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Comparison of synthesized and acquired high b-value diffusion-weighted MRI for detection of prostate cancer. 比较合成和获取的高 b 值弥散加权磁共振成像在检测前列腺癌方面的应用。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-08 DOI: 10.1186/s40644-024-00723-6
Karoline Kallis, Christopher C Conlin, Allison Y Zhong, Troy S Hussain, Aritrick Chatterjee, Gregory S Karczmar, Rebecca Rakow-Penner, Anders M Dale, Tyler M Seibert

Background: High b-value diffusion-weighted images (DWI) are used for detection of clinically significant prostate cancer (csPCa). This study qualitatively and quantitatively compares synthesized DWI (sDWI) to acquired (aDWI) for detection of csPCa.

Methods: One hundred fifty-one consecutive patients who underwent prostate MRI and biopsy were included in the study. Axial DWI with b = 0, 500, 1000, and 2000 s/mm2 using a 3T clinical scanner using a 32-channel phased-array body coil were acquired. We retrospectively synthesized DWI for b = 2000 s/mm2 via extrapolation based on mono-exponential decay, using b = 0 and b = 500 s/mm2 (sDWI500) and b = 0, b = 500 s/mm2, and b = 1000 s/mm2 (sDWI1000). Differences in signal intensity between sDWI and aDWI were evaluated within different regions of interest (prostate alone, prostate plus 5 mm, 30 mm and 70 mm margin and full field of view). The maximum DWI value within each ROI was evaluated for prediction of csPCa. Classification accuracy was compared to Restriction Spectrum Imaging restriction score (RSIrs), a previously validated biomarker based on multi-exponential DWI. Discrimination of csPCa was evaluated via area under the receiver operating characteristic curve (AUC).

Results: Within the prostate, mean ± standard deviation of percent mean differences between sDWI and aDWI signal were -46 ± 35% for sDWI1000 and -67 ± 24% for sDWI500. AUC for aDWI, sDWI500, sDWI1000, and RSIrs within the prostate 0.62[95% confidence interval: 0.53, 0.71], 0.63[0.54, 0.72], 0.65[0.56, 0.73] and 0.78[0.71, 0.86], respectively.

Conclusion: sDWI is qualitatively comparable to aDWI within the prostate. However, hyperintense artifacts are introduced with sDWI in the surrounding pelvic tissue that interfere with quantitative cancer detection and might mask metastases. In the prostate, RSIrs yields superior quantitative csPCa detection than sDWI or aDWI.

背景:高b值弥散加权成像(DWI)用于检测有临床意义的前列腺癌(csPCa)。本研究对合成 DWI(sDWI)和获取的 DWI(aDWI)进行了定性和定量比较,以检测 csPCa:研究纳入了 151 名连续接受前列腺 MRI 和活检的患者。我们使用一台使用 32 通道相控阵体线圈的 3T 临床扫描仪采集了 b = 0、500、1000 和 2000 s/mm2 的轴向 DWI。我们通过基于单指数衰减的外推法,使用 b = 0 和 b = 500 s/mm2(sDWI500)以及 b = 0、b = 500 s/mm2 和 b = 1000 s/mm2(sDWI1000)回顾性地合成了 b = 2000 s/mm2 的 DWI。在不同的感兴趣区(单独前列腺、前列腺加 5 毫米、30 毫米和 70 毫米边缘以及全视野)内评估 sDWI 和 aDWI 信号强度的差异。对每个区域内的最大 DWI 值进行评估,以预测 csPCa。分类准确性与限制性频谱成像限制性评分(RSIrs)进行了比较,后者是之前基于多指数 DWI 验证过的生物标记物。通过接收者操作特征曲线下面积(AUC)对 csPCa 的判别进行评估:结果:在前列腺内,sDWI1000 和 sDWI500 的 sDWI 和 aDWI 信号平均差异百分比的平均值(标准差)分别为 -46 ± 35% 和 -67 ± 24%。前列腺内 aDWI、sDWI500、sDWI1000 和 RSIrs 的 AUC 分别为 0.62[95%置信区间:0.53,0.71]、0.63[0.54,0.72]、0.65[0.56,0.73] 和 0.78[0.71,0.86]。结论:在前列腺内,sDWI 的质量与 aDWI 相当,但在盆腔周围组织中,sDWI 会产生高强度伪影,干扰癌症的定量检测,并可能掩盖转移灶。在前列腺中,RSIrs 对 csPCa 的定量检测优于 sDWI 或 aDWI。
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引用次数: 0
Diagnostic efficiency of intravoxel incoherent motion-based virtual magnetic resonance elastography in pulmonary neoplasms. 基于体细胞内非相干运动的虚拟磁共振弹性成像对肺部肿瘤的诊断效率。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-06 DOI: 10.1186/s40644-024-00728-1
Shuo Zhang, Yonghao Du, Ting Liang, Xuyin Zhang, Yinxia Guo, Jian Yang, Xianjun Li, Gang Niu

Background: The aim of the study were as below. (1) To investigate the feasibility of intravoxel incoherent motion (IVIM)-based virtual magnetic resonance elastography (vMRE) to provide quantitative estimates of tissue stiffness in pulmonary neoplasms. (2) To verify the diagnostic performance of shifted apparent diffusion coefficient (sADC) and reconstructed virtual stiffness values in distinguishing neoplasm nature.

Methods: This study enrolled 59 patients (37 males, 22 females) with one pulmonary neoplasm who underwent computed tomography-guided percutaneous transthoracic needle biopsy (PTNB) with pathological diagnosis (26 adenocarcinoma, 10 squamous cell carcinoma, 3 small cell carcinoma, 4 tuberculosis and 16 non-specific benign; mean age, 60.81 ± 9.80 years). IVIM was performed on a 3 T magnetic resonance imaging scanner before biopsy. sADC and virtual shear stiffness maps reflecting lesion stiffness were reconstructed. sADC and virtual stiffness values of neoplasm were extracted, and the diagnostic performance of vMRE in distinguishing benign and malignant and detailed pathological type were explored.

Results: Compared to benign neoplasms, malignant ones had a significantly lower sADC and a higher virtual stiffness value (P < 0.001). Subsequent subtype analyses showed that the sADC values of adenocarcinoma and squamous cell carcinoma groups were significantly lower than non-specific benign group (P = 0.013 and 0.001, respectively). Additionally, virtual stiffness values of the adenocarcinoma and squamous cell carcinoma subtypes were significantly higher than non-specific benign group (P = 0.008 and 0.001, respectively). However, no significant correlation was found among other subtype groups.

Conclusions: Non-invasive vMRE demonstrated diagnostic efficiency in differentiating the nature of pulmonary neoplasm. vMRE is promising as a new method for clinical diagnosis.

研究背景研究目的如下(1)研究基于体细胞内非相干运动(IVIM)的虚拟磁共振弹性成像(vMRE)对肺部肿瘤组织僵硬度进行定量估计的可行性。(2)验证移位表观弥散系数(sADC)和重建虚拟硬度值在区分肿瘤性质方面的诊断性能:本研究选取了 59 名患有一种肺部肿瘤的患者(37 名男性,22 名女性),他们在计算机断层扫描引导下接受了经皮穿刺活检(PTNB)并进行了病理诊断(26 例腺癌,10 例鳞状细胞癌,3 例小细胞癌,4 例肺结核,16 例非特异性良性肿瘤;平均年龄(60.81±9.80)岁)。活检前在 3 T 磁共振成像扫描仪上进行 IVIM 扫描,重建 sADC 和反映病变僵硬度的虚拟剪切僵硬度图,提取肿瘤的 sADC 和虚拟僵硬度值,探讨 vMRE 在区分良性和恶性以及详细病理类型方面的诊断性能:结果:与良性肿瘤相比,恶性肿瘤的 sADC 值明显较低,虚拟硬度值明显较高:无创 vMRE 在区分肺部肿瘤性质方面具有诊断效率。
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引用次数: 0
Review on radiomic analysis in 18F-fluorodeoxyglucose positron emission tomography for prediction of melanoma outcomes. 18F- 氟脱氧葡萄糖正电子发射断层扫描中用于预测黑色素瘤预后的放射线组学分析综述。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-05 DOI: 10.1186/s40644-024-00732-5
Karim Amrane, Coline Le Meur, Philippe Thuillier, Christian Berthou, Arnaud Uguen, Désirée Deandreis, David Bourhis, Vincent Bourbonne, Ronan Abgral

Over the past decade, several strategies have revolutionized the clinical management of patients with cutaneous melanoma (CM), including immunotherapy and targeted tyrosine kinase inhibitor (TKI)-based therapies. Indeed, immune checkpoint inhibitors (ICIs), alone or in combination, represent the standard of care for patients with advanced disease without an actionable mutation. Notably BRAF combined with MEK inhibitors represent the therapeutic standard for disease disclosing BRAF mutation. At the same time, FDG PET/CT has become part of the routine staging and evaluation of patients with cutaneous melanoma. There is growing interest in using FDG PET/CT measurements to predict response to ICI therapy and/or target therapy. While semiquantitative values such as standardized uptake value (SUV) are limited for predicting outcome, new measures including tumor metabolic volume, total lesion glycolysis and radiomics seem promising as potential imaging biomarkers for nuclear medicine. The aim of this review, prepared by an interdisciplinary group of experts, is to take stock of the current literature on radiomics approaches that could improve outcomes in CM.

在过去十年中,有几种策略彻底改变了皮肤黑色素瘤(CM)患者的临床治疗,包括免疫疗法和基于酪氨酸激酶抑制剂(TKI)的靶向疗法。事实上,免疫检查点抑制剂(ICIs),无论是单独使用还是联合使用,都是治疗无可操作性突变的晚期患者的标准疗法。值得注意的是,BRAF 联合 MEK 抑制剂代表了治疗 BRAF 突变疾病的标准。与此同时,FDG PET/CT 已成为皮肤黑色素瘤患者常规分期和评估的一部分。人们对使用 FDG PET/CT 测量来预测对 ICI 治疗和/或靶向治疗的反应越来越感兴趣。虽然标准化摄取值(SUV)等半定量值对预测结果的作用有限,但包括肿瘤代谢体积、病变总糖酵解和放射组学在内的新测量方法似乎很有希望成为核医学的潜在成像生物标记物。本综述由一个跨学科专家小组撰写,目的是对可改善中医预后的放射组学方法的现有文献进行评估。
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引用次数: 0
[68Ga]Ga‑PSMA‑617 PET-based radiomics model to identify candidates for active surveillance amongst patients with GGG 1-2 prostate cancer at biopsy. 基于[68Ga]Ga-PSMA-617 PET的放射组学模型,在活检结果为GGG 1-2的前列腺癌患者中确定主动监测的候选者。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-04 DOI: 10.1186/s40644-024-00735-2
Jinhui Yang, Ling Xiao, Ming Zhou, Yujia Li, Yi Cai, Yu Gan, Yongxiang Tang, Shuo Hu

Purpose: To develop a radiomics-based model using [68Ga]Ga-PSMA PET/CT to predict postoperative adverse pathology (AP) in patients with biopsy Gleason Grade Group (GGG) 1-2 prostate cancer (PCa), assisting in the selection of patients for active surveillance (AS).

Methods: A total of 75 men with biopsy GGG 1-2 PCa who underwent radical prostatectomy (RP) were enrolled. The patients were randomly divided into a training group (70%) and a testing group (30%). Radiomics features of entire prostate were extracted from the [68Ga]Ga-PSMA PET scans and selected using the minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator regression model. Logistic regression analyses were conducted to construct the prediction models. Receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve were employed to evaluate the diagnostic value, clinical utility, and predictive accuracy of the models, respectively.

Results: Among the 75 patients, 30 had AP confirmed by RP. The clinical model showed an area under the curve (AUC) of 0.821 (0.695-0.947) in the training set and 0.795 (0.603-0.987) in the testing set. The radiomics model achieved AUC values of 0.830 (0.720-0.941) in the training set and 0.829 (0.624-1.000) in the testing set. The combined model, which incorporated the Radiomics score (Radscore) and free prostate-specific antigen (FPSA)/total prostate-specific antigen (TPSA), demonstrated higher diagnostic efficacy than both the clinical and radiomics models, with AUC values of 0.875 (0.780-0.970) in the training set and 0.872 (0.678-1.000) in the testing set. DCA showed that the net benefits of the combined model and radiomics model exceeded those of the clinical model.

Conclusion: The combined model shows potential in stratifying men with biopsy GGG 1-2 PCa based on the presence of AP at final pathology and outperforms models based solely on clinical or radiomics features. It may be expected to aid urologists in better selecting suitable patients for AS.

目的:利用[68Ga]Ga-PSMA PET/CT建立一个基于放射组学的模型,预测活检格里森分级1-2组(GGG)前列腺癌(PCa)患者的术后不良病理(AP),帮助选择接受主动监测(AS)的患者:方法:共招募了 75 名接受前列腺癌根治术(RP)的活检 GGG 1-2 级 PCa 男性患者。这些患者被随机分为训练组(70%)和测试组(30%)。从[68Ga]Ga-PSMA PET 扫描图像中提取整个前列腺的放射组学特征,并使用最小冗余最大相关性算法和最小绝对收缩与选择算子回归模型进行筛选。采用逻辑回归分析构建预测模型。采用接收者操作特征曲线(ROC)、决策曲线分析(DCA)和校准曲线分别评估模型的诊断价值、临床实用性和预测准确性:在 75 例患者中,30 例经 RP 确诊为 AP。临床模型的训练集曲线下面积(AUC)为 0.821(0.695-0.947),测试集为 0.795(0.603-0.987)。放射组学模型在训练集中的 AUC 值为 0.830(0.720-0.941),在测试集中为 0.829(0.624-1.000)。结合放射组学评分(Radscore)和游离前列腺特异性抗原(FPSA)/总前列腺特异性抗原(TPSA)的组合模型比临床模型和放射组学模型都具有更高的诊断效力,在训练集中的AUC值为0.875(0.780-0.970),在测试集中的AUC值为0.872(0.678-1.000)。DCA显示,组合模型和放射组学模型的净收益超过了临床模型:综合模型在根据最终病理结果是否存在AP对活检GGG 1-2型PCa男性患者进行分层方面显示出潜力,并且优于仅基于临床或放射组学特征的模型。它有望帮助泌尿科医生更好地选择合适的患者进行AS治疗。
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引用次数: 0
Bibliometric analysis of the application of deep learning in cancer from 2015 to 2023. 2015年至2023年深度学习在癌症中应用的文献计量分析。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-04 DOI: 10.1186/s40644-024-00737-0
Ruiyu Wang, Shu Huang, Ping Wang, Xiaomin Shi, Shiqi Li, Yusong Ye, Wei Zhang, Lei Shi, Xian Zhou, Xiaowei Tang

Background: Recently, the application of deep learning (DL) has made great progress in various fields, especially in cancer research. However, to date, the bibliometric analysis of the application of DL in cancer is scarce. Therefore, this study aimed to explore the research status and hotspots of the application of DL in cancer.

Methods: We retrieved all articles on the application of DL in cancer from the Web of Science database Core Collection database. Biblioshiny, VOSviewer and CiteSpace were used to perform the bibliometric analysis through analyzing the numbers, citations, countries, institutions, authors, journals, references, and keywords.

Results: We found 6,016 original articles on the application of DL in cancer. The number of annual publications and total citations were uptrend in general. China published the greatest number of articles, USA had the highest total citations, and Saudi Arabia had the highest centrality. Chinese Academy of Sciences was the most productive institution. Tian, Jie published the greatest number of articles, while He Kaiming was the most co-cited author. IEEE Access was the most popular journal. The analysis of references and keywords showed that DL was mainly used for the prediction, detection, classification and diagnosis of breast cancer, lung cancer, and skin cancer.

Conclusions: Overall, the number of articles on the application of DL in cancer is gradually increasing. In the future, further expanding and improving the application scope and accuracy of DL applications, and integrating DL with protein prediction, genomics and cancer research may be the research trends.

背景:最近,深度学习(DL)在各个领域的应用取得了长足的进步,尤其是在癌症研究领域。然而,迄今为止,关于深度学习在癌症中的应用的文献计量分析还很少。因此,本研究旨在探索深度学习在癌症中应用的研究现状和热点:我们从 Web of Science 数据库的 Core Collection 数据库中检索了所有有关 DL 在癌症中应用的文章。我们使用 Biblioshiny、VOSviewer 和 CiteSpace 进行了文献计量分析,分析了数量、引文、国家、机构、作者、期刊、参考文献和关键词:我们找到了 6016 篇关于 DL 在癌症中应用的原创文章。每年发表的文章数量和总被引次数总体呈上升趋势。中国发表的文章数量最多,美国的总被引次数最高,沙特阿拉伯的中心地位最高。中国科学院是发表论文最多的机构。田杰发表的文章数量最多,何开明是被联合引用最多的作者。IEEE Access 是最受欢迎的期刊。对参考文献和关键词的分析表明,DL主要用于乳腺癌、肺癌和皮肤癌的预测、检测、分类和诊断:总体而言,有关 DL 在癌症中应用的文章数量正在逐步增加。今后,进一步扩大和提高 DL 的应用范围和准确性,并将 DL 与蛋白质预测、基因组学和癌症研究相结合,可能是研究的趋势。
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引用次数: 0
3D airway geometry analysis of factors in airway navigation failure for lung nodules. 肺结节气道导航失败因素的三维气道几何分析。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-04 DOI: 10.1186/s40644-024-00730-7
Hwan-Ho Cho, Junsu Choe, Jonghoon Kim, Yoo Jin Oh, Hyunjin Park, Kyungjong Lee, Ho Yun Lee

Background: This study aimed to quantitatively reveal contributing factors to airway navigation failure during radial probe endobronchial ultrasound (R-EBUS) by using geometric analysis in a three-dimensional (3D) space and to investigate the clinical feasibility of prediction models for airway navigation failure.

Methods: We retrospectively reviewed patients who underwent R-EBUS between January 2017 and December 2018. Geometric quantification was analyzed using in-house software built with open-source python libraries including the Vascular Modeling Toolkit ( http://www.vmtk.org ), simple insight toolkit ( https://sitk.org ), and sci-kit image ( https://scikit-image.org ). We used a machine learning-based approach to explore the utility of these significant factors.

Results: Of the 491 patients who were eligible for analysis (mean age, 65 years +/- 11 [standard deviation]; 274 men), the target lesion was reached in 434 and was not reached in 57. Twenty-seven patients in the failure group were matched with 27 patients in the success group based on propensity scores. Bifurcation angle at the target branch, the least diameter of the last section, and the curvature of the last section are the most significant and stable factors for airway navigation failure. The support vector machine can predict airway navigation failure with an average area under the curve of 0.803.

Conclusions: Geometric analysis in 3D space revealed that a large bifurcation angle and a narrow and tortuous structure of the closest bronchus from the lesion are associated with airway navigation failure during R-EBUS. The models developed using quantitative computer tomography scan imaging show the potential to predict airway navigation failure.

背景:本研究旨在通过三维(3D)空间的几何分析,定量揭示径向探头支气管内超声(R-EBUS)过程中气道导航失败的诱因,并探讨气道导航失败预测模型的临床可行性:我们回顾性分析了2017年1月至2018年12月期间接受R-EBUS检查的患者。使用开源 python 库(包括 Vascular Modeling Toolkit ( http://www.vmtk.org )、simple insight toolkit ( https://sitk.org )和 sci-kit image ( https://scikit-image.org ))构建的内部软件对几何量化进行了分析。我们使用基于机器学习的方法来探索这些重要因素的效用:在符合分析条件的 491 名患者(平均年龄 65 岁 +/- 11 [标准差];274 名男性)中,434 人达到目标病灶,57 人未达到目标病灶。根据倾向评分,27 名失败组患者与 27 名成功组患者进行了配对。目标分支的分叉角、最后一段的最小直径和最后一段的曲率是气道导航失败的最重要和最稳定的因素。支持向量机可以预测气道导航失败,平均曲线下面积为 0.803:三维空间几何分析表明,分叉角大、距离病变最近的支气管结构狭窄迂曲与 R-EBUS 过程中气道导航失败有关。利用定量计算机断层扫描成像建立的模型显示了预测气道导航失败的潜力。
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引用次数: 0
Automation of Wilms' tumor segmentation by artificial intelligence. 利用人工智能自动分割 Wilms 肿瘤。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-02 DOI: 10.1186/s40644-024-00729-0
Olivier Hild, Pierre Berriet, Jérémie Nallet, Lorédane Salvi, Marion Lenoir, Julien Henriet, Jean-Philippe Thiran, Frédéric Auber, Yann Chaussy

Background: 3D reconstruction of Wilms' tumor provides several advantages but are not systematically performed because manual segmentation is extremely time-consuming. The objective of our study was to develop an artificial intelligence tool to automate the segmentation of tumors and kidneys in children.

Methods: A manual segmentation was carried out by two experts on 14 CT scans. Then, the segmentation of Wilms' tumor and neoplastic kidney was automatically performed using the CNN U-Net and the same CNN U-Net trained according to the OV2ASSION method. The time saving for the expert was estimated depending on the number of sections automatically segmented.

Results: When segmentations were performed manually by two experts, the inter-individual variability resulted in a Dice index of 0.95 for tumor and 0.87 for kidney. Fully automatic segmentation with the CNN U-Net yielded a poor Dice index of 0.69 for Wilms' tumor and 0.27 for kidney. With the OV2ASSION method, the Dice index varied depending on the number of manually segmented sections. For the segmentation of the Wilms' tumor and neoplastic kidney, it varied respectively from 0.97 to 0.94 for a gap of 1 (2 out of 3 sections performed manually) to 0.94 and 0.86 for a gap of 10 (1 section out of 6 performed manually).

Conclusion: Fully automated segmentation remains a challenge in the field of medical image processing. Although it is possible to use already developed neural networks, such as U-Net, we found that the results obtained were not satisfactory for segmentation of neoplastic kidneys or Wilms' tumors in children. We developed an innovative CNN U-Net training method that makes it possible to segment the kidney and its tumor with the same precision as an expert while reducing their intervention time by 80%.

背景:Wilms'肿瘤的三维重建具有多种优势,但由于人工分割非常耗时,因此并未系统地进行。我们研究的目的是开发一种人工智能工具,自动分割儿童肿瘤和肾脏:方法:由两名专家对 14 张 CT 扫描图像进行人工分割。然后,使用 CNN U-Net 和根据 OV2ASSION 方法训练的同一 CNN U-Net 自动执行 Wilms 肿瘤和肿瘤性肾脏的分割。根据自动分割的切片数量估算专家节省的时间:结果:当两位专家手动进行分割时,个体间的差异导致肿瘤的 Dice 指数为 0.95,肾脏的 Dice 指数为 0.87。使用 CNN U-Net 进行全自动分割时,Wilms 肿瘤和肾脏的 Dice 指数分别为 0.69 和 0.27。使用 OV2ASSION 方法,Dice 指数随人工分割切片的数量而变化。在分割 Wilms 肿瘤和肿瘤性肾脏时,当间隙为 1 时,Dice 指数分别为 0.97 和 0.94(3 个切片中人工分割了 2 个);当间隙为 10 时,Dice 指数分别为 0.94 和 0.86(6 个切片中人工分割了 1 个):全自动分割仍然是医学图像处理领域的一项挑战。虽然可以使用已开发的神经网络(如 U-Net),但我们发现在分割儿童肿瘤性肾脏或 Wilms 肿瘤时,所获得的结果并不令人满意。我们开发了一种创新的 CNN U-Net 训练方法,可以像专家一样精确地分割肾脏及其肿瘤,同时将专家的干预时间减少 80%。
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引用次数: 0
MRI-guided in-bore biopsy of the prostate - defining the optimal number of cores needed. 核磁共振成像引导下的前列腺孔内活检--确定所需核芯的最佳数量。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1186/s40644-024-00734-3
Moritz Gross, Edith Eisenhuber, Petra Assinger, Raphael Schima, Martin Susani, Stefan Doblhammer, Wolfgang Schima

Background: Numerous studies have shown that magnetic resonance imaging (MRI)-targeted biopsy approaches are superior to traditional systematic transrectal ultrasound guided biopsy (TRUS-Bx). The optimal number of biopsy cores to be obtained per lesion identified on multiparametric MRI (mpMRI) images, however, remains a matter of debate. The aim of this study was to evaluate the incremental value of additional biopsy cores in an MRI-targeted "in-bore"-biopsy (MRI-Bx) setting.

Patients and methods: Two hundred and forty-five patients, who underwent MRI-Bx between June 2014 and September 2021, were included in this retrospective single-center analysis. All lesions were biopsied with at least five biopsy cores and cumulative detection rates for any cancer (PCa) as well as detection rates of clinically significant cancers (csPCa) were calculated for each sequentially labeled biopsy core. The cumulative per-core detection rates are presented as whole numbers and as proportion of the maximum detection rate reached, when all biopsy cores were considered. CsPCa was defined as Gleason Score (GS) ≥ 7 (3 + 4).

Results: One hundred and thirty-two of 245 Patients (53.9%) were diagnosed with prostate cancer and csPCa was found in 64 (26.1%) patients. The first biopsy core revealed csPCa/ PCa in 76.6% (49/64)/ 81.8% (108/132) of cases. The second, third and fourth core found csPCa/ PCa not detected by previous cores in 10.9% (7/64)/ 8.3% (11/132), 7.8% (5/64)/ 5.3% (7/132) and 3.1% (2/64)/ 3% (4/132) of cases, respectively. Obtaining one or more cores beyond the fourth biopsy core resulted in an increase in detection rate of 1.6% (1/64)/ 1.5% (2/132).

Conclusion: We found that obtaining five cores per lesion maximized detection rates. If, however, future research should establish a clear link between the incidence of serious complications and the number of biopsy cores obtained, a three-core biopsy might suffice as our results suggest that about 95% of all csPCa are detected by the first three cores.

背景:大量研究表明,磁共振成像(MRI)靶向活检方法优于传统的系统性经直肠超声引导活检(TRUS-Bx)。然而,多参数磁共振成像(mpMRI)图像上确定的每个病灶的最佳活检核心数量仍存在争议。本研究的目的是评估在磁共振成像靶向 "孔内 "活检(MRI-Bx)中额外活检核心的增量价值:这项回顾性单中心分析纳入了2014年6月至2021年9月期间接受MRI-Bx检查的245名患者。所有病变均通过至少五个活检核心进行活检,并计算了每个顺序标记的活检核心的任何癌症(PCa)累积检出率以及具有临床意义的癌症(csPCa)检出率。每个切片核的累计检出率以整数和在考虑所有切片核时达到的最高检出率的比例表示。CsPCa的定义是格里森评分(GS)≥ 7 (3 + 4):结果:245 名患者中有 132 人(53.9%)被确诊为前列腺癌,其中 64 人(26.1%)发现了 csPCa。在 76.6%(49/64)/81.8%(108/132)的病例中,第一个活检核心发现了 csPCa/PCa。在第二、第三和第四个活检核心中,分别有 10.9% (7/64)/ 8.3% (11/132)、7.8% (5/64)/ 5.3% (7/132) 和 3.1% (2/64)/ 3% (4/132) 的病例发现了之前活检核心未检测到的 csPCa/ PCa。在第四个活检核心之后再获取一个或多个核心,可使检出率提高1.6% (1/64)/ 1.5% (2/132):我们发现,每个病灶取 5 个活检核心可最大限度地提高检出率。结论:我们发现,每个病灶取 5 个活检核心可最大限度地提高检出率。不过,如果未来的研究能在严重并发症的发生率和活检核心数量之间建立明确的联系,那么取 3 个核心活检可能就足够了,因为我们的结果表明,大约 95% 的 csPCa 都是通过前 3 个核心检测出来的。
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引用次数: 0
Correction: Patient eligibility for trials with imaging response assessment at the time of molecular tumor board presentation. 更正:在肿瘤分子委员会报告时进行影像反应评估的试验患者资格。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-07-01 DOI: 10.1186/s40644-024-00724-5
Nabeel Mansour, Kathrin Heinrich, Danmei Zhang, Michael Winkelmann, Maria Ingenerf, Lukas Gold, Konstantin Klambauer, Martina Rudelius, Frederick Klauschen, Michael von Bergwelt-Baildon, Jens Ricke, Volker Heinemann, C Benedikt Westphalen, Wolfgang G Kunz
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引用次数: 0
MRI features and tumor-infiltrating CD8 + T cells-based nomogram for predicting meningioma recurrence risk. 基于磁共振成像特征和肿瘤浸润 CD8 + T 细胞的脑膜瘤复发风险预测提名图。
IF 3.5 2区 医学 Q2 ONCOLOGY Pub Date : 2024-06-28 DOI: 10.1186/s40644-024-00731-6
Tao Han, Xianwang Liu, Changyou Long, Shenglin Li, Fengyu Zhou, Peng Zhang, Bin Zhang, Mengyuan Jing, Liangna Deng, Yuting Zhang, Junlin Zhou

Objective: This study was based on MRI features and number of tumor-infiltrating CD8 + T cells in post-operative pathology, in predicting meningioma recurrence risk.

Methods: Clinical, pathological, and imaging data of 102 patients with surgically and pathologically confirmed meningiomas were retrospectively analyzed. Patients were divided into recurrence and non-recurrence groups based on follow-up. Tumor-infiltrating CD8 + T cells in tissue samples were quantitatively assessed with immunohistochemical staining. Apparent diffusion coefficient (ADC) histogram parameters from preoperative MRI were quantified in MaZda. Considering the high correlation between ADC histogram parameters, we only chose ADC histogram parameter that had the best predictive efficacy for COX regression analysis further. A visual nomogram was then constructed and the recurrence probability at 1- and 2-years was determined. Finally, subgroup analysis was performed with the nomogram.

Results: The risk factors for meningioma recurrence were ADCp1 (hazard ratio [HR] = 0.961, 95% confidence interval [95% CI]: 0.937 ~ 0.986, p = 0.002) and CD8 + T cells (HR = 0.026, 95%CI: 0.001 ~ 0.609, p = 0.023). The resultant nomogram had AUC values of 0.779 and 0.784 for 1- and 2-years predicted recurrence rates, respectively. The survival analysis revealed that patients with low CD8 + T cells counts or ADCp1 had higher recurrence rates than those with high CD8 + T cells counts or ADCp1. Subgroup analysis revealed that the AUC of nomogram for predicting 1-year and 2-year recurrence of WHO grade 1 and WHO grade 2 meningiomas was 0.872 (0.652) and 0.828 (0.751), respectively.

Conclusions: Preoperative ADC histogram parameters and tumor-infiltrating CD8 + T cells may be potential biomarkers in predicting meningioma recurrence risk.

Clinical relevance statement: The findings will improve prognostic accuracy for patients with meningioma and potentially allow for targeted treatment of individuals who have the recurrent form.

研究目的本研究基于核磁共振成像特征和术后病理中肿瘤浸润的 CD8 + T 细胞数量预测脑膜瘤的复发风险:方法: 对102例经手术和病理证实的脑膜瘤患者的临床、病理和影像学数据进行回顾性分析。根据随访情况将患者分为复发组和非复发组。通过免疫组化染色对组织样本中的肿瘤浸润 CD8 + T 细胞进行定量评估。术前磁共振成像的表观弥散系数(ADC)直方图参数在MaZda中进行量化。考虑到 ADC 直方图参数之间的高度相关性,我们只选择了预测效果最好的 ADC 直方图参数进一步进行 COX 回归分析。然后构建了一个可视化提名图,并确定了 1 年和 2 年的复发概率。最后,利用提名图进行亚组分析:结果:脑膜瘤复发的危险因素为 ADCp1(危险比 [HR] = 0.961,95% 置信区间 [95% CI]:0.937 ~ 0.90.937 ~ 0.986,p = 0.002)和 CD8 + T 细胞(HR = 0.026,95%CI:0.001 ~ 0.609,p = 0.023)。由此得出的提名图的 1 年和 2 年预测复发率 AUC 值分别为 0.779 和 0.784。生存分析表明,CD8 + T 细胞计数或 ADCp1 低的患者的复发率高于 CD8 + T 细胞计数或 ADCp1 高的患者。亚组分析显示,预测WHO 1级和WHO 2级脑膜瘤1年和2年复发的提名图AUC分别为0.872(0.652)和0.828(0.751):结论:术前ADC直方图参数和肿瘤浸润CD8 + T细胞可能是预测脑膜瘤复发风险的潜在生物标志物:这些发现将提高脑膜瘤患者预后的准确性,并有可能对复发患者进行有针对性的治疗。
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引用次数: 0
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Cancer Imaging
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