Quantitative Imaging in Medicine and Surgery最新文献_第6页

The transition from hypertension to hypertensive heart disease and heart failure with preserved ejection fraction: a retrospective cross-sectional study of myocardial magnetic resonance strain and tissue characteristics. 从高血压到高血压性心脏病和射血分数保留型心力衰竭的转变：心肌磁共振应变和组织特征的回顾性横断面研究。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI: 10.21037/qims-24-803

Rui Li, Feng Lei, Feng Liu, Liang Cao, Xu Cao, Meng Niu, Shunlin Guo

Background: Due to the variability of symptoms and signs associated with heart failure, along with the lack of specific tests for definitive diagnosis, the noninvasive diagnosis of heart failure with preserved ejection fraction (HFpEF) continues to pose significant clinical challenges. This investigation was designed to elucidate the clinical manifestations of HFpEF and to analyze cardiac magnetic resonance (CMR)-derived myocardial strain metrics and tissue characteristics in a cohort exhibiting HFpEF with hypertension (HFpEF-HTN).Methods: This retrospective analysis consisted of 128 patients diagnosed HFpEF-HTN, 78 individuals with hypertensive heart disease (HHD), 89 individuals with hypertension (HTN), and 60 normotensive healthy controls and was conducted from August 2021 to February 2024. All participants were recruited from The First Hospital of Lanzhou University and underwent laboratory examinations and 3.0 T CMR. The study compared clinical features and CMR-derived structural and functional parameters across different groups. Logistic regression was employed to determine the association between CMR parameters and HFpEF-HTN. Spearman correlation coefficient analysis was used to clarify the relationship between myocardial strain parameters and left ventricular (LV) ejection fraction and right ventricular (RV) ejection fraction. Additionally, the area under the curve (AUC) from receiver operating characteristic (ROC) analysis was used to compare the diagnostic performance of different CMR parameters for HFpEF-HTN.Results: Patients diagnosed with (HFpEF-HTN) were characterized by an older demographic profile, a higher prevalence of smoking history, elevated systolic and diastolic blood pressure, increased levels of N-terminal pro-brain natriuretic peptide, and more advanced New York Heart Association functional class as compared to other studied groups. In terms of myocardial deformation, individuals with HFpEF-HTN exhibited pronounced impairments in both LV and RV function, as evidenced by significantly reduced longitudinal strain (LS), circumferential strain (CS), and radial strain (RS), relative to HTN, HHD, the control cohorts (all P values <0.001). Patients with HFpEF-HTN showed significantly elevated levels of late gadolinium enhancement, native T1, and extracellular volume fraction (ECV) indicative of myocardial interstitial fibrosis as compared to patients with HHD. Additionally, as compared to ECV, LV GCS emerged as a superior diagnostic indicator, demonstrating greater diagnostic accuracy in differentiating HFpEF-HTN patients from those with HHD (AUC =0.85; P<0.001). Moreover, LVEF showed a mild correlation with CMR-derived LV GLS (R=-0.43; P<0.001), LV GCS (R=-0.42; P<0.001), and LV GRS, (R=0.56; P<0.001) in all patients.Conclusions: Myocardial strain, T1 mapping, and ECV can be used for the quantitative evaluation of LV and RV ventricular

背景：由于心力衰竭相关症状和体征的多变性，以及缺乏明确诊断的特异性检查，射血分数保留型心力衰竭（HFpEF）的无创诊断仍然是重大的临床挑战。本研究旨在阐明 HFpEF 的临床表现，并分析心脏磁共振（CMR）得出的心肌应变指标和高血压 HFpEF 患者（HFpEF-HTN）的组织特征：这项回顾性分析包括128名确诊为HFpEF-HTN的患者、78名高血压性心脏病（HHD）患者、89名高血压（HTN）患者和60名血压正常的健康对照者，分析时间为2021年8月至2024年2月。所有参与者均来自兰州大学第一医院，并接受了实验室检查和 3.0 T CMR 检查。研究比较了不同组别的临床特征、CMR衍生的结构和功能参数。研究采用逻辑回归法确定 CMR 参数与 HFpEF-HTN 之间的关系。斯皮尔曼相关系数分析用于明确心肌应变参数与左心室射血分数和右心室射血分数之间的关系。此外，接受者操作特征（ROC）分析的曲线下面积（AUC）用于比较不同CMR参数对HFpEF-HTN的诊断性能：结果：与其他研究组相比，被诊断为（HFpEF-HTN）的患者具有以下特点：人口统计学特征较老、吸烟史发生率较高、收缩压和舒张压升高、N末端前脑钠尿肽水平升高、纽约心脏协会功能分级较高。在心肌变形方面，HFpEF-HTN 患者的左心室和右心室功能明显受损，表现为纵向应变（LS）、环向应变（CS）和径向应变（RS）相对于 HTN、HHD 和对照组显著降低（所有 P 值均为结论值）：心肌应变、T1映射和ECV可用于定量评估HFpEF-HTN患者左心室和左心室的重塑、功能障碍和组织特征，因此在这些患者的诊断中具有很大的潜力。

{"title":"The transition from hypertension to hypertensive heart disease and heart failure with preserved ejection fraction: a retrospective cross-sectional study of myocardial magnetic resonance strain and tissue characteristics.","authors":"Rui Li, Feng Lei, Feng Liu, Liang Cao, Xu Cao, Meng Niu, Shunlin Guo","doi":"10.21037/qims-24-803","DOIUrl":"10.21037/qims-24-803","url":null,"abstract":"Background: Due to the variability of symptoms and signs associated with heart failure, along with the lack of specific tests for definitive diagnosis, the noninvasive diagnosis of heart failure with preserved ejection fraction (HFpEF) continues to pose significant clinical challenges. This investigation was designed to elucidate the clinical manifestations of HFpEF and to analyze cardiac magnetic resonance (CMR)-derived myocardial strain metrics and tissue characteristics in a cohort exhibiting HFpEF with hypertension (HFpEF-HTN).Methods: This retrospective analysis consisted of 128 patients diagnosed HFpEF-HTN, 78 individuals with hypertensive heart disease (HHD), 89 individuals with hypertension (HTN), and 60 normotensive healthy controls and was conducted from August 2021 to February 2024. All participants were recruited from The First Hospital of Lanzhou University and underwent laboratory examinations and 3.0 T CMR. The study compared clinical features and CMR-derived structural and functional parameters across different groups. Logistic regression was employed to determine the association between CMR parameters and HFpEF-HTN. Spearman correlation coefficient analysis was used to clarify the relationship between myocardial strain parameters and left ventricular (LV) ejection fraction and right ventricular (RV) ejection fraction. Additionally, the area under the curve (AUC) from receiver operating characteristic (ROC) analysis was used to compare the diagnostic performance of different CMR parameters for HFpEF-HTN.Results: Patients diagnosed with (HFpEF-HTN) were characterized by an older demographic profile, a higher prevalence of smoking history, elevated systolic and diastolic blood pressure, increased levels of N-terminal pro-brain natriuretic peptide, and more advanced New York Heart Association functional class as compared to other studied groups. In terms of myocardial deformation, individuals with HFpEF-HTN exhibited pronounced impairments in both LV and RV function, as evidenced by significantly reduced longitudinal strain (LS), circumferential strain (CS), and radial strain (RS), relative to HTN, HHD, the control cohorts (all P values <0.001). Patients with HFpEF-HTN showed significantly elevated levels of late gadolinium enhancement, native T1, and extracellular volume fraction (ECV) indicative of myocardial interstitial fibrosis as compared to patients with HHD. Additionally, as compared to ECV, LV GCS emerged as a superior diagnostic indicator, demonstrating greater diagnostic accuracy in differentiating HFpEF-HTN patients from those with HHD (AUC =0.85; P<0.001). Moreover, LVEF showed a mild correlation with CMR-derived LV GLS (R=-0.43; P<0.001), LV GCS (R=-0.42; P<0.001), and LV GRS, (R=0.56; P<0.001) in all patients.Conclusions: Myocardial strain, T1 mapping, and ECV can be used for the quantitative evaluation of LV and RV ventricular ","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7684-7696"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tumour-pleura relationship on computed tomography (CT) provides effective risk stratification for peripheral pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) score of 4X. 计算机断层扫描（CT）上的肿瘤与胸膜关系可对肺成像报告和数据系统（Lung-RADS）评分为 4X 的周围肺结节进行有效的风险分层。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-21 DOI: 10.21037/qims-24-530

Liangna Deng, Kaibo Zhu, Jingjing Yang, Yuting Zhang, Mengyuan Jing, Peng Zhang, Tao Han, Bin Zhang, Junlin Zhou

Background: Pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) 4X are of greater clinical significance, and accurate differentiation of pathological types and visceral pleural invasion (VPI) of Lung-RADS 4X peripheral pulmonary nodules before treatment can aid in stratification. This study set out to investigate whether the tumour-pleura relationship on computed tomography (CT) can provide effective risk stratification for peripheral pulmonary nodules with Lung-RADS 4X.

Methods: This was a single institution, retrospective study of 482 consecutive patients with Lung-RADS score 4X, who were pathologically diagnosed with tuberculous granuloma and adenocarcinoma from January 2019 to December 2023. We assessed clinical factors (baseline characteristics and tumour markers) and CT findings. Univariate and multivariate logistic regression analyses were used to determine the classification of pulmonary nodules and predictors of VPI.

Results: Multivariate analysis revealed that gender [odds ratio (OR) =0.392; P<0.001], carcinoembryonic antigen (CEA) level (OR =8.331; P<0.001), type of nodules (OR =13.551 and 7.478; P<0.001 and P=0.016) and maximum base width of soft tissue component on the pleura side (OR =0.857; P=0.005) were significant independent factors for distinguishing tuberculous granuloma from adenocarcinoma. And the type of linear connection between lesion and pleura (OR =3.936; P<0.001), and the maximum base width of soft tissue components on the pleura side (OR =1.359; P=0.001) were correlated independently with VPI. The area under the curve (AUC) for predicting pulmonary nodules classification was 82.60% [95% confidence interval (CI): 78.85-86.35%), and the AUC for predicting VPI was 76.10% (95% CI: 69.83-82.38%).

Conclusions: The tumour-pleura relationship will be helpful in further risk stratification for peripheral pulmonary nodules with a score of Lung-RADS 4X.

背景：肺部影像报告和数据系统（Lung-RADS）4X肺结节具有更大的临床意义，在治疗前准确区分Lung-RADS 4X外周肺结节的病理类型和内脏胸膜侵犯（VPI）有助于分层。本研究旨在探讨计算机断层扫描（CT）上的肿瘤与胸膜关系是否能对肺-RADS 4X外周肺结节进行有效的风险分层：这是一项单机构回顾性研究，研究对象是2019年1月至2023年12月期间连续482例经病理诊断为结核性肉芽肿和腺癌的Lung-RADS评分4X患者。我们评估了临床因素（基线特征和肿瘤标志物）和 CT 结果。采用单变量和多变量逻辑回归分析来确定肺结节的分类和VPI的预测因素：结果：多变量分析表明，性别[几率比（OR）=0.392；PC结论：肿瘤与胸膜的关系将影响VPI的预测：肿瘤与胸膜的关系有助于对肺-RADS 4X 评分的周围肺结节进行进一步的风险分层。

{"title":"Tumour-pleura relationship on computed tomography (CT) provides effective risk stratification for peripheral pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) score of 4X.","authors":"Liangna Deng, Kaibo Zhu, Jingjing Yang, Yuting Zhang, Mengyuan Jing, Peng Zhang, Tao Han, Bin Zhang, Junlin Zhou","doi":"10.21037/qims-24-530","DOIUrl":"10.21037/qims-24-530","url":null,"abstract":"Background: Pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) 4X are of greater clinical significance, and accurate differentiation of pathological types and visceral pleural invasion (VPI) of Lung-RADS 4X peripheral pulmonary nodules before treatment can aid in stratification. This study set out to investigate whether the tumour-pleura relationship on computed tomography (CT) can provide effective risk stratification for peripheral pulmonary nodules with Lung-RADS 4X.Methods: This was a single institution, retrospective study of 482 consecutive patients with Lung-RADS score 4X, who were pathologically diagnosed with tuberculous granuloma and adenocarcinoma from January 2019 to December 2023. We assessed clinical factors (baseline characteristics and tumour markers) and CT findings. Univariate and multivariate logistic regression analyses were used to determine the classification of pulmonary nodules and predictors of VPI.Results: Multivariate analysis revealed that gender [odds ratio (OR) =0.392; P<0.001], carcinoembryonic antigen (CEA) level (OR =8.331; P<0.001), type of nodules (OR =13.551 and 7.478; P<0.001 and P=0.016) and maximum base width of soft tissue component on the pleura side (OR =0.857; P=0.005) were significant independent factors for distinguishing tuberculous granuloma from adenocarcinoma. And the type of linear connection between lesion and pleura (OR =3.936; P<0.001), and the maximum base width of soft tissue components on the pleura side (OR =1.359; P=0.001) were correlated independently with VPI. The area under the curve (AUC) for predicting pulmonary nodules classification was 82.60% [95% confidence interval (CI): 78.85-86.35%), and the AUC for predicting VPI was 76.10% (95% CI: 69.83-82.38%).Conclusions: The tumour-pleura relationship will be helpful in further risk stratification for peripheral pulmonary nodules with a score of Lung-RADS 4X.","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7138-7150"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uncommon presentation of Castleman disease in the duodenum: a case description and computed tomography imaging analysis. 十二指肠卡斯特曼病的罕见表现：病例描述和计算机断层扫描成像分析。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.21037/qims-24-704

Shuang Lai, Chunhong Hu, Qian Zheng

引用次数: 0

Efficacy and safety of a novel vena cava filter on pulmonary embolism prophylaxis: a prospective, multicenter, randomized, parallel, positive-controlled, noninferiority clinical trial. 新型腔静脉过滤器预防肺栓塞的有效性和安全性：一项前瞻性、多中心、随机、平行、阳性对照、非劣效性临床试验。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-14 DOI: 10.21037/qims-24-879

Maofeng Gong, Boxiang Zhao, Jianlong Liu, Gaojun Teng, Caifang Ni, Hao Xu, Zhen Li, Shuiting Zhai, Yanrong Zhang, Hua Xiang, Weizhu Yang, Jianping Gu

Background: There are different types of vena cava filter (VCF) available in clinical practice. However, limited data exist to determine whether one type is superior to another, and no single VCF is universally recommended in clinical guidelines. The objective of this study was to investigate the safety and efficacy of a novel VCF, Octoparms, for the prevention of pulmonary embolism (PE) and to compare it with the Celect filter.

Methods: This multicenter, randomized, open-label, parallel, positive-controlled, noninferiority trial was conducted in 10 centers across 6 provinces in China from October 2017 to March 2019. Patients who had confirmed lower extremity deep vein thrombosis or PE or who were at risk of PE with a clinical indication for VCF placement due to contraindication to or failure of anticoagulant therapy were included in the trial. The sample size for this trial was based on the assumption that the clinical success rate would be 95% and the noninferiority margin would be 10% for both filters. Each patient underwent baseline testing and was randomized using a web-based central system. Any additional interventions or standard treatments patients received along with the VCF placement were recorded. The primary endpoint was the overall clinical success rate, including technical and clinical success of filter placement and retrieval. The secondary endpoint was the safety of filter placement and retrieval, encompassing procedure-related and filter-related complications.

Results: A total of 188 patients were included and were divided into two groups: the Octoparms group (n=94) and the Celect group (n=94). Baseline characteristics and demographics were comparable between the two groups (P>0.05). Technical and clinical success rates for filter placement were achieved in 100% (188/188) of patients. The median dwelling time was 12.0 days (range, 4-190 days). Ten VCFs were left in situ as permanent devices. Of the remaining 178 patients, technical success and clinical success rates for filter retrieval were both achieved in 100% of cases (178/178). Clinical success rates were 92.6% (87/94) for the Octoparms group and 96.8% (91/94) for the Celect group, with a difference of -4.2% (hazard ratio 2.441, 95% confidence interval 0.612-9.741; P=0.206). The lower limit was greater than the noninferiority margin of -10%. Eight patients experienced a total of eight procedure-related complications. No filter-related complications, such as migration, deformation, inferior vena cava (IVC) penetration, peripheral organ damage, or IVC stenosis/occlusion, were observed (P>0.05).

Conclusions: The Octoparms filter exhibited a high rate of clinical success and a low rate of complications during placement and retrieval, demonstrating noninferiority to the Celect filter.

背景：临床上有多种不同类型的腔静脉过滤器（VCF）。然而，能确定一种类型是否优于另一种类型的数据十分有限，临床指南中也没有普遍推荐任何一种腔静脉过滤器。本研究旨在探讨新型腔静脉过滤器 Octoparms 用于预防肺栓塞（PE）的安全性和有效性，并将其与 Celect 过滤器进行比较：这项多中心、随机、开放标签、平行、阳性对照、非劣效试验于2017年10月至2019年3月在中国6个省的10个中心进行。试验纳入了确诊为下肢深静脉血栓或PE的患者，或因禁忌抗凝治疗或抗凝治疗失败而有PE风险且有VCF置入临床指征的患者。该试验的样本量是根据两种滤器的临床成功率均为 95% 和非劣效性差值均为 10% 的假设确定的。每位患者都接受了基线测试，并通过网络中央系统进行了随机分组。患者在植入 VCF 的同时接受的任何额外干预或标准治疗均被记录在案。主要终点是总体临床成功率，包括过滤器置入和取出的技术和临床成功率。次要终点是过滤器置入和取出的安全性，包括手术相关并发症和过滤器相关并发症：共纳入 188 名患者，分为两组：Octoparms 组（94 人）和 Celect 组（94 人）。两组患者的基线特征和人口统计学具有可比性（P>0.05）。100%（188/188）的患者在技术和临床上成功置入过滤器。中位停留时间为 12.0 天（4-190 天不等）。10个VCF作为永久性装置留在原位。在剩余的 178 例患者中，100% 的病例（178/178）都实现了过滤器取出的技术成功率和临床成功率。Octoparms 组的临床成功率为 92.6%（87/94），Celect 组为 96.8%（91/94），差异为-4.2%（危险比 2.441，95% 置信区间 0.612-9.741；P=0.206）。下限大于-10%的非劣效边际。八名患者共经历了八次手术相关并发症。未观察到过滤器相关并发症，如移位、变形、下腔静脉（IVC）穿透、外周器官损伤或 IVC 狭窄/闭塞（P>0.05）：结论：Octoparms 过滤器的临床成功率高，置入和取出过程中的并发症发生率低，与 Celect 过滤器相比并无劣势。

{"title":"Efficacy and safety of a novel vena cava filter on pulmonary embolism prophylaxis: a prospective, multicenter, randomized, parallel, positive-controlled, noninferiority clinical trial.","authors":"Maofeng Gong, Boxiang Zhao, Jianlong Liu, Gaojun Teng, Caifang Ni, Hao Xu, Zhen Li, Shuiting Zhai, Yanrong Zhang, Hua Xiang, Weizhu Yang, Jianping Gu","doi":"10.21037/qims-24-879","DOIUrl":"10.21037/qims-24-879","url":null,"abstract":"Background: There are different types of vena cava filter (VCF) available in clinical practice. However, limited data exist to determine whether one type is superior to another, and no single VCF is universally recommended in clinical guidelines. The objective of this study was to investigate the safety and efficacy of a novel VCF, Octoparms, for the prevention of pulmonary embolism (PE) and to compare it with the Celect filter.Methods: This multicenter, randomized, open-label, parallel, positive-controlled, noninferiority trial was conducted in 10 centers across 6 provinces in China from October 2017 to March 2019. Patients who had confirmed lower extremity deep vein thrombosis or PE or who were at risk of PE with a clinical indication for VCF placement due to contraindication to or failure of anticoagulant therapy were included in the trial. The sample size for this trial was based on the assumption that the clinical success rate would be 95% and the noninferiority margin would be 10% for both filters. Each patient underwent baseline testing and was randomized using a web-based central system. Any additional interventions or standard treatments patients received along with the VCF placement were recorded. The primary endpoint was the overall clinical success rate, including technical and clinical success of filter placement and retrieval. The secondary endpoint was the safety of filter placement and retrieval, encompassing procedure-related and filter-related complications.Results: A total of 188 patients were included and were divided into two groups: the Octoparms group (n=94) and the Celect group (n=94). Baseline characteristics and demographics were comparable between the two groups (P>0.05). Technical and clinical success rates for filter placement were achieved in 100% (188/188) of patients. The median dwelling time was 12.0 days (range, 4-190 days). Ten VCFs were left in situ as permanent devices. Of the remaining 178 patients, technical success and clinical success rates for filter retrieval were both achieved in 100% of cases (178/178). Clinical success rates were 92.6% (87/94) for the Octoparms group and 96.8% (91/94) for the Celect group, with a difference of -4.2% (hazard ratio 2.441, 95% confidence interval 0.612-9.741; P=0.206). The lower limit was greater than the noninferiority margin of -10%. Eight patients experienced a total of eight procedure-related complications. No filter-related complications, such as migration, deformation, inferior vena cava (IVC) penetration, peripheral organ damage, or IVC stenosis/occlusion, were observed (P>0.05).Conclusions: The Octoparms filter exhibited a high rate of clinical success and a low rate of complications during placement and retrieval, demonstrating noninferiority to the Celect filter.","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7073-7085"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discriminating bronchiolar adenoma from peripheral lung cancer by thin-section computed tomography (CT): a 2-center study. 通过薄层计算机断层扫描（CT）鉴别支气管腺瘤和周围型肺癌：一项双中心研究。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.21037/qims-24-687

Yang Tao, Ting-Wei Xiong, Qing-Shu Li, Shi-Hai Yang, Fa-Jin Lv, Zhi-Gang Chu

Background: Bronchiolar adenoma (BA) is frequently misdiagnosed as peripheral lung cancer (PLC) because it resembles PLC. Computed tomography (CT) examination is an effective tool for detecting and diagnosing lung diseases. To date, there has been no comprehensive study on the differential diagnosis of BAs and PLCs using thin-section computed tomography (TSCT) based on a large sample, and the efficiency of CT in diagnosing BAs has not been verified. The goal of this study was to distinguish BA from PLC by summarizing their clinical and TSCT characteristics.

Methods: A retrospective cross-sectional study on 71 cases with BAs and 218 matched controls with PLCs (from March 2020 to May 2023) within 2 centers (The First Affiliated Hospital of Chongqing Medical University and the Second Affiliated Hospital of Army Medical University) was conducted to investigate their clinical and radiological differences. The clinical characteristics and TSCT features of BAs and PLCs were summarized and compared. A multivariate logistic regression analysis was performed to reveal the key predictors of BAs.

Results: The BAs and PLCs exhibited significant differences in TSCT features. Multivariate analysis revealed that the lesion being located in basal segments [odds ratio (OR), 17.835; 95% confidence interval (CI): 6.977-45.588; P<0.001], irregular shape (OR, 4.765; 95% CI: 1.877-12.099; P=0.001), negative of spiculation sign (OR, 7.436; 95% CI: 2.063-26.809; P=0.002), central vessel sign with pulmonary artery (OR, 3.576; 95% CI: 1.557-8.211; P=0.003), peripheral vessel sign with pulmonary vein (OR, 12.444; 95% CI: 4.934-31.383; P<0.001), and distance from lesion edge to pleura (D-ETP) ≤5 mm (OR, 5.535; 95% CI: 2.346-13.057; P<0.001) were independent predictors of BAs, and the area under the curve (AUC) of this model was 0.935; 95% CI: 0.901-0.960 (sensitivity: 88.0%, specificity: 86.03%, P<0.001).

Conclusions: Peripheral pulmonary nodules locating in the basal segment of lower lobe with irregular shape, central vessel sign with pulmonary artery, peripheral vessel sign with pulmonary vein and D-ETP ≤5 mm, but without spiculation sign, should be highly suspected of BAs.

背景：支气管腺瘤（BA）因与周围型肺癌（PLC）相似而经常被误诊为周围型肺癌（PLC）。计算机断层扫描（CT）检查是检测和诊断肺部疾病的有效工具。迄今为止，还没有基于大样本使用薄层计算机断层扫描（TSCT）对 BA 和 PLC 进行鉴别诊断的全面研究，CT 诊断 BA 的效率也尚未得到验证。本研究的目的是通过总结 BA 和 PLC 的临床和 TSCT 特征来区分它们：方法：对两个中心（重庆医科大学附属第一医院和陆军军医大学附属第二医院）的 71 例 BA 和 218 例 PLC 配对对照（2020 年 3 月至 2023 年 5 月）进行回顾性横断面研究，以探讨它们的临床和放射学差异。总结并比较了 BA 和 PLC 的临床特征和 TSCT 特征。进行多变量逻辑回归分析，以揭示预测 BAs 的关键因素：结果：BAs和PLCs的TSCT特征有显著差异。多变量分析显示，病灶位于基底段[几率比（OR），17.835；95% 置信区间（CI）：6.977-45.588；PConclusions.]：位于下叶基底段、形状不规则、中心血管呈肺动脉征、周围血管呈肺静脉征、D-ETP ≤5 mm 但无棘突征的周围肺结节应高度怀疑为 BA。

{"title":"Discriminating bronchiolar adenoma from peripheral lung cancer by thin-section computed tomography (CT): a 2-center study.","authors":"Yang Tao, Ting-Wei Xiong, Qing-Shu Li, Shi-Hai Yang, Fa-Jin Lv, Zhi-Gang Chu","doi":"10.21037/qims-24-687","DOIUrl":"10.21037/qims-24-687","url":null,"abstract":"Background: Bronchiolar adenoma (BA) is frequently misdiagnosed as peripheral lung cancer (PLC) because it resembles PLC. Computed tomography (CT) examination is an effective tool for detecting and diagnosing lung diseases. To date, there has been no comprehensive study on the differential diagnosis of BAs and PLCs using thin-section computed tomography (TSCT) based on a large sample, and the efficiency of CT in diagnosing BAs has not been verified. The goal of this study was to distinguish BA from PLC by summarizing their clinical and TSCT characteristics.Methods: A retrospective cross-sectional study on 71 cases with BAs and 218 matched controls with PLCs (from March 2020 to May 2023) within 2 centers (The First Affiliated Hospital of Chongqing Medical University and the Second Affiliated Hospital of Army Medical University) was conducted to investigate their clinical and radiological differences. The clinical characteristics and TSCT features of BAs and PLCs were summarized and compared. A multivariate logistic regression analysis was performed to reveal the key predictors of BAs.Results: The BAs and PLCs exhibited significant differences in TSCT features. Multivariate analysis revealed that the lesion being located in basal segments [odds ratio (OR), 17.835; 95% confidence interval (CI): 6.977-45.588; P<0.001], irregular shape (OR, 4.765; 95% CI: 1.877-12.099; P=0.001), negative of spiculation sign (OR, 7.436; 95% CI: 2.063-26.809; P=0.002), central vessel sign with pulmonary artery (OR, 3.576; 95% CI: 1.557-8.211; P=0.003), peripheral vessel sign with pulmonary vein (OR, 12.444; 95% CI: 4.934-31.383; P<0.001), and distance from lesion edge to pleura (D-ETP) ≤5 mm (OR, 5.535; 95% CI: 2.346-13.057; P<0.001) were independent predictors of BAs, and the area under the curve (AUC) of this model was 0.935; 95% CI: 0.901-0.960 (sensitivity: 88.0%, specificity: 86.03%, P<0.001).Conclusions: Peripheral pulmonary nodules locating in the basal segment of lower lobe with irregular shape, central vessel sign with pulmonary artery, peripheral vessel sign with pulmonary vein and D-ETP ≤5 mm, but without spiculation sign, should be highly suspected of BAs.","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7086-7097"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of the presence and severity of spontaneous splenorenal or gastrorenal shunts via four-dimensional flow magnetic resonance imaging: a preliminary study. 通过四维血流磁共振成像评估自发性脾肾或胃肾分流的存在和严重程度：一项初步研究。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI: 10.21037/qims-24-826

You Zheng, Qiong Hu, Jun Zhou, Xiang Li, Xiaojing He, Tianwu Chen, Xi Liu, Weijuan Chen, Xin Li, Dajing Guo

Background: Four-dimensional phase-contrast magnetic resonance imaging (4D flow MRI) is a relatively new type of MRI acquisition technique that provides a unique and comprehensive set of information within a single acquisition, including hemodynamic and anatomical information. This study was designed to noninvasively evaluate the correlation between the presence and severity of spontaneous splenorenal shunt (SRS) or gastrorenal shunt (GRS) and 4D flow MRI-derived parameters.Methods: This retrospective case-control study enrolled 70 patients who were diagnosed with hepatocirrhosis portal hypertension and admitted to the Second Affiliated Hospital of Chongqing Medical University. Patients were divided into three groups according to the diameter of the SRS and GRS. 4D flow MRI-derived parameters, including the turbulent kinetic energy, total volume (TV), flow velocity, blood flow volume (BFV), maximum flow (MF), wall shear stress, and relative pressure, were obtained for eight cut planes: proximal to the splenomesenteric confluence and liver hilum of the portal vein (PV1/PV2); the left/right branch of the bifurcation of the PV (LPV/RPV), at the mesosplenic confluence of the splenic vein (SV1), at the splenic hilum of the SV (SV2); at the proximal to the splenomesenteric confluence of the superior mesenteric vein (SMV1), and 5 cm from the splenomesenteric confluence of the SMV (SMV2). Comparisons among the three groups were based on one-way analysis of variance (ANOVA). Logistic regression was used to identify the risk factors for small SRS/GRS (S-SRS/GRS) and for large SRS/GRS (L-SRS/GRS). Receiver operating characteristic curves were used to evaluate the diagnostic performance of the independent risk factors for SRS and GRS. The associations between the clinical data and the 4D flow MRI-derived parameters of GRS and SRS were assessed via Spearman correlation coefficient analysis.Results: The presence of SRS or GRS was correlated with TVLPV (r=-0.302; P=0.035), TVPV1 (r=-0.385; P=0.001), TVPV2 (r=-0.301; P=0.013), BFVPV1 (r=-0.360; P=0.010), BFVSMV2 (r=0.371; P=0.008), MFPV1 (r=-0.341; P=0.004), and MFPV2 (r=-0.291; P=0.017). Meanwhile, the severity of the SRS or GRS was correlated with alanine aminotransferase level (r=-0.535; P<0.001), BFVLPV (r=-0.560; P=0.008), aspartate aminotransferase level (r=-0.321; P=0.038), and model for end-stage liver disease score (r=0.323; P=0.039). TVPV1, TVPV2, BFVPV1, BFVPV2, and MFSMV2 were found to be independent risk factors for L-SRS/GRS, with intermediate diagnostic efficacy, with the area under the curve (AUC)TV PV1=0.706 [95% confidence interval (CI): 0.519-0.853; sensitivity, 61.54%; specificity, 80.77%; P=0.018], AUCBF

背景：四维相位对比磁共振成像（4D flow MRI）是一种相对较新的磁共振成像采集技术，可在一次采集中提供独特而全面的信息，包括血液动力学和解剖学信息。本研究旨在无创评估自发性脾肾分流（SRS）或胃肾分流（GRS）的存在和严重程度与 4D 血流 MRI 衍生参数之间的相关性：这项回顾性病例对照研究共纳入了70名重庆医科大学附属第二医院收治的肝硬化门静脉高压症患者。根据 SRS 和 GRS 的直径将患者分为三组。获得八个切面的四维血流 MRI 衍生参数，包括湍流动能、总容积（TV）、流速、血流量（BFV）、最大流量（MF）、壁切应力和相对压力：门静脉（PV1/PV2）的脾肠汇合处和肝门端近端；门静脉分叉的左/右分支（LPV/RPV）；脾静脉的脾间汇合处（SV1）；SV 的脾门端（SV2）；在肠系膜上静脉（SMV1）的脾-肠汇合处近端，以及距离肠系膜上静脉（SMV2）的脾-肠汇合处 5 厘米处。三组间的比较基于单因素方差分析（ANOVA）。逻辑回归用于确定小SRS/GRS（S-SRS/GRS）和大SRS/GRS（L-SRS/GRS）的风险因素。受体操作特征曲线用于评估SRS和GRS独立风险因素的诊断性能。通过斯皮尔曼相关系数分析评估了GRS和SRS的临床数据与4D血流MRI衍生参数之间的关联：结果：SRS或GRS的存在与TVLPV（r=-0.302；P=0.035）、TVPV1（r=-0.385；P=0.001）、TVPV2（r=-0.301；P=0.013）、BFVPV1（r=-0.360；P=0.010）、BFVSMV2（r=0.371；P=0.008）、MFPV1（r=-0.341；P=0.004）、MFPV2（r=-0.291；P=0.017）。同时，SRS 或 GRS 的严重程度与丙氨酸氨基转移酶水平（r=-0.535；PLPV（r=-0.560；P=0.008）、天冬氨酸氨基转移酶水平（r=-0.321；P=0.038）和终末期肝病模型评分（r=0.323；P=0.039）相关。研究发现，TVPV1、TVPV2、BFVPV1、BFVPV2和MFSMV2是L-SRS/GRS的独立危险因素，诊断效果居中，曲线下面积（AUC）TV PV1=0.706[95%置信区间（CI）：0.519-0.853；敏感性，61.54%；特异性，80.77%；P=0.018]，AUCBFV PV1=0.694（95% CI：0.507-0.844；敏感性，95.00%；特异性，63.16%；P=0.035），AUCTV PV2 =0.729 （95% CI：0.544-0.870；敏感性，77.78%；特异性，66.67%；P=0.016），AUCBFV PV2 =0.718 （95% CI：0.531-0.862；灵敏度，60.00%；特异性，82.35%；P=0.017），AUCMF SMV2 =0.788 (95% CI: 0.608-0.912; 灵敏度，44.00%；特异性，84.46%；P=0.005)。随着 PV1 和 PV2 的 TV 以及 PV1 和 PV2 的 BFV 的降低，L-SRS/GRS 的风险增加。随着 SMV2 的 MF 增加，出现 L-SRS/GRS 的风险也增加：结论：4D血流MRI衍生参数与SRS或GRS的存在和严重程度相关。同时，L-SRS/GRS存在的独立风险因素是LPV、PV1和PV2的TV；PV1和SMV2的BFV；以及PV1和PV2的MF。

{"title":"Evaluation of the presence and severity of spontaneous splenorenal or gastrorenal shunts via four-dimensional flow magnetic resonance imaging: a preliminary study.","authors":"You Zheng, Qiong Hu, Jun Zhou, Xiang Li, Xiaojing He, Tianwu Chen, Xi Liu, Weijuan Chen, Xin Li, Dajing Guo","doi":"10.21037/qims-24-826","DOIUrl":"10.21037/qims-24-826","url":null,"abstract":"Background: Four-dimensional phase-contrast magnetic resonance imaging (4D flow MRI) is a relatively new type of MRI acquisition technique that provides a unique and comprehensive set of information within a single acquisition, including hemodynamic and anatomical information. This study was designed to noninvasively evaluate the correlation between the presence and severity of spontaneous splenorenal shunt (SRS) or gastrorenal shunt (GRS) and 4D flow MRI-derived parameters.Methods: This retrospective case-control study enrolled 70 patients who were diagnosed with hepatocirrhosis portal hypertension and admitted to the Second Affiliated Hospital of Chongqing Medical University. Patients were divided into three groups according to the diameter of the SRS and GRS. 4D flow MRI-derived parameters, including the turbulent kinetic energy, total volume (TV), flow velocity, blood flow volume (BFV), maximum flow (MF), wall shear stress, and relative pressure, were obtained for eight cut planes: proximal to the splenomesenteric confluence and liver hilum of the portal vein (PV1/PV2); the left/right branch of the bifurcation of the PV (LPV/RPV), at the mesosplenic confluence of the splenic vein (SV1), at the splenic hilum of the SV (SV2); at the proximal to the splenomesenteric confluence of the superior mesenteric vein (SMV1), and 5 cm from the splenomesenteric confluence of the SMV (SMV2). Comparisons among the three groups were based on one-way analysis of variance (ANOVA). Logistic regression was used to identify the risk factors for small SRS/GRS (S-SRS/GRS) and for large SRS/GRS (L-SRS/GRS). Receiver operating characteristic curves were used to evaluate the diagnostic performance of the independent risk factors for SRS and GRS. The associations between the clinical data and the 4D flow MRI-derived parameters of GRS and SRS were assessed via Spearman correlation coefficient analysis.Results: The presence of SRS or GRS was correlated with TVLPV (r=-0.302; P=0.035), TVPV1 (r=-0.385; P=0.001), TVPV2 (r=-0.301; P=0.013), BFVPV1 (r=-0.360; P=0.010), BFVSMV2 (r=0.371; P=0.008), MFPV1 (r=-0.341; P=0.004), and MFPV2 (r=-0.291; P=0.017). Meanwhile, the severity of the SRS or GRS was correlated with alanine aminotransferase level (r=-0.535; P<0.001), BFVLPV (r=-0.560; P=0.008), aspartate aminotransferase level (r=-0.321; P=0.038), and model for end-stage liver disease score (r=0.323; P=0.039). TVPV1, TVPV2, BFVPV1, BFVPV2, and MFSMV2 were found to be independent risk factors for L-SRS/GRS, with intermediate diagnostic efficacy, with the area under the curve (AUC)TV PV1=0.706 [95% confidence interval (CI): 0.519-0.853; sensitivity, 61.54%; specificity, 80.77%; P=0.018], AUCBF","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7625-7639"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple myeloma segmentation net (MMNet): an encoder-decoder-based deep multiscale feature fusion model for multiple myeloma segmentation in magnetic resonance imaging. 多发性骨髓瘤分割网（MMNet）：基于编码器-解码器的深度多尺度特征融合模型，用于磁共振成像中的多发性骨髓瘤分割。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.21037/qims-24-683

Xin Zhao, Lili Chen, Nannan Zhang, Yuchan Lv, Xue Hu

Background: Patients with multiple myeloma (MM), a malignant disease involving bone marrow plasma cells, shows significant susceptibility to bone degradation, impairing normal hematopoietic function. The accurate and effective segmentation of MM lesion areas is crucial for the early detection and diagnosis of myeloma. However, the presence of complex shape variations, boundary ambiguities, and multiscale lesion areas, ranging from punctate lesions to extensive bone damage, presents a formidable challenge in achieving precise segmentation. This study thus aimed to develop a more accurate and robust segmentation method for MM lesions by extracting rich multiscale features.Methods: In this paper, we propose a novel, multiscale feature fusion encoding-decoding model architecture specifically designed for MM segmentation. In the encoding stage, our proposed multiscale feature extraction module, dilated dense connected net (DCNet), is employed to systematically extract multiscale features, thereby augmenting the model's sensing field. In the decoding stage, we propose the CBAM-atrous spatial pyramid pooling (CASPP) module to enhance the extraction of multiscale features, enabling the model to dynamically prioritize both channel and spatial information. Subsequently, these features are concatenated with the final output feature map to optimize segmentation outcomes. At the feature fusion bottleneck layer, we incorporate the dynamic feature fusion (DyCat) module into the skip connection to dynamically adjust feature extraction parameters and fusion processes.Results: We assessed the efficacy of our approach using a proprietary dataset of MM, yielding notable advancements. Our dataset comprised 753 magnetic resonance imaging (MRI) two-dimensional (2D) slice images of the spinal regions from 45 patients with MM, along with their corresponding ground truth labels. These images were primarily obtained from three sequences: T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and short tau inversion recovery (STIR). Using image augmentation techniques, we expanded the dataset to 3,000 images, which were employed for both model training and prediction. Among these, 2,400 images were allocated for training purposes, while 600 images were reserved for validation and testing. Our method showed increase in the intersection over union (IoU) and Dice coefficients by 7.9 and 6.7 percentage points, respectively, as compared to the baseline model. Furthermore, we performed comparisons with alternative image segmentation methodologies, which confirmed the sophistication and efficacy of our proposed model.Conclusions: Our proposed multiple myeloma segmentation net (MMNet), can effectively extract multiscale features from images and enhance the correlation between channel and spatial information. Furthermore, a systematic evaluation of the proposed network architecture was condu

背景：多发性骨髓瘤（MM）是一种涉及骨髓浆细胞的恶性疾病，患者的骨质极易退化，损害正常的造血功能。准确有效地分割多发性骨髓瘤病变区域对于骨髓瘤的早期检测和诊断至关重要。然而，由于存在复杂的形状变化、边界模糊以及多尺度病变区域（从点状病变到广泛的骨损伤），要实现精确分割是一项艰巨的挑战。因此，本研究旨在通过提取丰富的多尺度特征，开发一种更精确、更稳健的 MM 病变分割方法：本文提出了一种新颖的多尺度特征融合编码-解码模型架构，专为 MM 病变分割设计。在编码阶段，我们提出的多尺度特征提取模块--扩张密集连接网（DCNet）被用来系统地提取多尺度特征，从而增强模型的感应场。在解码阶段，我们提出了 CBAM-atrous spatial pyramid pooling（CASPP）模块来增强多尺度特征的提取，使模型能够动态地优先处理信道和空间信息。随后，将这些特征与最终输出特征图连接起来，以优化分割结果。在特征融合瓶颈层，我们将动态特征融合（DyCat）模块纳入跳转连接，以动态调整特征提取参数和融合过程：结果：我们使用一个专有的 MM 数据集评估了我们方法的功效，并取得了显著的进步。我们的数据集包括 45 名 MM 患者脊柱区域的 753 幅磁共振成像（MRI）二维（2D）切片图像以及相应的地面实况标签。这些图像主要来自三种序列：T1加权成像（T1WI）、T2加权成像（T2WI）和短头绪反转恢复（STIR）。利用图像增强技术，我们将数据集扩展到 3,000 张图像，用于模型训练和预测。其中，2400 张图像用于训练，600 张图像用于验证和测试。与基线模型相比，我们的方法在交集大于联合（IoU）和骰子系数方面分别提高了 7.9 和 6.7 个百分点。此外，我们还与其他图像分割方法进行了比较，这证实了我们提出的模型的先进性和有效性：我们提出的多发性骨髓瘤分割网（MMNet）能有效地从图像中提取多尺度特征，并增强通道和空间信息之间的相关性。此外，我们还在自建的有限数据集上对所提出的网络架构进行了系统评估。这项工作有望为未来临床应用的算法开发提供有价值的见解。

{"title":"Multiple myeloma segmentation net (MMNet): an encoder-decoder-based deep multiscale feature fusion model for multiple myeloma segmentation in magnetic resonance imaging.","authors":"Xin Zhao, Lili Chen, Nannan Zhang, Yuchan Lv, Xue Hu","doi":"10.21037/qims-24-683","DOIUrl":"10.21037/qims-24-683","url":null,"abstract":"Background: Patients with multiple myeloma (MM), a malignant disease involving bone marrow plasma cells, shows significant susceptibility to bone degradation, impairing normal hematopoietic function. The accurate and effective segmentation of MM lesion areas is crucial for the early detection and diagnosis of myeloma. However, the presence of complex shape variations, boundary ambiguities, and multiscale lesion areas, ranging from punctate lesions to extensive bone damage, presents a formidable challenge in achieving precise segmentation. This study thus aimed to develop a more accurate and robust segmentation method for MM lesions by extracting rich multiscale features.Methods: In this paper, we propose a novel, multiscale feature fusion encoding-decoding model architecture specifically designed for MM segmentation. In the encoding stage, our proposed multiscale feature extraction module, dilated dense connected net (DCNet), is employed to systematically extract multiscale features, thereby augmenting the model's sensing field. In the decoding stage, we propose the CBAM-atrous spatial pyramid pooling (CASPP) module to enhance the extraction of multiscale features, enabling the model to dynamically prioritize both channel and spatial information. Subsequently, these features are concatenated with the final output feature map to optimize segmentation outcomes. At the feature fusion bottleneck layer, we incorporate the dynamic feature fusion (DyCat) module into the skip connection to dynamically adjust feature extraction parameters and fusion processes.Results: We assessed the efficacy of our approach using a proprietary dataset of MM, yielding notable advancements. Our dataset comprised 753 magnetic resonance imaging (MRI) two-dimensional (2D) slice images of the spinal regions from 45 patients with MM, along with their corresponding ground truth labels. These images were primarily obtained from three sequences: T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and short tau inversion recovery (STIR). Using image augmentation techniques, we expanded the dataset to 3,000 images, which were employed for both model training and prediction. Among these, 2,400 images were allocated for training purposes, while 600 images were reserved for validation and testing. Our method showed increase in the intersection over union (IoU) and Dice coefficients by 7.9 and 6.7 percentage points, respectively, as compared to the baseline model. Furthermore, we performed comparisons with alternative image segmentation methodologies, which confirmed the sophistication and efficacy of our proposed model.Conclusions: Our proposed multiple myeloma segmentation net (MMNet), can effectively extract multiscale features from images and enhance the correlation between channel and spatial information. Furthermore, a systematic evaluation of the proposed network architecture was condu","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7176-7199"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting the Ki-67 proliferation index in cervical cancer: a preliminary comparative study of four non-Gaussian diffusion-weighted imaging models combined with histogram analysis. 预测宫颈癌的 Ki-67 增殖指数：结合直方图分析的四种非高斯扩散加权成像模型的初步比较研究。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI: 10.21037/qims-24-576

Yun Su, Kunjie Zeng, Zhuoheng Yan, Xiaojun Yang, Lingjie Yang, Lu Yang, Riyu Han, Fengqiong Huang, Hong Deng, Xiaohui Duan

Background: The prognosis for patients with cervical cancer (CC) is strongly correlated with the Ki-67 proliferation index (PI). However, the Ki-67 PI obtained through biopsy has certain limitations. The non-Gaussian distribution diffusion model of magnetic resonance imaging (MRI) may play an important role in characterizing tissue heterogeneity. At present, there are limited data available concerning the prediction of Ki-67 PI using models based on histogram features of non-Gaussian diffusion distribution. This study aimed to determine whether preoperative histogram features from multiple non-Gaussian models of diffusion-weighted imaging can predict the Ki-67 PI in patients with CC.Methods: Our cross-sectional prospective study recruited a total of 53 patients suspected of having CC who underwent 3.0-T MRI at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2022 and January 2023. Fifteen b values (0-4,000 s/mm2) were used for diffusion-weighted imaging. A total of nine parameters from four non-Gaussian diffusion-weighted imaging models, including continuous-time random walk (CTRW), diffusion kurtosis imaging (DKI), fractional order calculus (FROC), and intravoxel incoherent motion (IVIM), were used. Whole-tumor volumetric histogram analysis of these parameters was then obtained. In logistic regression, significant histogram characteristics were statistically examined across two groups to build the final prediction model. To assess diagnostic parameters of the proposed model in the diagnosis of the Ki-67 PI, along with the sensitivity, specificity, and diagnostic accuracy of these various parameters from the four models, receiver operating feature analysis was applied.Results: Among the 53 patients (55.3±9.6 years, ranging from 23 to 79 years) included in the study, 15 had a Ki-67 PI ≤50% and 38 had a Ki-67 PI >50%. Univariable analysis determined that 12 histogram features were statistically different between the two groups. In multivariable logistic regression, we ultimately selected 6 histogram features to construct the final prediction model, with CTRW_α_10th percentile [odds ratio (OR) =0.955; 95% confidence interval (CI): 0.92-0.99; P=0.019], CTRW_α_robust mean absolute deviation (OR =0.893; 95% CI: 0.81-0.99; P=0.028), and CTRW_α_uniformity (OR =0.000, 95% CI: 0.00-0.90, P=0.047) being the independent predictive variables. The area under the curve of the combined prediction model was 0.845 (95% CI: 0.74-0.95), with a sensitivity of 78.9% (95% CI: 0.63-0.90), a specificity of 86.7% (95% CI: 0.60-0.98), an accuracy of 81.1% (95% CI: 0.68-0.91), a positive predictive value of 93.8% (95% CI: 0.79-0.99), and a negative predictive value of 61.9% (95% CI: 0.38-0.82).Conclusions: The histogram features of multiple non-Gaussian diffusion-weighted imaging can help to predict the Ki-67 PI of CC, providing a new meth

背景：宫颈癌（CC）患者的预后与 Ki-67 增殖指数（PI）密切相关。然而，通过活检获得的 Ki-67 PI 有一定的局限性。磁共振成像（MRI）的非高斯分布扩散模型可在描述组织异质性方面发挥重要作用。目前，关于使用基于非高斯扩散分布直方图特征的模型预测 Ki-67 PI 的数据还很有限。本研究旨在确定多种非高斯扩散加权成像模型的术前直方图特征能否预测CC患者的Ki-67 PI：我们的横断面前瞻性研究共招募了53例疑似CC患者，他们于2022年1月至2023年1月期间在中山大学孙逸仙纪念医院接受了3.0T磁共振成像检查。弥散加权成像使用了15个b值（0-4,000 s/mm2）。共使用了四个非高斯扩散加权成像模型的九个参数，包括连续时间随机漫步（CTRW）、扩散峰度成像（DKI）、分数阶微积分（FROC）和体内非相干运动（IVIM）。然后对这些参数进行全肿瘤容积直方图分析。在逻辑回归中，对两组间重要的直方图特征进行统计分析，以建立最终的预测模型。为了评估所提出的模型在诊断 Ki-67 PI 时的诊断参数，以及四个模型中这些不同参数的敏感性、特异性和诊断准确性，应用了接收者操作特征分析：在纳入研究的 53 名患者（55.3±9.6 岁，23 至 79 岁不等）中，15 名患者的 Ki-67 PI ≤50%，38 名患者的 Ki-67 PI >50%。单变量分析表明，两组之间有 12 个直方图特征存在统计学差异。在多变量逻辑回归中，我们最终选择了 6 个直方图特征来构建最终的预测模型，其中 CTRW_α_10th 百分位数 [odds ratio (OR) =0.955; 95% confidence interval (CI): 0.92-0.99；P=0.019]、CTRW_α_robust 平均绝对偏差（OR =0.893；95% CI：0.81-0.99；P=0.028）和 CTRW_α_uniformity （OR =0.000，95% CI：0.00-0.90，P=0.047）为独立预测变量。综合预测模型的曲线下面积为 0.845（95% CI：0.74-0.95），灵敏度为 78.9%（95% CI：0.63-0.90），特异度为 86.7%（95% CI：0.60-0.98），准确度为 81.1%（95% CI：0.68-0.91），阳性预测值为 93.8%（95% CI：0.79-0.99），阴性预测值为 61.9%（95% CI：0.38-0.82）：多重非高斯扩散加权成像的直方图特征有助于预测CC的Ki-67 PI，为无创评估CC的关键生物学特征提供了一种新方法。

{"title":"Predicting the Ki-67 proliferation index in cervical cancer: a preliminary comparative study of four non-Gaussian diffusion-weighted imaging models combined with histogram analysis.","authors":"Yun Su, Kunjie Zeng, Zhuoheng Yan, Xiaojun Yang, Lingjie Yang, Lu Yang, Riyu Han, Fengqiong Huang, Hong Deng, Xiaohui Duan","doi":"10.21037/qims-24-576","DOIUrl":"10.21037/qims-24-576","url":null,"abstract":"Background: The prognosis for patients with cervical cancer (CC) is strongly correlated with the Ki-67 proliferation index (PI). However, the Ki-67 PI obtained through biopsy has certain limitations. The non-Gaussian distribution diffusion model of magnetic resonance imaging (MRI) may play an important role in characterizing tissue heterogeneity. At present, there are limited data available concerning the prediction of Ki-67 PI using models based on histogram features of non-Gaussian diffusion distribution. This study aimed to determine whether preoperative histogram features from multiple non-Gaussian models of diffusion-weighted imaging can predict the Ki-67 PI in patients with CC.Methods: Our cross-sectional prospective study recruited a total of 53 patients suspected of having CC who underwent 3.0-T MRI at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2022 and January 2023. Fifteen b values (0-4,000 s/mm2) were used for diffusion-weighted imaging. A total of nine parameters from four non-Gaussian diffusion-weighted imaging models, including continuous-time random walk (CTRW), diffusion kurtosis imaging (DKI), fractional order calculus (FROC), and intravoxel incoherent motion (IVIM), were used. Whole-tumor volumetric histogram analysis of these parameters was then obtained. In logistic regression, significant histogram characteristics were statistically examined across two groups to build the final prediction model. To assess diagnostic parameters of the proposed model in the diagnosis of the Ki-67 PI, along with the sensitivity, specificity, and diagnostic accuracy of these various parameters from the four models, receiver operating feature analysis was applied.Results: Among the 53 patients (55.3±9.6 years, ranging from 23 to 79 years) included in the study, 15 had a Ki-67 PI ≤50% and 38 had a Ki-67 PI >50%. Univariable analysis determined that 12 histogram features were statistically different between the two groups. In multivariable logistic regression, we ultimately selected 6 histogram features to construct the final prediction model, with CTRW_α_10th percentile [odds ratio (OR) =0.955; 95% confidence interval (CI): 0.92-0.99; P=0.019], CTRW_α_robust mean absolute deviation (OR =0.893; 95% CI: 0.81-0.99; P=0.028), and CTRW_α_uniformity (OR =0.000, 95% CI: 0.00-0.90, P=0.047) being the independent predictive variables. The area under the curve of the combined prediction model was 0.845 (95% CI: 0.74-0.95), with a sensitivity of 78.9% (95% CI: 0.63-0.90), a specificity of 86.7% (95% CI: 0.60-0.98), an accuracy of 81.1% (95% CI: 0.68-0.91), a positive predictive value of 93.8% (95% CI: 0.79-0.99), and a negative predictive value of 61.9% (95% CI: 0.38-0.82).Conclusions: The histogram features of multiple non-Gaussian diffusion-weighted imaging can help to predict the Ki-67 PI of CC, providing a new meth","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7484-7495"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of nasolacrimal duct intubation failure for primary acquired nasolacrimal duct obstruction: a computed tomography-dacryocystography (CT-DCG) study. 原发性获得性鼻泪管阻塞鼻泪管插管失败的预测因素：计算机断层扫描-泪囊造影（CT-DCG）研究。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-23 DOI: 10.21037/qims-24-519

Wushuang Wang, Tong Lin, Lan Gong, Yan Wang

Background: Making a choice between nasolacrimal duct intubation and dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) is an important issue in clinical practice. This study aimed to determine the potential lacrimal sac characteristics that could be used as predictors of unsuccessful intubation for PANDO based on computed tomography-dacryocystography (CT-DCG).

Methods: In this retrospective comparative observational study, we included PANDO patients with a history of failed intubation for nasolacrimal duct obstruction as the intubation failure group and PANDO patients without a history of intubation as the control group. We analyzed the lacrimal sac height, lacrimal sac width, and obstruction site based on CT-DCG, all measured based on several reference levels on axial sections (upper, intermediate, lower level, common canaliculus level, and lowermost contrast level), which were defined according to the contrast and the bony structure.

Results: A total of 114 sides of the PANDO were studied, including 36 in the intubation failure group and 78 in the control group. The intubation failure group showed a smaller lacrimal sac height (11.69±4.59 mm) and width (2.28±1.97 mm, intermediate level) than the control group (14.13±2.92, 3.32±2.02 mm, P=0.005 and 0.012, respectively). The intubation failure group had a higher obstruction site than the control group (P=0.009).

Conclusions: A small lacrimal sac and high obstruction site are predictors of nasolacrimal duct intubation failure in PANDO. For PANDO patients with a small lacrimal sac or a high obstruction position, DCR is recommended as opposed to intubation.

背景：在原发性获得性鼻泪管阻塞（PANDO）的鼻泪管插管和泪囊鼻腔吻合术（DCR）之间做出选择是临床实践中的一个重要问题。本研究旨在根据计算机断层扫描-淚囊造影（CT-DCG）确定可用作预测 PANDO 插管失败的潜在泪囊特征：在这项回顾性比较观察研究中，我们将有鼻泪管阻塞插管失败史的 PANDO 患者作为插管失败组，将无插管史的 PANDO 患者作为对照组。我们分析了基于CT-DCG的泪囊高度、泪囊宽度和阻塞部位，所有测量均基于轴切片上的几个参考水平（上水平、中水平、下水平、总管水平和最下对比水平），这些参考水平是根据对比度和骨性结构定义的：共研究了 114 侧 PANDO，其中插管失败组 36 例，对照组 78 例。插管失败组的泪囊高度（11.69±4.59 mm）和宽度（2.28±1.97 mm，中等水平）小于对照组（分别为14.13±2.92、3.32±2.02 mm，P=0.005和0.012）。插管失败组的阻塞部位高于对照组（P=0.009）：结论：小泪囊和高阻塞部位是 PANDO 患者鼻泪管插管失败的预测因素。对于泪囊较小或阻塞位置较高的 PANDO 患者，建议采用 DCR 而不是插管。

{"title":"Predictors of nasolacrimal duct intubation failure for primary acquired nasolacrimal duct obstruction: a computed tomography-dacryocystography (CT-DCG) study.","authors":"Wushuang Wang, Tong Lin, Lan Gong, Yan Wang","doi":"10.21037/qims-24-519","DOIUrl":"10.21037/qims-24-519","url":null,"abstract":"Background: Making a choice between nasolacrimal duct intubation and dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) is an important issue in clinical practice. This study aimed to determine the potential lacrimal sac characteristics that could be used as predictors of unsuccessful intubation for PANDO based on computed tomography-dacryocystography (CT-DCG).Methods: In this retrospective comparative observational study, we included PANDO patients with a history of failed intubation for nasolacrimal duct obstruction as the intubation failure group and PANDO patients without a history of intubation as the control group. We analyzed the lacrimal sac height, lacrimal sac width, and obstruction site based on CT-DCG, all measured based on several reference levels on axial sections (upper, intermediate, lower level, common canaliculus level, and lowermost contrast level), which were defined according to the contrast and the bony structure.Results: A total of 114 sides of the PANDO were studied, including 36 in the intubation failure group and 78 in the control group. The intubation failure group showed a smaller lacrimal sac height (11.69±4.59 mm) and width (2.28±1.97 mm, intermediate level) than the control group (14.13±2.92, 3.32±2.02 mm, P=0.005 and 0.012, respectively). The intubation failure group had a higher obstruction site than the control group (P=0.009).Conclusions: A small lacrimal sac and high obstruction site are predictors of nasolacrimal duct intubation failure in PANDO. For PANDO patients with a small lacrimal sac or a high obstruction position, DCR is recommended as opposed to intubation.","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"14 10","pages":"7229-7236"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total regression of a duodenal tubulovillous adenoma after chemotherapy: results of an ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan. 化疗后十二指肠管状腺瘤完全消退：18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）结果。

IF 2.9 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Quantitative Imaging in Medicine and Surgery

Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI: 10.21037/qims-23-1767

Mahaman Mallam Abdoul Rachid, Jian-Nan Li, Pan Zhe

引用次数: 0