Magn Reson Imaging 2024; 60:2216-2228. [PMID: 38460124 DOI: 10.1002/jmri.29337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Pulse wave velocity (PWV) in the pulmonary arteries (PA) is a marker of vascular stiffening. Currently, only phase-contrast (PC) MRI-based options exist to measure PA-PWV. PURPOSE To test feasibility, repeatability, and correlation to clinical data of Phase-Resolved Functional Lung (PREFUL) MRI-based calculation of PA-PWV. STUDY TYPE Retrospective. SUBJECTS 79 (26 female) healthy subjects (age range 19-78), 58 (24 female) patients with chronic obstructive pulmonary disease (COPD, age range 40-77), 60 (33 female) patients with suspected pulmonary hypertension (PH, age range 28-85). SEQUENCE 2D spoiled gradient echo, 1.5T. ASSESSMENT PA-PWV was measured from PREFUL-derived cardiac cycles based on the determination of temporal and spatial distance between lung vasculature voxels using a simplified (sPWV) method and a more comprehensive (cPWV) method including more elaborate distance calculation. For 135 individuals, PC MRI-based PWV (PWV-QA) was measured. STATISTICAL TESTS Intraclass-correlation-coefficient (ICC) and coefficient of variation (CoV) were used to test repeatability. Nonparametric tests were used to compare cohorts. Correlation of sPWV/cPWV, PWV-QA, forced expiratory volume in 1 sec (FEV1) %predicted, residual volume (RV) %predicted, age, and right heart catheterization (RHC) data were tested. Significance level α = 0.05 was used. RESULTS sPWV and cPWV showed no significant differences between repeated measurements (P-range 0.10-0.92). CoV was generally lower than 15%. COPD and PH patients had significantly higher sPWV and cPWV than healthy subjects. Significant correlation was found between sPWV or cPWV and FEV1%pred. (R = -0.36 and R = -0.44), but not with RHC (P-range -0.11 - 0.91) or age (P-range 0.23-0.89). Correlation to RV%pred. was significant for cPWV (R = 0.42) but not for sPWV (R = 0.34, P = 0.055). For all cohorts, sPWV and cPWV were significantly correlated with PWV-QA (R = -0.41 and R = 0.48). DATA CONCLUSION PREFUL-derived PWV is feasible and repeatable. PWV is increased in COPD and PH patients and correlates to airway obstruction and hyperinflation. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Marius M Wernz
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Robin A Müller
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Maximilian Zubke
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Christoph Czerner
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Karen M Olsson
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Marius M Hoeper
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Jens M Hohlfeld
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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24
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Yoo SY, Kim HY, Kim DH, Shim WS, Lee SM, Lee DH, Koo JM, Yoo JH, Koh S, Park JC, Yu J, Jeon JS, Baek MJ, Kim DD, Lee JY, Oh SJ, Kim SK, Lee JY, Kang KW. Laser-responsive erastin-loaded chondroitin sulfate nanomedicine targeting CD44 and system x c- in liver cancer: A non-ferroptotic approach. J Control Release 2024; 375:574-588. [PMID: 39293529 DOI: 10.1016/j.jconrel.2024.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 08/23/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
Erastin, a ferroptosis-inducing system xc- inhibitor, faces clinical challenges due to suboptimal physicochemical and pharmacokinetic properties, as well as relatively low potency and off-target toxicity. Addressing these, we developed ECINs, a novel laser-responsive erastin-loaded nanomedicine utilizing indocyanine green (ICG)-grafted chondroitin sulfate A (CSA) derivatives. Our aim was to improve erastin's tumor targeting via CSA-CD44 interactions and enhance its antitumor efficacy through ICG's photothermal and photodynamic effects in the laser-on state while minimizing off-target effects in the laser-off state. ECINs, with their nanoscale size of 186.7 ± 1.1 nm and high erastin encapsulation efficiency of 93.0 ± 0.8%, showed excellent colloidal stability and sustained drug release up to 120 h. In vitro, ECINs demonstrated a mechanism of cancer cell inhibition via G1-phase cell cycle arrest, indicating a non-ferroptotic action. In vivo biodistribution studies in SK-HEP-1 xenograft mice revealed that ECINs significantly enhanced tumor distribution of erastin (1.9-fold greater than free erastin) while substantially reducing off-target accumulation in the lungs and spleen by 203-fold and 19.1-fold, respectively. Combined with laser irradiation, ECINs significantly decreased tumor size (2.6-fold, compared to free erastin; 2.4-fold, compared to ECINs without laser irradiation) with minimal systemic toxicity. This study highlights ECINs as a dual-modality approach for liver cancer treatment, demonstrating significant efficacy against tumors overexpressing CD44 and system xc-.
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Affiliation(s)
- So-Yeol Yoo
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Hyun Young Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Dong Hyun Kim
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Wan Seob Shim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Sang Min Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Dong Hwan Lee
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jang Mo Koo
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Ji Hoon Yoo
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Seokjin Koh
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jong Chan Park
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jieun Yu
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Jang Su Jeon
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Min-Jun Baek
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Dae-Duk Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea; Natural Products Research Institute, Seoul National University, Seoul 08826, Republic of Korea
| | - Ji-Yoon Lee
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Soo Jin Oh
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Republic of Korea; Department of Pharmacology, College of Medicine, University of Ulsan, Seoul, 05505, Republic of Korea
| | - Sang Kyum Kim
- College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea.
| | - Jae-Young Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea; Natural Products Research Institute, Seoul National University, Seoul 08826, Republic of Korea.
| | - Keon Wook Kang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea.
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25
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Zhuang Y, Yao L, Liu Y. Value of transperineal three-dimensional ultrasonography in diagnosis of pelvic floor dysfunction. Br J Radiol 2024; 97:1799-1805. [PMID: 39137140 DOI: 10.1093/bjr/tqae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 04/16/2024] [Accepted: 08/09/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVES To investigate the correlation between 3-dimensional ultrasonography parameters and pelvic floor dysfunction (PFD) and its application value in diagnosis and treatment. METHODS Ninety-two patients with PFD and 22 without who underwent 3-dimensional ultrasonography were selected. Transperineal 3-dimensional ultrasonography was performed by Voluson E8 colour Doppler ultrasonography to analyse the anteroposterior diameter (LHAD), transverse diameter (LHLD), pelvic diaphragmatic hiatus area (LHA), and bladder neck mobility (BND) of the patients. Diagnostic sensitivity and specificity of ultrasound parameters in PFD were analysed using Receiver Operating Characteristic (ROC) curves. Paired sample t test was used to analyse the improvement of pelvic floor muscle training (PFMT) in patients with PFD. RESULTS Patients with PFD had significantly higher levels of △LHAD, △LHLD, △LHA, and BND than controls (all P < .01). Binary logistic regression analysis showed that △LHA or BND levels were independent risk factors for the development of PFD. The ROC results showed that the area under the ROC curve with BND level was the highest (0.917). The diagnostic sensitivity of BND in PFD was 100.0% and the specificity was 70.7%. In urinary incontinence (UI) patients, there was a significant positive correlation between the occurrence of UI and BND levels (all r > 0, P < .05). After PFMT treatment, the levels of △LHAD, △LHLD, △LHA, and BND in patients with PFD were significantly decreased (all P < .001). CONCLUSIONS The abnormal changes in the level of 3-dimensional ultrasound parameters can be used as a sensitive indicator to evaluate PFD and a guiding parameter for PFMT treatment. ADVANCES IN KNOWLEDGE The feasibility of operation and repetition by 3-dimensional pelvic floor ultrasonography could provide a reliable imaging basis for clinical diagnosis and treatment of patients with PFD.
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Affiliation(s)
- Yingbin Zhuang
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Liping Yao
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Yanjie Liu
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
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26
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Gacek E, Ellingson AM, Barocas VH. Residual Strain and Joint Pressurization Maintain Collagen Tension for On-Joint Lumbar Facet Capsular Ligaments. J Biomech Eng 2024; 146:111005. [PMID: 39082759 PMCID: PMC11369690 DOI: 10.1115/1.4066091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/25/2024] [Indexed: 08/21/2024]
Abstract
Modeling the lumbar facet capsular ligament's (FCL) mechanical behavior under various physiological motions has often been a challenge due to limited knowledge about the on-joint in situ ligament state arising from attachment to the bone or other internal loads. Building on prior work, this study presents an enhanced computational model of the lumbar facet capsular ligament by incorporating residual strain and joint pressurization strain, factors neglected in prior models. Further, the model can predict strain and stress distribution across the ligament under various spinal motions, highlighting the influence of the ligament's attachment to the bone, internal synovial fluid pressurization, and distribution of collagen fiber alignment on the overall mechanical response of the ligament. Joint space inflation was found to influence the total observed stress and strain fields, both at rest and during motion. A significant portion of the ligament was found to be in tension, even in the absence of external load. Additionally, the model's ability to account for residual strain offers a more realistic portrayal of the collagen fibers and elastin matrix's role in ligament mechanics. We conclude that (1) computational models of the lumbar facet capsular ligament should not assume that the ligament is unloaded when the joint is in its neutral position, and (2) the ligament is nearly always in tension, which may be important in terms of its long-term growth and remodeling.
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Affiliation(s)
- Elizabeth Gacek
- Department of Biomedical Engineering, University of Minnesota - Twin Cities, Minneapolis, MN 55455
| | - Arin M Ellingson
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota - Twin Cities, Minneapolis, MN 55455
| | - Victor H Barocas
- Department of Biomedical Engineering, University of Minnesota - Twin Cities, Minneapolis, MN 55455
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27
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Abbo AAH, Hassan BAA, Ibrahim AAO. Multicystic dysplastic kidney in adults: A case report of unilateral presentation in an adult sudanese female. Urol Case Rep 2024; 57:102839. [PMID: 39310115 PMCID: PMC11414668 DOI: 10.1016/j.eucr.2024.102839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 09/25/2024] Open
Abstract
Multicystic dysplastic kidney is a congenital anomaly typically diagnosed in infancy, rare in adults, in our case of a 25-year-old Sudanese female presented with left flank pain. Imaging showed the left kidney replaced by cysts, consistent with MCDK, and ovarian cyst. She underwent a successful open simple nephrectomy; and histopathology confirmed MCDK. Our case highlights diagnostic and management challenges of MCDK in adults. Conservative management is increasing, especially for asymptomatic patients with normal contralateral kidney function. Healthcare barriers in Sudan, including limited awareness and political unrest, complicate timely diagnosis and treatment. Multidisciplinary care and improved healthcare access are essential.
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Affiliation(s)
- Amer Abbo Hassan Abbo
- Ribat University Hospital, Khartoum, Sudan
- National Ribat University, Khartoum City, Sudan
| | - Basil Amer Abbo Hassan
- Ribat University Hospital, Khartoum, Sudan
- National Ribat University, Khartoum City, Sudan
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28
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Mundada K, Pellerito JS, Srivastava B, Revzin MV. Ultrasound Contrast Agents: Current Role in Adults and Children for Various Indications. Radiol Clin North Am 2024; 62:1035-1062. [PMID: 39393849 DOI: 10.1016/j.rcl.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2024]
Abstract
Intravenous contrast-enhanced ultrasound (CEUS) is a rapidly evolving imaging technique that uses a microbubble contrast agent to enhance ultrasonographic images by augmenting characterization of blood vessels and organ perfusion. CEUS is considered as a useful problem-solving tool and as an indicated first-line imaging modality in select settings. CEUS technique has an inherent advantage over its predecessor B-mode and Doppler imaging. This article reviews different approved and off-label use of CEUS in the pediatric and adult population and also discusses Food and Drug Administration-approved contrast agents in the United States, their reported side effects, and ongoing efforts in the field.
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Affiliation(s)
- Krishna Mundada
- Department of Nuclear Medicine, Seth G.S. Medical College and K.E.M Hospital, Mumbai
| | - John S Pellerito
- Department of Radiology, Division of US, CT and MRI, Peripheral Vascular Laboratory, North Shore - Long Island Jewish Health System
| | | | - Margarita V Revzin
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
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29
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Altorfer FCS, Tan ET, Sneag DB. Editorial for "Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review". J Magn Reson Imaging 2024; 60:1840-1841. [PMID: 38190425 DOI: 10.1002/jmri.29215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
| | - Ek T Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Darryl B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
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30
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AL_Akhali ES, Alshoabi SA, Hamid AM, Alsultan KD, Omer AM, Alhammadi MA. Cardiac amyloidosis: A diagnostic challenge. Radiol Case Rep 2024; 19:4730-4735. [PMID: 39228955 PMCID: PMC11366889 DOI: 10.1016/j.radcr.2024.07.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/18/2024] [Accepted: 07/21/2024] [Indexed: 09/05/2024] Open
Abstract
Cardiac amyloidosis is indeed a condition characterized by the deposition of amyloid proteins in the myocardium, leading to thickening and stiffening of the heart muscle. These abnormal protein deposits can interfere with the heart's normal functioning and may pose diagnostic challenges due to its varied clinical presentation and resemblance to other heart condition. Here, we present a case of 55-year-old female patient of uncontrolled hypertensions for 15 years. About 15 years ago, she presented with chest pain and was diagnosed with cardiomyopathy (CM) characterized by low left ventricle (LV) function of unknown cause. Despite being on antihypertensive treatment, the patient continued to experience chest heaviness with persistent elevate blood pressure. An echocardiogram revealed increased LV septal wall thickness, valvular thickening, and biatrial dilation. Subsequently, cardiac magnetic resonance imaging (CMR) was performed, which revealed left atrium enlargement and asymmetrical myocardial wall thickening, particularly at the septum. White blood axial image revealed thickened inter atrial septum, while late gadolinium enhancement (LGE) magnetic resonance (LGE MR) images showed patchy LGE at the base relative to the apex of the myocardium, highlighting the base-to-apex gradient, subendocardial pattern enhancement at apical lateral wall, and transmural pattern enhancement of the mid anteroseptal and inferoseptal wall. Additionally, a short axis time to invert T1 scout image of left ventricle displayed an abnormal nulling pattern initially in the myocardium, followed by the blood pool, and finally the spleen. These findings collectively led to the diagnosis of cardiac amyloidosis.
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Affiliation(s)
| | - Sultan A. Alshoabi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | | | - Kamal D. Alsultan
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Awatif M. Omer
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Mohammed A. Alhammadi
- Diagnostic Radiology Department, King Faisal Specialist Hospital and Research Center, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
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31
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Hsueh HW, Chao CC, Lin YH, Tseng PH, Su MY, Hsieh ST. Neck triangle nerve enlargement in hereditary transthyretin amyloidosis correlates with changes in the autonomic, cardiac, and gastrointestinal systems. J Intern Med 2024. [PMID: 39436674 DOI: 10.1111/joim.20019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2024]
Abstract
BACKGROUND Hereditary transthyretin amyloidosis (ATTRv) is a hereditary disease that affects multiple bodily systems. Although sonography generally reveals enlargement of nerves in the limbs, the brachial plexus, and vagus nerve, the clinical significance of these findings remains unclear. METHODS We performed sonographic measurements of the median nerve, cervical spinal nerves at the C5-C7 level, and the vagus nerve in patients with ATTRv and healthy controls. Clinical profiles and cardiac and gastrointestinal examination results were also collected for linear regression analysis. RESULTS We recruited 47 patients with ATTRv (males/females: 34/13, age: 65.6 ± 5.3 years). The sampled segments were all significantly larger than those of the controls. In the clinical profiles, the sum of the Z scores of the neck triangle nerves (cervical spinal nerves and vagus nerve) and of all nerves (cervical spinal nerves, vagus nerve, and median nerve at the wrist) significantly correlated with the familial amyloid polyneuropathy stage, onset of autonomic nervous system (ANS) symptoms, and autonomic symptom scores. On cardiac examinations, several ultrasonography and magnetic resonance imaging parameters (primarily those that reflect heart volume) were found to be significantly correlated with the sum of the Z scores of the cervical spinal nerves but not with the Z score of the vagus nerve. In gastrointestinal evaluation, the cross-sectional area of the vagus nerve was correlated with gastric emptying time parameters on scintigraphy. CONCLUSIONS Neck triangle nerve enlargement on sonography correlated with parameters related to ANS dysfunction, indicating that nerve enlargement observed on ultrasonography may serve as a potential surrogate biomarker of ATTRv.
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Affiliation(s)
- Hsueh-Wen Hsueh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Chao Chao
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Huei Tseng
- Division of Hepatology & Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Mao-Yuan Su
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
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32
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Kamal O, Haghshomar M, Yang J, Lalani T, Bijan B, Yaghmai V, Mendiratta-Lala M, Hong CW, Fowler KJ, Sirlin CB, Kambadakone A, Lee J, Borhani AA, Fung A. CT/MRI technical pitfalls for diagnosis and treatment response assessment using LI-RADS and how to optimize. Abdom Radiol (NY) 2024:10.1007/s00261-024-04632-x. [PMID: 39433603 DOI: 10.1007/s00261-024-04632-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 10/02/2024] [Accepted: 10/04/2024] [Indexed: 10/23/2024]
Abstract
Hepatocellular carcinoma (HCC), the most common primary liver cancer, is a significant global health burden. Accurate imaging is crucial for diagnosis and treatment response assessment, often eliminating the need for biopsy. The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation and reporting of liver imaging for diagnosis and treatment response assessment, categorizing observations using defined categories that are based on the probability of malignancy or post-treatment tumor viability. Optimized imaging protocols are essential for accurate visualization and characterization of liver findings by LI-RADS. Common technical pitfalls, such as suboptimal postcontrast phase timing, and MRI-specific challenges like subtraction misregistration artifacts, can significantly reduce image quality and diagnostic accuracy. The use of hepatobiliary contrast agents introduces additional challenges including arterial phase degradation and suboptimal uptake in advanced cirrhosis. This review provides radiologists with comprehensive insights into the technical aspects of liver imaging for LI-RADS. We discuss common pitfalls encountered in routine clinical practice and offer practical solutions to optimize imaging techniques. We also highlight technical advances in liver imaging, including multi-arterial MR acquisition and compressed sensing. By understanding and addressing these technical aspects, radiologists can improve accuracy and confidence in the diagnosis and treatment response assessment for hepatocellular carcinoma.
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Affiliation(s)
- Omar Kamal
- Oregon Health and Science University, Portland, OR, USA.
| | - Maryam Haghshomar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jessica Yang
- Royal Prince Alfred and Concord Hospitals, Sydney, NSW, Australia
| | - Tasneem Lalani
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Bijan Bijan
- University of California Davis Medical Center, Sacramento, CA, USA
| | | | | | | | | | | | | | - James Lee
- University of Kentucky, Lexington, KY, USA
| | - Amir A Borhani
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alice Fung
- Oregon Health and Science University, Portland, OR, USA
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Lin DX, Zhuo XB, Lin Y, Lei WD, Chang GJ, Zhang Y, Zhang SY. Enhancing parathyroid preservation in papillary thyroid carcinoma surgery using nano-carbon suspension. Sci Rep 2024; 14:24680. [PMID: 39433967 DOI: 10.1038/s41598-024-76126-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Accepted: 10/10/2024] [Indexed: 10/23/2024] Open
Abstract
This study evaluates the clinical significance of nano-carbon suspension in total thyroidectomy with cervical lymph node dissection for papillary thyroid carcinoma (PTC). The objective of this study was to assess the efficacy of nano-carbon suspension in enhancing parathyroid gland preservation, reducing postoperative complications, and improving surgical precision. A retrospective analysis on 219 PTC patients who underwent total thyroidectomy with cervical lymph node dissection between March 2014 and March 2018 was conducted. Patients were divided into two groups: an experimental group (n = 107) that received nano-carbon suspension and a control group (n = 112) that did not. Comparative analyses included demographics, surgical parameters, postoperative calcium and parathyroid hormone (PTH) levels, the number of dissected lymph nodes, and the incidence of complications. Baseline characteristics, including age, sex, and BMI, showed no statistically significant differences between the experimental and control groups. Postoperative calcium levels were significantly more stable in the experimental group, with median levels of 2.22 mmol/L on day 1 versus 2.06 mmol/L in the control group (P < 0.001), and 2.29 mmol/L at week 1 versus 2.22 mmol/L (P < 0.001). PTH levels were higher in the experimental group (35 pg/mL on day 1 versus 28 pg/mL, P < 0.001; 37 pg/mL at week 1 versus 30 pg/mL, P < 0.001). The experimental group had a greater median number of dissected lymph nodes (median 11.00 versus 7.00, P < 0.001) and a lower pathological parathyroid gland count (6.5% versus 23.2%, P < 0.001). Postoperative numbness and twitching were significantly reduced (4.7% versus 16.1%, P = 0.006), and the recurrence rate at 12 months was lower (4.7% versus 12.5%, P = 0.040). The use of Nano-carbon suspension in thyroidectomy and cervical lymph node dissection for PTC enhances parathyroid gland preservation, improves surgical precision, and reduces specific postoperative complications, supporting its standard adoption in thyroid cancer surgeries to optimize patient outcomes.
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Affiliation(s)
- De-Xin Lin
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde, 352100, China.
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, 352100, China.
| | - Xin-Bin Zhuo
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde, 352100, China
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, 352100, China
| | - Yin Lin
- Department of Gastroenterology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding, 355200, China
| | - Wen-Di Lei
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde, 352100, China
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, 352100, China
| | - Gui-Jian Chang
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde, 352100, China
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, 352100, China
| | - Yong Zhang
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Clinical Medicine of Fujian Medical University, Ningde, 352100, China
- Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, 352100, China
| | - Shi-Yan Zhang
- Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding, 355200, China.
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Krolak C, Wei A, Shumaker M, Dighe M, Averkiou M. A Comprehensive and Repeatable Contrast-Enhanced Ultrasound Quantification Approach for Clinical Evaluations of Tumor Blood Flow. Invest Radiol 2024:00004424-990000000-00256. [PMID: 39418656 DOI: 10.1097/rli.0000000000001127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
OBJECTIVE The aim of this study is to define a comprehensive and repeatable contrast-enhanced ultrasound (CEUS) imaging protocol and analysis method to quantitatively assess lesional blood flow. Easily repeatable CEUS evaluations are essential for longitudinal treatment monitoring. The quantification method described here aims to provide a structure for future clinical studies. MATERIALS AND METHODS This retrospective analysis study included liver CEUS studies in 80 patients, 40 of which contained lesions (primarily hepatocellular carcinoma, n = 28). Each patient was given at least 2 injections of a microbubble contrast agent, and 60-second continuous loops were acquired for each injection to enable evaluation of repeatability. For each bolus injection, 1.2 mL of contrast was delivered, whereas continuous, stationary scanning was performed. Automated respiratory gating and motion compensation algorithms dealt with breathing motion. Similar in size regions of interest were drawn around the lesion and liver parenchyma, and time-intensity curves (TICs) with linearized image data were generated. Four bolus transit parameters, rise time (RT), mean transit time (MTT), peak intensity (PI), and area under the curve (AUC), were extracted either directly from the actual TIC data or from a lognormal distribution curve fitted to the TIC. Interinjection repeatability for each parameter was evaluated with coefficient of variation. A 95% confidence interval was calculated for all fitted lognormal distribution curve coefficient of determination (R2) values, which serves as a data quality metric. One-sample t tests were performed between values obtained from injection pairs and between the fitted lognormal distribution curve and direct extraction from the TIC calculation methods to establish there were no significant differences between injections and measurement precision, respectively. RESULTS Average interinjection coefficient of variation with both the fitted curve and direct calculation of RT and MTT was less than 21%, whereas PI and AUC were less than 40% for lesion and parenchyma regions of interest. The 95% confidence interval for the R2 value of all fitted lognormal curves was [0.95, 0.96]. The 1-sample t test for interinjection value difference showed no significant differences, indicating there was no relationship between the order of the repeated bolus injections and the resulting parameters. The 1-sample t test between the values from the fitted lognormal distribution curve and the direct extraction from the TIC calculation found no statistically significant differences (α = 0.05) for all perfusion-related parameters except lesion and parenchyma PI and lesion MTT. CONCLUSIONS The scanning protocol and analysis method outlined and validated in this study provide easily repeatable quantitative evaluations of lesional blood flow with bolus transit parameters in CEUS data that were not available before. With vital features such as probe stabilization ideally performed with an articulated arm and an automated respiratory gating algorithm, we were able to achieve interinjection repeatability of blood flow parameters that are comparable or surpass levels currently established for clinical 2D CEUS scans. Similar values and interinjection repeatability were achieved between calculations from a fitted curve or directly from the data. This demonstrated not only the strength of the protocol to generate TICs with minimal noise, but also suggests that curve fitting might be avoided for a more standardized approach. Utilizing the imaging protocol and analysis method defined in this study, we aim for this methodology to potentially assist clinicians to assess true perfusion changes for treatment monitoring with CEUS in longitudinal studies.
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Affiliation(s)
- Connor Krolak
- From the Department of Bioengineering, University of Washington, Seattle, WA (C.K., A.W., M.S., M.A.); and Department of Radiology, University of Washington, Seattle, WA (M.D.)
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Mostafa K, Seoudy H, Aludin S, Schunk D, Peckolt H, Wolf C, Saad M, Both M, Jansen O, Frank D, Langguth P. Computed tomography for the detection of myocardial hypoperfusion in acute myocardial infarction and the associated CT-to-catheter time. Sci Rep 2024; 14:24456. [PMID: 39424899 PMCID: PMC11489678 DOI: 10.1038/s41598-024-75499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 10/07/2024] [Indexed: 10/21/2024] Open
Abstract
Emergency computed tomography (CT) often does not allow for comprehensive coronary artery assessment. However, CT may reveal pathological myocardial hypoperfusion suggestive of acute myocardial infarction (AMI), especially in patients presenting with a different diagnostic hypothesis. CT hypoperfusion is known to be associated with myocardial infarction, however the diagnostic value of CT hypoperfusion for the detection of AMI is still not well evaluated. This was a single-centre retrospective study including patients who underwent invasive coronary angiography (ICA) due to suspected AMI based on incidental perfusion defects upon emergency CT imaging between 2018 and 2023. A total of 22 patients (mean age 66.3 ± 10.8 years, 11 female) were included in this analysis. The diagnosis of AMI was established in all cases leading to ICA. Culprit coronary artery lesions with an indication of percutaneous coronary intervention were detected in all patients who underwent ICA. Spearmann correlation for hypoperfused segments on CT imaging and the corresponding vascular territory upon ICA was significantly substantial (ρ = 0.73, p = < 0.001). The higher the number of affected myocardial segments, the faster ICA was initiated. Mean time between the suspicion of AMI on CT imaging and ICA was 196 (29-4044) minutes. Myocardial hypoperfusion on emergency CT imaging should be considered as AMI until proven otherwise, independent of the clinical scenario leading to performance of CT imaging and whether imaging was performed for the exclusion of non-cardiac pathologies. Early initiation of further diagnostic workup may potentially avoid delays to invasive treatment and reduce the CT-to-catheter-time. Our study explicitly underlines that myocardial hypoperfusion upon contrast enhanced CT imaging needs to be considered as sign of acute myocardial infarction and indicates targeted clinical workup to rule out this diagnosis and to shorten the timeframe from imaging diagnosis to interventional treatment.
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Affiliation(s)
- Karim Mostafa
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany.
| | - Hatim Seoudy
- Department of Internal Medicine III, Cardiology, Angiology and Critical Care, University Hospital Schleswig Holstein, Kiel, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Kiel, Germany
| | - Schekeb Aludin
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany
| | - Domagoj Schunk
- Interdisciplinary Emergency Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hannes Peckolt
- Interdisciplinary Emergency Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Carmen Wolf
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany
| | - Mohammed Saad
- Department of Internal Medicine III, Cardiology, Angiology and Critical Care, University Hospital Schleswig Holstein, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany
| | - Derk Frank
- Department of Internal Medicine III, Cardiology, Angiology and Critical Care, University Hospital Schleswig Holstein, Kiel, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Kiel, Germany
| | - Patrick Langguth
- Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany
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Braet DJ, Baker TJ, Delbono L, Spahlinger G, Graham N, Arora A, Figueroa CA, Eliason JL, Burris NS. Three-dimensional characterization of sex differences in abdominal aortic aneurysm progression via vascular deformation mapping. Sci Rep 2024; 14:24215. [PMID: 39414930 PMCID: PMC11484807 DOI: 10.1038/s41598-024-75334-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 10/04/2024] [Indexed: 10/18/2024] Open
Abstract
Although abdominal aortic aneurysms (AAA) are more common in men, women are at greater risk for AAA growth/rupture. Vascular deformation mapping (VDM) utilizes deformable image registration to qualify and quantify 3D-AAA growth using computed tomography angiograms (CTA). In this study we leveraged VDM to investigate sex differences in AAA growth patterns. Patients with infra-renal AAA and ≥ 2 CTA were identified. Males and females were matched for age, hypertension, and smoking history. Patient characteristics, maximum diameter (Dmax), and AAA volume were obtained. CTA images were segmented, and VDM was conducted to quantify 3D AAA growth rate per year (GR, cm/year). Statistical shape modeling was utilized to compute mean aneurysm shapes and 3D GR. Average GR was evaluated at specific regions of the aortic surface for males and females. Seventeen males and 17 females were matched. At the individual level, there were no sex differences in changes in Dmax or AAA volume. However, females had larger GR across the anterior and right lateral AAA (1.33 vs 0.89 and 1.56 vs 0.74 cm/year, respectively), despite no difference in posterior or left lateral AAA GR. Despite comparable changes in Dmax, AAA volume, and GR magnitude, women demonstrated a more eccentric, anterior-predominant, AAA growth pattern.
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Affiliation(s)
- Drew J Braet
- Section of Vascular Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
| | - Timothy J Baker
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Luciano Delbono
- Section of Vascular Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | | | - Nathan Graham
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Akul Arora
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - C Alberto Figueroa
- Section of Vascular Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Jonathan L Eliason
- Section of Vascular Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
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Hosse C, Moos M, Becker LS, Sieren M, Müller L, Stoehr F, Schaarschmidt BM, Barbone G, Collettini F, Fehrenbach U, Hinrichs JB, Kloeckner R, Geisel D, Tacke F, Gebauer B, Auer TA. Trans-arterial embolization for treatment of acute lower gastrointestinal bleeding-a multicenter analysis. Eur Radiol 2024:10.1007/s00330-024-11102-x. [PMID: 39414657 DOI: 10.1007/s00330-024-11102-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 09/13/2024] [Accepted: 09/24/2024] [Indexed: 10/18/2024]
Abstract
PURPOSE To assess the technical feasibility, safety, and clinical success rate of trans-arterial embolization (TAE) as an emergency treatment for acute lower gastrointestinal bleeding (LGIB). MATERIALS AND METHODS Consecutive patients who received urgent TAE due to active LGIB at five academic centers in Germany were retrospectively analyzed. LGIB was confirmed and localized using contrast-enhanced computed tomography (CT) or endoscopy. Outcome parameters including technical and clinical success rates as well as ischemia-related adverse events were analyzed. Furthermore, treatment-related variables that may affect technical and clinical success were analyzed using a regression model. RESULTS One hundred and forty-one patients were included. TAE was performed in 91% (128/141) of patients. In 81% (114/141) of patients, TAE was performed due to active bleeding visible at angiography, the remaining 10% (14/141) underwent empiric embolization based on pre-interventional imaging. In 9% (13/141) of patients, no TAE was performed. Microcoils were the most used embolic 48.5% (62/128), followed by glue 23.5% (30/128) and Microparticles (8%; 10/128). In the case of bleeding visible in angiography, the technical success rate was 100% (114/114); the clinical success rate was 93.6% (120/128). Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% (18/128) of all patients after embolization. Thirty-day mortality was 14% (21/141). Regression analysis revealed no significant correlations but a statistical trend toward a higher incidence of bowel resection when glue was used (p = 0.090) and toward a higher 30-day mortality when an unselective embolization was performed (p = 0.057). CONCLUSION TAE for LGIB has a high technical and clinical success rate. Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% of patients without identifying a significant correlation to the embolization technique or an embolic. KEY POINTS Question Is trans-arterial embolization (TAE) viable as an emergency treatment for acute lower gastrointestinal bleeding (LGIB)? Findings TAE demonstrated a 100% technical and 93.6% clinical success rate in treating acute LGIB, with severe ischemia-related adverse events occurring in 14% of patients. Clinical relevance TAE is highly effective and has an acceptable complication rate in treating lower gastrointestinal bleeding, emphasizing the need for a direct head-to-head comparison between endovascular and endoscopic therapy.
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Affiliation(s)
- Clarissa Hosse
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Maximilian Moos
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany
| | - Lena S Becker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, 30625, Hannover, Germany
| | - Malte Sieren
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, Lübeck, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany
| | - Fabian Stoehr
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany
| | - Benedikt M Schaarschmidt
- Institute of Diagnostic and Interventional Radiology and Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Gianluca Barbone
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353, Berlin, Germany
| | - Federico Collettini
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Berlin Insitute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Jan B Hinrichs
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, St. Bernward Krankenhaus Hildesheim, Hildesheim, Germany
| | - Roman Kloeckner
- Institute of Interventional Radiology, University Hospital Schleswig-Holstein-Campus Lübeck, Lübeck, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Frank Tacke
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353, Berlin, Germany
| | - Bernhard Gebauer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Timo A Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität zu Berlin, 10117, Berlin, Germany.
- Berlin Insitute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany.
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Li X, Li X, Qin J, Lei L, Guo H, Zheng X, Zeng X. Machine learning-derived peripheral blood transcriptomic biomarkers for early lung cancer diagnosis: Unveiling tumor-immune interaction mechanisms. Biofactors 2024. [PMID: 39415336 DOI: 10.1002/biof.2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 09/30/2024] [Indexed: 10/18/2024]
Abstract
Lung cancer continues to be the leading cause of cancer-related mortality worldwide. Early detection and a comprehensive understanding of tumor-immune interactions are crucial for improving patient outcomes. This study aimed to develop a novel biomarker panel utilizing peripheral blood transcriptomics and machine learning algorithms for early lung cancer diagnosis, while simultaneously providing insights into tumor-immune crosstalk mechanisms. Leveraging a training cohort (GSE135304), we employed multiple machine learning algorithms to formulate a Lung Cancer Diagnostic Score (LCDS) based on peripheral blood transcriptomic features. The LCDS model's performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) in multiple validation cohorts (GSE42834, GSE157086, and an in-house dataset). Peripheral blood samples were obtained from 20 lung cancer patients and 10 healthy control subjects, representing an in-house cohort recruited at the Sixth People's Hospital of Chengdu. We employed advanced bioinformatics techniques to explore tumor-immune interactions through comprehensive immune infiltration and pathway enrichment analyses. Initial screening identified 844 differentially expressed genes, which were subsequently refined to 87 genes using the Boruta feature selection algorithm. The random forest (RF) algorithm demonstrated the highest accuracy in constructing the LCDS model, yielding a mean AUC of 0.938. Lower LCDS values were significantly associated with elevated immune scores and increased CD4+ and CD8+ T-cell infiltration, indicative of enhanced antitumor-immune responses. Higher LCDS scores correlated with activation of hypoxia, peroxisome proliferator-activated receptor (PPAR), and Toll-like receptor (TLR) signaling pathways, as well as reduced DNA damage repair pathway scores. Our study presents a novel, machine learning-derived peripheral blood transcriptomic biomarker panel with potential applications in early lung cancer diagnosis. The LCDS model not only demonstrates high accuracy in distinguishing lung cancer patients from healthy individuals but also offers valuable insights into tumor-immune interactions and underlying cancer biology. This approach may facilitate early lung cancer detection and contribute to a deeper understanding of the molecular and cellular mechanisms underlying tumor-immune crosstalk. Furthermore, our findings on the relationship between LCDS and immune infiltration patterns may have implications for future research on therapeutic strategies targeting the immune system in lung cancer.
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Affiliation(s)
- Xiaohua Li
- Department of Respiratory and Critical Care Medicine, Sixth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Xuebing Li
- Department of Respiratory and Critical Care Medicine, People's Hospital of Yaan, Yaan, Sichuan, China
| | - Jiangyue Qin
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Lei
- Department of Oncology, Sixth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Hua Guo
- Department of Respiratory and Critical Care Medicine, Sixth People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Xi Zheng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xuefeng Zeng
- Department of Respiratory and Critical Care Medicine, Sixth People's Hospital of Chengdu, Chengdu, Sichuan, China
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Baek HS, Kim J, Jeong C, Lee J, Ha J, Jo K, Kim MH, Sohn TS, Lee IS, Lee JM, Lim DJ. Deep Learning Analysis With Gray Scale and Doppler Ultrasonography Images to Differentiate Graves' Disease. J Clin Endocrinol Metab 2024; 109:2872-2881. [PMID: 38609169 DOI: 10.1210/clinem/dgae254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/20/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024]
Abstract
CONTEXT Thyrotoxicosis requires accurate and expeditious differentiation between Graves' disease (GD) and thyroiditis to ensure effective treatment decisions. OBJECTIVE This study aimed to develop a machine learning algorithm using ultrasonography and Doppler images to differentiate thyrotoxicosis subtypes, with a focus on GD. METHODS This study included patients who initially presented with thyrotoxicosis and underwent thyroid ultrasonography at a single tertiary hospital. A total of 7719 ultrasonography images from 351 patients with GD and 2980 images from 136 patients with thyroiditis were used. Data augmentation techniques were applied to enhance the algorithm's performance. Two deep learning models, Xception and EfficientNetB0_2, were employed. Performance metrics such as accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and F1 score were calculated for both models. Image preprocessing, neural network model generation, and neural network training results verification were performed using DEEP:PHI® platform. RESULTS The Xception model achieved 84.94% accuracy, 89.26% sensitivity, 73.17% specificity, 90.06% PPV, 71.43% NPV, and an F1 score of 89.66 for the diagnosis of GD. The EfficientNetB0_2 model exhibited 85.31% accuracy, 90.28% sensitivity, 71.78% specificity, 89.71% PPV, 73.05% NPV, and an F1 score of 89.99. CONCLUSION Machine learning models based on ultrasound and Doppler images showed promising results with high accuracy and sensitivity in differentiating GD from thyroiditis.
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Affiliation(s)
- Han-Sang Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea
| | - Jinyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Chaiho Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea
| | - Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kwanhoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Tae Seo Sohn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea
| | - Ihn Suk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, Republic of Korea
| | - Jong Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Yan Y, Chen Q, Xiang Z, Wang Q, Long Z, Liang H, Ameer S, Zou J, Dai X, Zhu Z. Amino acid metabolomics and machine learning-driven assessment of future liver remnant growth after hepatectomy in livers of various backgrounds. J Pharm Biomed Anal 2024; 249:116369. [PMID: 39047463 DOI: 10.1016/j.jpba.2024.116369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/30/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
Accurate assessment of future liver remnant growth after partial hepatectomy (PH) in patients with different liver backgrounds is a pressing clinical issue. Amino acid (AA) metabolism plays a crucial role in liver regeneration. In this study, we combined metabolomics and machine learning (ML) to develop a generalized future liver remnant assessment model for multiple liver backgrounds. The liver index was calculated at 0, 6, 24, 48, 72 and 168 h after 70 % PH in healthy mice and mice with nonalcoholic steatohepatitis or liver fibrosis. The serum levels of 39 amino acids (AAs) were measured using UPLC-MS/MS. The dataset was randomly divided into training and testing sets at a 2:1 ratio, and orthogonal partial least squares regression (OPLS) and minimally biased variable selection in R (MUVR) were used to select a metabolite signature of AAs. To assess liver remnant growth, nine ML models were built, and evaluated using the coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE). The post-Pareto technique for order preference by similarity to the ideal solution (TOPSIS) was employed for ranking the ML algorithms, and a stacking technique was utilized to establish consensus among the superior algorithms. Compared with those of OPLS, the signature AAs set identified by MUVR (Thr, Arg, EtN, Phe, Asa, 3MHis, Abu, Asp, Tyr, Leu, Ser, and bAib) are more concise. Post-Pareto TOPSIS ranking demonstrated that the majority of ML algorithm in combinations with MUVR outperformed those with OPLS. The established SVM-KNN consensus model performed best, with an R2 of 0.79, an MAE of 0.0029, and an RMSE of 0.0035 for the testing set. This study identified a metabolite signature of 12 AAs and constructed an SVM-KNN consensus model to assess future liver remnant growth after PH in mice with different liver backgrounds. Our preclinical study is anticipated to establish an alternative and generalized assessment method for liver regeneration.
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Affiliation(s)
- Yuqing Yan
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China; Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qianping Chen
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China; Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zhiqiang Xiang
- Department of Hepatobiliary Surgery, Hunan University of Medicine General Hospital, Huaihua, Hunan, China
| | - Qian Wang
- The First Affiliated Hospital, Department of Reproductive Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhangtao Long
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Hao Liang
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Sajid Ameer
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Jianjun Zou
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China; Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, China.
| | - Xiaoming Dai
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
| | - Zhu Zhu
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
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Zhang J, Wang Q, Guo TH, Gao W, Yu YM, Wang RF, Yu HL, Chen JJ, Sun LL, Zhang BY, Wang HJ. Computed tomography-based radiomic model for the prediction of neoadjuvant immunochemotherapy response in patients with advanced gastric cancer. World J Gastrointest Oncol 2024; 16:4115-4128. [DOI: 10.4251/wjgo.v16.i10.4115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 08/18/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Neoadjuvant immunochemotherapy (nICT) has emerged as a popular treatment approach for advanced gastric cancer (AGC) in clinical practice worldwide. However, the response of AGC patients to nICT displays significant heterogeneity, and no existing radiomic model utilizes baseline computed tomography to predict treatment outcomes.
AIM To establish a radiomic model to predict the response of AGC patients to nICT.
METHODS Patients with AGC who received nICT (n = 60) were randomly assigned to a training cohort (n = 42) or a test cohort (n = 18). Various machine learning models were developed using selected radiomic features and clinical risk factors to predict the response of AGC patients to nICT. An individual radiomic nomogram was established based on the chosen radiomic signature and clinical signature. The performance of all the models was assessed through receiver operating characteristic curve analysis, decision curve analysis (DCA) and the Hosmer-Lemeshow goodness-of-fit test.
RESULTS The radiomic nomogram could accurately predict the response of AGC patients to nICT. In the test cohort, the area under curve was 0.893, with a 95% confidence interval of 0.803-0.991. DCA indicated that the clinical application of the radiomic nomogram yielded greater net benefit than alternative models.
CONCLUSION A nomogram combining a radiomic signature and a clinical signature was designed to predict the efficacy of nICT in patients with AGC. This tool can assist clinicians in treatment-related decision-making.
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Affiliation(s)
- Jun Zhang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Qi Wang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Tian-Hui Guo
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Wen Gao
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Yi-Miao Yu
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Rui-Feng Wang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Hua-Long Yu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Jing-Jing Chen
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Ling-Ling Sun
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Bi-Yuan Zhang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Hai-Ji Wang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
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Whitesell RT, Nordman CR, Johnston SK, Sheafor DH. Clinical management of active bleeding: what the emergency radiologist needs to know. Emerg Radiol 2024:10.1007/s10140-024-02289-z. [PMID: 39400642 DOI: 10.1007/s10140-024-02289-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 10/04/2024] [Indexed: 10/15/2024]
Abstract
Active bleeding is a clinical emergency that often requires swift action driven by efficient communication. Extravasation of intravenous (IV) contrast on computed tomography (CT) is a hallmark of active hemorrhage. This can be seen on exams performed for a variety of indications and can occur anywhere in the body. As both traumatic and non-traumatic etiologies of significant blood loss are clinical emergencies, exams demonstrating active bleeding are often performed in emergency departments and read by emergency radiologists. Prompt communication of these findings to the appropriate emergency medicine and surgical providers is crucial. Although many types of active hemorrhage can be managed by interventional radiology techniques, endoscopic and surgical management or clinical observation may be appropriate in certain cases. To facilitate optimal care, it is important for emergency radiologists to understand the scope of indications for embolization of bleeding by interventional radiologists (IR) and when an IR consultation is warranted. Similarly, timely comprehensive diagnostic radiology reporting including pertinent positive and negative findings tailored for IR colleagues can expedite the appropriate intervention.
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Affiliation(s)
- Ryan T Whitesell
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA.
| | - Cory R Nordman
- Division of Interventional Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA.
| | - Sean K Johnston
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA.
| | - Douglas H Sheafor
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA.
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Tian J, Xu T, Fan L, Sun H. Value of Contrast-Enhanced Ultrasound in the Diagnosis of Clear Cell Renal Cell Carcinoma: A Meta-Analysis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 39400336 DOI: 10.1002/jcu.23861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 09/18/2024] [Indexed: 10/15/2024]
Abstract
This meta-analysis aims to evaluate the accuracy of contrast-enhanced ultrasound (CEUS) in diagnosing clear cell renal cell carcinoma (ccRCC). Literature published in five databases was searched. Twelve studies were included. The pooled results showed sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CEUS were 79% (95% CI: 75%-83%), 84% (95% CI: 80%-88%), 4.97 (95% CI: 3.86-6.39), 0.24 (95% CI: 0.20-0.30), and 20.32 (95% CI: 13.84-29.84), respectively. The area under the summary receiver operating characteristic curve was 0.86. In conclusion, CEUS demonstrates high sensitivity and specificity in diagnosing ccRCC, showing good diagnostic accuracy.
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Affiliation(s)
- Jiangke Tian
- Ultrasound Department, Beijing United Family Hospital, Beijing, China
| | - Tao Xu
- Ultrasound Department, Beijing United Family Hospital, Beijing, China
| | - Lijun Fan
- Ultrasound Department, Beijing United Family Hospital, Beijing, China
| | - Haiou Sun
- Ultrasound Department, Beijing United Family Hospital, Beijing, China
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Kumari M, Prasad SN, Meena A, Garg M. Rare presentation of May-Thurner syndrome in childhood with lower abdominal ectopic kidney. BMJ Case Rep 2024; 17:e260941. [PMID: 39395832 DOI: 10.1136/bcr-2024-260941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2024] Open
Abstract
We report a case of a child who presented clinically with features of nephrotic syndrome and May-Thurner syndrome consecutively in the first decade of life. Initially, the nephrotic syndrome was diagnosed and treated. May-Thurner syndrome was suspected clinically in later childhood when there was remission of nephrotic syndrome with persistent left lower leg swelling. The specific imaging modalities are used to document the mechanical compression of the left common iliac vein by the lower abdominal ectopic left kidney before definite management. Our discussion highlights the role of various imaging modalities in the diagnosis of May-Thurner syndrome.
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Affiliation(s)
- Madhuri Kumari
- Radiodiagnosis, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Surya Nandan Prasad
- Radiodiagnosis, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Anamika Meena
- Radiodiagnosis, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Manik Garg
- Radiodiagnosis, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
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Yang T, Yang J. Combined endovascular interventions for pulmonary embolism at high altitude in Tibet. Front Cardiovasc Med 2024; 11. [DOI: 10.3389/fcvm.2024.1384930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2024] Open
Abstract
BackgroundManaging pulmonary embolism (PE) at extremely high altitudes poses unique challenges due to harsh environmental conditions and limited healthcare resources.MethodThis study retrospectively analyzed Tibetan PE patients in the Tibet Autonomous Region of China to evaluate the effectiveness and safety of combined endovascular interventional therapy in high-altitude areas.ResultsThe average altitude of long-term residence for Tibetan patients was 3,863.4 ± 317.4 m, with an average age of 62.0 ± 16.0 years, and the time from computed tomography pulmonary angiography (CTPA) diagnosis to interventional treatment averaged 2.8 ± 2.2 days. The operation time for these patients was 106.1 ± 22.2 min, and the intraoperative dose of alteplase used was 23.3 ± 5.0 mg. All 9 patients reported profound remission of dyspnea and chest pain after endovascular interventions. The heart rate (p < 0.05) and respiratory rate (p < 0.001) of all enrolled patients were significantly decreased, and the peripheral capillary oxygen saturation (SpO2) was significantly increased (p < 0.05) after interventions. No severe complications, such as bleeding, occurred in any patient.ConclusionThis study demonstrated the potential clinical benefits and feasibility of combined endovascular interventional therapy for treating acute PE in extreme high-altitude regions.
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Thorpe JC, Thust SC, Gillon CHM, Rowe S, Swain CE, MacArthur DC, Howarth SP, Avula S, Morgan PS, Dineen RA. Comparison of Echo Planar and Turbo Spin Echo Diffusion-Weighted Imaging in Intraoperative MRI. J Magn Reson Imaging 2024. [PMID: 39389789 DOI: 10.1002/jmri.29614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/03/2024] [Accepted: 09/05/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) is routinely used in brain tumor surgery guided by intraoperative MRI (IoMRI). However, conventional echo planar imaging DWI (EPI-DWI) is susceptible to distortion and artifacts that affect image quality. Turbo spin echo DWI (TSE-DWI) is an alternative technique with minimal spatial distortions that has the potential to be the radiologically preferred sequence. PURPOSE To compare via single- and multisequence assessment EPI-DWI and TSE-DWI in the IoMRI setting to determine whether there is a radiological preference for either sequence. STUDY TYPE Retrospective. POPULATION Thirty-four patients (22 female) aged 2-61 years (24 under 18 years) undergoing IoMRI during surgical resection of intracranial tumors. FIELD STRENGTH/SEQUENCE 3-T, EPI-DWI, and TSE-DWI. ASSESSMENT Patients were scanned with EPI- and TSE-DWI as part of the standard IoMRI scanning protocol. A single-sequence assessment of spatial distortion and image artifact was performed by three neuroradiologists blinded to the sequence type. Images were scored regarding distortion and artifacts, around and remote to the resection cavity. A multisequence radiological assessment was performed by three neuroradiologists in full radiological context including all other IoMRI sequences from each case. The DWI images were directly compared with scorings of the radiologists on which they preferred with respect to anatomy, abnormality, artifact, and overall preference. STATISTICAL TESTS Wilcoxon signed-rank tests for single-sequence assessment, weighted kappa for single and multisequence assessment. A P-value <0.001 was considered statistically significant. RESULTS For the blinded single-sequence assessment, the TSE-DWI sequence was scored equal to or superior to the EPI-DWI sequence for distortion and artifacts, around and remote to the resection cavity for every case. In the multisequence assessment, all radiologists independently expressed a preference for TSE-DWI over EPI-DWI sequences on viewing brain anatomy, abnormalities, and artifacts. DATA CONCLUSION The TSE-DWI sequences may be favored over EPI-DWI for IoMRI in patients with intracranial tumors. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 5.
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Affiliation(s)
- James C Thorpe
- Medical Physics and Clinical Engineering, Nottingham University Hospitals, Nottingham, UK
| | - Stefanie C Thust
- Radiological Sciences, Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Department of Brain Rehabilitation and Repair, UCL Institute of Neurology, Queen Square, London, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | | | - Selene Rowe
- Radiology, Nottingham University Hospitals, Nottingham, UK
| | | | - Donald C MacArthur
- Neurosurgery, Nottingham University Hospitals, Nottingham, UK
- Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
| | - Simon P Howarth
- Neurosurgery, Nottingham University Hospitals, Nottingham, UK
| | - Shivaram Avula
- Radiology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - Paul S Morgan
- Medical Physics and Clinical Engineering, Nottingham University Hospitals, Nottingham, UK
- Radiological Sciences, Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Rob A Dineen
- Medical Physics and Clinical Engineering, Nottingham University Hospitals, Nottingham, UK
- Radiological Sciences, Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, UK
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Abikhzer G, Treglia G, Pelletier-Galarneau M, Buscombe J, Chiti A, Dibble EH, Glaudemans AWJM, Palestro CJ, Sathekge M, Signore A, Jamar F, Israel O, Gheysens O. EANM/SNMMI guideline/procedure standard for [ 18F]FDG hybrid PET use in infection and inflammation in adults v2.0. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06915-3. [PMID: 39387894 DOI: 10.1007/s00259-024-06915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 09/02/2024] [Indexed: 10/15/2024]
Abstract
INTRODUCTION Hybrid [18F]FDG PET imaging is currently the method of choice for a wide variety of infectious and inflammatory disorders and was recently adopted in several clinical guidelines. A large amount of evidence-based articles, guidelines and appropriate use criteria have been published since the first version of this guideline in 2013. PURPOSE To provide updated evidence-based information to assist physicians in recommending, performing and interpreting hybrid [18F]FDG PET examinations for infectious and inflammatory disorders in the adult population. METHODS A systematic literature search of evidence-based articles using whole-body [18F]FDG hybrid imaging on the indications covered within this guideline was performed. All systematic reviews and meta-analyses published within the last 10 years until January 2023 were identified in PubMed/Medline or Cochrane. For each indication covered in this manuscript, diagnostic performance was provided based on meta-analyses or systematic reviews. If not available, results from prospective or retrospective studies were considered based on predefined selection criteria. RESULTS AND CONCLUSIONS: Hybrid [18F]FDG PET is extremely useful in the work-up and management of adults with infectious and inflammatory diseases, as supported by extensive and rapidly growing evidence-based literature and adoption in clinical guidelines. Practical recommendations are provided describing evidence-based indications as well as interpretation criteria and pitfalls. Monitoring treatment response is the most challenging but insufficiently studied potential application in infection and inflammation imaging.
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Affiliation(s)
- Gad Abikhzer
- Department of Medical Imaging, Faculty of Medicine and Health Sciences, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Giorgio Treglia
- Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
| | | | - John Buscombe
- Department of Nuclear Medicine, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Arturo Chiti
- Department of Nuclear Medicine, IRCCS San Raffaele and Vita-Salute San Raffaele University, Milano, Italy
| | - Elizabeth H Dibble
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | | | - Mike Sathekge
- Nuclear Medicine Research Infrastructure (NuMeRI), University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, University Hospital S. Andrea, "Sapienza" University, Roma, Italy
| | - Francois Jamar
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Ora Israel
- Rappaport School of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research (IREC), Université Catholique de Louvain, Brussels, Belgium
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Mamoon S, Xia Z, Alfakih A, Lu J. UCLN: Toward the Causal Understanding of Brain Disorders With Temporal Lag Dynamics. IEEE Trans Neural Syst Rehabil Eng 2024; 32:3729-3740. [PMID: 39352819 DOI: 10.1109/tnsre.2024.3471646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Resting-state functional magnetic resonance imaging (rs-fMRI) has emerged as a powerful tool for exploring interactions among brain regions. A growing body of research is actively investigating various computational approaches for estimating causal effects among brain regions. Compared to traditional methods, causal relationship reveals the causal influences among distinct brain regions, offering a deeper understanding of brain network dynamics. However, existing methods either neglect the concept of temporal lag across brain regions or set the temporal lag value to a fixed value. To address this limitation, we propose a Unified Causal and Temporal Lag Network (termed UCLN) that jointly learns the causal effects and temporal lag values among brain regions. Our method effectively captures variations in temporal lag between distant brain regions by avoiding the predefined lag value across the entire brain. The brain networks obtained are directed and weighted graphs, enabling a more comprehensive disentanglement of complex interactions. In addition, we also introduce three guiding mechanisms for efficient brain network modeling. The proposed method outperforms state-of-the-art approaches in classification accuracy on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Our findings indicate that the method not only achieves superior classification but also successfully identifies crucial neuroimaging biomarkers associated with the disease.
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Liu Y, Han Z, Wang J, Wang Q, Qie X. Inferior vena cava collapsibility index for predicting hypotension after spinal anesthesia in patients undergoing total knee arthroplasty. DIE ANAESTHESIOLOGIE 2024:10.1007/s00101-024-01468-4. [PMID: 39382631 DOI: 10.1007/s00101-024-01468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/14/2024] [Accepted: 07/29/2024] [Indexed: 10/10/2024]
Abstract
OBJECTIVE This study aimed to identify risk factors associated with hypotension in patients undergoing total knee arthroplasty (TKA) under spinal anesthesia. METHOD A total of 200 patients (50-75 years of age) who underwent elective TKA under spinal anesthesia between October 2023 and January 2024 were enrolled. Patients were divided into two groups (hypotensive and nonhypotensive) depending on the occurrence of postspinal anesthesia hypotension (PSAH). Patient characteristics (age, sex, body mass index, and medical history), blood pressure, heart rate, and ultrasound data before anesthesia were documented. Multivariate logistic regression models were used to determine risk factors for hypotension after spinal anesthesia. Furthermore, a nomogram was constructed according to independent predictive factors. The area under the curve (AUC) and calibration curves were employed to assess the performance of the nomogram. RESULTS In total, 175 patients were analyzed and 79 (45.1%) developed PSAH. Logistic regression analysis revealed that variability of the inferior vena cava (odds ratio, OR, 1.147; 95% confidence interval, CI: 1.090-1.207; p < 0.001) and systolic arterial blood pressure (SABP, OR 1.078; 95% CI: 1.043-1.115; p < 0.001) were independent risk factors for PSAH. Receiver operating characteristic (ROC) curve analysis showed that the AUC of the inferior vena cava collapsibility index (IVCCI) and SABP alone were 0.806 and 0.701, respectively, while the AUC of both combined was 0.841. Specifically, an IVCCI of > 37.5% and systolic arterial blood pressure of > 157 mm Hg were considered threshold values. Furthermore, we found that the combination had a better predictive value with higher AUC value, sensitivity, and specificity than the index alone. The nomogram model and calibration curves demonstrated the satisfactory predictive performance of the model. CONCLUSION Elevated preoperative systolic arterial blood pressure and a higher IVCCI were identified as independent risk factors for hypotension in patients receiving spinal anesthesia, which may help guide personalized treatment.
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Affiliation(s)
- Yang Liu
- Department of Anesthesiology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation, Cangzhou, China
| | - Ziyu Han
- Basic Medical College, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jianhua Wang
- Department of Anesthesiology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation, Cangzhou, China
| | - Qiujun Wang
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaojuan Qie
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, China.
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Kataria B, Woisetschläger M, Nilsson Althén J, Sandborg M, Smedby Ö. Image quality assessments in abdominal CT: Relative importance of dose, iterative reconstruction strength and slice thickness. Radiography (Lond) 2024; 30:1563-1571. [PMID: 39378665 DOI: 10.1016/j.radi.2024.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/20/2024] [Accepted: 09/23/2024] [Indexed: 10/10/2024]
Abstract
INTRODUCTION Low contrast resolution in abdominal computed tomography (CT) may be negatively affected by attempts to lower patient doses. Iterative reconstruction (IR) algorithms play a key role in mitigating this problem. The reconstructed slice thickness also influences image quality. The aim was to assess the interaction and influence of patient dose, slice thickness, and IR strength on image quality in abdominal CT. METHOD With a simultaneous acquisition, images at 42 and 98 mAs were obtained in 25 patients. Multiplanar images with slice thicknesses of 1, 2, and 3 mm and advanced modeled iterative reconstruction (ADMIRE) strengths of 3 (AD3) and 5 (AD5) were reconstructed. Four radiologists evaluated the images in a pairwise manner based on five image criteria. Ordinal logistic regression with mixed effects was used to evaluate the effect of tube load, ADMIRE strength, and slice thickness using the visual grading regression technique. RESULTS For all assessed image criteria, the regression analysis showed significantly (p < 0.001) higher image quality for AD5, but lower for tube load 42 mAs, and slice thicknesses of 1 mm and 2 mm, compared to the reference categories of AD3, 98 mAs, and 3 mm, respectively. AD5 at 2 mm was superior to AD3 at 3 mm for all image criteria studied. AD5 1 mm produced inferior image quality for liver parenchyma and overall image quality compared to AD3 3 mm. Interobserver agreement (ICC) ranged from 0.874 to 0.920. CONCLUSION ADMIRE 5 at 2 mm slice thickness may allow for further dose reductions due to its superiority when compared to ADMIRE 3 at 3 mm slice thickness. IMPLICATIONS FOR PRACTICE Combination of thinner slices and higher ADMIRE strength facilitates imaging at low dose.
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Affiliation(s)
- B Kataria
- Department of Radiology, Linköping University, Linköping, Sweden; Department of Health, Medicine & Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science & Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - M Woisetschläger
- Department of Radiology, Linköping University, Linköping, Sweden; Department of Health, Medicine & Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science & Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - J Nilsson Althén
- Department of Health, Medicine & Caring Sciences, Linköping University, Linköping, Sweden; Department of Medical Physics, Linköping University, Linköping, Sweden.
| | - M Sandborg
- Department of Health, Medicine & Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science & Visualization (CMIV), Linköping University, Linköping, Sweden; Department of Medical Physics, Linköping University, Linköping, Sweden.
| | - Ö Smedby
- Department of Biomedical Engineering and Health Systems (MTH), KTH Royal Institute of Technology, Stockholm, Sweden.
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