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Akinci D'Antonoli T, Cavallo AU, Vernuccio F, Stanzione A, Klontzas ME, Cannella R, Ugga L, Baran A, Fanni SC, Petrash E, Ambrosini I, Cappellini LA, van Ooijen P, Kotter E, Pinto Dos Santos D, Cuocolo R. Reproducibility of radiomics quality score: an intra- and inter-rater reliability study. Eur Radiol 2024; 34:2791-2804. [PMID: 37733025 PMCID: PMC10957586 DOI: 10.1007/s00330-023-10217-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES To investigate the intra- and inter-rater reliability of the total radiomics quality score (RQS) and the reproducibility of individual RQS items' score in a large multireader study. METHODS Nine raters with different backgrounds were randomly assigned to three groups based on their proficiency with RQS utilization: Groups 1 and 2 represented the inter-rater reliability groups with or without prior training in RQS, respectively; group 3 represented the intra-rater reliability group. Thirty-three original research papers on radiomics were evaluated by raters of groups 1 and 2. Of the 33 papers, 17 were evaluated twice with an interval of 1 month by raters of group 3. Intraclass coefficient (ICC) for continuous variables, and Fleiss' and Cohen's kappa (k) statistics for categorical variables were used. RESULTS The inter-rater reliability was poor to moderate for total RQS (ICC 0.30-055, p < 0.001) and very low to good for item's reproducibility (k - 0.12 to 0.75) within groups 1 and 2 for both inexperienced and experienced raters. The intra-rater reliability for total RQS was moderate for the less experienced rater (ICC 0.522, p = 0.009), whereas experienced raters showed excellent intra-rater reliability (ICC 0.91-0.99, p < 0.001) between the first and second read. Intra-rater reliability on RQS items' score reproducibility was higher and most of the items had moderate to good intra-rater reliability (k - 0.40 to 1). CONCLUSIONS Reproducibility of the total RQS and the score of individual RQS items is low. There is a need for a robust and reproducible assessment method to assess the quality of radiomics research. CLINICAL RELEVANCE STATEMENT There is a need for reproducible scoring systems to improve quality of radiomics research and consecutively close the translational gap between research and clinical implementation. KEY POINTS • Radiomics quality score has been widely used for the evaluation of radiomics studies. • Although the intra-rater reliability was moderate to excellent, intra- and inter-rater reliability of total score and point-by-point scores were low with radiomics quality score. • A robust, easy-to-use scoring system is needed for the evaluation of radiomics research.
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Affiliation(s)
- Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.
| | - Armando Ugo Cavallo
- Division of Radiology, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | | | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Agah Baran
- MVZ Diagnostikum Berlin Gmbh, Diagnostisches Zentrum, Berlin, Germany
| | | | - Ekaterina Petrash
- Radiology Department, Research Institute of Children Oncology and Haematology of National Medical Research Center of Oncology n.a.N.N. Blokhin of Ministry of Health of RF, Moscow, Russia
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | | | - Peter van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elmar Kotter
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Daniel Pinto Dos Santos
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
- Department of Radiology, University Hospital of Frankfurt, Frankfurt, Germany
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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Kocak B, Akinci D'Antonoli T, Mercaldo N, Alberich-Bayarri A, Baessler B, Ambrosini I, Andreychenko AE, Bakas S, Beets-Tan RGH, Bressem K, Buvat I, Cannella R, Cappellini LA, Cavallo AU, Chepelev LL, Chu LCH, Demircioglu A, deSouza NM, Dietzel M, Fanni SC, Fedorov A, Fournier LS, Giannini V, Girometti R, Groot Lipman KBW, Kalarakis G, Kelly BS, Klontzas ME, Koh DM, Kotter E, Lee HY, Maas M, Marti-Bonmati L, Müller H, Obuchowski N, Orlhac F, Papanikolaou N, Petrash E, Pfaehler E, Pinto Dos Santos D, Ponsiglione A, Sabater S, Sardanelli F, Seeböck P, Sijtsema NM, Stanzione A, Traverso A, Ugga L, Vallières M, van Dijk LV, van Griethuysen JJM, van Hamersvelt RW, van Ooijen P, Vernuccio F, Wang A, Williams S, Witowski J, Zhang Z, Zwanenburg A, Cuocolo R. METhodological RadiomICs Score (METRICS): a quality scoring tool for radiomics research endorsed by EuSoMII. Insights Imaging 2024; 15:8. [PMID: 38228979 DOI: 10.1186/s13244-023-01572-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
PURPOSE To propose a new quality scoring tool, METhodological RadiomICs Score (METRICS), to assess and improve research quality of radiomics studies. METHODS We conducted an online modified Delphi study with a group of international experts. It was performed in three consecutive stages: Stage#1, item preparation; Stage#2, panel discussion among EuSoMII Auditing Group members to identify the items to be voted; and Stage#3, four rounds of the modified Delphi exercise by panelists to determine the items eligible for the METRICS and their weights. The consensus threshold was 75%. Based on the median ranks derived from expert panel opinion and their rank-sum based conversion to importance scores, the category and item weights were calculated. RESULT In total, 59 panelists from 19 countries participated in selection and ranking of the items and categories. Final METRICS tool included 30 items within 9 categories. According to their weights, the categories were in descending order of importance: study design, imaging data, image processing and feature extraction, metrics and comparison, testing, feature processing, preparation for modeling, segmentation, and open science. A web application and a repository were developed to streamline the calculation of the METRICS score and to collect feedback from the radiomics community. CONCLUSION In this work, we developed a scoring tool for assessing the methodological quality of the radiomics research, with a large international panel and a modified Delphi protocol. With its conditional format to cover methodological variations, it provides a well-constructed framework for the key methodological concepts to assess the quality of radiomic research papers. CRITICAL RELEVANCE STATEMENT A quality assessment tool, METhodological RadiomICs Score (METRICS), is made available by a large group of international domain experts, with transparent methodology, aiming at evaluating and improving research quality in radiomics and machine learning. KEY POINTS • A methodological scoring tool, METRICS, was developed for assessing the quality of radiomics research, with a large international expert panel and a modified Delphi protocol. • The proposed scoring tool presents expert opinion-based importance weights of categories and items with a transparent methodology for the first time. • METRICS accounts for varying use cases, from handcrafted radiomics to entirely deep learning-based pipelines. • A web application has been developed to help with the calculation of the METRICS score ( https://metricsscore.github.io/metrics/METRICS.html ) and a repository created to collect feedback from the radiomics community ( https://github.com/metricsscore/metrics ).
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.
| | - Nathaniel Mercaldo
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Bettina Baessler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Anna E Andreychenko
- Laboratory for Digital Public Health Technologies, ITMO University, St. Petersburg, Russian Federation
| | - Spyridon Bakas
- Division of Computational Pathology, Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
- Center for Federated Learning in Precision Medicine, Indiana University, Indianapolis, IN, USA
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Keno Bressem
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Irene Buvat
- Institut Curie, Inserm, PSL University, Laboratory of Translational Imaging in Oncology, Orsay, France
| | - Roberto Cannella
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | | | - Armando Ugo Cavallo
- Division of Radiology, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - Leonid L Chepelev
- Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada
| | - Linda Chi Hang Chu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Aydin Demircioglu
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital , Essen, Germany
| | - Nandita M deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
- Department of Imaging, The Royal Marsden National Health Service (NHS) Foundation Trust, London, UK
| | - Matthias Dietzel
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | | | - Andrey Fedorov
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laure S Fournier
- Department of Radiology, Université Paris Cité, AP-HP, Hôpital Européen Georges Pompidou, PARCC UMRS 970, INSERM, Paris, France
| | | | - Rossano Girometti
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, Udine, Italy
| | - Kevin B W Groot Lipman
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Georgios Kalarakis
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Division of Radiology, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Medical School, University of Crete, Heraklion, Greece
| | - Brendan S Kelly
- Department of Radiology, St Vincent's University Hospital, Dublin, Ireland
- Insight Centre for Data Analytics, UCD, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
- Computational Biomedicine Laboratory, Institute of Computer Science, FORTH, Heraklion, Crete, Greece
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | - Elmar Kotter
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Mario Maas
- Department of Radiology & Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Luis Marti-Bonmati
- Medical Imaging Department and Biomedical Imaging Research Group, Hospital Universitario y Politécnico La Fe and Health Research Institute, Valencia, Spain
| | - Henning Müller
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Sierra, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva (UniGe), Geneva, Switzerland
| | - Nancy Obuchowski
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Fanny Orlhac
- Institut Curie, Inserm, PSL University, Laboratory of Translational Imaging in Oncology, Orsay, France
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
- Department of Radiology, Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - Ekaterina Petrash
- Radiology department, Research Institute of Pediatric Oncology and Hematology n. a. L.A. Durnov, National Medical Research Center of Oncology n. a. N.N. Blokhin Ministry of Health of Russian Federation, Moscow, Russia
- Medical Department IRA-Labs, Moscow, Russia
| | - Elisabeth Pfaehler
- Institute for advanced simulation (IAS-8): Machine learning and data analytics, Forschungszentrum Jülich, Jülich, Germany
| | - Daniel Pinto Dos Santos
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
- Institute for Diagnostic and Interventional Radiology, Goethe-University Frankfurt Am Main, Frankfurt, Germany
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Sebastià Sabater
- Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Philipp Seeböck
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Nanna M Sijtsema
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alberto Traverso
- Department of Radiotherapy, Maastro Clinic, Maastricht, the Netherlands
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - Lisanne V van Dijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Robbert W van Hamersvelt
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Peter van Ooijen
- Department of Radiotherapy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, Palermo, 90127, Italy
| | - Alan Wang
- Centre for Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Stuart Williams
- Department of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, Norfolk, UK
| | - Jan Witowski
- Department of Radiology, New York University Grossman School of Medicine, New York, USA
| | - Zhongyi Zhang
- School of Information and Communication Technology, Griffith University, Nathan, Brisbane, Australia
| | - Alex Zwanenburg
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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Abbas E, Fanni SC, Bandini C, Francischello R, Febi M, Aghakhanyan G, Ambrosini I, Faggioni L, Cioni D, Lencioni RA, Neri E. Delta-radiomics in cancer immunotherapy response prediction: A systematic review. Eur J Radiol Open 2023; 11:100511. [PMID: 37520768 PMCID: PMC10371799 DOI: 10.1016/j.ejro.2023.100511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background The new immunotherapies have not only changed the oncological therapeutic approach but have also made it necessary to develop new imaging methods for assessing the response to treatment. Delta radiomics consists of the analysis of radiomic features variation between different medical images, usually before and after therapy. Purpose This review aims to evaluate the role of delta radiomics in the immunotherapy response assessment. Methods A systematic search was performed in PubMed, Scopus, and Web Of Science using "delta radiomics AND immunotherapy" as search terms. The included articles' methodological quality was measured using the Radiomics Quality Score (RQS) tool. Results Thirteen articles were finally included in the systematic review. Overall, the RQS of the included studies ranged from 4 to 17, with a mean RQS total of 11,15 ± 4,18 with a corresponding percentage of 30.98 ± 11.61 %. Eleven articles out of 13 performed imaging at multiple time points. All the included articles performed feature reduction. No study carried out prospective validation, decision curve analysis, or cost-effectiveness analysis. Conclusions Delta radiomics has been demonstrated useful in evaluating the response in oncologic patients undergoing immunotherapy. The overall quality was found law, due to the lack of prospective design and external validation. Thus, further efforts are needed to bring delta radiomics a step closer to clinical implementation.
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Affiliation(s)
- Engy Abbas
- The Joint Department of Medical Imaging, University of Toronto, University Health Network, Sinai Health System, Women’s College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9
| | | | - Claudio Bandini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Roberto Francischello
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Maria Febi
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Gayane Aghakhanyan
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Dania Cioni
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | | | - Emanuele Neri
- The Joint Department of Medical Imaging, University of Toronto, University Health Network, Sinai Health System, Women’s College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
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Gould A, Ambrosini I, Masci PG, Mcnally RJ, Chowienczyk PJ, Faconti L. "Resistant hypertension, catecholamine excess, left ventricular hypertrophy and systolic dysfunction: hypertensive cardiomyopathy?". J Hum Hypertens 2023; 37:1129-1130. [PMID: 37568006 DOI: 10.1038/s41371-023-00852-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/14/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Allon Gould
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Pier-Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London Guy's and St Thomas NHS Trust Foundation, London, UK
| | - Ryan John Mcnally
- School of Cardiovascular Medicine & Sciences, King's College London Guy's and St Thomas NHS Trust Foundation, London, UK
| | - Philip J Chowienczyk
- School of Cardiovascular Medicine & Sciences, King's College London Guy's and St Thomas NHS Trust Foundation, London, UK
| | - Luca Faconti
- School of Cardiovascular Medicine & Sciences, King's College London Guy's and St Thomas NHS Trust Foundation, London, UK.
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Cappello G, Giannini V, Cannella R, Tabone E, Ambrosini I, Molea F, Damiani N, Landolfi I, Serra G, Porrello G, Gozzo C, Incorvaia L, Badalamenti G, Grignani G, Merlini A, D’Ambrosio L, Bartolotta TV, Regge D. A mutation-based radiomics signature predicts response to imatinib in Gastrointestinal Stromal Tumors (GIST). Eur J Radiol Open 2023; 11:100505. [PMID: 37484979 PMCID: PMC10362081 DOI: 10.1016/j.ejro.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Objectives To develop a mutation-based radiomics signature to predict response to imatinib in Gastrointestinal Stromal Tumors (GISTs). Methods Eighty-two patients with GIST were enrolled in this retrospective study, including 52 patients from one center that were used to develop the model, and 30 patients from a second center to validate it. Reference standard was the mutational status of tyrosine-protein kinase (KIT) and platelet-derived growth factor α (PDGFRA). Patients were dichotomized in imatinib sensitive (group 0 - mutation in KIT or PDGFRA, different from exon 18-D842V), and imatinib non-responsive (group 1 - PDGFRA exon 18-D842V mutation or absence of mutation in KIT/PDGFRA). Initially, 107 texture features were extracted from the tumor masks of baseline computed tomography scans. Different machine learning methods were then implemented to select the best combination of features for the development of the radiomics signature. Results The best performance was obtained with the 5 features selected by the ANOVA model and the Bayes classifier, using a threshold of 0.36. With this setting the radiomics signature had an accuracy and precision for sensitive patients of 82 % (95 % CI:60-95) and 90 % (95 % CI:73-97), respectively. Conversely, a precision of 80 % (95 % CI:34-97) was obtained in non-responsive patients using a threshold of 0.9. Indeed, with the latter setting 4 patients out of 5 were correctly predicted as non-responders. Conclusions The results are a first step towards using radiomics to improve the management of patients with GIST, especially when tumor tissue is unavailable for molecular analysis or when molecular profiling is inconclusive.
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Affiliation(s)
- Giovanni Cappello
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
| | - Valentina Giannini
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
| | - Roberto Cannella
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Via del Vespro 129, Palermo 90127, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Italy
| | - Emanuele Tabone
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Italy
- Previously at Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
| | - Francesca Molea
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
| | - Nicolò Damiani
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
| | - Ilenia Landolfi
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
| | - Giovanni Serra
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
| | - Giorgia Porrello
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Via del Vespro 129, Palermo 90127, Italy
| | - Cecilia Gozzo
- Department of Radiology, Humanitas, Istituto Clinico Catanese, Catania, Italy
| | - Lorena Incorvaia
- Department of Surgical, Oncological, and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giuseppe Badalamenti
- Department of Surgical, Oncological, and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giovanni Grignani
- Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
| | - Alessandra Merlini
- Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Oncology, University of Turin, Regione Gonzole 10, Orbassano, Turin 10043, Italy
| | - Lorenzo D’Ambrosio
- Department of Oncology, University of Turin, Regione Gonzole 10, Orbassano, Turin 10043, Italy
- Medical Oncology, University Hospital S. Luigi Gonzaga, regione Gonzole 10, Orbassano, Turin 10043, Italy
- Previously at Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
| | - Tommaso Vincenzo Bartolotta
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Via del Vespro 129, Palermo 90127, Italy
- Department of Radiology, Fondazione Istituto Giuseppe Giglio, Ct.da Pietrapollastra, Via Pisciotto, Cefalù, Palermo 90015, Italy
| | - Daniele Regge
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 Km 3.95, Candiolo, Turin 10060, Italy
- Department of Surgical Sciences, University of Turin, Turin 10124, Italy
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Lencioni R, Fanni SC, Morganti R, Febi M, Ambrosini I, De Gori C, D'Amore CA, Bruni L, D'Agostino G, Milazzo A, Guerri G, Coppola M, Mazzeo ML, Cioni D, Neri E. Looking for appropriateness in follow-up CT of oncologic patients: Results from a cross-sectional study. Eur J Radiol 2023; 167:111080. [PMID: 37683331 DOI: 10.1016/j.ejrad.2023.111080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/31/2023] [Accepted: 09/03/2023] [Indexed: 09/10/2023]
Abstract
PURPOSE The objective of this study was to assess the inappropriateness rate of oncological follow-up CT examinations. METHODS Out of 7.000 oncology patients referred for follow-up CT examinations between March and October 2022, a random sample of 10 % was included. Radiology residents assessed the appropriateness using the Italian Society of Medical Oncology (AIOM) guidelines, supervised by senior radiologists. Association between inappropriateness and clinical variables was investigated and variables influencing inappropriateness were analyzed through a binary logistic regression. RESULTS Three-hundred-eighty-eight examinations (56.1 %) were consistent with AIOM guidelines. An additional 100 (14.5 %) examinations did not follow the recommended schedule but were nevertheless considered appropriate because of suspected recurrence/progression (10.7 %) or adverse event requiring imaging assessment (3.8 %). Two-hundred-four (29.4 %) examinations were rated as inappropriate. Inappropriateness causes were as follows: CT not included in the relevant guideline (n = 47); CT extended to additional anatomical regions (n = 59); CT requested at a shorter time-interval (n = 98). No statistically significant difference was found in age, sex, scan region, and primary cancer between appropriate and inappropriate examinations. The only variable significantly associated with inappropriateness was being referred by a specific hospital unit named "unit 2" in the study (p = 0.009), which was demonstrated to be the only appropriateness independent predictor (OR 1.952). CONCLUSION This study shows that majority of oncological patients referred for follow-up CT follows standard guidelines. However, a non-negligible proportion was rated as inappropriate, mainly due to the shorter time-interval. No clinical variable was associated with inappropriateness, except for referral by a specific hospital unit.
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Affiliation(s)
- Riccardo Lencioni
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy; Cancer Imaging Program, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy
| | - Salvatore Claudio Fanni
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy.
| | - Riccardo Morganti
- SOD Clinical Trial Statistical Support, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy
| | - Maria Febi
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Ilaria Ambrosini
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Carmelo De Gori
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Caterina Aida D'Amore
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Luciana Bruni
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Giulia D'Agostino
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Alessio Milazzo
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Gianluca Guerri
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Marzia Coppola
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Maria Letizia Mazzeo
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Dania Cioni
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
| | - Emanuele Neri
- Academic Division and School of Radiology, Department of Translational Research, University of Pisa, Italy
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Fanni SC, Febi M, Francischello R, Caputo FP, Ambrosini I, Sica G, Faggioni L, Masala S, Tonerini M, Scaglione M, Cioni D, Neri E. Radiomics Applications in Spleen Imaging: A Systematic Review and Methodological Quality Assessment. Diagnostics (Basel) 2023; 13:2623. [PMID: 37627882 PMCID: PMC10453085 DOI: 10.3390/diagnostics13162623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
The spleen, often referred to as the "forgotten organ", plays numerous important roles in various diseases. Recently, there has been an increased interest in the application of radiomics in different areas of medical imaging. This systematic review aims to assess the current state of the art and evaluate the methodological quality of radiomics applications in spleen imaging. A systematic search was conducted on PubMed, Scopus, and Web of Science. All the studies were analyzed, and several characteristics, such as year of publication, research objectives, and number of patients, were collected. The methodological quality was evaluated using the radiomics quality score (RQS). Fourteen articles were ultimately included in this review. The majority of these articles were published in non-radiological journals (78%), utilized computed tomography (CT) for extracting radiomic features (71%), and involved not only the spleen but also other organs for feature extraction (71%). Overall, the included papers achieved an average RQS total score of 9.71 ± 6.37, corresponding to an RQS percentage of 27.77 ± 16.04. In conclusion, radiomics applications in spleen imaging demonstrate promising results in various clinical scenarios. However, despite all the included papers reporting positive outcomes, there is a lack of consistency in the methodological approaches employed.
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Affiliation(s)
- Salvatore Claudio Fanni
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Maria Febi
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Roberto Francischello
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Francesca Pia Caputo
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Giacomo Sica
- Radiology Unit, Monaldi Hospital, 80131 Napoli, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Salvatore Masala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Michele Tonerini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56124 Pisa, Italy
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Dania Cioni
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy
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Fanni SC, Febi M, Colligiani L, Volpi F, Ambrosini I, Tumminello L, Aghakhanyan G, Aringhieri G, Cioni D, Neri E. A first look into radiomics application in testicular imaging: A systematic review. Front Radiol 2023; 3:1141499. [PMID: 37492385 PMCID: PMC10365019 DOI: 10.3389/fradi.2023.1141499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 07/27/2023]
Abstract
The aim of this systematic review was to evaluate the state of the art of radiomics in testicular imaging by assessing the quality of radiomic workflow using the Radiomics Quality Score (RQS) and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A systematic literature search was performed to find potentially relevant articles on the applications of radiomics in testicular imaging, and 6 final articles were extracted. The mean RQS was 11,33 ± 3,88 resulting in a percentage of 31,48% ± 10,78%. Regarding QUADAS-2 criteria, no relevant biases were found in the included papers in the patient selection, index test, reference standard criteria and flow-and-timing domain. In conclusion, despite the publication of promising studies, radiomic research on testicular imaging is in its very beginning and still hindered by methodological limitations, and the potential applications of radiomics for this field are still largely unexplored.
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Boraschi P, Donati F, Ambrosini I, Bruni L, Mazzeo ML, Tintori R, Tonerini M, Neri E. Diagnostic and Therapeutic Radiology of the GI Tract, Liver, and Pancreas in Patients with COVID. Gastroenterol Clin North Am 2023; 52:185-200. [PMID: 36813425 PMCID: PMC9626443 DOI: 10.1016/j.gtc.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pulmonary involvement has been extensively reported in the literature. Current data highlight how COVID-19 is a systemic disease, affecting many other organs, including the gastrointestinal, hepatobiliary, and pancreatic organs. Recently, these organs have been investigated using imaging modalities of ultrasound and particularly computed tomography. Radiological findings of the gastrointestinal, hepatic, and pancreatic involvement in patients with COVID-19 are generally nonspecific but are nonetheless helpful to evaluate and manage COVID-19 patients with involvement of these organs.
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Affiliation(s)
- Piero Boraschi
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy.
| | - Francescamaria Donati
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Ilaria Ambrosini
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Luciana Bruni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Maria Letizia Mazzeo
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Rachele Tintori
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Michele Tonerini
- Unit of Emergency Radiology, Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
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Russo F, Mazzetti S, Regge D, Ambrosini I, Giannini V, Manfredi M, De Luca S, Bollito E, Porpiglia F. Reply to Anwar R. Padhani, Ivo G. Schoots, Jelle O. Barentsz. Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2021.04.009: Fast-MRI Feasibility in Biopsy-naïve Patients: Clarifications on the Study Methods and Results. Eur Urol Oncol 2021; 4:866-867. [PMID: 34315690 DOI: 10.1016/j.euo.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Filippo Russo
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Simone Mazzetti
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy; Department of Surgical Sciences, University of Turin, Turin, Italy.
| | - Daniele Regge
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy; Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Ilaria Ambrosini
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Valentina Giannini
- Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy; Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Matteo Manfredi
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Stefano De Luca
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Enrico Bollito
- Department of Pathology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
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Morselli F, Fang L, Ambrosini I, Chowienczyk PJ, Faconti L. Uncertain Etiology of Left Ventricular Hypertrophy in a Young Subject With Hypertension Treated With Dexamphetamine. Am J Med 2020; 133:e227-e229. [PMID: 31672486 DOI: 10.1016/j.amjmed.2019.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Franca Morselli
- King's College London, British Heart Foundation Centre, London
| | - Lingyun Fang
- King's College London, British Heart Foundation Centre, London
| | - Ilaria Ambrosini
- Unit of Radiology at Institute for Cancer Research and Treatment (IRCC)-FPO Candiolo, Turin, Italy
| | | | - Luca Faconti
- King's College London, British Heart Foundation Centre, London.
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12
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Fabiani I, Pugliese NR, La Carruba S, Carerj S, Conte L, Colonna P, Caso P, Benedetto F, Antonini-Canterin F, Romano MF, Citro R, Ambrosini I, Di Bello V. P6511Interactive role of diastolic dysfunction and ventricular remodeling in stage a and b heart failure with preserved ejection fraction: impact on clinical practice. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- I Fabiani
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
| | - N R Pugliese
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
| | | | - S Carerj
- AOU S. Giovanni e Ruggi, Salerno, Italy
| | - L Conte
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
| | - P Colonna
- Polyclinic Hospital of Bari, Bari, Italy
| | - P Caso
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | - F Benedetto
- Bianchi Melacrino Morelli Hospital (BMM), Reggio Calabria, Italy
| | | | - M F Romano
- Sant'Anna School of Advanced Studies, Pisa, Italy
| | - R Citro
- University of Messina, Department of Clinical and Experimental Medicine, Messina, Italy
| | - I Ambrosini
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
| | - V Di Bello
- University of Pisa, Department of Surgery, Medical, Molecular and Critical Area Pathology, Pisa, Italy
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