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Qi H, Hou Y, Zheng Z, Zheng M, Sun X, Xing L. MRI radiomics predicts the efficacy of EGFR-TKI in EGFR-mutant non-small-cell lung cancer with brain metastasis. Clin Radiol 2024:S0009-9260(24)00138-7. [PMID: 38637187 DOI: 10.1016/j.crad.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 04/20/2024]
Abstract
AIM To develop and validate models based on magnetic resonance imaging (MRI) radiomics for predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in EGFR-mutant non-small-cell lung cancer (NSCLC) patients with brain metastases. MATERIALS AND METHODS 117 EGFR-mutant NSCLC patients with brain metastases who received EGFR-TKI treatment were included in this study from January 1, 2014 to December 31, 2021. Patients were randomly divided into training and validation cohorts in a ratio of 2:1. Radiomics features extracted from brain MRI were screened by least absolute shrinkage and selection operator (LASSO) algorithm. Logistic regression analysis and Cox proportional hazard regression analysis were used to screen clinical risk factors. Clinical (C), radiomics (R), and combined (C + R) nomograms were constructed in models predicting short-term efficacy and intracranial progression-free survival (iPFS), respectively. Calibration curves, Harrell's concordance index (C-index), and decision curve analysis (DCA) were used to evaluate the performance of models. RESULTS Overall response rate (ORR) was 57.3% and median iPFS was 12.67 months. The C + R nomograms were more effective. In the short-term efficacy model, the C-indexes of C + R nomograms in training cohort and validation cohort were 0.860 (0.820-0.901, 95%CI) and 0.843 (0.783-0.904, 95%CI). In iPFS model, the C-indexes of C + R nomograms in training cohort and validation cohort were 0.837 (0.751-0.923, 95%CI) and 0.850 (0.763-0.937, 95%CI). CONCLUSION The C + R nomograms were more effective in predicting EGFR-TKI efficacy of EGFR-mutant NSCLC patients with brain metastases than single clinical or radiomics nomograms.
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Affiliation(s)
- H Qi
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Y Hou
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Z Zheng
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China
| | - M Zheng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - X Sun
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China
| | - L Xing
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
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Ma CI, Tirtorahardjo JA, Schweizer SS, Zhang J, Fang Z, Xing L, Xu M, Herman DA, Kleinman MT, McCullough BS, Barrios AM, Andrade RM. Gold(I) ion and the phosphine ligand are necessary for the anti- Toxoplasma gondii activity of auranofin. Microbiol Spectr 2024; 12:e0296823. [PMID: 38206030 PMCID: PMC10845965 DOI: 10.1128/spectrum.02968-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
Auranofin, an FDA-approved drug for rheumatoid arthritis, has emerged as a promising antiparasitic medication in recent years. The gold(I) ion in auranofin is postulated to be responsible for its antiparasitic activity. Notably, aurothiomalate and aurothioglucose also contain gold(I), and, like auranofin, they were previously used to treat rheumatoid arthritis. Whether they have antiparasitic activity remains to be elucidated. Herein, we demonstrated that auranofin and similar derivatives, but not aurothiomalate and aurothioglucose, inhibited the growth of Toxoplasma gondii in vitro. We found that auranofin affected the T. gondii biological cycle (lytic cycle) by inhibiting T. gondii's invasion and triggering its egress from the host cell. However, auranofin could not prevent parasite replication once T. gondii resided within the host. Auranofin treatment induced apoptosis in T. gondii parasites, as demonstrated by its reduced size and elevated phosphatidylserine externalization (PS). Notably, the gold from auranofin enters the cytoplasm of T. gondii, as demonstrated by scanning transmission electron microscopy-energy dispersive X-ray spectroscopy (STEM-EDS) and Inductively Coupled Plasma-Mass Spectrometry (ICP-MS).IMPORTANCEToxoplasmosis, caused by Toxoplasma gondii, is a devastating disease affecting the brain and the eyes, frequently affecting immunocompromised individuals. Approximately 60 million people in the United States are already infected with T. gondii, representing a population at-risk of developing toxoplasmosis. Recent advances in treating cancer, autoimmune diseases, and organ transplants have contributed to this at-risk population's exponential growth. Paradoxically, treatments for toxoplasmosis have remained the same for more than 60 years, relying on medications well-known for their bone marrow toxicity and allergic reactions. Discovering new therapies is a priority, and repurposing FDA-approved drugs is an alternative approach to speed up drug discovery. Herein, we report the effect of auranofin, an FDA-approved drug, on the biological cycle of T. gondii and how both the phosphine ligand and the gold molecule determine the anti-parasitic activity of auranofin and other gold compounds. Our studies would contribute to the pipeline of candidate anti-T. gondii agents.
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Affiliation(s)
- C. I. Ma
- Department of Medicine, Division of Infectious Diseases, University of California at Irvine, Irvine, California, USA
| | - J. A. Tirtorahardjo
- Department of Microbiology and Molecular Genetics, University of California at Irvine, Irvine, California, USA
| | - S. S. Schweizer
- School of Biological Sciences; University of California at Irvine, Irvine, California, USA
| | - J. Zhang
- School of Biological Sciences; University of California at Irvine, Irvine, California, USA
| | - Z. Fang
- School of Biological Sciences; University of California at Irvine, Irvine, California, USA
| | - L. Xing
- Irvine Materials Research Institute; University of California at Irvine, Irvine, California, USA
| | - M. Xu
- Irvine Materials Research Institute; University of California at Irvine, Irvine, California, USA
| | - D. A. Herman
- Department of Medicine, Occupational and Environmental Medicine, University of California at Irvine, Irvine, California, USA
| | - M. T. Kleinman
- Department of Medicine, Occupational and Environmental Medicine, University of California at Irvine, Irvine, California, USA
| | - B. S. McCullough
- Department of Medicinal Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - A. M. Barrios
- Department of Medicinal Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - R. M. Andrade
- Department of Medicine, Division of Infectious Diseases, University of California at Irvine, Irvine, California, USA
- Department of Microbiology and Molecular Genetics, University of California at Irvine, Irvine, California, USA
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Hou X, Tian F, Guo L, Yu Y, Hu Y, Chen S, Wang M, Yang Z, Wang J, Fan X, Xing L, Wu S, Zhang N. Remnant cholesterol is associated with hip BMD and low bone mass in young and middle-aged men: a cross-sectional study. J Endocrinol Invest 2024:10.1007/s40618-023-02279-x. [PMID: 38183565 DOI: 10.1007/s40618-023-02279-x] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE Remnant cholesterol (RC) is a contributor to cardiovascular diseases, obesity, diabetes, and metabolic syndrome. However, the specific relationship between RC and bone metabolism remains unexplored. Therefore, we aimed to investigate the relationships of RC with hip bone mineral density (BMD) and the risk of low bone mass. METHODS Physical examination data was collected from men aged < 60 years as part of the Kailuan Study between 2014 and 2018. The characteristics of the participants were compared between RC quartile groups. A generalized linear regression model was used to evaluate the relationship between RC and hip BMD and a logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for low bone mass. Additional analyses were performed after stratification by body mass index (BMI) (≥ or < 24 kg/m2). Sensitivity analyses were performed by excluding individuals who were taking lipid-lowering therapy or had cancer, cardiovascular diseases, or diabetes. RESULTS Data from a total of 7,053 participants were included in the analysis. After adjustment for confounding factors, RC negatively correlated with hip BMD (β = - 0.0079, 95% CI: - 0.0133, - 0.0025). The risk of low bone mass increased from the lowest to the highest RC quartile, with ORs of 1 (reference), 1.09 (95% CI: (0.82, 1.44), 1.35 (95%CI: 1.02, 1.77), and 1.43 (95% CI: 1.09, 1.89) for Q1, Q2, Q3, and Q4, respectively (P for trend = 0.004) in the fully adjusted model. Compared to RC < 0.80 mmol/l group, the risk of low bone mass increased 39% in RC ≥ 0.80 mmol/l group (P < 0.001). The correlation between RC and hip BMD was stronger in participants with BMI ≥ 24 kg/m2 group (β = - 0.0159, 95% CI: - 0.0289, - 0.0029). The results of sensitivity analyses were consistent with the main results. CONCLUSION We have identified a negative correlation between serum RC and hip BMD, and a higher RC concentration was found to be associated with a greater risk of low bone mass in young and middle-aged men.
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Affiliation(s)
- X Hou
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - F Tian
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - L Guo
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Y Yu
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Y Hu
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - S Chen
- Kailuan General Hospital, Tangshan, People's Republic of China
| | - M Wang
- Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Z Yang
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - J Wang
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - X Fan
- Kailuan General Hospital, Tangshan, People's Republic of China
| | - L Xing
- School of Public Health, North China University of Science and Technology, Tangshan, People's Republic of China
- Affiliated Hospital of North China University of Science and Technology, Tangshan, People's Republic of China
| | - S Wu
- Kailuan General Hospital, Tangshan, People's Republic of China.
| | - N Zhang
- Kailuan General Hospital, Tangshan, People's Republic of China.
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Jin LD, Xing L, Lin SF, Jin XQ, Wang Y, Shen YH, Xu J, Sun LH. Comparison of different dosages of propofol combined with its equivalent alfentanil in outpatient abortion: a prospective, double-blinded, randomized trial. Eur Rev Med Pharmacol Sci 2024; 28:126-135. [PMID: 38235864 DOI: 10.26355/eurrev_202401_34898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE This study aimed at determining the optimal dose combination of alfentanil and propofol for outpatient abortion anesthesia. PATIENTS AND METHODS The study was separated into two parts. In the first part, patients were to determine the median effective dose (ED50) and the 95% effective dose (ED95) of alfentanil in combination with 2.5 mg·kg-1 propofol to inhibit body movements during the abortion using the Dixon up-and-down sequential allocation method. In the second part, 170 patients were randomly divided into group C (2.0 mg·kg-1 propofol with alfentanil 12.16 μg·kg-1) and group E (2.5 mg·kg-1 propofol with its ED95) to compare the anesthetic effect. The primary outcome was the sedation level during general anesthesia. The secondary outcomes were circulation, respiratory complications, and postoperative recovery quality. RESULTS The ED50 and the ED95 values of alfentanil were 3.37 μg·kg-1 (95% CI: 2.58-3.97 μg·kg-1) and 4.68 μg·kg-1 (95% CI: 4.04-9.32 μg·kg-1). The frequency of deep sedation in group E was significantly higher than in group C (76.5% vs. 60%). Patients in group C showed more wakefulness even during the surgery (14.3% vs. 4.4%). The results of our exploratory analyses did not reveal differences in respiratory depression, circulatory depression, postoperative side effects, or recovery outcomes. CONCLUSIONS The combination of 2.5 mg·kg-1 propofol and 4.68 μg·kg-1 alfentanil produces a better sedative effect than the combination of 2.0 mg·kg-1 propofol and 12.16 μg·kg-1 alfentanil without increasing additional risks associated with anesthesia.
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Affiliation(s)
- L-D Jin
- Department of Anesthesiology, Linping District Women and Children Care Hospital, Hangzhou, China.
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Wu H, Ji P, Ma H, Xing L. A Comprehensive Review of Digital Twin from the Perspective of Total Process: Data, Models, Networks and Applications. Sensors (Basel) 2023; 23:8306. [PMID: 37837136 PMCID: PMC10575411 DOI: 10.3390/s23198306] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
With the rapid development of industrial digitalization and intelligence, there is an urgent need to accurately depict the physical world in digital space, and, in turn, regulate and optimize the behavior of physical entities based on massive data collection and analysis. As a technology that combines virtual space and physical space, digital twin can satisfy all of the above needs, and has attracted widespread attention. Due to the promising application prospects of digital twins, both academia and industry have launched research in this field, and related studies have been conducted from different perspectives. Accordingly, some articles summarizing the existing work have also been published, but they are all from a single perspective, lacking a systematic introduction and summary. Based on this, this paper conducts a comprehensive review of the existing work on digital twins from four perspectives: data, model, network and application, and strives to gain a better understanding of the development of the field from the physical to the virtual and back to the physical. Meanwhile, current research challenges and future directions for the development of digital twins are all discussed.
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Affiliation(s)
| | | | | | - Ling Xing
- The School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (H.W.); (P.J.); (H.M.)
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Liu J, Islam MT, Xing L. A Self-Attention-Based Neural Network for Predicting Immune Checkpoint Inhibitors Response. Int J Radiat Oncol Biol Phys 2023; 117:e475-e476. [PMID: 37785508 DOI: 10.1016/j.ijrobp.2023.06.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Cancer cells evade immune system by negatively regulating T cells via immune checkpoints (e.g., PD-1). By blocking these checkpoints, the ability of immune system to recognize and kill cancer cells restores. Individual response rate of checkpoint blockade varies among patients, with 50%-80% in specific types of cancer such as melanoma, while only 15%-30% in most other tumors. Yet it is still an open question what is the set of biomarkers that are crucial to the response to immune checkpoint inhibitors (ICI). The overall goal of this study is to develop and validate a biologically-aware interpretable deep learning model to identify the biomarkers that can predict the survival outcome to ICI treatment. MATERIALS/METHODS The self-attention mechanism could yield interpretable results where important biomarkers may have more "attention". However, in classical self-attention mechanism, the prior biological knowledge of protein interactions (PPI) and gene pathways are not incorporated. In this study, we propose a weighted biologically-aware attention score, where it is weighted against the gene centrality and pathway length. The genes that are closely connected to mutated genes receive 'high attention', while the genes that are far away from mutated genes along the pathway receive "lower attention". We then train, validate and test our model using 1,660 patients of nine types of cancer. To validate the prediction, 1. We evaluate the accuracy via concordance index. 2. We identified the genes that receive high attention and verify their functions in existed literature. 3. We perform sanity check by removing these genes from the data, re-training and predicting again, and comparing the prediction accuracy. RESULTS Our framework has achieved an average accuracy (measured via c-index) of 0.60 ± 0.06 for NSCLC and 0.58 ± 0.07 for melanoma, which is superior to both the gold standard COX-PH model (0.57 ± 0.06 for NSCLC and 0.53 ± 0.03 for melanoma) and DeepSurv (0.54 ± 0.05 for NSCLC and 0.51 ± 0.10 for melanoma). Genes that receive high attention have been validated by supporting literature, which provides an additional means of verifying the prediction in comparison to "black box" deep learning models, where there is no way to comprehend the reason behind predictions. Removing the top 8% high-attention genes (∼25 genes) from the data while using the remaining 92% for making predictions resulted in a drop in accuracy to 0.55 ± 0.073 for NSCLC and 0.56 ± 0.03 for melanoma, underscoring the significance of these genes. Patient stratification is also performed by dividing patients into responders and non-responders based on prediction score. CONCLUSION In this study, we propose and validate a biologically-aware self-attention based deep learning model which outperforms commonly-used survival models. Additionally, this tool has the potential to identify key biomarkers while assist in clinical decision-making, which demonstrates a promising step for immunotherapy response prediction.
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Affiliation(s)
- J Liu
- Stanford University, Palo Alto, CA
| | - M T Islam
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Ye S, Shen L, Islam MT, Xing L. Accelerating Volumetric CT and MRI Imaging by Reference-Free Deep Learning Transformation from Low-Resolution to High-Resolution. Int J Radiat Oncol Biol Phys 2023; 117:e742. [PMID: 37786155 DOI: 10.1016/j.ijrobp.2023.06.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) High-resolution (HR) images are important in precision radiation oncology. However, acquiring HR volumetric CT and MRI images is often time consuming; also, the resolution in some direction(s) (e.g., z-direction in the case of CT) is often limited by imaging hardware or fundamental imaging principle. Super-resolution (SR) imaging, i.e., the low-resolution (LR) to HR image transformation, is widely used to improve image resolution. Data-driven deep learning (DL) methods have achieved great success in SR imaging, yet they can hardly be applied to medical imaging as they require large amount of LR-HR image pairs to train the model. We therefore propose a reference-free DL method to increase resolutions of volumetric medical images in an efficient way. MATERIALS/METHODS We propose a maximum likelihood estimation (MLE)-based implicit neural representation (INR) network for SR imaging. The INR network aims to represent an image as a continuous function parameterized by a coordinate-based multi-layer perceptron. The INR network takes image coordinates as input and outputs corresponding pixel intensities. To train the network without using any HR images, we use a MLE framework to model LR observations' statistics and their relation to the latent HR image. The predicted HR image from the INR's output is transformed to LR images based on the MLE, and the network parameters are then optimized by minimizing the distance between the transformed LR images and actual LR observations. We demonstrate the efficacy of the proposed method on CT and MRI images for 2x, 4x, and 8x SR using only one or two LR image(s). The performance is compared with a conventional SR method named plain MLE, in terms of visual quality and numerical qualities of PSNR and SSIM. RESULTS Our method outperformed the plain MLE method in the experiment. Table 1 reports the numerical improvements of our method over the compared plain MLE method. For 2x SR with a single LR image, our method achieved significant improvements in both PSNR and SSIM. When using two LR images, the better structural restoration capability of our method became more obvious with higher SR magnifications, as indicated by the increased SSIM differences. Better noise suppression capability of our method is observed in all our studies, as indicated by the PSNR values. In visual quality evaluation, we observed sharper image details with less noise in SR images generated by the proposed method, compared with the plain MLE method. CONCLUSION The proposed novel reference-free DL method can efficiently provide high-quality HR images with only one or two LR images for CT and MRI imaging. This method can be easily generalized to many other radiation therapy related applications without the requirement for HR reference images.
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Affiliation(s)
- S Ye
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Shen
- Harvard Medical School, Boston, MA
| | - M T Islam
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Dai X, Yang Y, Liu W, Niedermayer TR, Kovalchuk N, Gensheimer MF, Beadle BM, Le QT, Xing L. Reinforcement Learning Powered Station Parameter Optimized Radiation Therapy (SPORT): A Novel Treatment Planning and Beam Delivery Technique. Int J Radiat Oncol Biol Phys 2023; 117:e658. [PMID: 37785951 DOI: 10.1016/j.ijrobp.2023.06.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Conventional intensity modulated radiation therapy (IMRT) with a typical 5-20 fixed beams often does not provide sufficient angular sampling required for conformal dose shaping, whereas current volumetric modulated arc therapy (VMAT) discretizes the angular space into equally spaced control points without considering the differential need for intensity modulation of different angles, leading to undersampling at some angles while oversampling at some other angles. Our goal is to develop a node or station parameter optimized radiation therapy (SPORT) strategy with simultaneously optimized angular sampling and beam modulation by leveraging state-of-the-art reinforcement learning and the unique capability of modern digital LINACs in dose delivery through programmable nodal points. MATERIALS/METHODS We developed a SPORT optimization framework, in which, the process of programming control points (or station parameters) was formulated as a stochastic dynamic programming problem, which was solved by a reinforcement learning-based algorithm. On-policy reinforcement learning method, namely, state-action-reward-state-action (SARSA) was integrated with deep convolutional neural network to predict station parameters by utilizing the patient's anatomical structures meanwhile considering the delivery capability of a typical digital LINAC machine. Here, the deep convolutional neural network estimated the state-action value by using the quality of the plan with current station parameters when a next potential station parameter was selected. The state-action value was then updated by SARSA learning. The quality of the plan was quantified by dosimetry constraints. The model was assessed by a retrospective study on a cohort of patients underwent head-and-neck radiation therapy. Dosimetric analysis and delivery efficiency comparisons were used to evaluate the performance of the proposed framework. RESULTS Our model was used to generate 16 plans unseen in the original training set. All the plans predicted by our model achieved better dose distributions without violating clinical planning constraints. Moreover, instead of using 4 full standard arcs in the original clinically used plans obtained via manual optimization, the predicted plans only used one full standard arc (about 178 control points) plus boost from a few sub-arcs (less than 30 degrees of gantry angles), which significantly improved the efficiency of the beam delivery. We are in the process of integrating the sub-arcs into the full arc by considering the programmable capability of modern LINACs. CONCLUSION We demonstrated that a machine learning-based SPORT framework capable of optimizing the spatial sampling and beam modulation simultaneously for modern radiation therapy. The framework not only significantly improves the quality and efficiency of beam delivery, but also has the potential to be incorporated into current clinical workflow to improve the efficiency of dose planning and delivery.
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Affiliation(s)
- X Dai
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Yang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - T R Niedermayer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - N Kovalchuk
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Sang S, Xing L. Automated Small Tumor Segmentation by a Template-Based Global Hierarchical Attention Method. Int J Radiat Oncol Biol Phys 2023; 117:e485. [PMID: 37785535 DOI: 10.1016/j.ijrobp.2023.06.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Accurate segmentation of tumors is significant for radiation therapy treatment planning and clinical decision-making. While deep convolutional neural network-based methods have found valuable applications in automatic medical segmentation, tumor segmentation, especially small tumor segmentation, remains challenging due to deficiencies of current deep learning in convolutional and pooling operations, which often results in the loss of small object information. This research proposes a global hierarchical attention-based method for accurate and automated segmentation of small tumors by exploiting the associations between small tumors and the feature maps of large tumors. MATERIALS/METHODS This study included 131 patients with liver cancer. The in-plane resolution of the patients' CTs is from 0.55 mm to 1.0 mm and slice spacing from 0.45 mm to 6.0 mm. We randomly selected 100 CT scans as the training set and others as the testing set. Each CT slice of the testing set was separated into groups according to tumor size as follows: 0.1-2.0, 2.1-5.0, 5.1-10.0, and 10.1-20.0 cm. The CT slice without tumor or tumor size > 20 cm were excluded. This work presents a tumor template-based hierarchical attention method to quantify the relation between small and large tumors by computing their feature maps. The relation of small-large tumors can compensate for the information loss of small tumors during the convolutional and pooling operations and improve the performance of small tumor segmentation. RESULTS Among 20,693 CT slices of the 31 testing patients, 3.0% CT slices with tumors ≤2 cm, 6.7% ≤5 cm, 10.6% ≤10 cm, and 13.4%≤20 cm. We compared our method with six widely used segmentation models. The results show our model outperforms other methods on all sizes of liver tumors, especially for small size tumors: For the 0.1-2.0 cm liver tumor, it achieved 8.4%, 10.0%, 11.3%, 9.1%, 10.9%, and 9.6% improvement compared to Unet, PAN, DeepLabV3, FPN, LinkNet, and PSPNet, respectively. CONCLUSION We found that the small-large tumors relation can significantly improve small tumor segmentation, which is valuable for treatment planning, and clinical decision-making. Our experimental results show that our method can significantly improve the accuracy of segmenting small liver tumors compared to existing deep-learning-based models. The method is quite general and can be extended to other types of tumor detection and segmentation. We discovered that the relationship between small and large tumors can significantly enhance the segmentation of small tumors, which has significant value for treatment planning and clinical decision-making. Our experiments demonstrate that our approach significantly improves the accuracy of small liver tumor segmentation compared to existing deep learning-based models. Our method is quite versatile and can be extended to other types of tumor detection and segmentation.
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Affiliation(s)
- S Sang
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Sun L, Zhao W, Lyu T, Chen Y, Xing L, Liu W. An Efficient Transformer Model for Synthesizing Dual Energy CT from Single Energy Scanner. Int J Radiat Oncol Biol Phys 2023; 117:e721-e722. [PMID: 37786104 DOI: 10.1016/j.ijrobp.2023.06.2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Dual-energy CT can be used to optimize radiation treatment. Recently, deep learning has been demonstrated to synthesize high-energy CT images from low-energy ones for dose reduction and lower CT system burden. As the state-of-the-art deep learning architecture, the computation burden of Transformer increases quadratically with the feature size, making the model training resource-demanding or even infeasible. Here, we introduce an efficient transformer for the balance between CT image synthesis quality and computational burden. MATERIALS/METHODS The model is a U-shape deep neural network with encoders and decoders built by Transformer blocks. The model input is low-energy 100kVp CT image and the output is high-energy 140kVp one. Each block has a Self Channel Correlation Unit (SCCU) and a Self Spatial Attention Unit (SSAU). Local shortcuts are applied for both units. Under-sampling operation achieved by pixel shuffling is used to obtain multi-scale feature maps, and the transformer block is applied on each feature scale. Symmetric skip connection sending features from shallow layers to deep layers, thus an additional 1 × 1 convolution is used for feature fusion in each decoder. In a SCCU, the feature is first mapped to one Query, one Key, and one Value. Then the Query and the Key tensors perform matrix multiplication to compute cross covariance of feature channels. The channel correlation score can be obtained by normalization of the covariance, and it is used to weight the Value tensor. As a result, the model complexity only increases linearly with the feature size. Besides the channel weighting, we enhance spatial information using SSAU, where the feature is mapped to two tensors. One tensor after activation is used to point-wisely calibrate another tensor. Additional Transformer blocks are cascaded to the last decoder for feature refinement. Because of the structure similarity of low- and high-energy CT images, a global shortcut is used to ease model training. Clinical iodine contrast-enhanced dual energy CT image datasets of 19 patients are used in this study. The dual-energy scanning is performed by a SOMATOM Definition Flash DECT scanner. We split the datasets into training dataset of 15 patients, validation dataset of 1 patient, and testing dataset of 3 patients. The image size is 512 × 512 with pixel size 0.5 × 0.5 mm2. RESULTS The U-Net model with 1.95M parameters and 44.87G FLOPS achieved the averaged PSNR value of 44.55 dB (s.t.d. 1.34) and averaged RMSE value of 0.0060 (s.t.d. 0.001). In comparison, our efficient Transformer with 1.408M parameters and 31.375G FLOPS achieved the averaged PSNR value of 44.78 dB (s.t.d. 1.37) and RMSE value of 0.0059 (s.t.d. 0.001), demonstrating our model has better performance with small model size and less computation. CONCLUSION The efficient Transformer model allows high-resolution CT image synthesis with small model scale and computation burden from low-energy CT image.
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Affiliation(s)
- L Sun
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Zhao
- School of physics, Beijing University, Beijing, China; Beihang Hangzhou Innovation Institute, Hangzhou, China
| | - T Lyu
- Zhejiang Lab, Hangzhou, China
| | - Y Chen
- School of Computer Science and Engineering, Southeast University, Nanjing, China
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Wen Q, Yang Z, Qiu Q, Xing L, Li R. The Role of CT-Based Radiomics Nomogram in Differential Diagnosis of Immune Checkpoint Inhibitor-Related Pneumonitis from Radiation Pneumonitis for Patients with ESCC. Int J Radiat Oncol Biol Phys 2023; 117:e350-e351. [PMID: 37785215 DOI: 10.1016/j.ijrobp.2023.06.2424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The combination of immunotherapy and chemoradiotherapy has widely used for patients with esophageal squamous cell carcinoma (ESCC) and induced treatment-related adverse effects, particularly immune checkpoint inhibitor-related pneumonitis (CIP) and radiation pneumonitis (RP). The aim of this study is to differentiate between CIP and RP by the CT radiomics and clinical or radiological parameters. MATERIALS/METHODS A total of 76 ESCC patients with pneumonitis were enrolled in this retrospective study and divided into training dataset (n = 53) and validation dataset (n = 23). A total of 837 radiomics features were extracted from regions of interest (ROIs) based on the lung parenchyma window of CT images. A radiomics signature was constructed on the basis of the predictive features by the least absolute shrinkage and selection operator (LASSO). A logistic regression was applied to develop radiomics nomogram. Receiver operating characteristics (ROC) curve and area under the curve (AUC) were applied to evaluate the performance of pneumonitis etiology identification. RESULTS No significant difference was detected between training dataset and validation dataset. The radiomics signature which was made up of four radiomics features shown a favorable performance on differentiating between CIP and RP with the α-binormal-based and empirical AUC = 0.831 and 0.843. Patients with RP had a close relationship with location (p = 0.003) and shape of lesions (p = 0.002). The nomogram that combined with radiomics signature and clinical factors improved the classifying performance on discrimination in the training dataset (AUCαbin = 0.963 and AUCemp = 0.964). The results were verified in the validation dataset with AUC = 0.967 and 0.964. CONCLUSION CT-based radiomics features have potential values for differentiating between patients with CIP and RP. Addition of bilateral changes and sharp border produced superior model performance on classifying, which could be a useful method to improve related clinical decision-making.
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Affiliation(s)
- Q Wen
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Department of Radiotherapy, Stanford University, Palo Alto, CA
| | - Z Yang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Q Qiu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - L Xing
- Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - R Li
- Department of Radiation Oncology, Stanford University, Stanford, CA
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Nomura Y, Ashraf MR, Xing L. Deep Learning-Based Single-View Fluorescence Dose Reconstruction for 3D Dosimetry. Int J Radiat Oncol Biol Phys 2023; 117:S49-S50. [PMID: 37784512 DOI: 10.1016/j.ijrobp.2023.06.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) 3D dose distribution measurement is crucial for precise radiotherapy. Radiation-excited fluorescence imaging has potential for the 3D dosimetry with high spatial resolution, but multiple fluorescence images from different view-angles are required for analytical reconstruction techniques. Furthermore, the imaging data are contaminated by anisotropic Cherenkov light emission and statistical noise. This project aims to establish a novel deep learning-based model to predict 3D dose distributions from a single-view 2D fluorescence image while simultaneously removing the adverse effects of Cherenkov signals and other noises. MATERIALS/METHODS A total of 124 single-aperture static photon beams were delivered to an acrylic tank containing 1 g/L quinine hemisulfate water solution with varying aperture shapes and collimator angle. The emitted optical signals were detected by a low-cost CMOS camera for 20 seconds, and image pre-processing was performed to obtain input 2D fluorescence images with 0.3 × 0.3 mm spatial resolution. 3D back-projected dose distribution images were also calculated from the input fluorescence images. Ground-truth of 3D dose distributions and 2D field map images were obtained from a clinical treatment planning system with 1.4 × 1.4 × 1.4 mm spatial resolution. The proposed deep learning-based dose reconstruction method involved 3 steps. First, 2D fluence map images at the bottom plane of the tank were predicted from the fluorescence images by using a customized convolutional neural network (CNN). Second, the predicted fluence map images were transformed into the 2D field map images on the isocenter plane by applying perspective transformation. Finally, 2D dose distributions at a given radiological depth were calculated by using the predicted field map images, the back-projected dose distribution images, and the radiological depth value as inputs of a shallow CNN. Both CNN models were trained separately, and the 3D dose distributions were predicted by concatenating the output 2D dose distributions at various radiological depths. RESULTS The proposed CNN model yielded accurate 2D field map images. Averaged Dice similarity coefficient and mean absolute error of the field maps in the test data was 92.0% ± 4.6% and 0.0132 ± 0.0113, respectively. Moreover, our deep learning-based approach was able to predict accurate 3D dose distributions from the 2D fluorescence images. Mean squared error and averaged 3D gamma passing ratio (3%/3mm) were 9.55 mGy ± 6.8 mGy and 86.3% ± 9.86%, respectively. CONCLUSION Theproposed deep learning-based method calculated accurate 3D dose distributions from a single-view 2D fluorescence image. Since this technique require only a single CMOS camera image and fluorescent material, it can be readily used for any external radiotherapy modalities, including SRS/SBRT with small fields. This method is useful for acquiring 3D dose distribution data for precise dose verification within a few seconds.
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Affiliation(s)
- Y Nomura
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - M R Ashraf
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Yang Y, Wang JY, Dong P, Kovalchuk N, Gensheimer MF, Beadle BM, Bagshaw HP, Buyyounouski MK, Le QT, Xing L. Clinical Implementation of an Automated IMRT/VMAT Treatment Planning Tool. Int J Radiat Oncol Biol Phys 2023; 117:e739-e740. [PMID: 37786147 DOI: 10.1016/j.ijrobp.2023.06.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To create an in-house automated treatment planning tool for IMRT/VMAT treatments and evaluate the dosimetric plan quality against manually generated plans. MATERIALS/METHODS A scripting application programming interface is employed to interact with a commercial treatment planning system (TPS) to implement automatic plan evaluation and update optimization parameters by mimicking the human planning process. The automated planning performs in an iterative fashion until reaching an acceptable tradeoff among target coverage/dose homogeneity and sparing of critical organs at risk. In each iteration, the dose constraints, priorities, and optimization structures for are automatically updated based on the results of the current iteration. Twenty previously treated plans (10 prostate and 10 head and neck), were preliminarily used to evaluate the performance of the automated planning tool. The differences in target and organ-at-risk metrics from the manually generated clinical plans were analyzed using paired t-test to evaluate clinical acceptability of tour automated planning tool. The current in-house-developed automated planning solution is able to create plans for different disease sites, including head & neck, prostate, pelvis, and lung. So far, the VMAT plans for more than 150 different cases have been generated with the tool. The results for these were also evaluated. RESULTS Compared to the manually generated clinical head and neck plans, all auto plans achieved PTV D95% coverage and critical organs at risk sparing without statistically significant change in average global Dmax (107.4% for manual vs 107.3% for automated plans). The auto-planning solution provided reduced maximum doses to brainstem and spinal cord (average reductions with standard deviations of 5.1 ± 2.6 Gy and 2.9 ± 1.4 Gy, respectively, all p <0.03), reduced average mean doses to contralateral parotid, ipsilateral parotid, contralateral submandibular gland, pharynx, esophagus, cochleae (reductions of 2.2 ± 2.9 Gy, 4.8 ± 4.7 Gy, 3.6 ± 5.2 Gy, 2.0 ± 7.1 Gy, 3.9 ± 2.6 Gy, 3.8 ± 5.0 Gy, respectively, all p < 0.045). Similar results were observed for the prostate plans. With the same PTV coverage and without statistically significant change in average global Dmax (106.5% for manual vs 106.8% for automated plans), the automated solution provided superior sparing for both bladder and rectum. Bladder V75, V70, V65 were reduced by 0.6% ± 2.1%, 0.8% ± 2.5%, and 0.9% ± 2.9% (all p <0.04), respectively. Rectum V75, V70, V65, V60 were reduced by 1.0% ± 2.3%, 1.2% ± 2.8%, 1.3% ± 3.2%, 1.6% ± 3.6% (all p < 0.01), respectively. CONCLUSION Our automated treatment planning solution is capable of efficiently generating VMAT plans for different disease sites with superior dosimetric indices compared to manually generated plans. Our tool is integrated within a commercial TPS platform, so it has the advantage of seamless adoption into the standard workflow to improve plan quality and treatment planning efficiency in our clinic.
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Affiliation(s)
- Y Yang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - P Dong
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - N Kovalchuk
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H P Bagshaw
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M K Buyyounouski
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Han B, Bagshaw HP, Gensheimer MF, Xing L, Chen Y. Patient-Adaptive Automated Segmentation in Daily kVCT Images for Radiotherapy of Head and Neck and Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e668. [PMID: 37785974 DOI: 10.1016/j.ijrobp.2023.06.2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study was to examine the use of transfer learning in deep learning-based auto-segmentation of daily kilovoltage computed tomography (kVCT) images for patient-specific adaptive radiotherapy. Using data from the first cohort of patients treated with the innovative BgRT system, the objective of this study was to evaluate the potential benefits of this approach in facilitating efficient and effective adaptive radiotherapy. MATERIALS/METHODS For the head and neck (HaN) site and pelvic site, we first trained a deep convolutional segmentation network using a population dataset, consisting of 67 and 56 patient cases, respectively. This population network was then fine-tuned for a specific patient using a transfer learning approach, adapting the network weights. The auto-segmentation network utilized in this study was a 23-layer U-Net with batch normalization, a dropout rate of 0.5, and four skip connections between the encoder and decoder at different levels. We used initial planning CT and 5-26 sets of daily kVCT scans with a total of 8,039 images for patient-specific learning in the 6 HaN cases and 4 pelvic cases, particularly analyzing the relationship between the number of sequential patient-specific training data and the performance of the auto-segmentation. We compared the performance of the patient-specific network with the population network and the clinical rigid registration method, using the Dice similarity coefficient (DSC) as the evaluation metric. Additionally, we investigated the corresponding dosimetric impacts of the different auto-segmentation and registration methods. RESULTS The patient-specific network showed improved mean DSC scores of 0.88 and 0.90 for three HaN organs at risk (OARs) and eight pelvic targets and OARs, respectively, compared to the population network (0.70 and 0.63) and the registration method (0.72 and 0.72). The DSC of the patient-specific network steadily improved as the number of longitudinal training cases increased, reaching near saturation after 6 training cases. The use of the patient-specific auto-segmentation resulted in a reduction of the mean discrepancy in target and OAR doses between delivery and planning from 5.5% with the clinical rigid registration to 1.1%. CONCLUSION The use of patient-specific transfer learning in auto-segmenting kVCT images showed higher accuracy compared to a conventional population network and clinical registration-based method. This approach holds promise for enhancing dose evaluation accuracy in adaptive radiotherapy.
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Affiliation(s)
- B Han
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H P Bagshaw
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Chen
- Department of Radiation Oncology, Stanford University, Stanford, CA
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Liu L, Shen L, Johansson A, Cao Y, Balter J, Vitzthum L, Xing L. Real Time Volumetric MRI for MR-Guided 3D Motion Tracking via Sparse Prior-Augmented Neural Representation Learning. Int J Radiat Oncol Biol Phys 2023; 117:S47-S48. [PMID: 37784506 DOI: 10.1016/j.ijrobp.2023.06.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To reconstruct volumetric MRI from orthogonal cine acquisition aided by sparse priors of 2 static 3D MRI through implicit neural representation (NeRP) learning, with the goal of eliminating large-scale training datasets for data-driven sparse MRI reconstruction and supporting clinical workflow of real time 3D motion tracking during MR-guided radiotherapy. MATERIALS/METHODS A multi-layer perceptron network was trained to learn the NeRP of a patient-specific MRI dataset, where the network takes 4D data coordinates of voxel locations and motion states as inputs and outputs corresponding voxel intensities. By first learning the NeRP of 2 static 3D MRI with different breathing motion states, prior knowledge of patient breathing motion was embedded into network weights through optimization. The prior knowledge was then augmented from 2 to 31 motion states by querying the optimized network at interpolated/extrapolated motion state coordinates. Starting from the prior-augmented network as an initialization point, the network was further trained using sparse samples of 2 orthogonal cine slices. The final volumetric reconstruction was obtained by querying the trained network at desired 3D spatial locations. We evaluated the proposed method using 5-minute volumetric MRI time series with 340 ms temporal resolution collected from 7 liver carcinoma patients. The time series was acquired using golden-angle radial MRI sequence and reconstructed through retrospective sorting. Two MRI with inhale and exhale states respectively were selected from the first 30 sec of the time series for prior embedding and augmentation. The remaining 4.5-min time series was used for volumetric reconstruction evaluation, where we retrospectively subsampled each MRI to 2 orthogonal slices and compared network-reconstructed images to ground truth images in terms of image quality and the capability of supporting 3D target motion tracking. RESULTS Across the 7 patients evaluated, the peak signal to noise ratio between model reconstruction and ground truth was 54.66 ± 6.16 dB and the structural similarity index measure was 0.99 ± 0.01. Gross tumor volume (GTV) contours estimated by deforming a reference state MRI to model-reconstructed and ground truth MRI showed good consistency. The 95-percentile Hausdorff distance between GTV contours was 1.89 ± 1.13 mm, which is less than the voxel dimension. The mean GTV centroid position difference between ground truth and model estimation was less than 1 mm in all 3 orthogonal directions. CONCLUSION Volumetric MRI from orthogonal cine acquisition with sparse priors is feasible by modeling prior knowledge through implicit neural representation learning. The model-reconstructed images showed sufficient accuracy in supporting 3D motion tracking of abdominal targets. By eliminating the need for large scale training datasets, the method promises to enable clinical implementation of 3D motion tracking for precision radiation therapy.
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Affiliation(s)
- L Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Shen
- Harvard Medical School, Boston, MA
| | | | - Y Cao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - J Balter
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - L Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Teng F, Wang P, Yin T, Xing L, Yu J. Analyzing the Predictive Effects of PD-L1 Expression, Early Changes of bTMB and Circulated CD8+T Cells during Treatment for Responses of RT Combined with ICI in NSCLC. Int J Radiat Oncol Biol Phys 2023; 117:e262-e263. [PMID: 37785003 DOI: 10.1016/j.ijrobp.2023.06.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The beneficial role of immunotherapy and the clinical relevance of current biomarkers remain inconclusive; thus, appropriate strategies and reliable predictors need further definition. A rational combination of biomarkers is needed. Here, we estimated potential predictive factors for responses of radiotherapy (RT) combined with immune checkpoint inhibitor (ICI) in a phase II trial to determine the efficacy and safety of combination of moderate hypofractionated RT with ICI in patients with oligometastatic NSCLC (NCT03557411). MATERIALS/METHODS Pretreatment tumor tissue samples and longitudinal blood were collected for immune and tumor biomarker analysis. We examined pre-treatment (pre-ICI) PD-L1 expression in tumor cells. Circulating tumor cell (CTC), PD-L1+CTC, blood tumor mutation burden (bTMB), CD8+T cells, CD4+T cells, NK cells, B cells in circulation were acquired pre-ICI and 1 month after ICI starting (1-mth). In addition, early changes of CTC (CTC), PD-L1+CTC (PD-L1+CTC), bTMB (bTMB), CD8+T cells (CD8+T cells), CD4+T cells (CD4+T cells), NK cells (NK cells), B cells (B cells) were also analyzed to estimate the predictive effects for treatment. RESULTS High pre-ICI bTMB and increased CD8+T cells at 1 month was associated with better PFS (p = 0.016; p = 0.006). Interaction analyses revealed that each combination of two markers in the 5 markers including PD-L1, pre-ICI bTMB, 1-mth bTMB, 1-mth CD8+T cells and CD8+T cells was significantly associated with PFS, except for CTC, PD-L1+CTC, CD4+T cells, NK cells and B cells in circulation due to low power. Unsupervised cluster analysis based on these markers revealed three sub-cohorts. Cohort-1 was overrepresented by patients with progressive disease (81%) of whom were negative for 3-4 of the 5 biomarkers. Cohort-3 was overrepresented by patients with partial response (70%) of whom were positive for 3-4 of the 5 biomarkers. Survival analyses of the 3 cohorts indicated a significant association with PFS (p = 0.017). CONCLUSION This study suggests that a combination of PD-L1 expression, early changes of bTMB and circulated CD8+T cells as a better predictive biomarker for response to RT combined with ICI. Consequently, refinement of this set of biomarkers and validation in a larger set of patients is warranted.
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Affiliation(s)
- F Teng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - P Wang
- Shandong Cancer Hospital & Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - T Yin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - L Xing
- Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - J Yu
- Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
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Zhu W, Xing L, Zhao H. Does Epigallocatechin Gallate as a Radiation Protective Agent Reduce the Anti-Tumor Effect of Radiotherapy in Postoperative Breast Cancer Radiotherapy? Int J Radiat Oncol Biol Phys 2023; 117:e217. [PMID: 37784891 DOI: 10.1016/j.ijrobp.2023.06.1114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Based on the previous encouraging results, we further explored whether EGCG would have a protective effect on potential tumor lesions, that is, reduce the efficacy of radiotherapy. We selected patients with stage III breast cancer with or without EGCG. The local control rate, distant metastasis rate, DFS and OS were compared between the two groups. MATERIALS/METHODS Patients with stage III breast cancer who were treated with EGCG and radiotherapy was selected from a phase II clinical study (ClinicalTrials.gov, No. NCT02580279). Each patient was matched with one control patient without EGCG From the medical database of our hospital matching for age and stage. The control group of stage-and age-matched patients was selected at random from the medical database of our hospital RESULTS: We identified 43 EGCG patients and 43 matched controls. The median age was 45 years (range: 26-67). Between the two groups, there were no obvious differences in the baseline demographic or clinical features. When compared to the placebo group, the mean radiation-induced dermatitis index (RIDI) in the EGCG group was substantially lower (2.56±1.14 vs 3.36±1.16 T = -3.232, P = 0.002). Repeated measures ANOVA indicated the significant differences in the RTOG score during the course of radiotherapy between the two groups (F = 9.611 P = 0.003). The patients mostly experienced RID two or three weeks after starting radiotherapy, although in the EGCG group, it appeared later (3.19±0.91 weeks) than it did in the placebo group (2.67±0.84 weeks), P = 0.008. The median follow-up for patients in the EGCG group at the time of data collection was 50.6 months with 95% confidence interval (CI) from 43.9 to 57.3. While it was 48.6 months (95% CI: 43.4-53.9) for patients in the control group. There was no significant difference in overall survival (OS), disease free-survival (DFS) and freedom from locoregional (LRF) and distant failure (DMF) (P > 0.05). At the data cut-off (December 2021), the 4-year DFS with EGCG was 71.4% compared to 65.4% with conventional therapy, and the 4-year OS was 77.0% compared to 80.3%. CONCLUSION The prophylactic use of EGCG solution reduced the RID score of stage III breast cancer patients without negatively impacting the therapeutic effect of radiotherapy on the tumor. EGCG is safe and feasible choice for RID for breast cancer during radiotherapy.
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Affiliation(s)
- W Zhu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - L Xing
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - H Zhao
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Zhang W, Xu M, Chen F, Su Y, Yu M, Xing L, Chang Y, Yan T. Targeting the JAK2-STAT3 pathway to inhibit cGAS-STING activation improves neuronal senescence after ischemic stroke. Exp Neurol 2023; 368:114474. [PMID: 37419174 DOI: 10.1016/j.expneurol.2023.114474] [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: 02/22/2023] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
Neuroinflammation after cerebral ischemia is a key event in progressive brain injury after ischemic stroke. The JAK2/STAT3 pathway is pivotal for neuroinflammation; however, its role in brain senescence after ischemic stroke is unclear. Here, we report that inflammation is increased in the brains of C57BL/6 stroke mice. Treatment of ischemic stroke in adult mice with a JAK kinase inhibitor (AG490) alleviated neurobehavioral defects, reduced brain infarct volume, reduced expression of pro-inflammatory cytokines, and decreased activation of pro-inflammatory microglia. Moreover, AG490 treatment reduced oxidative DNA damage and cellular senescence in the brains of mice following ischemic stroke. Cyclic GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING) were associated with inflammation and senescence. Furthermore, AG490 blocked cGAS/STING/NF-κBp65 expression. Overall, our results indicate that inhibition of JAK2/STAT3 can alleviate the negative neurological consequences of ischemic stroke, likely due to repression of cGAS/STING/NF-κB p65, leading to reduced neuroinflammation and neuronal senescence. Therefore, JAK2/STAT3 may represent a viable therapeutic target for preventing senescence after ischemic stroke.
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Meijie Xu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Fangyu Chen
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Yue Su
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Mingjing Yu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Ling Xing
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Yifan Chang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Tao Yan
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post Neurotrauma, Neurorepair, and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.
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Wang JY, Chen Y, Pham D, Lewis J, Beadle BM, Gensheimer MF, Le QT, Gu X, Xing L. Prospective Clinical Adoption of Artificial Intelligence for Organ Contouring in Head and Neck Radiation Treatment Planning. Int J Radiat Oncol Biol Phys 2023; 117:e490-e491. [PMID: 37785549 DOI: 10.1016/j.ijrobp.2023.06.1721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients that undergo head and neck (H&N) radiation therapy (RT) require laborious delineation of organs-at-risk (OARs) on computed tomography (CT) scans in a treatment planning system (TPS) to minimize radiation to normal tissue. This task can be completed rapidly and accurately with recently developed artificial intelligence-based semantic segmentation models. The current study aims to deploy and evaluate a strategy for improving clinical practice with this technology. MATERIALS/METHODS Deep learning models were trained and tested with CT scans and OAR contours from previous H&N RT cases at our clinic. Two medical physicists vetted the models and selected a 2.5D U-Net for further implementation. The model was embedded in a dedicated server at the hospital, programmed to read H&N CT scans staged for import into the TPS, generate auto-contours, and write them into a TPS-compatible format made available alongside the scan. In the pilot implementation, the auto-contouring service was utilized for more than 60 cases, prospectively. The auto-contours were quantitatively evaluated against the treatment-approved contours to determine how much modification was performed by the clinical team. RESULTS The 2.5D U-Net selected for clinical integration segments 21 OARs in less than 3 minutes per scan. Across all the prospective cases, the mean Dice score and mean 95th percentile Hausdorff distance (mm) between the auto-contour and treatment-approved contour for each of the 21 OARs were as follows, respectively: brainstem (0.93, 1.94), optic chiasm (0.70, 2.96), left cochlea (0.69, 2.37), right cochlea (0.68, 2.44), esophagus (0.88, 2.46), left globe (0.93, 1.50), right globe (0.93, 1.63), glottis (0.91, 2.13), larynx (0.93, 2.76), mandible (0.90, 4.86), left optic nerve (0.78, 1.64), right optic nerve (0.82, 1.65), oral cavity (0.86, 8.46), left parotid gland (0.91, 2.78), right parotid gland (0.91, 2.39), pharynx (0.85, 2.39), spinal cord (0.87, 2.27), left submandibular gland (0.85, 3.46), right submandibular gland (0.83, 3.69), left temporal lobe (0.94, 2.20), and right temporal lobe (0.95, 2.09). The auto-contours for the optic chiasm, optic nerves, cochleas, and submandibular glands differed substantially from the final contours, a finding corroborated by the clinical team; the rest were clinically acceptable with minor or no edits necessary. CONCLUSION The proposed strategy provides a sophisticated starting point for treatment planning that has garnered overall favorable feedback from the participating radiation oncologists and dosimetrists. Consequently, the technique is being extended to other treatment sites.
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Affiliation(s)
- J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Chen
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Lewis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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20
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Wu H, Jin J, Ma H, Xing L. Hybrid Cooperative Cache Based on Temporal Convolutional Networks in Vehicular Edge Network. Sensors (Basel) 2023; 23:4619. [PMID: 37430532 DOI: 10.3390/s23104619] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 07/12/2023]
Abstract
With the continuous development of intelligent vehicles, people's demand for services has also rapidly increased, leading to a sharp increase in wireless network traffic. Edge caching, due to its location advantage, can provide more efficient transmission services and become an effective method to solve the above problems. However, the current mainstream caching solutions only consider content popularity to formulate caching strategies, which can easily lead to cache redundancy between edge nodes and lead to low caching efficiency. To solve these problems, we propose a hybrid content value collaborative caching strategy based on temporal convolutional network (called THCS), which achieves mutual collaboration between different edge nodes under limited cache resources, thereby optimizing cache content and reducing content delivery latency. Specifically, the strategy first obtains accurate content popularity through temporal convolutional network (TCN), then comprehensively considers various factors to measure the hybrid content value (HCV) of cached content, and finally uses a dynamic programming algorithm to maximize the overall HCV and make optimal cache decisions. We have obtained the following conclusion through simulation experiments: compared with the benchmark scheme, THCS has improved the cache hit rate by 12.3% and reduced the content transmission delay by 16.7%.
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Affiliation(s)
- Honghai Wu
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Jichong Jin
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Huahong Ma
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Ling Xing
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
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21
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Li X, Xv F, Ma LZ, Xing L, Zhao JB, Zhi WJ, Wang LF, Wang Y, Mao HD, Liu SY, Liu YH, Song Q. Acquired heat acclimation in rats subjected to physical exercise under environmental heat stress alleviates brain injury caused by exertional heat stroke. Brain Res 2023; 1811:148393. [PMID: 37150340 DOI: 10.1016/j.brainres.2023.148393] [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: 12/25/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Exertional heatstroke (EHS) is an emergency with a high mortality rate, characterized by central nervous system dysfunctions. This study aims to establish a Heat acclimation/acclimatization (HA) rat model in locomotion to recapitulate the physical state of human in severe environment of high temperature and humidity, and investigate the mechanism of organism protection in HA. (2) Methods: Wistar rats were exposed to 36°C and ran 2 h/d for 21 days, acquired thermal tolerance test was conducted to assess the thermotolerance and exercise ability. Core temperature and consumption of water and food were observed. Expression of HSP70 and HSP90 of different tissues were determined by WB. Pathological structure of brain tissue was detected with HE staining. Proteomics was used to identify the differently expressed proteins in cerebral cortex of different groups. And key molecules were identified by RT-PCR and WB. (3) Results: HA rats displayed stronger thermotolerance and exercised ability on acquired thermal tolerance test. Brain water content of HA+EHS group reduced compared with EHS group. HE staining revealed slighter brain injuries of HA+EHS group than that of EHS. Proteomics focused on cell death-related pathways and key molecules Aquaporin 4 (AQP4) related to cell edema. Identification results showed HA increased AQP4, Bcl-xl, ratio of p-Akt/AKT and Bcl-xl/Bax, down-regulated Cleaved Caspase-3. (4) Conclusions: This HA model can ameliorate brain injury of EHS by reducing cerebral edema and cell apoptosis, offering experimental evidence for EHS prophylaxis.
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Affiliation(s)
- Xin Li
- Postgraduate School, Medical School of Chinese PLA, Beijing 100853, China; Department of Emergency, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
| | - Fan Xv
- Postgraduate School, Medical School of Chinese PLA, Beijing 100853, China.
| | - Li-Zhen Ma
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China.
| | - Ling Xing
- Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing. 100176, China.
| | - Jin-Bao Zhao
- Department of Emergency, sixth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China.
| | - Wei-Jia Zhi
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China.
| | - Li-Feng Wang
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China.
| | - Yang Wang
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China.
| | - Han-Ding Mao
- Postgraduate School, Medical School of Chinese PLA, Beijing 100853, China.
| | - Shu-Yuan Liu
- Department of Emergency, sixth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China.
| | - Ya-Hua Liu
- Department of Emergency, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
| | - Qing Song
- Postgraduate School, Medical School of Chinese PLA, Beijing 100853, China; Department of Critical Care Medicine, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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22
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Xing L, Wang K, Wu H, Ma H, Zhang X. Intrusion Detection Method for Internet of Vehicles Based on Parallel Analysis of Spatio-Temporal Features. Sensors (Basel) 2023; 23:s23094399. [PMID: 37177603 PMCID: PMC10181641 DOI: 10.3390/s23094399] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
The problems with network security that the Internet of Vehicles (IoV) faces are becoming more noticeable as it continues to evolve. Deep learning-based intrusion detection techniques can assist the IoV in preventing network threats. However, previous methods usually employ a single deep learning model to extract temporal or spatial features, or extract spatial features first and then temporal features in a serial manner. These methods usually have the problem of insufficient extraction of spatio-temporal features of the IoV, which affects the performance of intrusion detection and leads to a high false-positive rate. To solve the above problems, this paper proposes an intrusion detection method for IoV based on parallel analysis of spatio-temporal features (PA-STF). First, we built an optimal subset of features based on feature correlations of IoV traffic. Then, we used the temporal convolutional network (TCN) and long short-term memory (LSTM) to extract spatio-temporal features in the IoV traffic in a parallel manner. Finally, we fused the spatio-temporal features extracted in parallel based on the self-attention mechanism and used a multilayer perceptron to detect attacks in the Internet of Vehicles. The experimental results show that the PA-STF method reduces the false-positive rate by 1.95% and 1.57% on the NSL-KDD and UNSW-NB15 datasets, respectively, with the accuracy and F1 score also being superior.
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Affiliation(s)
- Ling Xing
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Kun Wang
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Honghai Wu
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Huahong Ma
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
| | - Xiaohui Zhang
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471000, China
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23
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Kong J, Liu Y, Qian M, Xing L, Gao S. The relationship between Porphyromonas gingivalis and oesophageal squamous cell carcinoma:A literature review. Epidemiol Infect 2023; 151:e69. [PMID: 37009715 DOI: 10.1017/s0950268823000298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Oesophageal cancer is the most common gastrointestinal malignancy in China and one of the major causes of death due to cancer worldwide. The occurrence of oesophageal cancer is a multifactor, multistage, and multistep process influenced by heredity, the environment, and microorganisms. Specifically, bacterial infection may be involved in the process of tissue carcinogenesis by directly or indirectly influencing tumour occurrence and development. Porphyromonas gingivalis is an important pathogen causing periodontitis, and periodontitis can promote the occurrence of various tumours. An increasing number of studies to date have shown that P. gingivalis plays an important role in the occurrence and development of oesophageal cancer. Overall, exploring how P. gingivalis promotes oesophageal cancer occurrence and development and how it affects the prognosis of these patients is of great importance for the diagnosis, prevention, and treatment of this type of cancer. Herein, the latest progress is reviewed.
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24
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Xing L, Yu J, Zhao R, Yang W, Guo Y, Li J, Xiao C, Ren Y, Dong L, Lv D, Zhao L, Lin Y, Zhang X, Chen L, Zhang A, Wang Y, Jiang D, Liu A, Ma C. 125P Real-world treatment patterns in stage III NSCLC patients: Interim results of a prospective, multicenter, non-interventional study (MOOREA). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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25
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Huang Y, Zhao P, Zhang Q, Xing L, Wu H, Ma H. A Semantic-Enhancement-Based Social Network User-Alignment Algorithm. Entropy (Basel) 2023; 25:172. [PMID: 36673313 PMCID: PMC9858570 DOI: 10.3390/e25010172] [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: 12/13/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
User alignment can associate multiple social network accounts of the same user. It has important research implications. However, the same user has various behaviors and friends across different social networks. This will affect the accuracy of user alignment. In this paper, we aim to improve the accuracy of user alignment by reducing the semantic gap between the same user in different social networks. Therefore, we propose a semantically enhanced social network user alignment algorithm (SENUA). The algorithm performs user alignment based on user attributes, user-generated contents (UGCs), and user check-ins. The interference of local semantic noise can be reduced by mining the user's semantic features for these three factors. In addition, we improve the algorithm's adaptability to noise by multi-view graph-data augmentation. Too much similarity of non-aligned users can have a large negative impact on the user-alignment effect. Therefore, we optimize the embedding vectors based on multi-headed graph attention networks and multi-view contrastive learning. This can enhance the similar semantic features of the aligned users. Experimental results show that SENUA has an average improvement of 6.27% over the baseline method at hit-precision30. This shows that semantic enhancement can effectively improve user alignment.
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Affiliation(s)
- Yuanhao Huang
- The College of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China
| | - Pengcheng Zhao
- The College of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China
| | - Qi Zhang
- The School of Information Engineering, Southwest University of Science and Technology, Mianyang 621010, China
| | - Ling Xing
- The College of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China
| | - Honghai Wu
- The College of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China
| | - Huahong Ma
- The College of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China
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26
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Abstract
The displacement of a suspension of particles by an immiscible fluid in a capillary tube or in porous media is a canonical configuration that finds application in a large number of natural and industrial applications, including water purification, dispersion of colloids and microplastics, coating and functionalization of tubings. The influence of particles dispersed in the fluid on the interfacial dynamics and on the properties of the liquid film left behind remain poorly understood. Here, we study the deposition of a coating film on the walls of a capillary tube induced by the translation of a suspension plug pushed by air. We identify the different deposition regimes as a function of the translation speed of the plug, the particle size, and the volume fraction of the suspension. The thickness of the coating film is characterized, and we show that similarly to dip coating, three coating regimes are observed, liquid only, heterogeneous, and thick films. We also show that, at first order, the thickness of films thicker than the particle diameter can be predicted using the effective viscosity of the suspension. Nevertheless, we also report that for large particles and concentrated suspensions, a shear-induced migration mechanism leads to local variations in volume fraction and modifies the deposited film thickness and composition.
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Affiliation(s)
- D-H Jeong
- Department of Mechanical Engineering, University of California, Santa Barbara, CA 93106, USA.
| | - L Xing
- Department of Mechanical Engineering, University of California, Santa Barbara, CA 93106, USA.
| | - J-B Boutin
- Department of Mechanical Engineering, University of California, Santa Barbara, CA 93106, USA.
| | - A Sauret
- Department of Mechanical Engineering, University of California, Santa Barbara, CA 93106, USA.
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27
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Nomura Y, Ashraf R, Shi M, Xing L. Deep Learning-Based Fluorescence Light Discrimination for High Spatial Resolution Radiotherapy Dose Verification. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Chen Y, Yu L, Zhou Y, Shen L, Kovalchuk N, Xing L, Han B, Gensheimer M. Systematic Study of Patient-Specific Organs at Risk Auto-Segmentation on Daily kVCT Images for Adaptive Head and Neck Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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29
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Vasudevan V, Shen L, Huang C, Chuang C, Islam M, Ren H, Yang Y, Dong P, Xing L. Neural Representation for Three-Dimensional Dose Distribution and its Applications in Precision Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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30
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Liu L, Shen L, Xing L. Neural Representation of Linear Accelerator Beam Data from a Single Reference Dataset for Fast Commissioning and Quality Assurance. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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31
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Chen Y, Butler S, Xing L, Han B, Bagshaw H. Patient-Specific Auto-Segmentation of Target and OARs via Deep Learning on Daily Fan-Beam CT for Adaptive Prostate Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Zhou C, Xiong Z, Bai H, Xing L, Jia Y, Yuan X. Parameter-Adaptive TVF-EMD Feature Extraction Method Based on Improved GOA. Sensors (Basel) 2022; 22:7195. [PMID: 36236294 PMCID: PMC9571525 DOI: 10.3390/s22197195] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
In order to separate the sub-signals and extract the feature frequency in the signal accurately, we proposed a parameter-adaptive time-varying filtering empirical mode decomposition (TVF-EMD) feature extraction method based on the improved grasshopper optimization algorithm (IGOA). The method not only improved the local optimal problem of GOA, but could also determine the bandwidth threshold and B-spline order of TVF-EMD adaptively. Firstly, a nonlinear decreasing strategy was introduced in this paper to adjust the decreasing coefficient of GOA dynamically. Then, energy entropy mutual information (EEMI) was introduced to comprehensively consider the energy distribution of the modes and the dependence between the modes and the original signal, and the EEMI was used as the objective function. In addition, TVF-EMD was optimized by IGOA and the optimal parameters matching the input signal were obtained. Finally, the feature frequency of the signal was extracted by analyzing the sensitive mode with larger kurtosis. The optimization experiments of 23 sets of benchmark functions showed that IGOA not only enhanced the balance between exploration and development, but also improved the global and local search ability and stability of the algorithm. The analysis of the simulation signal and bearing signal shows that the parameter-adaptive TVF-EMD method can separate the modes with specific physical meanings accurately. Compared with ensemble empirical mode decomposition (EEMD), variational mode decomposition (VMD), TVF-EMD with fixed parameters and GOA-TVF-EMD, the decomposition performance of the proposed method is better. The proposed method not only improved the under-decomposition, over-decomposition and modal aliasing problems of TVF-EMD, but could also accurately separate the frequency components of the signal and extract the included feature information, so it has practical significance in mechanical fault diagnosis.
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Affiliation(s)
- Chengjiang Zhou
- School of Information Science and Technology, Yunnan Normal University, Kunming 650500, China
- The Laboratory of Pattern Recognition and Artificial Intelligence, Kunming 650500, China
| | - Zenghui Xiong
- School of Information Science and Technology, Yunnan Normal University, Kunming 650500, China
- The Laboratory of Pattern Recognition and Artificial Intelligence, Kunming 650500, China
| | - Haicheng Bai
- School of Information Science and Technology, Yunnan Normal University, Kunming 650500, China
- The Laboratory of Pattern Recognition and Artificial Intelligence, Kunming 650500, China
| | - Ling Xing
- School of Information Science and Technology, Yunnan Normal University, Kunming 650500, China
- The Laboratory of Pattern Recognition and Artificial Intelligence, Kunming 650500, China
| | - Yunhua Jia
- School of Information Science and Technology, Yunnan Normal University, Kunming 650500, China
- The Laboratory of Pattern Recognition and Artificial Intelligence, Kunming 650500, China
| | - Xuyi Yuan
- Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming 650500, China
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33
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Xie P, Li F, You I, Xing L, Wu H, Ma H. A Secrecy Transmission Protocol with Energy Harvesting for Federated Learning. Sensors (Basel) 2022; 22:5506. [PMID: 35898011 PMCID: PMC9371431 DOI: 10.3390/s22155506] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
In federated learning (FL), model parameters of deep learning are communicated between clients and the central server. To better train deep learning models, the spectrum resource and transmission security need to be guaranteed. Toward this end, we propose a secrecy transmission protocol based on energy harvesting and jammer selection for FL, in which the secondary transmitters can harvest energy from the primary source. Specifically, a secondary transmitter STi is first selected, which can offer the best transmission performance for the secondary users to access the primary frequency spectrum. Then, another secondary transmitter STn, which has the best channel for eavesdropping, is also chosen as a friendly jammer to provide secrecy service. Furthermore, we use outage probability (OP) and intercept probability (IP) as metrics to evaluate performance. Meanwhile, we also derive closed-form expressions of OP and IP of primary users and OP of secondary users for the proposed protocol, respectively. We also conduct a theoretical analysis of the optimal secondary transmission selection (OSTS) protocol. Finally, the performance of the proposed protocol is validated through numerical experiments. The results show that the secrecy performance of the proposed protocol is better than the OSTS and OCJS, respectively.
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Affiliation(s)
- Ping Xie
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (P.X.); (F.L.); (L.X.); (H.W.); (H.M.)
| | - Fan Li
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (P.X.); (F.L.); (L.X.); (H.W.); (H.M.)
| | - Ilsun You
- Department of Financial Information Security, Kookmin University, Seoul 02707, Korea
| | - Ling Xing
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (P.X.); (F.L.); (L.X.); (H.W.); (H.M.)
| | - Honghai Wu
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (P.X.); (F.L.); (L.X.); (H.W.); (H.M.)
| | - Huahong Ma
- School of Information Engineering, Henan University of Science and Technology, Luoyang 471023, China; (P.X.); (F.L.); (L.X.); (H.W.); (H.M.)
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Lin X, Zhang H, Liu J, Wu CL, McDavid A, Boyce BF, Xing L. Aged Callus Skeletal Stem/Progenitor Cells Contain an Inflammatory Osteogenic Population With Increased IRF and NF-κB Pathways and Reduced Osteogenic Potential. Front Mol Biosci 2022; 9:806528. [PMID: 35755815 PMCID: PMC9218815 DOI: 10.3389/fmolb.2022.806528] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/29/2022] [Indexed: 11/15/2022] Open
Abstract
Skeletal stem/progenitor cells (SSPCs) are critical for fracture repair by providing osteo-chondro precursors in the callus, which is impaired in aging. However, the molecular signatures of callus SSPCs during aging are not known. Herein, we performed single-cell RNA sequencing on 11,957 CD45-CD31-Ter119- SSPCs isolated from young and aged mouse calluses. Combining unsupervised clustering, putative makers, and DEGs/pathway analyses, major SSPC clusters were annotated as osteogenic, proliferating, and adipogenic populations. The proliferating cluster had a differentiating potential into osteogenic and adipogenic lineages by trajectory analysis. The osteoblastic/adipogenic/proliferating potential of individual clusters was further evidenced by elevated expression of genes related to osteoblasts, adipocytes, or proliferation. The osteogenic cluster was sub-clustered into house-keeping and inflammatory osteogenic populations that were decreased and increased in aged callus, respectively. The majority of master regulators for the inflammatory osteogenic population belong to IRF and NF-κB families, which was confirmed by immunostaining, RT-qPCR, and Western blot analysis. Furthermore, cells in the inflammatory osteogenic sub-cluster had reduced osteoblast differentiation capacity. In conclusion, we identified 3 major clusters in callus SSPCs, confirming their heterogeneity and, importantly, increased IRF/NF-κB-mediated inflammatory osteogenic population with decreased osteogenic potential in aged cells.
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Affiliation(s)
- X. Lin
- Department of Pathology and Laboratory Medicine, Rochester, NY, United States
| | - H. Zhang
- Department of Pathology and Laboratory Medicine, Rochester, NY, United States
| | - J. Liu
- Department of Pathology and Laboratory Medicine, Rochester, NY, United States
| | - C L. Wu
- Center for Musculoskeletal Research, Rochester, NY, United States
| | - A. McDavid
- Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - B. F. Boyce
- Department of Pathology and Laboratory Medicine, Rochester, NY, United States
- Center for Musculoskeletal Research, Rochester, NY, United States
| | - L. Xing
- Department of Pathology and Laboratory Medicine, Rochester, NY, United States
- Center for Musculoskeletal Research, Rochester, NY, United States
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Shen L, Zhao W, Pauly J, Xing L. PD-0324 A Geometry-Informed Deep Learning Framework for Ultra-Sparse 3D Tomographic Image Reconstruction. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02817-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Nomura Y, Huang C, Xing L. PD-0732 Dosimetric feature-based beam orientation selection in intensity-modulated radiation therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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37
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Robinson C, Xing L, Tanaka H, Tasaka S, Badiyan S, Nasrallah H, Biswas T, Shtivelband M, Schuette W, Shi A, Hepner A, Barrett K, Rigas J, Jiang H, Lin S. 122TiP Phase III study of durvalumab with SBRT for unresected stage I/II, lymph-node negative NSCLC (PACIFIC-4/RTOG 3515). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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38
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Xia MX, Shi ZM, Xing L, Gao DJ, Ye X, Wang TT, Wu J, Qian YW, Qin WH, Hu B. Endoscopic radiofrequency ablation may improve overall survival in patients with inoperable ampullary carcinoma. Dig Endosc 2022; 34:587-595. [PMID: 34233037 DOI: 10.1111/den.14078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/08/2022]
Abstract
OBJECTIVES Patients with advanced ampullary carcinoma (AC) who are unsuitable for surgery are most likely to have poor outcomes. The role of endoscopic radiofrequency ablation (RFA) in this population has not been fully defined. We aimed to assess the short- and long-term outcomes of RFA in a large cohort of AC patients. METHODS In this retrospective study, data of consecutive patients with pathologically proven AC who underwent successful endobiliary RFA and/or stent placement were collected. All patients did not undergo surgical resection. The primary outcome was overall survival (OS). The secondary outcomes included clinical success and adverse events. RESULTS A total of 85 patients, 50 in the RFA plus stenting group and 35 in the stenting alone group, were identified. The median OS was significantly longer in the RFA group than in the stenting alone group (16.9 vs. 9.8 months, P < 0.001). In multivariable Cox analysis, RFA (hazards ratio 0.408; 95% confidence interval 0.235-0.706; P = 0.001) was the only independent OS predictor. Eight patients with stage II tumors, exclusively from the RFA group, survived for more than 3 years. Clinical success was comparable between the two groups (96% vs. 100%, P = 0.231). Early adverse events between the two groups were similar (10% vs. 2.9%, P = 0.206); however, late biliary/pancreatic stenoses occurred in three RFA patients who were successfully managed with endoscopic interventions. CONCLUSIONS Endoscopic RFA appears to prolong patients' survival with acceptable safety; it may therefore be a feasible treatment option for patients with inoperable ampullary cancers.
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Affiliation(s)
- Ming-Xing Xia
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Zhi-Mei Shi
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Ling Xing
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Dao-Jian Gao
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Xin Ye
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Tian-Tian Wang
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Jun Wu
- Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Shanghai, China
| | - You-Wen Qian
- Department of, Pathology, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Wen-Hao Qin
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Bing Hu
- Departments of, Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Shanghai, China
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Gao DJ, Xing L, Ye X, Wang TT, Wu J, Xia MX, Hu B. Long Slimmer Metal Stent Is Feasible and Effective for Endoscopic Dual Stent-by-Stent Placement in Malignant Hilar Biliary Stricture. Dig Dis Sci 2022; 67:1073-1082. [PMID: 33675491 DOI: 10.1007/s10620-021-06906-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bilateral endoscopic biliary stenting remains technically challenging, which limits its wider clinical application. AIMS We have developed a novel long (10-12 cm) and slimmer (6 mm) self-expanded metal stent. The aim of this study was to evaluate the feasibility, efficacy, and safety of the new metal stent for palliative treatment of malignant hilar biliary strictures (MHBS). METHODS This retrospective study of prospectively collected data included 45 patients with unresectable malignant hilar biliary strictures of Bismuth type II or higher. A pair of long slimmer metal stents were sequentially placed into the intrahepatic duct using the stent-by-stent mode. The success rate and short- and long-term clinical outcomes were observed. RESULTS The technical success rate was 100%, with a mean procedure time of 43.7 ± 11.5 min. The clinical success was achieved in 44 patients (97.8%). Early adverse events included mild acute pancreatitis (n = 2) and cholangitis (n = 3). Later cholangitis occurred in 14 of the 45 patients due to stent occlusions. The median stent patency was 260 days (95% CI 228.3-291.7). Stent malfunctions occurred in 23 of the 45 patients, and 15 of them received bilateral endoscopic plastic stents placements. The technical success for the re-intervention was 100% with the mean procedure time of 24.3 ± 4.5 min. The median overall survival of the whole group was 229 days (95% CI 171.2-286.8). CONCLUSIONS The long slimmer metal stent for bilateral endoscopic stent-by-stent placement proved to be safe, feasible, and effective for MHBS and facilitates endoscopic re-intervention as well.
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Affiliation(s)
- Dao-Jian Gao
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Ling Xing
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Xin Ye
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Tian-Tian Wang
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Jun Wu
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Ming-Xing Xia
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China
| | - Bing Hu
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Shanghai, 200438, People's Republic of China.
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Liu S, Xing L, Zhang J, Wang K, Duan M, Wei M, Zhang B, Chang Z, Zhang H, Shang P. Expression pattern of CRYAB and CTGF genes in two pig breeds at different altitudes. ARQ BRAS MED VET ZOO 2022. [DOI: 10.1590/1678-4162-12403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Tibetan pigs are characterized by significant phenotypic differences relative to lowland pigs. Our previous study demonstrated that the genes CRYAB and CTGF were differentially expressed in heart tissues between Tibetan (highland breed) and Yorkshire (lowland breed) pigs, indicating that they might participate in hypoxia adaptation. CRYAB (ɑB-crystallin) and CTGF (connective tissue growth factor) have also been reported to be associated with lung development. However, the expression patterns of CRYAB and CTGF in lung tissues at different altitudes and their genetic characterization are not well understood. In this study, qRT-PCR and western blot of lung tissue revealed higher CRYAB expression levels in highland and middle-highland Tibetan and Yorkshire pigs than in their lowland counterparts. With an increase in altitude, the expression level of CTGF increased in Tibetan pigs, whereas it decreased in Yorkshire pigs. Furthermore, two novel single-nucleotide polymorphism were identified in the 5′ flanking region of CRYAB (g.39644482C>T and g.39644132T>C) and CTGF (g.31671748A>G and g.31671773T>G). The polymorphism may partially contribute to the differences in expression levels between groups at the same altitude. These findings provide novel insights into the high-altitude hypoxia adaptations of Tibetan pigs.
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Affiliation(s)
- S. Liu
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - L. Xing
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - J. Zhang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - K. Wang
- Henan Agricultural University, People’s Republic of China
| | - M. Duan
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - M. Wei
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
| | - B. Zhang
- China Agricultural University, People’s Republic of China
| | - Z. Chang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China
| | - H. Zhang
- China Agricultural University, People’s Republic of China
| | - P. Shang
- Tibet Agriculture and Animal Husbandry College, People’s Republic of China; The Provincial and Ministerial co-founded collaborative innovation center for R & D in Tibet characteristic Agricultural and Animal Husbandry resources, People’s Republic of China
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Zhai Y, Xing L, Hu X, Li W, Tang X, Guo S. The effect of inoculation with arbuscular mycorrhizal fungi on root traits and salt tolerance of Tagetes erecta. PEAS 2022. [DOI: 10.3176/proc.2022.4.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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42
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Xing L, Yu J, Peters S, Besse B, Spira A, Wang J, Yang Y, Wang H. 167TiP AdvanTIG-301: Anti-TIGIT monoclonal antibody (mAb) ociperlimab (OCI) + tislelizumab (TIS) + concurrent chemoradiotherapy (cCRT) followed by OCI + TIS or TIS + cCRT followed by TIS vs cCRT followed by durvalumab (DUR) in previously untreated, locally advanced, unresectable NSCLC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Wang JY, Bai YP, Xing L, Piao YS, He XJ, Yue CL, Zhao XL, Liu HG. [Clinicopathological characteristics of SMARCB1(INI1)-deficient sinonasal carcinoma]. Zhonghua Bing Li Xue Za Zhi 2021; 50:1240-1245. [PMID: 34719161 DOI: 10.3760/cma.j.cn112151-20210629-00469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinicopathological characteristics, diagnosis, differential diagnosis and prognostic factors of SMARCB1 (INI1)-deficient sinonasal carcinoma (SDSC). Methods: Sixteen cases of SDSC diagnosed in the Department of Pathology, Beijing Tongren Hospital from January 2016 to September 2020 were enrolled. Ninety-nine cases of small round cell malignant tumors of the head and neck were selected as the control, including poorly-differentiated squamous cell carcinoma (n=10), poorly-differentiated adenocarcinoma (n=5), undifferentiated carcinoma (SNUC, n=4), NUT carcinoma (n=5), neuroendocrine carcinoma (n=10), and other non-epithelial tumors [olfactory neuroblastoma (n=10), rhabdomyosarcoma (n=10), NK/T-cell lymphoma (n=10), malignant melanoma (n=10), Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET, n=5)] and non-keratinizing undifferentiated nasopharyngeal carcinoma (n=20). The clinical and pathologic characteristics of SDSC, and immunohistochemical (IHC) expression of broad-spectrum CKpan, CK7, CK8/18, CK5/6, p63, p40, p16, INI1, NUT and neuroendocrine markers (Syn, CgA, CD56) were evaluated. In situ hybridization (ISH) was used to detect EBER and fluorescence in situ hybridization (FISH) to detect INI1 gene deletion. Results: The 16 cases of SDSC accounted for 1.3% (16/1 218) of all malignant sinonasal tumors in the author's unit during this time period, and 2.4% (16/657) of all malignant epithelial tumors. Microscopically, there was no clear squamous and adenomatous differentiation, but "rhabdoid-like" cells, are often seen. All SDSC cases were positive for CKpan and CK8/18, negative for INI1; Epstein-Barr virus was not detected by ISH; and INI1 gene deletion was observed in all 11 SDSC patients with FISH. Twelve cases were followed up for 3-47 months. One died of tumor-related diseases half a year after diagnosis, and the remaining patients were alive with tumor, the longest survival time was 47 months. Conclusion: SDSC should be differentiated from a variety of poorly-differentiated tumors in the sinonasal area. Histologically, SDSC has no clear differentiation, but the tumor cells are characteristically basal-like or rhabdoid-like, with non-specific vacuoles, translucent or vacuolar nuclei, prominent nucleoli and necrotic foci. They are negative for INI1 IHC staining, and FISH demonstrates INI1 gene deletion. The clinical prognosis is still unclear, further studies on its biologic behavior and treatment methods are warranted.
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Affiliation(s)
- J Y Wang
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Y P Bai
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - L Xing
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - Y S Piao
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - X J He
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - C L Yue
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - X L Zhao
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
| | - H G Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China
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Liang X, Bassenne M, Zhao W, Jia M, Zhang Z, Huang C, Gensheimer M, Beadle B, Le Q, Xing L. Human-Level Comparable Control Volumes Mapping With an Unsupervised-Learning Model for CT-Guided Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Huang C, Yang Y, Nomura Y, Xing L. Fully Automated Treatment Planning Using the Pareto Optimal Projection Search (POPS) Algorithm. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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46
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Han B, Kovalchuk N, Capaldi D, Simiele E, White J, Purwar A, Yeung T, Maganti S, Mitra A, Voronenko Y, Oderinde O, Shirvani S, Kuduvalli G, Vitzthum L, Chang D, Xing L, Surucu M. First Beam Commissioning Report of a Novel Medical Linear Accelerator Designed for Biologically Guided Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Shen L, Zhao W, Capaldi D, Pauly J, Xing L. Enabling Few-View 3D Tomographic Image Reconstruction by Geometry-Informed Deep Learning. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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48
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Kashyap M, Panjwani N, Hasan M, Huang C, Bush K, Dong P, Zaky S, Chin A, Vitzthum L, Loo B, Diehn M, Xing L, Gensheimer M. Deep Learning Based Identification and Segmentation of Lung Tumors on Computed Tomography Images. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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49
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Shen L, Yu L, Zhao W, Pauly J, Xing L. Novel-View X-Ray Projection Synthesis Through Geometry-Integrated Deep Learning. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Wu Y, Ma Y, Kovalchuk N, Du J, Xing L. Retrospective Tuning of MRI Contrast From a Single T1-Weighted Image. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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