bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of renal elasticity evaluated by real-time shear wave elastography with renal fibrosis in patients with chronic kidney disease
Authors: Chen Ziman , Wang Yingli , Ying Michael Tin Cheung , Su Zhongzhen , Han Xinyang , Gunda Simon Takadiyi 
Published: January 2024

Abstract

Objective
Renal fibrosis is a final common pathological hallmark in the progression of chronic kidney disease (CKD). Non-invasive evaluation of renal fibrosis by mapping renal stiffness obtained by shear wave elastography (SWE) may facilitate the clinical therapeutic regimen for CKD patients.

Methods
A cohort of 162 patients diagnosed with CKD, who underwent renal biopsy, was prospectively and consecutively recruited between April 2019 and December 2021. The assessment of renal cortex stiffness was performed using SWE imaging. The patients were classified into different groups based on pathological renal fibrosis (mild group: n = 74; moderate-to-severe group: n = 88). Binary logistic regression model and generalized additive model were conducted to investigate the association of renal elasticity with renal fibrosis.

Results
Compared with the mildly impaired group, the moderate-to-severe group showed a significant decline in renal elasticity (P &lt; .001). In the fully adjusted model, each 10 kPa drop in renal elasticity was associated with a 3.5-fold increment in the risk of moderate-to-severe renal fibrosis (fully adjusted odds ratio, 4.54; 95% CI, 2.41-8.57). Particularly, participants in the lowest elasticity group (≤29.92 kPa) had a 20-fold increased chance of moderate-to-severe renal fibrosis than those in the group with highest elasticity (≥37.93 kPa). An inverse linear association was observed between renal elasticity increment and moderate-to-severe renal fibrosis risk.

Conclusion
There is a negative linear association between increased renal elasticity and moderate-to-severe renal fibrosis risk among CKD patients. Patients with diminished renal stiffness have a higher risk of moderate-to-severe renal fibrosis.

Advances in knowledge
CKD patients with reduced renal stiffness have a higher likelihood of moderate-to-severe renal fibrosis.
Non-invasive prediction model of axillary lymph node status in patients with early-stage breast cancer: a feasibility study based on dynamic contrast-enhanced-MRI radiomics
Authors: Chen Weiyue , Lin Guihan , Kong Chunli , Wu Xulu , Hu Yumin , Chen Minjiang , Xia Shuiwei , Lu Chenying , Xu Min , Ji Jiansong 
Published: January 2024

Abstract

Objectives
Accurate axillary evaluation plays an important role in prognosis and treatment planning for breast cancer. This study aimed to develop and validate a dynamic contrast-enhanced (DCE)-MRI-based radiomics model for preoperative evaluation of axillary lymph node (ALN) status in early-stage breast cancer.

Methods
A total of 410 patients with pathologically confirmed early-stage invasive breast cancer (training cohort, N = 286; validation cohort, N = 124) from June 2018 to August 2022 were retrospectively recruited. Radiomics features were derived from the second phase of DCE-MRI images for each patient. ALN status-related features were obtained, and a radiomics signature was constructed using SelectKBest and least absolute shrinkage and selection operator regression. Logistic regression was applied to build a combined model and corresponding nomogram incorporating the radiomics score (Rad-score) with clinical predictors. The predictive performance of the nomogram was evaluated using receiver operator characteristic (ROC) curve analysis and calibration curves.

Results
Fourteen radiomic features were selected to construct the radiomics signature. The Rad-score, MRI-reported ALN status, BI-RADS category, and tumour size were independent predictors of ALN status and were incorporated into the combined model. The nomogram showed good calibration and favourable performance for discriminating metastatic ALNs (N + (≥1)) from non-metastatic ALNs (N0) and metastatic ALNs with heavy burden (N + (≥3)) from low burden (N + (1-2)), with the area under the ROC curve values of 0.877 and 0.879 in the training cohort and 0.859 and 0.881 in the validation cohort, respectively.

Conclusions
The DCE-MRI-based radiomics nomogram could serve as a potential non-invasive technique for accurate preoperative evaluation of ALN burden, thereby assisting physicians in the personalized axillary treatment for early-stage breast cancer patients.

Advances in knowledge
This study developed a potential surrogate of preoperative accurate evaluation of ALN status, which is non-invasive and easy-to-use.
Prediction of Gleason score in prostate cancer patients based on radiomic features of transrectal ultrasound images
Authors: Cheng Tao , Li Huiming 
Published: January 2024

Abstract

Objectives
The aim of this study was to develop a model for predicting the Gleason score of patients with prostate cancer based on ultrasound images.

Methods
Transrectal ultrasound images of 838 prostate cancer patients from The Cancer Imaging Archive database were included in this cross-section study. Data were randomly divided into the training set and testing set (ratio 7:3). A total of 103 radiomic features were extracted from the ultrasound image. Lasso regression was used to select radiomic features. Random forest and broad learning system (BLS) methods were utilized to develop the model. The area under the curve (AUC) was calculated to evaluate the model performance.

Results
After the screening, 10 radiomic features were selected. The AUC and accuracy of the radiomic feature variables random forest model in the testing set were 0.727 (95% CI, 0.694-0.760) and 0.646 (95% CI, 0.620-0.673), respectively. When PSA and radiomic feature variables were included in the random forest model, the AUC and accuracy of the model were 0.770 (95% CI, 0.740-0.800) and 0.713 (95% CI, 0.688-0.738), respectively. While the BLS method was utilized to construct the model, the AUC and accuracy of the model were 0.726 (95% CI, 0.693-0.759) and 0.698 (95% CI, 0.673-0.723), respectively. In predictions for different Gleason grades, the highest AUC of 0.847 (95% CI, 0.749-0.945) was found to predict Gleason grade 5 (Gleason score ≥9).

Conclusions
A model based on transrectal ultrasound image features showed a good ability to predict Gleason scores in prostate cancer patients.

Advances in knowledge
This study used ultrasound-based radiomics to predict the Gleason score of patients with prostate cancer.
Using intravoxel incoherent motion imaging to evaluate uric acid-induced renal injury and efficacy after treatment
Authors: Cheng Zhong-Yuan , Gong Shang-Ao , Chen Ping-Kang , Yu Zong-Chao , Qiu Chen , Lin Ji-Xin , Mo Jia-Bin , Qian Long , Feng You-Zhen , Cai Xiang-Ran 
Published: January 2024

Abstract

Objectives
To validate the feasibility of intravoxel incoherent motion imaging (IVIM) for monitoring renal injury and uric acid-lowering efficacy in a rat model of hyperuricaemia.

Methods
A total of 92 rats were analysed and categorized into 4 groups: control (CON), hyperuricaemia (HUA), allopurinol intervention (ALL), and combined intervention (COM). Eight rats were randomly selected from each group and underwent IVIM scanning on days 0, 1, 3, 5, 7, and 9. Quantitative magnetic resonance values (D, D*, and f values) measured from the different renal anatomical regions. Quantitative histopathological analysis was performed to assess renal tubular injury using neutrophil gelatinase-associated lipocalin (NGAL), and renal fibrosis using alpha-smooth-muscle-actin (α-SMA). Pearson’s correlation analysis was used to determine the correlation between IVIM-derived parameters and the expression of NGAL and α-SMA.

Results
The D values of the HUA, ALL, and COM groups generally showed a downward trend over time, and this fluctuation was most significant in the HUA group. The D values showed significant intergroup differences at each point, whereas only a few discrepancies were found in the D* and f values. In addition, the renal D value was negatively correlated with the positive staining rates for NGAL and α-SMA (P &lt; .05), except for the lack of correlation between Dos and α-SMA (P &gt; .05).

Conclusion
IVIM could be a noninvasive and potential assessment modality for the evaluation of renal injury induced by hyperuricaemia and its prognostic efficacy.

Advances in knowledge
IVIM could be a surrogate manner in monitoring renal damage induced by hyperuricaemia and its treatment evaluation.
Multimodal radiomics based on 18F-Prostate-specific membrane antigen-1007 PET/CT and multiparametric MRI for prostate cancer extracapsular extension prediction
Authors: Pan Kehua , Yao Fei , Hong Weifeng , Xiao Juan , Bian Shuying , Zhu Dongqin , Yuan Yaping , Zhang Yayun , Zhuang Yuandi , Yang Yunjun 
Published: January 2024

Abstract

Objectives
To compare the performance of the multiparametric magnetic resonance imaging (mpMRI) radiomics and 18F-Prostate-specific membrane antigen (PSMA)-1007 PET/CT radiomics model in diagnosing extracapsular extension (EPE) in prostate cancer (PCa), and to evaluate the performance of a multimodal radiomics model combining mpMRI and PET/CT in predicting EPE.

Methods
We included 197 patients with PCa who underwent preoperative mpMRI and PET/CT before surgery. mpMRI and PET/CT images were segmented to delineate the regions of interest and extract radiomics features. PET/CT, mpMRI, and multimodal radiomics models were constructed based on maximum correlation, minimum redundancy, and logistic regression analyses. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and indices derived from the confusion matrix.

Results
AUC values for the mpMRI, PET/CT, and multimodal radiomics models were 0.85 (95% CI, 0.78-0.90), 0.73 (0.64-0.80), and 0.83 (0.75-0.89), respectively, in the training cohort and 0.74 (0.61-0.85), 0.62 (0.48-0.74), and 0.77 (0.64-0.87), respectively, in the testing cohort. The net reclassification improvement demonstrated that the mpMRI radiomics model outperformed the PET/CT one in predicting EPE, with better clinical benefits. The multimodal radiomics model performed better than the single PET/CT radiomics model (P &lt; .05).

Conclusion
The mpMRI and 18F-PSMA-PET/CT combination enhanced the predictive power of EPE in patients with PCa. The multimodal radiomics model will become a reliable and robust tool to assist urologists and radiologists in making preoperative decisions.

Advances in knowledge
This study presents the first application of multimodal radiomics based on PET/CT and MRI for predicting EPE.
Impact of technological advances in treatment planning, image guidance, and treatment delivery on target margin design for prostate cancer radiotherapy: an updated review
Authors: Winter Jeff D , Reddy Varun , Li Winnie , Craig Tim , Raman Srinivas 
Published: January 2024

Abstract
Recent innovations in image guidance, treatment delivery, and adaptive radiotherapy (RT) have created a new paradigm for planning target volume (PTV) margin design for patients with prostate cancer. We performed a review of the recent literature on PTV margin selection and design for intact prostate RT, excluding post-operative RT, brachytherapy, and proton therapy. Our review describes the increased focus on prostate and seminal vesicles as heterogenous deforming structures with further emergence of intra-prostatic GTV boost and concurrent pelvic lymph node treatment. To capture recent innovations, we highlight the evolution in cone beam CT guidance, and increasing use of MRI for improved target delineation and image registration and supporting online adaptive RT. Moreover, we summarize new and evolving image-guidance treatment platforms as well as recent reports of novel immobilization strategies and motion tracking. Our report also captures recent implementations of artificial intelligence to support image guidance and adaptive RT. To characterize the clinical impact of PTV margin changes via model-based risk estimates and clinical trials, we highlight recent high impact reports. Our report focusses on topics in the context of PTV margins but also showcase studies attempting to move beyond the PTV margin recipes with robust optimization and probabilistic planning approaches. Although guidelines exist for target margins conventional using CT-based image guidance, further validation is required to understand the optimal margins for online adaptation either alone or combined with real-time motion compensation to minimize systematic and random uncertainties in the treatment of patients with prostate cancer.
Metabolic syndrome: imaging features and clinical outcomes
Authors: Badawy Mohamed , Elsayes Khaled M , Lubner Meghan G , Shehata Mostafa A , Fowler Kathryn , Kaoud Arwa , Pickhardt Perry J 
Published: January 2024

Abstract
Metabolic syndrome, which affects around a quarter of adults worldwide, is a group of metabolic abnormalities characterized mainly by insulin resistance and central adiposity. It is strongly correlated with cardiovascular and all-cause mortality. Early identification of the changes induced by metabolic syndrome in target organs and timely intervention (eg, weight reduction) can decrease morbidity and mortality. Imaging can monitor the main components of metabolic syndrome and identify early the development and progression of its sequelae in various organs. In this review, we discuss the imaging features across different modalities that can be used to evaluate changes due to metabolic syndrome, including fatty deposition in different organs, arterial stiffening, liver fibrosis, and cardiac dysfunction. Radiologists can play a vital role in recognizing and following these target organ injuries, which in turn can motivate lifestyle modification and therapeutic intervention.
An evaluation of CT radiation doses within the Yorkshire Lung Screening Trial
Authors: Iball Gareth R , Beeching Charlotte E , Gabe Rhian , Tam Hui Zhen , Darby Michael , Crosbie Philip A J , Callister Matthew E J 
Published: January 2024

Abstract

Objectives
To evaluate radiation doses for all low-dose CT scans performed during the first year of a lung screening trial.

Methods
For all lung screening scans that were performed using a CT protocol that delivered image quality meeting the RSNA QIBA criteria, radiation dose metrics, participant height, weight, gender, and age were recorded. Values of volume CT dose index (CTDIvol) and dose length product (DLP) were evaluated as a function of weight in order to assess the performance of the scan protocol across the participant cohort. Calculated effective doses were used to establish the additional lifetime attributable cancer risks arising from trial scans.

Results
Median values of CTDIvol, DLP, and effective dose (IQR) from the 3521 scans were 1.1 mGy (0.70), 42.4 mGycm (24.9), and 1.15 mSv (0.67), whilst for 60-80kg participants the values were 1.0 mGy (0.30), 35.8 mGycm (11.4), and 0.97 mSv (0.31). A statistically significant correlation between CTDIvol and weight was identified for males (r = 0.9123, P &lt; .001) and females (r = 0.9052, P &lt; .001), however, the effect of gender on CTDIvol was not statistically significant (P = .2328) despite notable differences existing at the extremes of the weight range. The additional lifetime attributable cancer risks from a single scan were in the range 0.001%-0.006%.

Conclusions
Low radiation doses can be achieved across a typical lung screening cohort using scan protocols that have been shown to deliver high levels of image quality. The observed dose levels may be considered as typical values for lung screening scans on similar types of scanners for an equivalent participant cohort.

Advances in knowledge
Presentation of typical radiation dose levels for CT lung screening examinations in a large UK trial. Effective radiation doses can be of the order of 1 mSv for standard sized participants. Lifetime attributable cancer risks resulting from a single low-dose CT scan did not exceed 0.006%.
Can conventional magnetic resonance imaging at presentation predict chemoresistance in osteosarcoma?
Authors: Kanthawang Thanat , Wudhikulprapan Wanat , Phinyo Phichayut , Settakorn Jongkolnee , Pruksakorn Dumnoensun , Link Thomas M , Pattamapaspong Nuttaya 
Published: January 2024

Abstract

Objectives
Histological tumour necrosis is the current indicator for the response of osteosarcoma after neoadjuvant chemotherapy. Chemoresistant tumours require close monitoring and adjustment of treatment. Characteristics of tumours on baseline MRI may be able to predict response to chemotherapy. The aim is to identify which baseline MRI findings can help predict chemoresistant osteosarcoma.

Methods
Baseline MRI before giving neoadjuvant chemotherapy of 95 patients during 2008-2021 was reviewed by 2 musculoskeletal radiologists. Histological necrosis from surgical specimens was the reference standard. MRIs were reviewed for tumour characteristics (tumour volume, maximum axial diameter, central necrosis, haemorrhage, fluid-fluid level), peritumoural bone and soft tissue oedema, and other parameters including intra-articular extension, epiphyseal involvement, neurovascular involvement, pathologic fracture, and skip metastasis. The cut-off thresholds were generated by receiver operating characteristic curves which then tested for diagnostic accuracy.

Results
Two-third of patients were chemoresistance (histological necrosis &lt;90%). Tumour volume &gt;150 mL, maximum axial diameter &gt;7.0 cm, area of necrosis &gt;50%, presence of intra-articular extension, and peritumoural soft tissue oedema &gt;6.5 cm significantly predicted chemoresistance, particularly when found in combination. Tumour volume &gt;150 mL and maximum axial diameter &gt;7.0 cm could be used as an independent predictor (multivariable analysis, P-value = .025, .045).

Conclusions
Findings on baseline MRI could help predicting chemoresistant osteosarcoma with tumour size being the strongest predictor.

Advances in knowledge
Osteosarcomas with large size, large cross-sectional diameter, large area of necrosis, presence of intra-articular extension, and extensive peritumoural soft tissue oedema were most likely to have a poor response to neoadjuvant chemotherapy.
Clinical efficacy and safety of microwave ablation combined with percutaneous osteoplasty for palliative treatment in pelvic osteolytic metastases
Authors: Wang Zhilong , Zuo Taiyang , Lin Wenli , Du Zhenhua , Zhang Xiaofan , Liang Yining 
Published: January 2024

Abstract

Objectives
To evaluate the impact of microwave ablation (MWA) on pain relief, quality of life, mobility, and local tumour progression in adult patients with pelvic osteolytic bone metastasis and to test the safety of MWA.

Methods
This study retrospectively analysed the data from 20 patients with pelvic osteolytic metastases who received MWA combined with percutaneous osteoplasty (POP). The visual analogue scale (VAS), musculoskeletal tumour society system (MSTS), and Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22) were used to evaluate the pain, limb function, and quality of life. The intraoperative and postoperative complications were recorded. The tumour recurrence and survival time were analysed during the follow-up period (range 3-26 months).

Results
All (n = 20) MWA and POP operations were completed successfully. Four patients (20%; 95% CI, 6%-44%) had mild bone cement leakage from surrounding tissues, and there were no obvious symptoms or serious complications. There were significant differences in VAS, MSTS, and QLQ-BM22 scores before and after the operation (P &lt; .001). During the postoperative follow-up period, 9 patients died. The median survival time was 8 months (range 3-26 months; IQR: 4.5-13; 95% CI, 4.2-15.3 months), and the 1-year survival rate was 65% (13/20; 95% CI, 41%-85%). Tumour recurrence occurred in 4 cases (20%; 95% CI, 6%-44%) after the operation, and the median time of recurrence was 12 months (range 8-16 months; IQR: 8.25-12.75; 95% CI, 5.5-18.5 months).

Conclusions
MWA combined with POP is an effective and safe treatment for pelvic osteolytic metastases. It can significantly relieve local pain, reconstruct limb function, improve patients’ quality of life, and effectively control local tumour progression.

Advances in knowledge
So far, the experience of using microwave in the treatment of pelvic metastases is still limited. MWA combined with POP in the treatment of pelvic osteolytic metastases can provide significant clinical benefits in acceptable low-risk minimally invasive situations and should be provided to patients with appropriate pelvic metastases in a multidisciplinary approach.
Evidence-informed recommendations on managing breast screening atypia: perspectives from an expert panel consensus meeting reviewing results from the Sloane atypia project
Authors: Freeman Karoline , Mansbridge Alice , Stobart Hilary , Clements Karen , Wallis Matthew G , Pinder Sarah E , Kearins Olive , Shaaban Abeer M , Kirwan Cliona C , Wilkinson Louise S , Webb Sharon , O’Sullivan Emma , Jenkins Jacquie , Wright Suzanne , Taylor Kathryn , Bailey Claire , Holcombe Chris , Wyld Lynda , Edwards Kim , Jenkinson David J , Sharma Nisha , Provenzano Elena , Hilton Bridget , Stallard Nigel , Thompson Alastair M , Taylor-Phillips Sian 
Published: January 2024

Abstract
Evidence-based clinical guidelines are essential to maximize patient benefit and to reduce clinical uncertainty and inconsistency in clinical practice. Gaps in the evidence base can be addressed by data acquired in routine practice. At present, there is no international consensus on management of women diagnosed with atypical lesions in breast screening programmes. Here, we describe how routine NHS breast screening data collected by the Sloane atypia project was used to inform a management pathway that maximizes early detection of cancer and minimizes over-investigation of lesions with uncertain malignant potential. A half-day consensus meeting with 11 clinical experts, 1 representative from Independent Cancer Patients’ Voice, 6 representatives from NHS England (NHSE) including from Commissioning, and 2 researchers was held to facilitate discussions of findings from an analysis of the Sloane atypia project. Key considerations of the expert group in terms of the management of women with screen detected atypia were: (1) frequency and purpose of follow-up; (2) communication to patients; (3) generalizability of study results; and (4) workforce challenges. The group concurred that the new evidence does not support annual surveillance mammography for women with atypia, irrespective of type of lesion, or woman’s age. Continued data collection is paramount to monitor and audit the change in recommendations.