Academic Radiology最新文献_第8页

Relationship of the Novel Scoring System for Lower Extremity Venous Thrombosis with Pulmonary Embolism 下肢静脉血栓新评分系统与肺栓塞的关系

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.010

Rationale and Objective

To develop a new scoring system, the "Lower extremity venous Doppler ultrasound scoring system" (LEVDUS), to predict the diagnosis of pulmonary embolism (PE) localization in patients with deep vein thrombosis (DVT).

Methods

This single-center retrospective study included 182 patients aged ≥ 18 years. We used scoring according to thrombosis localization and stage in Doppler US. Patients with PE were divided into three categories based on the pulmonary artery (PA) location on CT pulmonary angiography. LEVDUS values were compared according to the PE classification. The threshold value was determined for the diagnosis of PE in the receiver operating characteristics analysis. Factors affecting the diagnosis of PE were evaluated by logistic regression analysis.

Results

A total of 182 patients were included (female patients: 55.5% [101/182]). The median age of the patients was 68 (IQR, 56–77). The rates of DVT and PE were 35.2% (64/182) and 52.7% (96/182), respectively. Although the median LEVDUS and d-dimer values in the subsegmental PE group were higher, LEVDUS was statistically significant but d-dimer was not (p = 0.005 and p = 0.022, respectively). In addition, both LEVDUS and d-dimer median values in the other PE groups were statistically significantly higher than the non-PE group (p < 0.001). The cut-off value for the diagnosis of PE was LEVDUS ≥ 2.5. LEVDUS was 1.2-fold higher for the presence of PE.

Conclusion

LEVDUS provides useful information in predicting the presence of PE in patients and provides a common diagnostic language between radiologists and emergency or clinic physicians.

理论依据和研究目的开发一种新的评分系统--"下肢静脉多普勒超声评分系统"（LEVDUS），用于预测深静脉血栓（DVT）患者肺栓塞（PE）的定位诊断。我们根据多普勒超声的血栓定位和分期进行评分。根据 CT 肺血管造影显示的肺动脉（PA）位置，将 PE 患者分为三类。根据 PE 分类比较 LEVDUS 值。接受者操作特征分析确定了诊断 PE 的阈值。结果共纳入 182 例患者（女性患者占 55.5% [101/182]）。患者的中位年龄为 68 岁（IQR，56-77）。深静脉血栓和 PE 的发生率分别为 35.2%（64/182）和 52.7%（96/182）。虽然PE亚段组的LEVDUS和d-二聚体中位值较高，但LEVDUS有统计学意义，而d-二聚体无统计学意义（分别为p = 0.005和p = 0.022）。此外，其他 PE 组的 LEVDUS 和 d-二聚体中位值均明显高于非 PE 组，具有统计学意义（p <0.001）。诊断 PE 的临界值为 LEVDUS ≥ 2.5。结论LEVDUS为预测患者是否存在PE提供了有用的信息，并为放射科医生和急诊或诊所医生提供了共同的诊断语言。

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引用次数: 0

Ultrasound Viscosity Imaging in Breast Lesions: A Multicenter Prospective Study 乳腺病变的超声粘度成像：多中心前瞻性研究

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.017

Rationale and Objectives

To explore and validate the clinical value of ultrasound (US) viscosity imaging in differentiating breast lesions by combining with BI-RADS, and then comparing the diagnostic performances with BI-RADS alone.

Materials and Methods

This multicenter, prospective study enrolled participants with breast lesions from June 2021 to November 2022. A development cohort (DC) and validation cohort (VC) were established. Using histological results as reference standard, the viscosity-related parameter with the highest area under the receiver operating curve (AUC) was selected as the optimal one. Then the original BI-RADS would upgrade or not based on the value of this parameter. Finally, the results were validated in the VC and total cohorts. In the DC, VC and total cohorts, all breast lesions were divided into the large lesion, small lesion and overall groups respectively.

Results

A total of 639 participants (mean age, 46 years ± 14) with 639 breast lesions (372 benign and 267 malignant lesions) were finally enrolled in this study including 392 participants in the DC and 247 in the VC. In the DC, the optimal viscosity-related parameter in differentiating breast lesions was calculated to be A′-S2-Vmax, with the AUC of 0.88 (95% CI: 0.84, 0.91). Using > 9.97 Pa.s as the cutoff value, the BI-RADS was then modified. The AUC of modified BI-RADS significantly increased from 0.85 (95% CI: 0.81, 0.88) to 0.91 (95% CI: 0.87, 0.93), 0.85 (95% CI: 0.80, 0.89) to 0.90 (95% CI: 0.85, 0.93) and 0.85 (95% CI: 0.82, 0.87) to 0.90 (95% CI: 0.88, 0.92) in the DC, VC and total cohorts respectively (P < .05 for all).

Conclusion

The quantitative viscous parameters evaluated by US viscosity imaging contribute to breast cancer diagnosis when combined with BI-RADS.

理论依据和研究目的探讨并验证超声（US）粘度成像与 BI-RADS 相结合在鉴别乳腺病变方面的临床价值，然后比较其与 BI-RADS 单独诊断的性能。建立了开发队列（DC）和验证队列（VC）。以组织学结果为参考标准，选择接收者操作曲线下面积（AUC）最大的粘度相关参数作为最优参数。然后，原 BI-RADS 将根据该参数值进行升级或不升级。最后，在 VC 和总队列中对结果进行了验证。结果共有 639 人（平均年龄 46 岁 ± 14 岁）的 639 个乳腺病灶（372 个良性病灶和 267 个恶性病灶）被纳入本研究，其中 392 人参与了直肠癌研究，247 人参与了直肠癌研究。在 DC 中，计算得出区分乳腺病变的最佳粘度相关参数为 A′-S2-Vmax，AUC 为 0.88（95% CI：0.84，0.91）。以 > 9.97 Pa.s 为临界值，对 BI-RADS 进行了修改。修正后的 BI-RADS 的 AUC 从 0.85（95% CI：0.81，0.88）显著增加到 0.91（95% CI：0.87，0.93），0.85（95% CI：0.80，0.89）增加到 0.90（95% CI：0.85，0.93），0.85（95% CI：0.82，0.87）增加到 0.90（95% CI：0.结论 US 粘度成像评估的定量粘度参数结合 BI-RADS 有助于乳腺癌诊断。

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引用次数: 0

Disability in Radiology 放射学中的残疾。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2023.10.025

引用次数: 0

Percutaneous CT-Guided Microwave Ablation for the Treatment of Osteoid Osteomas: A Single Center Experience 经皮 CT 引导微波消融治疗骨样骨瘤：单中心经验。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.02.025

Rationale and Objectives

The aim of the current study was to evaluate the feasibility and effectiveness of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OO).

Materials and methods

Data from 59 consecutive patients who underwent percutaneous CT-MWA for OO treatment were examined in the current retrospective study. The period of this study spanned from January 2021 to May 2023 at a single institution. The study involved an evaluation of clinical and radiological characteristics, procedural data, Visual Analog Scale (VAS) pain scores, complication incidences, as well as clinical and technical success rates. Statistical analyses were performed by using the Wilcoxon test with Bonferroni correction, Friedman, Spearman, Mann–Whitney U test.

Results

59 patients with an average age of 17.31 ± 8.53 years underwent CT-guided MWA for the treatment of OO. The procedure demonstrated a high success rate, with 96.6% of cases achieving both technical and clinical success. However, recurrence was observed in two patients (3.4%) at the three-month follow-up. These cases were successfully managed with a second MWA procedure. The median VAS pain scores reported by the patients was significantly improved post-procedure: from 8.64 ± 1.14 before treatment to 0.63 ± 0.98 in the first month, 0.41 ± 1.02 in the third month, and 0.15 ± 0.45 in the sixth month. Only one patient (1.7%) experienced a minor complication; no major complications were recorded in this study.

Conclusion

CT-guided percutaneous MWA is a minimally invasive and a highly effective and safe approach for the treatment of OO.

依据和目的：本研究旨在评估CT引导下微波消融（MWA）治疗类骨瘤（OO）的可行性和有效性：本回顾性研究对59例连续接受经皮CT-MWA治疗OO患者的数据进行了检查。本研究的时间跨度为 2021 年 1 月至 2023 年 5 月，研究机构为一家。研究涉及临床和放射学特征、手术数据、视觉模拟量表（VAS）疼痛评分、并发症发生率以及临床和技术成功率的评估。统计分析采用带 Bonferroni 校正的 Wilcoxon 检验、Friedman 检验、Spearman 检验和 Mann-Whitney U 检验：59名平均年龄为（17.31±8.53）岁的患者在CT引导下接受了MWA治疗OO。手术成功率很高，96.6%的病例获得了技术和临床成功。然而，有两名患者（3.4%）在三个月的随访中出现复发。这些病例通过第二次 MWA 手术成功治愈。患者报告的 VAS 疼痛评分中位数在术后有了明显改善：从治疗前的 8.64 ± 1.14 降至第一个月的 0.63 ± 0.98、第三个月的 0.41 ± 1.02 和第六个月的 0.15 ± 0.45。只有一名患者（1.7%）出现了轻微并发症；本研究未记录到重大并发症：结论：CT引导下经皮MWA是治疗OO的一种微创、高效、安全的方法。

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引用次数: 0

Potential of Dual-Energy CT-Based Collagen Maps for the Assessment of Disk Degeneration in the Lumbar Spine 基于双能量 CT 的胶原蛋白图评估腰椎椎间盘退变的潜力。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.02.036

Rationale and Objectives

Lumbar disk degeneration is a common condition contributing significantly to back pain. The objective of the study was to evaluate the potential of dual-energy CT (DECT)-derived collagen maps for the assessment of lumbar disk degeneration.

Patients and Methods

We conducted a retrospective analysis of 127 patients who underwent dual-source DECT and MRI of the lumbar spine between 07/2019 and 10/2022. The level of lumbar disk degeneration was categorized by three radiologists as follows: no/mild (Pfirrmann 1&2), moderate (Pfirrmann 3&4), and severe (Pfirrmann 5). Recall (sensitivity) and accuracy of DECT collagen maps were calculated. Intraclass correlation coefficient (ICC) was used to evaluate inter-reader reliability. Subjective evaluations were performed using 5-point Likert scales for diagnostic confidence and image quality.

Results

We evaluated a total of 762 intervertebral disks from 127 patients (median age, 69.7 (range, 23.0–93.7), female, 56). MRI identified 230 non/mildly degenerated disks (30.2%), 484 moderately degenerated disks (63.5%), and 48 severely degenerated disks (6.3%). DECT collagen maps yielded an overall accuracy of 85.5% (1955/2286). Recall (sensitivity) was 79.3% (547/690) for the detection of no/mild lumbar disk degeneration, 88.7% (1288/1452) for the detection of moderate disk degeneration, and 83.3% (120/144) for the detection of severe disk degeneration (ICC = 0.9). Subjective evaluations of DECT collagen maps showed high diagnostic confidence (median 4) and good image quality (median 4).

Conclusion

The use of DECT collagen maps to distinguish different stages of lumbar disk degeneration may have clinical significance in the early diagnosis of disk-related pathologies in patients with contraindications for MRI or in cases of unavailability of MRI.

理由和目标：腰椎间盘退变是导致腰痛的常见疾病。本研究的目的是评估双源 CT（DECT）得出的胶原图在评估腰椎间盘退变方面的潜力：我们对 2019 年 7 月至 2022 年 10 月期间接受腰椎双源 DECT 和 MRI 检查的 127 名患者进行了回顾性分析。腰椎间盘退变的程度由三位放射科医生分类如下：无/轻度（Pfirrmann 1&2）、中度（Pfirrmann 3&4）和重度（Pfirrmann 5）。计算了 DECT 胶原图的召回率（灵敏度）和准确性。类内相关系数（ICC）用于评估读片者之间的可靠性。对诊断信心和图像质量采用 5 点李克特量表进行主观评价：我们共评估了 127 名患者（中位年龄 69.7 岁（23.0-93.7 岁），女性 56 人）的 762 个椎间盘。核磁共振成像确定了 230 个非/轻度退化椎间盘（30.2%）、484 个中度退化椎间盘（63.5%）和 48 个严重退化椎间盘（6.3%）。DECT 胶原图的总体准确率为 85.5%（1955/2286）。检测无/轻度腰椎间盘退变的召回率（灵敏度）为 79.3%（547/690），检测中度腰椎间盘退变的召回率（灵敏度）为 88.7%（1288/1452），检测严重腰椎间盘退变的召回率（灵敏度）为 83.3%（120/144）（ICC=0.9）。DECT胶原图的主观评价显示诊断可信度高（中位数4），图像质量好（中位数4）：结论：使用DECT胶原图来区分不同阶段的腰椎间盘退行性变可能对有核磁共振成像禁忌症或无法进行核磁共振成像的患者早期诊断椎间盘相关病变具有临床意义。

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引用次数: 0

A Sweet and Heavy Affair: Glucose, Epicardial Fat, and Heart Trouble 甜蜜而沉重的感情葡萄糖、心外膜脂肪和心脏问题。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.07.045

引用次数: 0

Habitat-Based Radiomics for Predicting EGFR Mutations in Exon 19 and 21 From Brain Metastasis 基于生境的放射组学预测脑转移中表皮生长因子受体外显子 19 和 21 的突变

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.016

Rationale and Objectives

To explore and externally validate habitat-based radiomics for preoperative prediction of epidermal growth factor receptor (EGFR) mutations in exon 19 and 21 from MRI imaging of non-small cell lung cancer (NSCLC)-originated brain metastasis (BM).

Methods

A total of 170, 62 and 61 patients from center 1, center 2 and center 3, respectively were included. All patients underwent contrast-enhanced T1-weighted (T1CE) and T2-weighted (T2W) MRI scans. Radiomics features were extracted from the tumor active (TA) and peritumoral edema (PE) regions in each MRI slice. The most important features were selected by the least absolute shrinkage and selection operator regression to develop radiomics signatures based on TA (RS-TA), PE (RS-PE) and their combination (RS-Com). Receiver operating characteristic (ROC) curve analysis was performed to access performance of radiomics models for both internal and external validation cohorts.

Results

10, four and six most predictive features were identified to be strongly associated with the EGFR mutation status, exon 19 and exon 21, respectively. The RSs derived from the PE region outperformed those from the TA region for predicting the EGFR mutation, exon 19 and exon 21. The RS-Coms generated the highest performance in the primary training (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.955 vs. 0.946 vs. 0.928), internal validation (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.879 vs. 0.819 vs. 0.882), external validation 1 (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.830 vs. 0.825 vs. 0.822), and external validation 2 (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.812 vs. 0.818 vs. 0.800) cohort.

Conclusion

The developed habitat-based radiomics model can be used to accurately predict the EGFR mutation subtypes, which may potentially guide personalized treatments for NSCLC patients with BM.

理论依据和研究目的探索并从外部验证基于生境的放射组学技术，用于术前预测非小细胞肺癌（NSCLC）脑转移瘤（BM）的磁共振成像中表皮生长因子受体（EGFR）外显子 19 和 21 的突变。所有患者均接受了对比增强T1加权（T1CE）和T2加权（T2W）磁共振成像扫描。从每个磁共振切片的肿瘤活跃区（TA）和瘤周水肿区（PE）提取放射组学特征。通过最小绝对收缩率和选择算子回归法选出最重要的特征，以建立基于TA（RS-TA）、PE（RS-PE）及其组合（RS-Com）的放射组学特征。结果10、4和6个最具预测性的特征分别与表皮生长因子受体突变状态、19号外显子和21号外显子密切相关。在预测表皮生长因子受体突变、19 号外显子和 21 号外显子方面，来自 PE 区域的 RS 优于来自 TA 区域的 RS。928），内部验证（AUCs，RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com，0.879 vs. 0.819 vs. 0.882），外部验证 1（AUCs，RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com，0.830 vs. 0.825 vs. 0.822）和外部验证 2（AUCs，RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com，0.812 vs. 0.818 vs. 0.800）队列。

{"title":"Habitat-Based Radiomics for Predicting EGFR Mutations in Exon 19 and 21 From Brain Metastasis","authors":"","doi":"10.1016/j.acra.2024.03.016","DOIUrl":"10.1016/j.acra.2024.03.016","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div><span>To explore and externally validate habitat-based radiomics for preoperative prediction of </span>epidermal growth factor receptor<span> (EGFR) mutations in exon 19 and 21 from MRI imaging of non-small cell lung cancer (NSCLC)-originated brain metastasis (BM).</span></div></div><div><h3>Methods</h3><div>A total of 170, 62 and 61 patients from center 1, center 2 and center 3, respectively were included. All patients underwent contrast-enhanced T1-weighted (T1CE) and T2-weighted (T2W) MRI scans. Radiomics features were extracted from the tumor active (TA) and peritumoral edema (PE) regions in each MRI slice. The most important features were selected by the least absolute shrinkage and selection operator regression to develop radiomics signatures based on TA (RS-TA), PE (RS-PE) and their combination (RS-Com). Receiver operating characteristic (ROC) curve analysis was performed to access performance of radiomics models for both internal and external validation cohorts.</div></div><div><h3>Results</h3><div>10, four and six most predictive features were identified to be strongly associated with the EGFR mutation status, exon 19 and exon 21, respectively. The RSs derived from the PE region outperformed those from the TA region for predicting the EGFR mutation, exon 19 and exon 21. The RS-Coms generated the highest performance in the primary training (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.955 vs. 0.946 vs. 0.928), internal validation (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.879 vs. 0.819 vs. 0.882), external validation 1 (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.830 vs. 0.825 vs. 0.822), and external validation 2 (AUCs, RS-EGFR-Com vs. RS-exon 19-Com vs. RS-exon 21-Com, 0.812 vs. 0.818 vs. 0.800) cohort.</div></div><div><h3>Conclusion</h3><div>The developed habitat-based radiomics model can be used to accurately predict the EGFR mutation subtypes, which may potentially guide personalized treatments for NSCLC patients with BM.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Revisiting the Clinical Interpretation of CT-Measured Pulmonary Artery-to-Aorta Ratio—The Rotterdam Study 重新审视 CT 测量的肺动脉与主动脉比率的临床解释--鹿特丹研究。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.037

Rationale

The pulmonary artery (PA) diameter-to-aorta ratio (PA:A) ratio is a novel marker in cardiovascular imaging for detecting pulmonary hypertension. However, we question the effect of the varying aorta diameter on the ratio, which complicates the interpretation of the PA:A ratio.

Objective

Investigate the variability of the PA:A ratio by examining the correlation between PA:A ratio and aorta diameter and by comparing the associations of the PA diameter, aorta diameters, and PA:A ratio.

Methods

We included 2197 participants from the Rotterdam Study who underwent non-contrast multidetector computed tomography to measure the PA and aorta diameters. Pearson correlation coefficient was calculated between the PA:A ratio and aorta diameter. Multiple linear regression analyses were performed to compare the determinants of the individual diameters and PA:A ratio.

Results

We found a statistically significant correlation between the PA:A ratio and aorta diameter (r = −0.38, p < 0.001). The PA diameter was statistically significantly associated with, height, weight, diastolic blood pressure, blood pressure medication, prevalence of atrial fibrillation, prevalence of heart failure, and prevalence of stroke (p < 0.05). Except for blood pressure medication, the PA:A ratio had similar determinants compared to the PA diameter but was also statistically significantly associated with sex, and systolic blood pressure (p < 0.05), which were statistically significantly associated with the aorta diameter (p < 0.05).

Conclusion

The PA:A ratio should not be interpreted without taking into account the variability of the individual components (PA and aorta diameter) according to the anthropomorphic and clinical characteristics.

理论依据肺动脉（PA）直径与主动脉比值（PA:A）是心血管成像中检测肺动脉高压的新标记。通过研究 PA:A 比值与主动脉直径之间的相关性，并比较 PA 直径、主动脉直径和 PA:A 比值之间的关联，我们对 PA:A 比值的可变性提出了质疑。方法我们纳入了鹿特丹研究中的 2197 名参与者，他们接受了非对比多载体计算机断层扫描，以测量 PA 和主动脉直径。计算了 PA:A 比值与主动脉直径之间的皮尔逊相关系数。结果我们发现 PA:A 比值与主动脉直径之间存在统计学意义上的显著相关性（r = -0.38，p <0.001）。PA 直径与身高、体重、舒张压、血压药物、心房颤动患病率、心力衰竭患病率和脑卒中患病率均有统计学意义（p < 0.05）。除血压药物外，PA:A 比值的决定因素与 PA 直径相似，但在统计学上与性别和收缩压显著相关（p < 0.05），而在统计学上与主动脉直径显著相关（p < 0.05）。

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引用次数: 0

A Deep Learning Model for Predicting Molecular Subtype of Breast Cancer by Fusing Multiple Sequences of DCE-MRI From Two Institutes 通过融合两家研究所的多序列 DCE-MRI 预测乳腺癌分子亚型的深度学习模型。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.002

Rationale and Objectives

To evaluate the performance of deep learning (DL) in predicting different breast cancer molecular subtypes using DCE-MRI from two institutes.

Materials and Methods

This retrospective study included 366 breast cancer patients from two institutes, divided into training (n = 292), validation (n = 49) and testing (n = 25) sets. We first transformed the public DCE-MRI appearance to ours to alleviate small-data-size and class-imbalance issues. Second, we developed a multi-branch convolutional-neural-network (MBCNN) to perform molecular subtype prediction. Third, we assessed the MBCNN with different regions of interest (ROIs) and fusion strategies, and compared it to previous DL models. Area under the curve (AUC) and accuracy (ACC) were used to assess different models. Delong-test was used for the comparison of different groups.

Results

MBCNN achieved the optimal performance under intermediate fusion and ROI size of 80 pixels with appearance transformation. It outperformed CNN and convolutional long-short-term-memory (CLSTM) in predicting luminal B, HER2-enriched and TN subtypes, but without demonstrating statistical significance except against CNN in TN subtypes, with testing AUCs of 0.8182 vs. [0.7208, 0.7922] (

p

= 0.44, 0.80), 0.8500 vs. [0.7300, 0.8200] (

p

= 0.36, 0.70) and 0.8900 vs. [0.7600, 0.8300] (

p

= 0.03, 0.63), respectively. When predicting luminal A, MBCNN outperformed CNN with AUCs of 0.8571 vs. 0.7619 (

p

= 0.08) without achieving statistical significance, and is comparable to CLSTM. For four-subtype prediction, MBCNN achieved an ACC of 0.64, better than CNN and CLSTM models with ACCs of 0.48 and 0.52, respectively.

Conclusion

Developed DL model with the feature extraction and fusion of DCE-MRI from two institutes enabled preoperative prediction of breast cancer molecular subtypes with high diagnostic performance.

材料与方法这项回顾性研究纳入了来自两家研究所的 366 名乳腺癌患者，分为训练集（n = 292）、验证集（n = 49）和测试集（n = 25）。我们首先将公开的 DCE-MRI 图像转换成我们的图像，以缓解数据量小和类别不平衡的问题。其次，我们开发了多分支卷积神经网络（MBCNN）来进行分子亚型预测。第三，我们用不同的兴趣区域（ROI）和融合策略对 MBCNN 进行了评估，并将其与之前的 DL 模型进行了比较。曲线下面积（AUC）和准确率（ACC）用于评估不同的模型。结果在中间融合和 ROI 大小为 80 像素的情况下，MBCNN 通过外观变换获得了最佳性能。它在预测管腔 B 型、HER2-富集型和 TN 亚型方面的表现优于 CNN 和卷积长短期记忆（CLSTM），但在 TN 亚型方面与 CNN 相比没有统计学意义，其测试 AUC 为 0.8182 vs. [0.7208, 0.7922] (p = 0.44, 0.80)、0.8500 vs. [0.7300, 0.8200] (p = 0.36, 0.70) 和 0.8900 vs. [0.7600, 0.8300] (p = 0.03, 0.63)。在预测管腔 A 时，MBCNN 的 AUC 值为 0.8571 vs. 0.7619（p = 0.08），优于 CNN，但未达到统计学显著性，与 CLSTM 相当。在四种亚型预测方面，MBCNN 的 ACC 为 0.64，优于 CNN 和 CLSTM 模型的 ACC（分别为 0.48 和 0.52）。

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引用次数: 0

Pseudo-time Series Structural MRI Revealing Progressive Gray Matter Changes with Elevated Intraocular Pressure in Primary Open-Angle Glaucoma: A Preliminary Study 伪时间序列结构磁共振成像揭示原发性开角型青光眼眼压升高时灰质的进行性变化：初步研究。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.acra.2024.03.013

Rationale and Objectives

Primary open-angle glaucoma (POAG) is accompanied with gray matter (GM) changes across the brain. However, causal relationships of the GM changes have not been fully understood. Our aim was to investigate the causality of GM progressive changes in POAG using Granger causality (GC) analysis and structural MRI.

Materials and Methods

Structural MRI from 20 healthy controls and 30 POAG patients with elevated intraocular pressure (IOP) were collected. We performed voxel-wise GM volume comparisons between control and POAG groups, and between control and four POAG subgroups (categorized by IOP). Then, we sequenced the structural MRI data of all POAG patients and conducted both voxel-wise and region of interest (ROI)-wise GC analysis to investigate the causality of GM volume changes in POAG brain.

Results

Compared to healthy controls, reduced GM volumes across the brain were found, GM volume enlargements in the thalamus, caudate nucleus and cuneus were also observed in POAG brain (false discovery rate (FDR) corrected at q< 0.05). As IOP elevated, the reductions of GM volume were more severe in the cerebellum and frontal lobe. GC analysis revealed that the bilateral cerebellum, visual cortices, and the frontal regions served independently as primary hubs of the directional causal network, and projected causal effects to the parietal and temporal regions of the brain (FDR corrected at q < 0.05).

Conclusion

POAG exhibits progressive GM alterations across the brain, with oculomotor regions and visual cortices as independent primary hubs. The current results may deepen our understanding of neuropathology of POAG.

理由和目的原发性开角型青光眼（POAG）伴随着整个大脑灰质（GM）的变化。然而，GM 变化的因果关系尚未完全明了。我们的目的是利用格兰杰因果关系（GC）分析和结构磁共振成像（MRI）研究 POAG 患者大脑灰质渐进性变化的因果关系。我们在对照组和 POAG 组之间，以及对照组和四个 POAG 亚组（按 IOP 分类）之间进行了体素 GM 容量比较。结果与健康对照组相比，POAG 患者整个大脑的 GM 体积缩小，丘脑、尾状核和楔状核的 GM 体积增大（假发现率 (FDR) 按 q< 校正；0.05）。随着眼压升高，小脑和额叶的基因组体积减少更为严重。GC分析表明，双侧小脑、视觉皮层和额叶区是独立的定向因果网络的主要枢纽，并将因果效应投射到大脑的顶叶和颞叶区（FDR校正为q< 0.05）。目前的研究结果可能会加深我们对 POAG 神经病理学的理解。

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引用次数: 0