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Pain-Related White-Matter Changes Following Mild Traumatic Brain Injury: A Longitudinal Diffusion Tensor Imaging Pilot Study.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-06 DOI: 10.3390/diagnostics15050642
Ho-Ching Yang, Tyler Nguyen, Fletcher A White, Kelly M Naugle, Yu-Chien Wu

Background: This study used diffusion tensor imaging (DTI) to detect brain microstructural changes in participants with mild traumatic brain injury (mTBI) who experienced post-traumatic headaches, a common issue that affects quality of life and rehabilitation. Despite its prevalence, the mechanisms behind post-traumatic headache are not well understood. Methods: Participants were recruited from Level 1 trauma centers, and MRI scans, including T1-weighted anatomical imaging and DTI, were acquired 1 month post-injury. Advanced imaging techniques corrected artifacts and extracted diffusion tensor measures reflecting white-matter integrity. Pain sensitivity assays were collected at 1 and 6 months post-injury, including quantitative sensory testing and psychological assessments. Results: Significant aberrations in axial diffusivity in the forceps major were observed in mTBI participants (n = 12) compared to healthy controls (n = 10) 1 month post-injury (p = 0.02). Within the mTBI group, DTI metrics at 1 month were significantly associated with pain-related and psychological outcomes at 6 months. Statistical models revealed group differences in the right sagittal stratum (p < 0.01), left insula (p < 0.04), and left superior longitudinal fasciculus (p < 0.05). Conclusions: This study shows that DTI metrics at 1 month post-injury are sensitive to mTBI and predictive of chronic pain and psychological outcomes at 6 months.

{"title":"Pain-Related White-Matter Changes Following Mild Traumatic Brain Injury: A Longitudinal Diffusion Tensor Imaging Pilot Study.","authors":"Ho-Ching Yang, Tyler Nguyen, Fletcher A White, Kelly M Naugle, Yu-Chien Wu","doi":"10.3390/diagnostics15050642","DOIUrl":"https://doi.org/10.3390/diagnostics15050642","url":null,"abstract":"<p><p><b>Background:</b> This study used diffusion tensor imaging (DTI) to detect brain microstructural changes in participants with mild traumatic brain injury (mTBI) who experienced post-traumatic headaches, a common issue that affects quality of life and rehabilitation. Despite its prevalence, the mechanisms behind post-traumatic headache are not well understood. <b>Methods:</b> Participants were recruited from Level 1 trauma centers, and MRI scans, including T1-weighted anatomical imaging and DTI, were acquired 1 month post-injury. Advanced imaging techniques corrected artifacts and extracted diffusion tensor measures reflecting white-matter integrity. Pain sensitivity assays were collected at 1 and 6 months post-injury, including quantitative sensory testing and psychological assessments. <b>Results:</b> Significant aberrations in axial diffusivity in the forceps major were observed in mTBI participants (<i>n</i> = 12) compared to healthy controls (<i>n</i> = 10) 1 month post-injury (<i>p</i> = 0.02). Within the mTBI group, DTI metrics at 1 month were significantly associated with pain-related and psychological outcomes at 6 months. Statistical models revealed group differences in the right sagittal stratum (<i>p</i> < 0.01), left insula (<i>p</i> < 0.04), and left superior longitudinal fasciculus (<i>p</i> < 0.05). <b>Conclusions</b>: This study shows that DTI metrics at 1 month post-injury are sensitive to mTBI and predictive of chronic pain and psychological outcomes at 6 months.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fine-Tuned Machine Learning Classifiers for Diagnosing Parkinson's Disease Using Vocal Characteristics: A Comparative Analysis.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-06 DOI: 10.3390/diagnostics15050645
Mehmet Meral, Ferdi Ozbilgin, Fatih Durmus

Background/Objectives: This paper is significant in highlighting the importance of early and precise diagnosis of Parkinson's Disease (PD) that affects both motor and non-motor functions to achieve better disease control and patient outcomes. This study seeks to assess the effectiveness of machine learning algorithms optimized to classify PD based on vocal characteristics to serve as a non-invasive and easily accessible diagnostic tool. Methods: This study used a publicly available dataset of vocal samples from 188 people with PD and 64 controls. Acoustic features like baseline characteristics, time-frequency components, Mel Frequency Cepstral Coefficients (MFCCs), and wavelet transform-based metrics were extracted and analyzed. The Chi-Square test was used for feature selection to determine the most important attributes that enhanced the accuracy of the classification. Six different machine learning classifiers, namely SVM, k-NN, DT, NN, Ensemble and Stacking models, were developed and optimized via Bayesian Optimization (BO), Grid Search (GS) and Random Search (RS). Accuracy, precision, recall, F1-score and AUC-ROC were used for evaluation. Results: It has been found that Stacking models, especially those fine-tuned via Grid Search, yielded the best performance with 92.07% accuracy and an F1-score of 0.95. In addition to that, the choice of relevant vocal features, in conjunction with the Chi-Square feature selection method, greatly enhanced the computational efficiency and classification performance. Conclusions: This study highlights the potential of combining advanced feature selection techniques with hyperparameter optimization strategies to enhance machine learning-based PD diagnosis using vocal characteristics. Ensemble models proved particularly effective in handling complex datasets, demonstrating robust diagnostic performance. Future research may focus on deep learning approaches and temporal feature integration to further improve diagnostic accuracy and scalability for clinical applications.

{"title":"Fine-Tuned Machine Learning Classifiers for Diagnosing Parkinson's Disease Using Vocal Characteristics: A Comparative Analysis.","authors":"Mehmet Meral, Ferdi Ozbilgin, Fatih Durmus","doi":"10.3390/diagnostics15050645","DOIUrl":"https://doi.org/10.3390/diagnostics15050645","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This paper is significant in highlighting the importance of early and precise diagnosis of Parkinson's Disease (PD) that affects both motor and non-motor functions to achieve better disease control and patient outcomes. This study seeks to assess the effectiveness of machine learning algorithms optimized to classify PD based on vocal characteristics to serve as a non-invasive and easily accessible diagnostic tool. <b>Methods</b>: This study used a publicly available dataset of vocal samples from 188 people with PD and 64 controls. Acoustic features like baseline characteristics, time-frequency components, Mel Frequency Cepstral Coefficients (MFCCs), and wavelet transform-based metrics were extracted and analyzed. The Chi-Square test was used for feature selection to determine the most important attributes that enhanced the accuracy of the classification. Six different machine learning classifiers, namely SVM, k-NN, DT, NN, Ensemble and Stacking models, were developed and optimized via Bayesian Optimization (BO), Grid Search (GS) and Random Search (RS). Accuracy, precision, recall, F1-score and AUC-ROC were used for evaluation. <b>Results</b>: It has been found that Stacking models, especially those fine-tuned via Grid Search, yielded the best performance with 92.07% accuracy and an F1-score of 0.95. In addition to that, the choice of relevant vocal features, in conjunction with the Chi-Square feature selection method, greatly enhanced the computational efficiency and classification performance. <b>Conclusions</b>: This study highlights the potential of combining advanced feature selection techniques with hyperparameter optimization strategies to enhance machine learning-based PD diagnosis using vocal characteristics. Ensemble models proved particularly effective in handling complex datasets, demonstrating robust diagnostic performance. Future research may focus on deep learning approaches and temporal feature integration to further improve diagnostic accuracy and scalability for clinical applications.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-06 DOI: 10.3390/diagnostics15050636
Javier Ivanovychs Carrillo-Rojas, Salvador Zavala-Villegas, Guadalupe Morales-Osorio, Fausto Daniel García-García, Mauricio González-Navarro, Viridiana Montsserrat Mendoza-Martínez, Nallely Bueno-Hernández

Background/Objectives: Gastroesophageal reflux disease (GERD) is associated with extraesophageal syndromes that require an objective assessment of abnormal acid exposure to establish the diagnosis. The COuGH RefluX score has been proposed as a diagnostic tool for GERD in patients with chronic laryngopharyngeal symptoms. The aim of the study was to evaluate the diagnostic performance of the COuGH RefluX score in the Mexican population. Methods: A cross-sectional study was conducted in patients with chronic laryngopharyngeal symptoms. Patients with cough, globus, sore throat, dysphonia, and/or throat clearing of ≥8 weeks duration, 24 h pH-impedance monitoring (pH-IM), and without objective evidence of GERD (defined as acid exposure time >6%) were included in the study. The COuGH RefluX score tool was applied and stratified as low probability with ≤2.5 points, intermediate probability with 3.0 to 4.5 points, and high probability with ≥5.0 points. The kappa test assessed the concordance between both tests; the area under the curve (AUR), sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each result. Results: 164 patients were included; the prevalence of GERD by pH-IM was 32% vs. 40.3% by COuGH RefluX score, the agreement was weak (κ = 0.34; p < 0.001), but the AUR was good (0.720 ± 0.17; p < 0.001). A score ≤ 2.5 had S = 49%, E = 88%, PPV = 89%, and NPV = 42% to rule out proven GERD, while a score ≥ 5 had S = 65%, E = 71%, PPV = 52%, and NPV = 82% for proven GERD. Conclusions: The COuGH RefluX score has low sensitivity but adequate specificity for GERD diagnosis in Mexican patients with chronic laryngopharyngeal symptoms.

{"title":"Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study.","authors":"Javier Ivanovychs Carrillo-Rojas, Salvador Zavala-Villegas, Guadalupe Morales-Osorio, Fausto Daniel García-García, Mauricio González-Navarro, Viridiana Montsserrat Mendoza-Martínez, Nallely Bueno-Hernández","doi":"10.3390/diagnostics15050636","DOIUrl":"https://doi.org/10.3390/diagnostics15050636","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Gastroesophageal reflux disease (GERD) is associated with extraesophageal syndromes that require an objective assessment of abnormal acid exposure to establish the diagnosis. The COuGH RefluX score has been proposed as a diagnostic tool for GERD in patients with chronic laryngopharyngeal symptoms. The aim of the study was to evaluate the diagnostic performance of the COuGH RefluX score in the Mexican population. <b>Methods:</b> A cross-sectional study was conducted in patients with chronic laryngopharyngeal symptoms. Patients with cough, globus, sore throat, dysphonia, and/or throat clearing of ≥8 weeks duration, 24 h pH-impedance monitoring (pH-IM), and without objective evidence of GERD (defined as acid exposure time >6%) were included in the study. The COuGH RefluX score tool was applied and stratified as low probability with ≤2.5 points, intermediate probability with 3.0 to 4.5 points, and high probability with ≥5.0 points. The kappa test assessed the concordance between both tests; the area under the curve (AUR), sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each result. <b>Results:</b> 164 patients were included; the prevalence of GERD by pH-IM was 32% vs. 40.3% by COuGH RefluX score, the agreement was weak (κ = 0.34; <i>p</i> < 0.001), but the AUR was good (0.720 ± 0.17; <i>p</i> < 0.001). A score ≤ 2.5 had S = 49%, E = 88%, PPV = 89%, and NPV = 42% to rule out proven GERD, while a score ≥ 5 had S = 65%, E = 71%, PPV = 52%, and NPV = 82% for proven GERD. <b>Conclusions:</b> The COuGH RefluX score has low sensitivity but adequate specificity for GERD diagnosis in Mexican patients with chronic laryngopharyngeal symptoms.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive Value of the Naples Prognostic Score for One-Year Mortality in NSTEMI Patients Undergoing Selective PCI.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-06 DOI: 10.3390/diagnostics15050640
Mesut Gitmez, Evren Ekingen, Sueda Zaman

Objectives: Non-ST-elevation myocardial infarction (NSTEMI) is a common and severe condition that requires rapid and accurate risk assessment and treatment. The Naples prognostic score (NPS) is a novel risk score that integrates nutritional and inflammatory parameters. The aim of this study was to investigate the NPS as a predictor of one-year mortality in NSTEMI patients undergoing percutaneous coronary intervention (PCI). Methods: This retrospective study included 197 NSTEMI patients who underwent selective PCI from January 2020 to December 2020. The NPS was calculated based on the total cholesterol, serum albumin, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio. Patients were categorized into two groups based on their NPS values: Group 1 (NPS 0-2) and Group 2 (NPS 3 or 4). The one-year mortality status of the patients was determined through phone calls or by querying the national death registry system. Results: During the follow-up period, the overall mortality rate was 19.3% (n = 38). The high NPS group exhibited a significantly higher mortality rate compared to the low NPS group, with rates of 33.7% and 8.1%, respectively (p < 0.001). A Cox regression analysis indicated that a high NPS score is an independent predictor of one-year mortality, with a hazard ratio of 4.52 (95% CI: 1.93-10.58; p < 0.001). Conclusions: The NPS is a simple, cheap, and easily accessible tool that can be used for risk stratification and treatment selection in NSTEMI patients. It also highlights the importance of inflammatory and nutritional status in influencing the prognosis of NSTEMI patients.

{"title":"Predictive Value of the Naples Prognostic Score for One-Year Mortality in NSTEMI Patients Undergoing Selective PCI.","authors":"Mesut Gitmez, Evren Ekingen, Sueda Zaman","doi":"10.3390/diagnostics15050640","DOIUrl":"https://doi.org/10.3390/diagnostics15050640","url":null,"abstract":"<p><p><b>Objectives:</b> Non-ST-elevation myocardial infarction (NSTEMI) is a common and severe condition that requires rapid and accurate risk assessment and treatment. The Naples prognostic score (NPS) is a novel risk score that integrates nutritional and inflammatory parameters. The aim of this study was to investigate the NPS as a predictor of one-year mortality in NSTEMI patients undergoing percutaneous coronary intervention (PCI). <b>Methods:</b> This retrospective study included 197 NSTEMI patients who underwent selective PCI from January 2020 to December 2020. The NPS was calculated based on the total cholesterol, serum albumin, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio. Patients were categorized into two groups based on their NPS values: Group 1 (NPS 0-2) and Group 2 (NPS 3 or 4). The one-year mortality status of the patients was determined through phone calls or by querying the national death registry system. <b>Results:</b> During the follow-up period, the overall mortality rate was 19.3% (<i>n</i> = 38). The high NPS group exhibited a significantly higher mortality rate compared to the low NPS group, with rates of 33.7% and 8.1%, respectively (<i>p</i> < 0.001). A Cox regression analysis indicated that a high NPS score is an independent predictor of one-year mortality, with a hazard ratio of 4.52 (95% CI: 1.93-10.58; <i>p</i> < 0.001). <b>Conclusions:</b> The NPS is a simple, cheap, and easily accessible tool that can be used for risk stratification and treatment selection in NSTEMI patients. It also highlights the importance of inflammatory and nutritional status in influencing the prognosis of NSTEMI patients.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Cross-Sectional Comparative Study: Could Asprosin and Peptide Tyrosine-Tyrosine Be Used in Schizophrenia to Define the Disease and Determine Its Phases?
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050632
Elif Özcan Tozoğlu, Nilifer Gürbüzer, Alev Lazoğlu Özkaya, Sümeyya Akyıldırım

Background/Objectives: We aimed to evaluate asprosin and peptide tyrosine-tyrosine (PYY) levels in schizophrenia patients and the relationships between these levels and clinical severity, as well as whether these two hormones have a role in determining the disease and/or the phases of the disease. Methods: This study included 50 patients with schizophrenia in the remission phase, 50 in the acute phase, and 50 controls. The Positive and Negative Syndrome Scale (PANSS) was filled out for patients. The patients' biochemical parameters and asprosin and PYY levels were measured. Results: Levels of asprosin and PYY were significantly different in all three groups (p < 0.001, p < 0.001). In the remission phase group, asprosin levels had a negative effect on PANSS general symptomatology scores (p: 0.002, p < 0.001). In the acute phase group, while PYY levels showed a negative effect on PANSS general symptomatology scores (p: 0.031), asprosin levels had a negative effect on all subscales of PANSS (p < 0.001). In the acute phase, a one-unit decrease in asprosin levels was associated with a 93% increase in PANSS total scores. The results of the receiver operating characteristic (ROC) analysis to distinguish the acute phase showed that PYY could not be used for diagnosis (p: 0.066), but asprosin was associated with the acute phase of schizophrenia (p < 0.001) and both asprosin and PYY were associated with the disease (p < 0.001, p < 0.001). Conclusions: We think that both asprosin and PYY can be used as potential biomarkers to identify schizophrenia, and only asprosin to identify the phases of the disease. PYY and asprosin levels may be markers that can be used to determine clinical severity.

背景/目的:我们的目的是评估精神分裂症患者体内的天冬氨酸和肽酪氨酸(PYY)水平,以及这些水平与临床严重程度之间的关系,同时评估这两种激素是否在决定疾病和/或疾病阶段方面发挥作用。研究方法这项研究包括 50 名处于缓解期的精神分裂症患者、50 名处于急性期的精神分裂症患者和 50 名对照组患者。患者填写阳性和阴性综合征量表(PANSS)。对患者的生化指标以及天冬氨酸和PYY水平进行了测量。结果显示三组患者的天冬氨酸和PYY水平均有显著差异(P < 0.001,P < 0.001)。在缓解期组,天冬氨酸水平对 PANSS 一般症状评分有负面影响(p: 0.002, p < 0.001)。在急性期组,虽然PYY水平对PANSS一般症状评分有负面影响(p:0.031),但阿司匹林水平对PANSS的所有分量表都有负面影响(p<0.001)。在急性期,阿司匹林水平每降低一个单位,PANSS 总分就会增加 93%。区分急性期的接收器操作特征(ROC)分析结果显示,PYY不能用于诊断(p:0.066),但asprosin与精神分裂症急性期相关(p < 0.001),asprosin和PYY均与疾病相关(p < 0.001,p < 0.001)。结论我们认为,asprosin 和 PYY 都可作为识别精神分裂症的潜在生物标记物,而只有 asprosin 可用于识别疾病的阶段。PYY和asprosin水平可能是用于确定临床严重程度的标志物。
{"title":"A Cross-Sectional Comparative Study: Could Asprosin and Peptide Tyrosine-Tyrosine Be Used in Schizophrenia to Define the Disease and Determine Its Phases?","authors":"Elif Özcan Tozoğlu, Nilifer Gürbüzer, Alev Lazoğlu Özkaya, Sümeyya Akyıldırım","doi":"10.3390/diagnostics15050632","DOIUrl":"https://doi.org/10.3390/diagnostics15050632","url":null,"abstract":"<p><p><b>Background/Objectives</b>: We aimed to evaluate asprosin and peptide tyrosine-tyrosine (PYY) levels in schizophrenia patients and the relationships between these levels and clinical severity, as well as whether these two hormones have a role in determining the disease and/or the phases of the disease. <b>Methods</b>: This study included 50 patients with schizophrenia in the remission phase, 50 in the acute phase, and 50 controls. The Positive and Negative Syndrome Scale (PANSS) was filled out for patients. The patients' biochemical parameters and asprosin and PYY levels were measured. <b>Results</b>: Levels of asprosin and PYY were significantly different in all three groups (<i>p</i> < 0.001, <i>p</i> < 0.001). In the remission phase group, asprosin levels had a negative effect on PANSS general symptomatology scores (<i>p</i>: 0.002, <i>p</i> < 0.001). In the acute phase group, while PYY levels showed a negative effect on PANSS general symptomatology scores (<i>p</i>: 0.031), asprosin levels had a negative effect on all subscales of PANSS (<i>p</i> < 0.001). In the acute phase, a one-unit decrease in asprosin levels was associated with a 93% increase in PANSS total scores. The results of the receiver operating characteristic (ROC) analysis to distinguish the acute phase showed that PYY could not be used for diagnosis (<i>p</i>: 0.066), but asprosin was associated with the acute phase of schizophrenia (<i>p</i> < 0.001) and both asprosin and PYY were associated with the disease (<i>p</i> < 0.001, <i>p</i> < 0.001). <b>Conclusions</b>: We think that both asprosin and PYY can be used as potential biomarkers to identify schizophrenia, and only asprosin to identify the phases of the disease. PYY and asprosin levels may be markers that can be used to determine clinical severity.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Outcomes in Crosslinking Therapy for Patients with Progressive Keratoconus.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050626
Tevfik Serhat Bahar, Vedat Şahin, Yusuf Ayaz, Mustafa Ünal

Background/Objectives: To investigate the mid- and long-term postoperative follow-up results of corneal crosslinking (CXL) treatment (using epi-on and epi-off techniques) in progressive keratoconus. Methods: This was a retrospective single center study conducted between October 2013 and July 2020. Patients who received CXL treatment with a diagnosis of progressive keratoconus were included in the study. Preoperative and postoperative recorded examination findings of autorefractometry, visual acuity, endothelial cell counts by specular microscopy, and corneal topography were analyzed retrospectively. According to the latest measurements, the results were divided into two groups: measurements between 6 and 12 months and measurements between 1 and3 years. Results: A total of 290 operated eyes of 201 patients were included in the study. The mean age of the patients was 21.34 ± 5.77 years, and 119 (59.2%) were male. Epi-off CXL was performed on 269 (92.8%) eyes and epi-on procedure was performed on 21 (7.2%) eyes. CXL had no significant effect on visual acuity. Significant improvement was observed in topographic/keratometric features of the cornea both after 6-12 months and after 1-3 years. Significant decreases were observed in K1 (p < 0.001), K2 (p < 0.001), KM (p < 0.001) values compared to the initial level. Conclusions: CXL treatment is an important treatment method in the treatment of keratoconus, preserving visual functions, significantly reducing the severity of astigmatism, and stopping the progression of keratoconus. Additionally, although epi-off and epi-on CXL methods were compared in our study, the sample size was limited, and more comprehensive and long-term studies are needed.

背景/目的研究进行性角膜屈光不正患者角膜交联(CXL)治疗(采用外显子导入和外显子导出技术)的术后中长期随访结果。研究方法这是一项回顾性单中心研究,研究时间为 2013 年 10 月至 2020 年 7 月。研究对象包括接受 CXL 治疗并确诊为进展性角膜炎的患者。回顾性分析了术前和术后记录的检查结果,包括自动折射仪、视力、镜下内皮细胞计数和角膜地形图。根据最新的测量结果分为两组:6 至 12 个月的测量结果和 1 至 3 年的测量结果。结果研究共纳入了 201 名患者的 290 只手术眼。患者的平均年龄为(21.34 ± 5.77)岁,男性 119 人(59.2%)。269只(92.8%)眼睛接受了外显-关闭CXL手术,21只(7.2%)眼睛接受了外显-开启手术。CXL 对视力无明显影响。在 6-12 个月和 1-3 年后,角膜地形图/角膜测量特征均有明显改善。与初始水平相比,K1(p < 0.001)、K2(p < 0.001)、KM(p < 0.001)值明显下降。结论CXL 治疗是治疗角膜病的一种重要方法,它能保护视力功能,显著降低散光的严重程度,阻止角膜病的发展。此外,虽然我们的研究比较了外延-关闭和外延-开启 CXL 方法,但样本量有限,需要进行更全面、更长期的研究。
{"title":"Long-Term Outcomes in Crosslinking Therapy for Patients with Progressive Keratoconus.","authors":"Tevfik Serhat Bahar, Vedat Şahin, Yusuf Ayaz, Mustafa Ünal","doi":"10.3390/diagnostics15050626","DOIUrl":"https://doi.org/10.3390/diagnostics15050626","url":null,"abstract":"<p><p><b>Background/Objectives:</b> To investigate the mid- and long-term postoperative follow-up results of corneal crosslinking (CXL) treatment (using epi-on and epi-off techniques) in progressive keratoconus. <b>Methods:</b> This was a retrospective single center study conducted between October 2013 and July 2020. Patients who received CXL treatment with a diagnosis of progressive keratoconus were included in the study. Preoperative and postoperative recorded examination findings of autorefractometry, visual acuity, endothelial cell counts by specular microscopy, and corneal topography were analyzed retrospectively. According to the latest measurements, the results were divided into two groups: measurements between 6 and 12 months and measurements between 1 and3 years. <b>Results:</b> A total of 290 operated eyes of 201 patients were included in the study. The mean age of the patients was 21.34 ± 5.77 years, and 119 (59.2%) were male. Epi-off CXL was performed on 269 (92.8%) eyes and epi-on procedure was performed on 21 (7.2%) eyes. CXL had no significant effect on visual acuity. Significant improvement was observed in topographic/keratometric features of the cornea both after 6-12 months and after 1-3 years. Significant decreases were observed in K1 (<i>p</i> < 0.001), K2 (<i>p</i> < 0.001), KM (<i>p</i> < 0.001) values compared to the initial level. <b>Conclusions:</b> CXL treatment is an important treatment method in the treatment of keratoconus, preserving visual functions, significantly reducing the severity of astigmatism, and stopping the progression of keratoconus. Additionally, although epi-off and epi-on CXL methods were compared in our study, the sample size was limited, and more comprehensive and long-term studies are needed.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CT Features of Mallory-Weiss Syndrome.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050623
Romain L'Huillier, Adrien Patenotte, Alexandra Braillon

We report in this clinical case Mallory-Weiss syndrome suspected on computed tomography (CT) and confirmed on endoscopy. Mallory-Weiss syndrome is a rare cause of upper gastrointestinal bleeding from vomiting-induced mucosal laceration(s) at the gastroesophageal junction. The description of Mallory-Weiss Syndrome is rare on imaging and this observation provides CT semiological elements useful in detecting signs of Mallory-Weiss syndrome.

{"title":"CT Features of Mallory-Weiss Syndrome.","authors":"Romain L'Huillier, Adrien Patenotte, Alexandra Braillon","doi":"10.3390/diagnostics15050623","DOIUrl":"https://doi.org/10.3390/diagnostics15050623","url":null,"abstract":"<p><p>We report in this clinical case Mallory-Weiss syndrome suspected on computed tomography (CT) and confirmed on endoscopy. Mallory-Weiss syndrome is a rare cause of upper gastrointestinal bleeding from vomiting-induced mucosal laceration(s) at the gastroesophageal junction. The description of Mallory-Weiss Syndrome is rare on imaging and this observation provides CT semiological elements useful in detecting signs of Mallory-Weiss syndrome.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Analysis and Validation of the IMPEDED VTE, IMPEDE VTE, and SAVED Risk Models in Predicting Venous Thromboembolism in Multiple Myeloma Patients: A Retrospective Study in Türkiye.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050633
Vildan Gursoy, Mehmet Baysal, Sevil Sadri, Fazil Cagri Hunutlu, Tuba Ersal, Ozgur Omer Gul, Elif Kose, Esra Celik, Serap Baysal, Tuğba Gullu Koca, Sinem Cubukcu, Ezel Ergun, Seyma Yavuz, Vildan Ozkocaman, Fahir Ozkalemkas

Background: Several thrombotic risk assessment models have been proposed for identifying patients with a high risk of thrombosis (the IMPEDE venous thromboembolism (VTE), SAVED, and PRISM scores) in multiple myeloma (MM). Recently, adding a biomarker (D-dimer) for the IMPEDE VTE score has shown that it can boost the detection power of IMPEDED VTE. However, data from studies comparing these models in MM are scarce. Even real-world data arguing the utility of thrombotic risk assessment models in MM from low- or middle-income countries like Türkiye are lacking. Methods: We aimed to show the possibility of detecting VTE using the IMPEDED VTE score in our cohort by retrospectively screening MM patients. Therefore, we aimed to compare the IMPEDE VTE, SAVED and IMPEDED VTE scoring models. Results: We conducted a retrospective analysis of 455 MM patients from three centers in Bursa, Türkiye, evaluating the incidence of VTE within six months of the treatment. The IMPEDED VTE score showed superior predictive accuracy (c-statistic of 0.701), compared to the IMPEDE VTE (0.618) and SAVED (0.633) scores, demonstrating the added value of D-dimer as a biomarker. The cumulative incidence of VTE in the cohort was 10.7%, comparable to rates observed in real-world studies. Conclusions: Despite the interventions and thrombotic risk assessment models, thrombosis remains a high-risk entity. Personalized risk assessment tools, such as IMPEDED VTE, could be used to manage thrombotic risk in MM patients, particularly in resource-limited settings. Albeit the thromboprophylaxis (51.6%), our findings support the utility of biomarker-enhanced models for better VTE-risk stratification, particularly in resource-limited settings.

{"title":"Comparative Analysis and Validation of the IMPEDED VTE, IMPEDE VTE, and SAVED Risk Models in Predicting Venous Thromboembolism in Multiple Myeloma Patients: A Retrospective Study in Türkiye.","authors":"Vildan Gursoy, Mehmet Baysal, Sevil Sadri, Fazil Cagri Hunutlu, Tuba Ersal, Ozgur Omer Gul, Elif Kose, Esra Celik, Serap Baysal, Tuğba Gullu Koca, Sinem Cubukcu, Ezel Ergun, Seyma Yavuz, Vildan Ozkocaman, Fahir Ozkalemkas","doi":"10.3390/diagnostics15050633","DOIUrl":"https://doi.org/10.3390/diagnostics15050633","url":null,"abstract":"<p><p><b>Background:</b> Several thrombotic risk assessment models have been proposed for identifying patients with a high risk of thrombosis (the IMPEDE venous thromboembolism (VTE), SAVED, and PRISM scores) in multiple myeloma (MM). Recently, adding a biomarker (D-dimer) for the IMPEDE VTE score has shown that it can boost the detection power of IMPEDED VTE. However, data from studies comparing these models in MM are scarce. Even real-world data arguing the utility of thrombotic risk assessment models in MM from low- or middle-income countries like Türkiye are lacking. <b>Methods:</b> We aimed to show the possibility of detecting VTE using the IMPEDED VTE score in our cohort by retrospectively screening MM patients. Therefore, we aimed to compare the IMPEDE VTE, SAVED and IMPEDED VTE scoring models. <b>Results:</b> We conducted a retrospective analysis of 455 MM patients from three centers in Bursa, Türkiye, evaluating the incidence of VTE within six months of the treatment. The IMPEDED VTE score showed superior predictive accuracy (c-statistic of 0.701), compared to the IMPEDE VTE (0.618) and SAVED (0.633) scores, demonstrating the added value of D-dimer as a biomarker. The cumulative incidence of VTE in the cohort was 10.7%, comparable to rates observed in real-world studies. <b>Conclusions:</b> Despite the interventions and thrombotic risk assessment models, thrombosis remains a high-risk entity. Personalized risk assessment tools, such as IMPEDED VTE, could be used to manage thrombotic risk in MM patients, particularly in resource-limited settings. Albeit the thromboprophylaxis (51.6%), our findings support the utility of biomarker-enhanced models for better VTE-risk stratification, particularly in resource-limited settings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing and Combining Artificial Intelligence and Spectral/Statistical Approaches for Elevating Prostate Cancer Assessment in a Biparametric MRI: A Pilot Study.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050625
Rulon Mayer, Yuan Yuan, Jayaram Udupa, Baris Turkbey, Peter Choyke, Dong Han, Haibo Lin, Charles B Simone

Background: Prostate cancer management optimally requires non-invasive, objective, quantitative, accurate evaluation of prostate tumors. The current research applies visual inspection and quantitative approaches, such as artificial intelligence (AI) based on deep learning (DL), to evaluate MRI. Recently, a different spectral/statistical approach has been used to successfully evaluate spatially registered biparametric MRIs for prostate cancer. This study aimed to further assess and improve the spectral/statistical approach through benchmarking and combination with AI. Methods: A zonal-aware self-supervised mesh network (Z-SSMNet) was applied to the same 42-patient cohort from previous spectral/statistical studies. Using the probability of clinical significance of prostate cancer (PCsPCa) and a detection map, the affiliated tumor volume, eccentricity was computed for each patient. Linear and logistic regression were applied to the International Society of Urological Pathology (ISUP) grade and PCsPCa, respectively. The R, p-value, and area under the curve (AUROC) from the Z-SSMNet output were computed. The Z-SSMNet output was combined with the spectral/statistical output for multiple-variate regression. Results: The R (p-value)-AUROC [95% confidence interval] from the Z-SSMNet algorithm relating ISUP to PCsPCa is 0.298 (0.06), 0.50 [0.08-1.0]; relating it to the average blob volume, it is 0.51 (0.0005), 0.37 [0.0-0.91]; relating it to total tumor volume, it is 0.36 (0.02), 0.50 [0.0-1.0]. The R (p-value)-AUROC computations showed a much poorer correlation for eccentricity derived from the Z-SSMNet detection map. Overall, DL/AI showed poorer performance relative to the spectral/statistical approaches from previous studies. Multi-variable regression fitted AI average blob size and SCR results at a level of R = 0.70 (0.000003), significantly higher than the results for the univariate regression fits for AI and spectral/statistical approaches alone. Conclusions: The spectral/statistical approaches performed well relative to Z-SSMNet. Combining Z-SSMNet with spectral/statistical approaches significantly enhanced tumor grade prediction, possibly providing an alternative to current prostate tumor assessment.

{"title":"Comparing and Combining Artificial Intelligence and Spectral/Statistical Approaches for Elevating Prostate Cancer Assessment in a Biparametric MRI: A Pilot Study.","authors":"Rulon Mayer, Yuan Yuan, Jayaram Udupa, Baris Turkbey, Peter Choyke, Dong Han, Haibo Lin, Charles B Simone","doi":"10.3390/diagnostics15050625","DOIUrl":"https://doi.org/10.3390/diagnostics15050625","url":null,"abstract":"<p><p><b>Background:</b> Prostate cancer management optimally requires non-invasive, objective, quantitative, accurate evaluation of prostate tumors. The current research applies visual inspection and quantitative approaches, such as artificial intelligence (AI) based on deep learning (DL), to evaluate MRI. Recently, a different spectral/statistical approach has been used to successfully evaluate spatially registered biparametric MRIs for prostate cancer. This study aimed to further assess and improve the spectral/statistical approach through benchmarking and combination with AI. <b>Methods:</b> A zonal-aware self-supervised mesh network (Z-SSMNet) was applied to the same 42-patient cohort from previous spectral/statistical studies. Using the probability of clinical significance of prostate cancer (PCsPCa) and a detection map, the affiliated tumor volume, eccentricity was computed for each patient. Linear and logistic regression were applied to the International Society of Urological Pathology (ISUP) grade and PCsPCa, respectively. The R, <i>p</i>-value, and area under the curve (AUROC) from the Z-SSMNet output were computed. The Z-SSMNet output was combined with the spectral/statistical output for multiple-variate regression. <b>Results:</b> The R (<i>p</i>-value)-AUROC [95% confidence interval] from the Z-SSMNet algorithm relating ISUP to PCsPCa is 0.298 (0.06), 0.50 [0.08-1.0]; relating it to the average blob volume, it is 0.51 (0.0005), 0.37 [0.0-0.91]; relating it to total tumor volume, it is 0.36 (0.02), 0.50 [0.0-1.0]. The R (<i>p</i>-value)-AUROC computations showed a much poorer correlation for eccentricity derived from the Z-SSMNet detection map. Overall, DL/AI showed poorer performance relative to the spectral/statistical approaches from previous studies. Multi-variable regression fitted AI average blob size and SCR results at a level of R = 0.70 (0.000003), significantly higher than the results for the univariate regression fits for AI and spectral/statistical approaches alone. <b>Conclusions:</b> The spectral/statistical approaches performed well relative to Z-SSMNet. Combining Z-SSMNet with spectral/statistical approaches significantly enhanced tumor grade prediction, possibly providing an alternative to current prostate tumor assessment.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transperineal Vulvar Ultrasound: A Review of Normal and Abnormal Findings with a Proposed Standardized Methodology.
IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-03-05 DOI: 10.3390/diagnostics15050627
Nina Montik, Camilla Grelloni, Giovanni Delli Carpini, Jessica Petrucci, Jacopo Di Giuseppe, Andrea Ciavattini

The vulva is a complex anatomical organ that may present with a wide range of pathologies. Even if it can be easily investigated, correctly interpreting vulvar appearance is often challenging. Vulvar ultrasound is an emerging diagnostic technique that may be helpful in different aspects of vulvar pathology. We aimed to summarize the state of the art of vulvar ultrasound, provide the necessary theoretical bases of embryology and anatomy, describe the normal and pathological vulvar sonographic characteristics, and propose a feasible and reproducible methodology for vulvar ultrasound. Vulvar sonographic scan should be performed with a linear probe, preferably > 15 mHz, following a standardized methodology. The sonographic appearance of the normal vulva reflects the different histology of its structures and, thus, their embryogenetic origin. The description of a suspected vulvar lesion should include localization, dimensions, volume, type of growth, shape, appearance of the edges, depth of invasion, echogenicity, and identification of vascularization. Cystic dilatation of obstructed Bartolini ducts is the most common benign finding in the vulva (fluctuant structures in the posterior third of the labia majora containing clear mucous fluid). Malignant vulvar lesions appear as hypoechogenic or heterogeneous solid lesions with irregular margins and a high degree of vascularization. Extramammary Paget Disease presents a homogeneous hypoechogenic creeping area in the epidermis due to neoplastic cells typical of this disease. The potential applications of vulvar ultrasound are examining the content of a vulvar swelling to guide its management and assessing the response to medical treatment in the case of lichen sclerosus. In managing patients affected by vulvar malignancies, it may play a critical role in local staging, stromal invasion determination, measuring the distance from the midline, and assessing the eligibility for sentinel lymph node procedure. Vulvar ultrasound is a minimally invasive and economical test that can be performed with minimal equipment. Further studies will be necessary to validate the clinical applications, quantify the diagnostic performance, and evaluate the agreement between operators.

外阴是一个复杂的解剖器官,可能会出现各种病变。即使很容易进行检查,正确解释外阴外观也往往具有挑战性。外阴超声是一种新兴的诊断技术,可能对外阴病理的不同方面有所帮助。我们旨在总结外阴超声的最新进展,提供必要的胚胎学和解剖学理论基础,描述正常和病理外阴超声特征,并提出可行且可重复的外阴超声检查方法。外阴超声扫描应使用线性探头,最好大于 15 mHz,并遵循标准化方法。正常外阴的声像图外观反映了其结构的不同组织学,因此也反映了其胚胎起源。对可疑外阴病变的描述应包括病变的位置、尺寸、体积、生长类型、形状、边缘外观、侵犯深度、回声性和血管的识别。外阴最常见的良性病变是阻塞的巴托里尼管囊性扩张(大阴唇后三分之一处的波动结构,内含透明粘液)。恶性外阴病变表现为低水肿或异型实变,边缘不规则,有高度血管化。乳腺外 Paget 病由于典型的肿瘤细胞,表皮会出现均匀的低糜烂性匍匐区。外阴超声的潜在应用包括检查外阴肿物的内容以指导治疗,以及评估苔藓硬化症患者对药物治疗的反应。在治疗外阴恶性肿瘤患者时,外阴超声可在局部分期、确定基质侵犯、测量与中线的距离以及评估前哨淋巴结手术的资格等方面发挥关键作用。外阴超声是一种微创、经济的检查方法,只需少量设备即可进行。有必要开展进一步的研究,以验证临床应用、量化诊断性能并评估操作者之间的一致性。
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引用次数: 0
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