Objective: To evaluate value of Nomogram prediction model based on CTA imaging features for selecting treatment methods for isolated superior mesenteric artery dissection (ISMAD).
Methods: Symptomatic ISMAD patients were randomly divided into a training set and a validation set in a 7:3 ratio. In the training set, relevant risk factors for conservative treatment failure in ISMAD patients were analyzed, and a Nomogram prediction model for treatment outcome of ISMAD was constructed with risk factors. The predictive value of the model was evaluated.
Results: Low true lumen residual ratio (TLRR), long dissection length, and large arterial angle (superior mesenteric artery [SMA]/abdominal aorta [AA]) were identified as independent high-risk factors for conservative treatment failure (P < 0.05). The receiver operating characteristic curve (ROC) results showed that the area under curve (AUC) of Nomogram prediction model was 0.826 (95% CI: 0.740-0.912), indicating good discrimination. The Hosmer-Lemeshow goodness-of-fit test showed good consistency between the predicted curve and the ideal curve of the Nomogram prediction model. The decision curve analysis (DCA) analysis results showed that when probability threshold for the occurrence of conservative treatment failure predicted was 0.05-0.98, patients could obtain more net benefits. Similar results were obtained for the predictive value in the validation set.
Conclusion: Low TLRR, long dissection length, and large arterial angle (SMA/AA) are independent high-risk factors for conservative treatment failure in ISMAD. The Nomogram model constructed with independent high-risk factors has good clinical effectiveness in predicting the failure.
{"title":"The value evaluation of Nomogram prediction model based on CTA imaging features for selecting treatment methods for isolated superior mesenteric artery dissection.","authors":"Xiaodong Jiang, Dongjian Chen, Qingbin Meng, Xiaokan Liu, Li Liang, Bosheng He, Wenbin Ding","doi":"10.1186/s12880-024-01438-7","DOIUrl":"https://doi.org/10.1186/s12880-024-01438-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate value of Nomogram prediction model based on CTA imaging features for selecting treatment methods for isolated superior mesenteric artery dissection (ISMAD).</p><p><strong>Methods: </strong>Symptomatic ISMAD patients were randomly divided into a training set and a validation set in a 7:3 ratio. In the training set, relevant risk factors for conservative treatment failure in ISMAD patients were analyzed, and a Nomogram prediction model for treatment outcome of ISMAD was constructed with risk factors. The predictive value of the model was evaluated.</p><p><strong>Results: </strong>Low true lumen residual ratio (TLRR), long dissection length, and large arterial angle (superior mesenteric artery [SMA]/abdominal aorta [AA]) were identified as independent high-risk factors for conservative treatment failure (P < 0.05). The receiver operating characteristic curve (ROC) results showed that the area under curve (AUC) of Nomogram prediction model was 0.826 (95% CI: 0.740-0.912), indicating good discrimination. The Hosmer-Lemeshow goodness-of-fit test showed good consistency between the predicted curve and the ideal curve of the Nomogram prediction model. The decision curve analysis (DCA) analysis results showed that when probability threshold for the occurrence of conservative treatment failure predicted was 0.05-0.98, patients could obtain more net benefits. Similar results were obtained for the predictive value in the validation set.</p><p><strong>Conclusion: </strong>Low TLRR, long dissection length, and large arterial angle (SMA/AA) are independent high-risk factors for conservative treatment failure in ISMAD. The Nomogram model constructed with independent high-risk factors has good clinical effectiveness in predicting the failure.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"267"},"PeriodicalIF":2.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-07DOI: 10.1186/s12880-024-01442-x
Kaixiang Zhang, Guoxin Zhao, Yinghui Liu, Yongbin Huang, Jie Long, Ning Li, Huangze Yan, Xiuzhu Zhang, Jingzhi Ma, Yuming Zhang
Background: Invasive pulmonary aspergillosis (IPA) is a serious fungal infection. However, current diagnostic methods have limitations. The purpose of this study was to use artificial intelligence to achieve a more accurate diagnosis of IPA.
Methods: Totally 263 patients (148 cases of IPA, 115 cases of non-IPA) were retrospectively enrolled from a single institution and randomly divided into training and test sets at a ratio of 7:3. Clinic-radiological independent risk factors for IPA were screened using univariate analysis and multivariate logistic regression analysis, after which a clinic-radiological model was constructed. The optimal radiomics features were extracted and screened based on CT images to construct the radiomics label score (Rad-score) and radiomics model. The optimal DL features were extracted and screened using four pre-trained convolutional neural networks, respectively, followed by the construction of the DL label score (DL-score) and DL model. Then, the radiomics-DL model was constructed. Finally, the combined model was constructed based on clinic-radiological independent risk factors, the Rad-score, and the DL-score. LR was adopted as the classifier. Receiver operating characteristic (ROC) curves were drawn, and the areas under the curve (AUC) were calculated to evaluate the efficacy of each model in predicting IPA. Additionally, based on the best-performing model on the LR classifier, four other machine learning (ML) classifiers were constructed to evaluate the predictive value for IPA.
Results: The AUC of the clinic-radiological model for predicting IPA in the training and test sets was 0.845 and 0.765, respectively. The AUC of the radiomics-DL and combined models in the training set was 0.871 and 0.932, while in the test set was 0.851 and 0.881, respectively. The combined model showed better predictive performance than all other models. DCA showed that taking 0.00-1.00 as the threshold, the clinical benefit of the combined model was higher than that of all other models. Then, the combined model was trained on four other machine learning classifiers, all of which achieved AUC values above 0.80 in the test set, showing good performance in predicting IPA.
Conclusion: Clinic, CT radiomics, and DL combined model could be used to predict IPA effectively.
{"title":"Clinic, CT radiomics, and deep learning combined model for the prediction of invasive pulmonary aspergillosis.","authors":"Kaixiang Zhang, Guoxin Zhao, Yinghui Liu, Yongbin Huang, Jie Long, Ning Li, Huangze Yan, Xiuzhu Zhang, Jingzhi Ma, Yuming Zhang","doi":"10.1186/s12880-024-01442-x","DOIUrl":"https://doi.org/10.1186/s12880-024-01442-x","url":null,"abstract":"<p><strong>Background: </strong>Invasive pulmonary aspergillosis (IPA) is a serious fungal infection. However, current diagnostic methods have limitations. The purpose of this study was to use artificial intelligence to achieve a more accurate diagnosis of IPA.</p><p><strong>Methods: </strong>Totally 263 patients (148 cases of IPA, 115 cases of non-IPA) were retrospectively enrolled from a single institution and randomly divided into training and test sets at a ratio of 7:3. Clinic-radiological independent risk factors for IPA were screened using univariate analysis and multivariate logistic regression analysis, after which a clinic-radiological model was constructed. The optimal radiomics features were extracted and screened based on CT images to construct the radiomics label score (Rad-score) and radiomics model. The optimal DL features were extracted and screened using four pre-trained convolutional neural networks, respectively, followed by the construction of the DL label score (DL-score) and DL model. Then, the radiomics-DL model was constructed. Finally, the combined model was constructed based on clinic-radiological independent risk factors, the Rad-score, and the DL-score. LR was adopted as the classifier. Receiver operating characteristic (ROC) curves were drawn, and the areas under the curve (AUC) were calculated to evaluate the efficacy of each model in predicting IPA. Additionally, based on the best-performing model on the LR classifier, four other machine learning (ML) classifiers were constructed to evaluate the predictive value for IPA.</p><p><strong>Results: </strong>The AUC of the clinic-radiological model for predicting IPA in the training and test sets was 0.845 and 0.765, respectively. The AUC of the radiomics-DL and combined models in the training set was 0.871 and 0.932, while in the test set was 0.851 and 0.881, respectively. The combined model showed better predictive performance than all other models. DCA showed that taking 0.00-1.00 as the threshold, the clinical benefit of the combined model was higher than that of all other models. Then, the combined model was trained on four other machine learning classifiers, all of which achieved AUC values above 0.80 in the test set, showing good performance in predicting IPA.</p><p><strong>Conclusion: </strong>Clinic, CT radiomics, and DL combined model could be used to predict IPA effectively.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"264"},"PeriodicalIF":2.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-07DOI: 10.1186/s12880-024-01441-y
Daan De Maeseneer, Pieter De Visschere, Mats Van den Broecke, Felix Delbare, Geert Villeirs, Sofie Verbeke, Valérie Fonteyne, Charles Van Praet, Karel Decaestecker, Alexander Decruyenaere, Sylvie Rottey
Background: Muscle invasive bladder cancer (MIBC) treatment combines systemic therapy and radical cystectomy (RC) or local (chemo-)radiotherapy. Response to systemic therapy is an important outcome predictor but is difficult to assess pre-operatively.
Methods: We analyzed multiparametric MRI (mpMRI) in consecutive MIBC patients receiving cisplatin-based neo-adjuvant chemotherapy at our institution. Two readers, blinded for pathological outcome, independently scored mpMRI before and after 2 and 4 cycles using both a qualitative 3-step method and nacVI-RADS. We analyzed accuracy of mpMRI scores to predict pathologic complete response (pCR) and inter-observer agreement.
Results: We analyzed 46 patients receiving NAC, 6 patients did not undergo RC after NAC and were excluded. Eleven out of 40 (28%) patients showed a pCR. mpMRI could be assessed in over 90% of patients. Radiologic complete response (rCR) using both methods was significantly associated with pCR, with an overall specificity of 96% and sensitivity of 36% and a high inter-observer agreement. rCR as assessed by the 3-step score was significantly associated with disease free survival (DFS) benefit.
Conclusion: The use of nacVI-RADS can predict pCR after NAC with high specificity but low sensitivity and a high inter-observer agreement. A 3-step score adds value in determining local residual disease, rCR assessed by this method could correlate with DFS benefit. mpMRI scores should be prospectively assessed in future trials of multimodal management of MIBC and can be a predictive asset in routine clinical management.
{"title":"Retrospective analysis of multiparametric MRI in predicting complete pathologic response of neo-adjuvant chemotherapy in bladder cancer.","authors":"Daan De Maeseneer, Pieter De Visschere, Mats Van den Broecke, Felix Delbare, Geert Villeirs, Sofie Verbeke, Valérie Fonteyne, Charles Van Praet, Karel Decaestecker, Alexander Decruyenaere, Sylvie Rottey","doi":"10.1186/s12880-024-01441-y","DOIUrl":"https://doi.org/10.1186/s12880-024-01441-y","url":null,"abstract":"<p><strong>Background: </strong>Muscle invasive bladder cancer (MIBC) treatment combines systemic therapy and radical cystectomy (RC) or local (chemo-)radiotherapy. Response to systemic therapy is an important outcome predictor but is difficult to assess pre-operatively.</p><p><strong>Methods: </strong>We analyzed multiparametric MRI (mpMRI) in consecutive MIBC patients receiving cisplatin-based neo-adjuvant chemotherapy at our institution. Two readers, blinded for pathological outcome, independently scored mpMRI before and after 2 and 4 cycles using both a qualitative 3-step method and nacVI-RADS. We analyzed accuracy of mpMRI scores to predict pathologic complete response (pCR) and inter-observer agreement.</p><p><strong>Results: </strong>We analyzed 46 patients receiving NAC, 6 patients did not undergo RC after NAC and were excluded. Eleven out of 40 (28%) patients showed a pCR. mpMRI could be assessed in over 90% of patients. Radiologic complete response (rCR) using both methods was significantly associated with pCR, with an overall specificity of 96% and sensitivity of 36% and a high inter-observer agreement. rCR as assessed by the 3-step score was significantly associated with disease free survival (DFS) benefit.</p><p><strong>Conclusion: </strong>The use of nacVI-RADS can predict pCR after NAC with high specificity but low sensitivity and a high inter-observer agreement. A 3-step score adds value in determining local residual disease, rCR assessed by this method could correlate with DFS benefit. mpMRI scores should be prospectively assessed in future trials of multimodal management of MIBC and can be a predictive asset in routine clinical management.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"268"},"PeriodicalIF":2.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-07DOI: 10.1186/s12880-024-01444-9
Qifan Ma, Jiliang Ren, Rui Wang, Ying Yuan, Xiaofeng Tao
Background: To investigate whether radiomics models derived from pretreatment CT could help to predict response to immunotherapy in oral squamous cell carcinoma (OSCC).
Methods: Retrospectively, a total of 40 patients with measurable OSCC were included. The patients were divided into responder group and non-responder group according to the comparison of pre-treatment and post-treatment CT findings. Radiomics features were extracted from pre-treatment CT images, and optimal features were selected by univariate analysis and the least absolute shrinkage and selection operator (LASSO) regression analysis. Neural network, support vector machine, random forest and logistic regression models were used to predict response to immunotherapy in OSCC, and leave-one-out cross validation was employed to assess the performance of the classifiers. The area under the curve (AUC), accuracy, sensitivity and specificity were calculated to quantify the predictive efficacy.
Results: A total of 7 features were selected to build models upon machine learning methods. By comparing different machine learning based models, the neural network model achieved the best predictive ability, with an AUC of 0.864, an accuracy of 82.5%, a sensitivity of 82.5%, and a specificity of 82.5%.
Conclusions: The pretreatment CT-based radiomics model showed good performance in predicting response to immunotherapy in OSCC. Pretreatment CT-based radiomics model might provide an alternative approach for the selection of patients who benefit from immunotherapy.
{"title":"Predicting response to immunotherapy in oral squamous cell carcinoma via a CT-based radiomics model.","authors":"Qifan Ma, Jiliang Ren, Rui Wang, Ying Yuan, Xiaofeng Tao","doi":"10.1186/s12880-024-01444-9","DOIUrl":"https://doi.org/10.1186/s12880-024-01444-9","url":null,"abstract":"<p><strong>Background: </strong>To investigate whether radiomics models derived from pretreatment CT could help to predict response to immunotherapy in oral squamous cell carcinoma (OSCC).</p><p><strong>Methods: </strong>Retrospectively, a total of 40 patients with measurable OSCC were included. The patients were divided into responder group and non-responder group according to the comparison of pre-treatment and post-treatment CT findings. Radiomics features were extracted from pre-treatment CT images, and optimal features were selected by univariate analysis and the least absolute shrinkage and selection operator (LASSO) regression analysis. Neural network, support vector machine, random forest and logistic regression models were used to predict response to immunotherapy in OSCC, and leave-one-out cross validation was employed to assess the performance of the classifiers. The area under the curve (AUC), accuracy, sensitivity and specificity were calculated to quantify the predictive efficacy.</p><p><strong>Results: </strong>A total of 7 features were selected to build models upon machine learning methods. By comparing different machine learning based models, the neural network model achieved the best predictive ability, with an AUC of 0.864, an accuracy of 82.5%, a sensitivity of 82.5%, and a specificity of 82.5%.</p><p><strong>Conclusions: </strong>The pretreatment CT-based radiomics model showed good performance in predicting response to immunotherapy in OSCC. Pretreatment CT-based radiomics model might provide an alternative approach for the selection of patients who benefit from immunotherapy.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"266"},"PeriodicalIF":2.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The aim of this study was to conduct a systematic review and meta-analysis to comprehensively evaluate the performance and methodological quality of artificial intelligence (AI) in predicting recurrence after single first-line treatment for liver cancer.
Methods: A rigorous and systematic evaluation was conducted on the AI studies related to recurrence after single first-line treatment for liver cancer, retrieved from the PubMed, Embase, Web of Science, Cochrane Library, and CNKI databases. The area under the curve (AUC), sensitivity (SENC), and specificity (SPEC) of each study were extracted for meta-analysis.
Results: Six percutaneous ablation (PA) studies, 16 surgical resection (SR) studies, and 5 transarterial chemoembolization (TACE) studies were included in the meta-analysis for predicting recurrence after hepatocellular carcinoma (HCC) treatment, respectively. Four SR studies and 2 PA studies were included in the meta-analysis for recurrence after intrahepatic cholangiocarcinoma (ICC) and colorectal cancer liver metastasis (CRLM) treatment. The pooled SENC, SEPC, and AUC of AI in predicting recurrence after primary HCC treatment via PA, SR, and TACE were 0.78, 0.90, and 0.92; 0.81, 0.77, and 0.86; and 0.73, 0.79, and 0.79, respectively. The values for ICC treated with SR and CRLM treated with PA were 0.85, 0.71, 0.86 and 0.69, 0.63,0.74, respectively.
Conclusion: This systematic review and meta-analysis demonstrates the comprehensive application value of AI in predicting recurrence after a single first-line treatment of liver cancer, with satisfactory results, indicating the clinical translation potential of AI in predicting recurrence after liver cancer treatment.
研究背景本研究旨在进行系统综述和荟萃分析,以全面评估人工智能(AI)在预测肝癌单次一线治疗后复发方面的性能和方法学质量:对从PubMed、Embase、Web of Science、Cochrane Library和CNKI数据库中检索到的与肝癌单次一线治疗后复发相关的人工智能研究进行了严格而系统的评估。提取每项研究的曲线下面积(AUC)、敏感性(SENC)和特异性(SPEC)进行荟萃分析:结果:6 项经皮消融术(PA)研究、16 项手术切除术(SR)研究和 5 项经动脉化疗栓塞术(TACE)研究分别被纳入了预测肝细胞癌(HCC)治疗后复发的荟萃分析。针对肝内胆管癌(ICC)和结直肠癌肝转移(CRLM)治疗后复发的荟萃分析纳入了 4 项 SR 研究和 2 项 PA 研究。AI预测PA、SR和TACE治疗原发性HCC后复发的汇总SENC、SEPC和AUC分别为0.78、0.90和0.92;0.81、0.77和0.86;0.73、0.79和0.79。SR治疗的ICC和PA治疗的CRLM的数值分别为0.85、0.71、0.86和0.69、0.63、0.74:本系统综述和荟萃分析展示了人工智能在预测肝癌单次一线治疗后复发的综合应用价值,结果令人满意,表明人工智能在预测肝癌治疗后复发方面具有临床转化潜力。
{"title":"Artificial intelligence in predicting recurrence after first-line treatment of liver cancer: a systematic review and meta-analysis.","authors":"Linyong Wu, Qingfeng Lai, Songhua Li, Shaofeng Wu, Yizhong Li, Ju Huang, Qiuli Zeng, Dayou Wei","doi":"10.1186/s12880-024-01440-z","DOIUrl":"10.1186/s12880-024-01440-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to conduct a systematic review and meta-analysis to comprehensively evaluate the performance and methodological quality of artificial intelligence (AI) in predicting recurrence after single first-line treatment for liver cancer.</p><p><strong>Methods: </strong>A rigorous and systematic evaluation was conducted on the AI studies related to recurrence after single first-line treatment for liver cancer, retrieved from the PubMed, Embase, Web of Science, Cochrane Library, and CNKI databases. The area under the curve (AUC), sensitivity (SENC), and specificity (SPEC) of each study were extracted for meta-analysis.</p><p><strong>Results: </strong>Six percutaneous ablation (PA) studies, 16 surgical resection (SR) studies, and 5 transarterial chemoembolization (TACE) studies were included in the meta-analysis for predicting recurrence after hepatocellular carcinoma (HCC) treatment, respectively. Four SR studies and 2 PA studies were included in the meta-analysis for recurrence after intrahepatic cholangiocarcinoma (ICC) and colorectal cancer liver metastasis (CRLM) treatment. The pooled SENC, SEPC, and AUC of AI in predicting recurrence after primary HCC treatment via PA, SR, and TACE were 0.78, 0.90, and 0.92; 0.81, 0.77, and 0.86; and 0.73, 0.79, and 0.79, respectively. The values for ICC treated with SR and CRLM treated with PA were 0.85, 0.71, 0.86 and 0.69, 0.63,0.74, respectively.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis demonstrates the comprehensive application value of AI in predicting recurrence after a single first-line treatment of liver cancer, with satisfactory results, indicating the clinical translation potential of AI in predicting recurrence after liver cancer treatment.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"263"},"PeriodicalIF":2.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-04DOI: 10.1186/s12880-024-01439-6
Jiaqi Ma, Xinsheng Nie, Xiangjiang Kong, Lingqing Xiao, Han Liu, Shengming Shi, Yupeng Wu, Na Li, Linlin Hu, Xiaofu Li
Background: The study aimed to identify the optimal model for predicting rectal cancer liver metastasis (RCLM). This involved constructing various prediction models to aid clinicians in early diagnosis and precise decision-making.
Methods: A retrospective analysis was conducted on 193 patients diagnosed with rectal adenocarcinoma were randomly divided into training set (n = 136) and validation set (n = 57) at a ratio of 7:3. The predictive performance of three models was internally validated by 10-fold cross-validation in the training set. Delineation of the tumor region of interest (ROI) was performed, followed by the extraction of radiomics features from the ROI. The least absolute shrinkage and selection operator (LASSO) regression algorithm and multivariate Cox analysis were employed to reduce the dimensionality of radiomics features and identify significant features. Logistic regression was employed to construct three prediction models: clinical, radiomics, and combined models (radiomics + clinical). The predictive performance of each model was assessed and compared.
Results: KRAS mutation emerged as an independent predictor of liver metastasis, yielding an odds ratio (OR) of 8.296 (95%CI: 3.471-19.830; p < 0.001). 5 radiomics features will be used to construct radiomics model. The combined model was built by integrating radiomics model with clinical model. In both the training set (AUC:0.842, 95%CI: 0.778-0.907) and the validation set (AUC: 0.805; 95%CI: 0.692-0.918), the AUCs for the combined model surpassed those of the radiomics and clinical models.
Conclusions: Our study reveals that KRAS mutation stands as an independent predictor of RCLM. The radiomics features based on MR play a crucial role in the evaluation of RCLM. The combined model exhibits superior performance in the prediction of liver metastasis.
{"title":"MRI T2WI-based radiomics combined with KRAS gene mutation constructed models for predicting liver metastasis in rectal cancer.","authors":"Jiaqi Ma, Xinsheng Nie, Xiangjiang Kong, Lingqing Xiao, Han Liu, Shengming Shi, Yupeng Wu, Na Li, Linlin Hu, Xiaofu Li","doi":"10.1186/s12880-024-01439-6","DOIUrl":"10.1186/s12880-024-01439-6","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to identify the optimal model for predicting rectal cancer liver metastasis (RCLM). This involved constructing various prediction models to aid clinicians in early diagnosis and precise decision-making.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 193 patients diagnosed with rectal adenocarcinoma were randomly divided into training set (n = 136) and validation set (n = 57) at a ratio of 7:3. The predictive performance of three models was internally validated by 10-fold cross-validation in the training set. Delineation of the tumor region of interest (ROI) was performed, followed by the extraction of radiomics features from the ROI. The least absolute shrinkage and selection operator (LASSO) regression algorithm and multivariate Cox analysis were employed to reduce the dimensionality of radiomics features and identify significant features. Logistic regression was employed to construct three prediction models: clinical, radiomics, and combined models (radiomics + clinical). The predictive performance of each model was assessed and compared.</p><p><strong>Results: </strong>KRAS mutation emerged as an independent predictor of liver metastasis, yielding an odds ratio (OR) of 8.296 (95%CI: 3.471-19.830; p < 0.001). 5 radiomics features will be used to construct radiomics model. The combined model was built by integrating radiomics model with clinical model. In both the training set (AUC:0.842, 95%CI: 0.778-0.907) and the validation set (AUC: 0.805; 95%CI: 0.692-0.918), the AUCs for the combined model surpassed those of the radiomics and clinical models.</p><p><strong>Conclusions: </strong>Our study reveals that KRAS mutation stands as an independent predictor of RCLM. The radiomics features based on MR play a crucial role in the evaluation of RCLM. The combined model exhibits superior performance in the prediction of liver metastasis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"262"},"PeriodicalIF":2.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1186/s12880-024-01428-9
Xiaoyun Wang, Xiaonan Tian, Yujin Zhang, Baogen Zhao, Ning Wang, Ting Gao, Li Zhang
Background: Cervical spondylotic myelopathy (CSM) is the most common chronic spinal cord injury with poor surgical and neurologic recovery in the advanced stages of the disease. DTI parameters can serve as important biomarkers for CSM prognosis. The study aimed to investigate the predictive value of dynamic diffusion tensor imaging (DTI) for the postoperative outcomes of CSM.
Methods: One hundred and five patients with CSM who underwent surgery were included in this study. Patients were assessed using the Modified Japanese Orthopedic Association Score (mJOA) before and one year after surgery and then divided into groups with good (≥ 50%) and poor (< 50%) prognoses according to the rate of recovery. All patients underwent preoperative dynamic magnetic resonance imaging of the cervical spine, including T2WI and DTI in natural(N), extension (E), and flexion (F) positions. ROM, Cross-sectional area, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) were measured at the narrowest level in three neck positions. Univariate and multivariate logistic regression were used to identify risk factors for poor postoperative recovery based on clinical characteristics, dynamic T2WI, and DTI parameters. Predictive models were developed for three different neck positions.
Results: Forty-four (41.9%) patients had a good postoperative prognosis, and 61 (58.1%) had a poor prognosis. Univariate analysis showed statistically significant differences in diabetes, number of compression segments, preoperative mJOA score, cross-sectional area ((Area-N), (Area-E), (Area-F)), ADC((ADC-N), (ADC-E), (ADC-F)) and FA (((FA-N), (FA-E), (FA-F)) (p < 0.05). Multivariable logistic regression showed that natural neck position: Area-N ([OR] 0.226; [CI] 0.069-0.732, p = 0.013),FA-N([OR]3.028;[CI]1.12-8.19,p = 0.029); extension ne-ck position: Area-E([OR]0.248;[CI]0.076-0.814,p = 0.021), FA-E([OR]4.793;[CI]1.737-13.228,p = 0.002);And flextion neck postion: Area-F([OR] 0.288; [CI] 0.095-0.87, p = 0.027),FA-F ([OR] 2.964; [CI] 1.126-7.801, p = 0.028) were independent risk factors for poor prognosis.The area under the curve (AUC) of the prediction models in the natural neck position, extension neck position, and flexion neck positions models were 0.708[(95% CI:0.608∼0.808), P < 0.001]; 0.738 [(95% CI:0.641∼0.835), P < 0.001]; 0.703 [(95% CI:0.602∼0.803), P < 0.001], respectively.
Conclusion: Dynamic DTI can predict postoperative outcomes in CSM. Reduced FA in the extension position is a valid predictor of poor postoperative neurological recovery in patients with CSM.
{"title":"Predictive value of dynamic diffusion tensor imaging for surgical outcomes in patients with cervical spondylotic myelopathy.","authors":"Xiaoyun Wang, Xiaonan Tian, Yujin Zhang, Baogen Zhao, Ning Wang, Ting Gao, Li Zhang","doi":"10.1186/s12880-024-01428-9","DOIUrl":"10.1186/s12880-024-01428-9","url":null,"abstract":"<p><strong>Background: </strong>Cervical spondylotic myelopathy (CSM) is the most common chronic spinal cord injury with poor surgical and neurologic recovery in the advanced stages of the disease. DTI parameters can serve as important biomarkers for CSM prognosis. The study aimed to investigate the predictive value of dynamic diffusion tensor imaging (DTI) for the postoperative outcomes of CSM.</p><p><strong>Methods: </strong>One hundred and five patients with CSM who underwent surgery were included in this study. Patients were assessed using the Modified Japanese Orthopedic Association Score (mJOA) before and one year after surgery and then divided into groups with good (≥ 50%) and poor (< 50%) prognoses according to the rate of recovery. All patients underwent preoperative dynamic magnetic resonance imaging of the cervical spine, including T2WI and DTI in natural(N), extension (E), and flexion (F) positions. ROM, Cross-sectional area, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) were measured at the narrowest level in three neck positions. Univariate and multivariate logistic regression were used to identify risk factors for poor postoperative recovery based on clinical characteristics, dynamic T2WI, and DTI parameters. Predictive models were developed for three different neck positions.</p><p><strong>Results: </strong>Forty-four (41.9%) patients had a good postoperative prognosis, and 61 (58.1%) had a poor prognosis. Univariate analysis showed statistically significant differences in diabetes, number of compression segments, preoperative mJOA score, cross-sectional area ((Area-N), (Area-E), (Area-F)), ADC((ADC-N), (ADC-E), (ADC-F)) and FA (((FA-N), (FA-E), (FA-F)) (p < 0.05). Multivariable logistic regression showed that natural neck position: Area-N ([OR] 0.226; [CI] 0.069-0.732, p = 0.013),FA-N([OR]3.028;[CI]1.12-8.19,p = 0.029); extension ne-ck position: Area-E([OR]0.248;[CI]0.076-0.814,p = 0.021), FA-E([OR]4.793;[CI]1.737-13.228,p = 0.002);And flextion neck postion: Area-F([OR] 0.288; [CI] 0.095-0.87, p = 0.027),FA-F ([OR] 2.964; [CI] 1.126-7.801, p = 0.028) were independent risk factors for poor prognosis.The area under the curve (AUC) of the prediction models in the natural neck position, extension neck position, and flexion neck positions models were 0.708[(95% CI:0.608∼0.808), P < 0.001]; 0.738 [(95% CI:0.641∼0.835), P < 0.001]; 0.703 [(95% CI:0.602∼0.803), P < 0.001], respectively.</p><p><strong>Conclusion: </strong>Dynamic DTI can predict postoperative outcomes in CSM. Reduced FA in the extension position is a valid predictor of poor postoperative neurological recovery in patients with CSM.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"260"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1186/s12880-024-01436-9
Yi Shen, Chao Zhu, Bingqian Chu, Jian Song, Yayuan Geng, Jianying Li, Bin Liu, Xingwang Wu
Objective: To evaluate the performance of a semi-automated artificial intelligence (AI) software program (CerebralDoc® system) in aneurysm detection and morphological measurement.
Methods: In this study, 354 cases of computed tomographic angiography (CTA) were retrospectively collected in our hospital. Among them, 280 cases were diagnosed with aneurysms by either digital subtraction angiography (DSA) and CTA (DSA group, n = 102), or CTA-only (non-DSA group, n = 178). The presence or absence of aneurysms, as well as their location and related morphological features determined by AI were evaluated using DSA and radiologist findings. Besides, post-processing image quality from AI and radiologists were also rated and compared.
Results: In the DSA group, AI achieved a sensitivity of 88.24% and an accuracy of 81.97%, whereas radiologists achieved a sensitivity of 95.10% and an accuracy of 84.43%, using DSA results as the gold standard. The AI in the non-DSA group achieved 81.46% sensitivity and 76.29% accuracy, as per the radiologists' findings. The comparison of position consistency results showed better performance under loose criteria than strict criteria. In terms of morphological characteristics, both the DSA and the non-DSA groups agreed well with the diagnostic results for neck width and maximum diameter, demonstrating excellent ICC reliability exceeding 0.80. The AI-generated images exhibited superior quality compared to the standard software for post-processing, while also demonstrating a significantly reduced processing time.
Conclusions: The AI-based aneurysm detection rate demonstrates a commendable performance, while the extracted morphological parameters exhibit a remarkable consistency with those assessed by radiologists, thereby showcasing significant potential for clinical application.
{"title":"Evaluation of the clinical application value of artificial intelligence in diagnosing head and neck aneurysms.","authors":"Yi Shen, Chao Zhu, Bingqian Chu, Jian Song, Yayuan Geng, Jianying Li, Bin Liu, Xingwang Wu","doi":"10.1186/s12880-024-01436-9","DOIUrl":"10.1186/s12880-024-01436-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of a semi-automated artificial intelligence (AI) software program (CerebralDoc<sup>®</sup> system) in aneurysm detection and morphological measurement.</p><p><strong>Methods: </strong>In this study, 354 cases of computed tomographic angiography (CTA) were retrospectively collected in our hospital. Among them, 280 cases were diagnosed with aneurysms by either digital subtraction angiography (DSA) and CTA (DSA group, n = 102), or CTA-only (non-DSA group, n = 178). The presence or absence of aneurysms, as well as their location and related morphological features determined by AI were evaluated using DSA and radiologist findings. Besides, post-processing image quality from AI and radiologists were also rated and compared.</p><p><strong>Results: </strong>In the DSA group, AI achieved a sensitivity of 88.24% and an accuracy of 81.97%, whereas radiologists achieved a sensitivity of 95.10% and an accuracy of 84.43%, using DSA results as the gold standard. The AI in the non-DSA group achieved 81.46% sensitivity and 76.29% accuracy, as per the radiologists' findings. The comparison of position consistency results showed better performance under loose criteria than strict criteria. In terms of morphological characteristics, both the DSA and the non-DSA groups agreed well with the diagnostic results for neck width and maximum diameter, demonstrating excellent ICC reliability exceeding 0.80. The AI-generated images exhibited superior quality compared to the standard software for post-processing, while also demonstrating a significantly reduced processing time.</p><p><strong>Conclusions: </strong>The AI-based aneurysm detection rate demonstrates a commendable performance, while the extracted morphological parameters exhibit a remarkable consistency with those assessed by radiologists, thereby showcasing significant potential for clinical application.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"261"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Magnetic Resonance Imaging (MRI) is extensively utilized in clinical diagnostics and medical research, yet the imaging process is often compromised by noise interference. This noise arises from various sources, leading to a reduction in image quality and subsequently hindering the accurate interpretation of image details by clinicians. Traditional denoising methods typically assume that noise follows a Gaussian distribution, thereby neglecting the more complex noise types present in MRI images, such as Rician noise. As a result, denoising remains a challenging and practical task.
Method: The main research work of this paper focuses on modifying mask information based on a global mask mapper. The mask mapper samples all blind spot pixels on the denoised image and maps them to the same channel. By incorporating perceptual loss, it utilizes all available information to improve performance while avoiding identity mapping. During the denoising process, the model may mistakenly remove some useful information as noise, resulting in a loss of detail in the denoised image. To address this issue, we train a generative adversarial network (GAN) with adaptive hybrid attention to restore the detailed information in the denoised MRI images.
Result: The two-stage model NRAE shows an improvement of nearly 1.4 dB in PSNR and approximately 0.1 in SSIM on clinical datasets compared to other classic models. Specifically, compared to the baseline model, PSNR is increased by about 0.6 dB, and SSIM is only 0.015 lower. From a visual perspective, NRAE more effectively restores the details in the images, resulting in richer and clearer representation of image details.
Conclusion: We have developed a deep learning-based two-stage model to address noise issues in medical MRI images. This method not only successfully reduces noise signals but also effectively restores anatomical details. The current results indicate that this is a promising approach. In future work, we plan to replace the current denoising network with more advanced models to further enhance performance.
{"title":"Dual stage MRI image restoration based on blind spot denoising and hybrid attention.","authors":"Renfeng Liu, Songyan Xiao, Tianwei Liu, Fei Jiang, Cao Yuan, Jianfeng Chen","doi":"10.1186/s12880-024-01437-8","DOIUrl":"https://doi.org/10.1186/s12880-024-01437-8","url":null,"abstract":"<p><strong>Background: </strong>Magnetic Resonance Imaging (MRI) is extensively utilized in clinical diagnostics and medical research, yet the imaging process is often compromised by noise interference. This noise arises from various sources, leading to a reduction in image quality and subsequently hindering the accurate interpretation of image details by clinicians. Traditional denoising methods typically assume that noise follows a Gaussian distribution, thereby neglecting the more complex noise types present in MRI images, such as Rician noise. As a result, denoising remains a challenging and practical task.</p><p><strong>Method: </strong>The main research work of this paper focuses on modifying mask information based on a global mask mapper. The mask mapper samples all blind spot pixels on the denoised image and maps them to the same channel. By incorporating perceptual loss, it utilizes all available information to improve performance while avoiding identity mapping. During the denoising process, the model may mistakenly remove some useful information as noise, resulting in a loss of detail in the denoised image. To address this issue, we train a generative adversarial network (GAN) with adaptive hybrid attention to restore the detailed information in the denoised MRI images.</p><p><strong>Result: </strong>The two-stage model NRAE shows an improvement of nearly 1.4 dB in PSNR and approximately 0.1 in SSIM on clinical datasets compared to other classic models. Specifically, compared to the baseline model, PSNR is increased by about 0.6 dB, and SSIM is only 0.015 lower. From a visual perspective, NRAE more effectively restores the details in the images, resulting in richer and clearer representation of image details.</p><p><strong>Conclusion: </strong>We have developed a deep learning-based two-stage model to address noise issues in medical MRI images. This method not only successfully reduces noise signals but also effectively restores anatomical details. The current results indicate that this is a promising approach. In future work, we plan to replace the current denoising network with more advanced models to further enhance performance.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"259"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1186/s12880-024-01433-y
Josephine Edith Pohl, Philipp Schwerk, René Mauer, Gabriele Hahn, Ricardo Beck, Guido Fitze, Jurek Schultz
Background: Several studies have advocated the use of ultrasound to diagnose distal forearm fractures in children. However, there is limited data on the diagnostic accuracy of ultrasound for distal forearm fractures when conducted by pediatric surgeons or trainees who manage orthopedic injuries in children. The objective of this study was to determine the diagnostic accuracy of point-of-care ultrasound (POCUS) for pediatric distal forearm fractures when conducted by pediatric surgeons and trainees after minimal training.
Methods: This diagnostic study was conducted in a tertiary hospital emergency department in Germany. Participants were children and adolescents under 15 years of age who presented to the emergency department with an acute, suspected, isolated distal forearm fracture requiring imaging. Pediatric surgeons and trainees, after minimal training for sonographic fracture diagnosis, performed 6-view distal forearm POCUS on each participant prior to X-ray imaging. All data was retrospectively collected from the hospital's routine digital patient files. The primary outcome was the diagnostic accuracy of POCUS compared to X-ray as the reference standard.
Results: From February to June 2021, 146 children under 15 met all inclusion and exclusion criteria, and 106 data sets were available for analysis. Regarding the presence of a fracture, X-ray and Wrist-POCUS showed the same result in 99.1%, with 83/106 (78.3%) fractures detected in both modalities and one suspected buckle fracture on POCUS not confirmed in the radiographs. Wrist-POCUS had a sensitivity of 100% (95% CI [0.956, 1]) and a specificity of 95.8% (95% CI [0.789, 0.999]) compared to radiographs. In 6 cases, there were minor differences regarding a concomitant ulnar buckle. The amount of prior ultrasound training had no influence on the accuracy of Wrist-POCUS for diagnosing distal forearm fractures. All fractures were reliably diagnosed even when captured POCUS images did not meet all quality criteria.
Conclusion: Pediatric surgeons and trainees, after minimal training in POCUS, had excellent diagnostic accuracy for distal forearm fractures in children and adolescents using POCUS compared to X-ray.
背景:多项研究提倡使用超声波诊断儿童前臂远端骨折。然而,由儿科外科医生或管理儿童骨科损伤的受训人员对前臂远端骨折进行超声诊断的准确性数据却很有限。本研究的目的是确定儿科外科医生和受训人员在经过最低限度的培训后对小儿前臂远端骨折进行护理点超声(POCUS)诊断的准确性:这项诊断研究在德国一家三级医院急诊科进行。参与者为 15 岁以下的儿童和青少年,他们因急性、疑似、孤立性前臂远端骨折而到急诊科就诊,需要进行影像学检查。小儿外科医生和受训人员在接受了最基本的骨折声学诊断培训后,在进行X光成像前对每位受试者进行了6视角前臂远端POCUS检查。所有数据均从医院的常规数字患者档案中进行回顾性收集。主要结果是与作为参考标准的X光相比,POCUS的诊断准确性:2021年2月至6月,146名15岁以下儿童符合所有纳入和排除标准,106组数据可供分析。关于是否存在骨折,X射线和腕部POCUS显示99.1%的结果相同,其中83/106(78.3%)的骨折在两种模式下均可检测到,POCUS显示的1处疑似扣骨骨折未在X射线照片中得到证实。与X光片相比,腕部POCUS的灵敏度为100%(95% CI [0.956,1]),特异性为95.8%(95% CI [0.789,0.999])。在 6 个病例中,并发尺骨扣的情况略有不同。之前接受过多少超声培训对 Wrist-POCUS 诊断前臂远端骨折的准确性没有影响。即使采集的POCUS图像不符合所有质量标准,所有骨折都能得到可靠诊断:结论:小儿外科医生和受训人员在接受过最低限度的 POCUS 培训后,使用 POCUS 诊断儿童和青少年前臂远端骨折的准确性优于 X 光检查。
{"title":"Diagnosis of suspected pediatric distal forearm fractures with point-of-care-ultrasound (POCUS) by pediatric orthopedic surgeons after minimal training.","authors":"Josephine Edith Pohl, Philipp Schwerk, René Mauer, Gabriele Hahn, Ricardo Beck, Guido Fitze, Jurek Schultz","doi":"10.1186/s12880-024-01433-y","DOIUrl":"https://doi.org/10.1186/s12880-024-01433-y","url":null,"abstract":"<p><strong>Background: </strong>Several studies have advocated the use of ultrasound to diagnose distal forearm fractures in children. However, there is limited data on the diagnostic accuracy of ultrasound for distal forearm fractures when conducted by pediatric surgeons or trainees who manage orthopedic injuries in children. The objective of this study was to determine the diagnostic accuracy of point-of-care ultrasound (POCUS) for pediatric distal forearm fractures when conducted by pediatric surgeons and trainees after minimal training.</p><p><strong>Methods: </strong>This diagnostic study was conducted in a tertiary hospital emergency department in Germany. Participants were children and adolescents under 15 years of age who presented to the emergency department with an acute, suspected, isolated distal forearm fracture requiring imaging. Pediatric surgeons and trainees, after minimal training for sonographic fracture diagnosis, performed 6-view distal forearm POCUS on each participant prior to X-ray imaging. All data was retrospectively collected from the hospital's routine digital patient files. The primary outcome was the diagnostic accuracy of POCUS compared to X-ray as the reference standard.</p><p><strong>Results: </strong>From February to June 2021, 146 children under 15 met all inclusion and exclusion criteria, and 106 data sets were available for analysis. Regarding the presence of a fracture, X-ray and Wrist-POCUS showed the same result in 99.1%, with 83/106 (78.3%) fractures detected in both modalities and one suspected buckle fracture on POCUS not confirmed in the radiographs. Wrist-POCUS had a sensitivity of 100% (95% CI [0.956, 1]) and a specificity of 95.8% (95% CI [0.789, 0.999]) compared to radiographs. In 6 cases, there were minor differences regarding a concomitant ulnar buckle. The amount of prior ultrasound training had no influence on the accuracy of Wrist-POCUS for diagnosing distal forearm fractures. All fractures were reliably diagnosed even when captured POCUS images did not meet all quality criteria.</p><p><strong>Conclusion: </strong>Pediatric surgeons and trainees, after minimal training in POCUS, had excellent diagnostic accuracy for distal forearm fractures in children and adolescents using POCUS compared to X-ray.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"255"},"PeriodicalIF":2.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}