bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the efficacy of neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients: meta-analysis of randomized controlled trials
Authors: Zeng De-Xing , Liu Ruo-Nan , Ren Xian-Kun , Zhang Peng , Tang Ling-Han , Tan Ling , Ur Rehman Zia , Zhao Mao-Ru , Guo Peng , Zhang Pan , Du Jun , Qin Xian , Wan Shi-Yan , Deng Lu-Qian , Luo Ya-Jun , Liu Zi-Lin , Xiao Jiang-Wei 
Published: January 2025

Background:
Preoperative neoadjuvant chemoradiotherapy (nCRT) is considered to be the standard treatment strategy for locally advanced rectal cancer (LARC); however, the risk of adverse events and postoperative recurrence remains significant. This study aimed to evaluate the non-inferiority of neoadjuvant chemotherapy (nCT) compared with nCRT in patients with LARC and to assess the possibility of eliminating radiotherapy on the basis of guaranteed efficacy.

Materials and methods:
We searched the PubMed, Embase, and Cochrane Library databases to identify randomized controlled trials (RCTs) comparing the efficacy of nCRT and nCT for LARC. The study protocol was registered with the Prospective Register of Systematic Reviews (PROSPERO).

Results:
A total of 2706 patients from 7 studies were included in the meta-analysis. There was no significant difference in overall survival (OS) or disease-free survival (DFS) between the nCT and nCRT groups. This study demonstrated a lower rate of infection (OR = 0.53, 95% CI = 0.34–0.82; P = 0.005), anastomotic leak (OR = 0.55, 95% CI = 0.34–0.87; P = 0.01), tumor regression grade (TRG) 0-1 (OR = 0.50, 95% CI = 0.36–0.69; P < 0.0001), preventive diverting ileostomy (OR = 0.41, 95% CI = 0.17–1.02; P = 0.05) and leukopenia (OR = 0.50, 95% CI = 0.25–1.01; P = 0.05) in the nCT group. However, there was no significant difference in the other toxic events, such as intestinal obstruction, urinary complications, diarrhoea, and surgical or pathological outcomes, such as clinical fistula, sphincter preservation, postoperative mortality (≤ 60 d), R0 resection, ypStage 0-I, positive circumferential resection margin (CRM +) or pathological complete response (pCR) between the two groups.

Conclusion:
This study indicated that OS and DFS were not lower in the nCT group than in the nCRT group. In addition, the nCT group had fewer complications. Preoperative nCT is expected to become a standard treatment option for most patients with stage II-III LARC. It is worth noting that radiotherapy can not be ignored for some patients who need to ensure the conversion effect of neoadjuvant therapy and strongly request to preserve organ function.
Utilizing explainable machine learning for progression-free survival prediction in high-grade serous ovarian cancer: insights from a prospective cohort study
Authors: Chen Zhuo , Ouyang Hui , Sun Botao , Ding Jiashan , Zhang Yu , Li Xinying 
Published: January 2025

Background:
High-grade serous ovarian cancer (HGSOC) remains one of the most challenging gynecological malignancies, with over 70% of ovarian cancer patients ultimately experiencing disease progression. The current prognostic tools for progression-free survival (PFS) in HGSOC patients have limitations. This study aims to develop an explainable machine learning (ML) model for predicting PFS in HGSOC patients.

Methods:
Nine ML algorithms for PFS prediction were developed using a prospective cohort of 310 HGSOC patients consecutively enrolled from a large Chinese tertiary hospital between January 2017 and December 2020. The optimal model was internally validated using the 1000 bootstrap method. The SHapley Additive exPlanations (SHAP) method was employed to interpret the model in terms of feature importance and feature effects. The final model, constructed with the optimal feature subset, was deployed as an interactive web-based Shiny app.

Results:
The random survival forest (RSF) model demonstrated superior predictive performance compared to other ML models, the RFS model constructed with an optimal feature subset in the optimal imputed dataset achieved a superior 1000 bootstrap C-index of 0.755 (95% CI: 0.750–0.780) and a Brier score of 0.183 (95% CI: 0.175–0.190). SHAP analysis identified tumor residual, HE4, FIGO stage, T stage, CA125, age, ascites volume, platelet counts, and BMI as the top nine contributing factors. It also revealed potential nonlinear relationships and important thresholds between HE4, CA125, age, ascites volume, platelet counts, the body mass index, and PFS risk. Additionally, interaction effects were found between tumor residual and age, HE4, and CA125. Finally, an interactive web-based Shiny app for the model was developed and accessible at https://rsfmodels.shinyapps.io/ocRSF/.

Conclusion:
An explainable ML model for PFS prediction in HGSOC patients was developed with superior results. The publicly accessible web tool based on the optimized model facilitates its utility in clinical settings, potentially improving individualized patient management and treatment decision-making in HGSOC.
Effectiveness and safety of radionuclide synovectomy with Yttrium-90 hydroxyapatite in patients with inflammatory arthritis: a longitudinal study
Authors: Bonga Krishna Nikhila , Agrawal Kanhaiyalal , Tripathy Sujit Kumar , Meher Bikash Ranjan , Mishra Archana , Padhy Biswa Mohan 
Published: January 2025

Background and objective
Yttrium-90 plays a significant role in managing drug-resistant inflammatory arthritis through radionuclide synovectomy, where the radioisotope is injected into the affected joint to alleviate pain and inflammation by targeting the synovial tissue. This study aims to evaluate the effectiveness and safety of Yttrium-90 hydroxyapatite radionuclide synovectomy in improving joint functionality, as judged by physicians, in patients with inflammatory arthritis who had not responded to conventional treatments.

Methods
Patients with inflammatory arthritis were recruited from the orthopedics department and referred to the nuclear medicine department for evaluation. A three-phase bone scan was conducted to identify eligible patients, who then received intra-articular injections of Yttrium-90 hydroxyapatite along with triamcinolone. After 48 h, patients underwent PET-CT imaging, followed by two follow-ups at 2 and 6 months to assess improvements in joint functionality and monitor for adverse reactions.

Results
Fifteen patients underwent radionuclide synovectomy. Significant improvements were observed between baseline and 2 months in joint restriction (P = 0.001), pain severity (P = 0.037), visual analog scale (VAS) (P = 0.004), and swelling (P = 0.002). At 6 months, further improvements were noted in joint restriction (P = 0.002), pain severity (P = 0.019), VAS (P = 0.013), and swelling (P = 0.023). However, no significant changes occurred between the 2- and 6-month follow-ups. One patient experienced radiation-induced skin necrosis, which resolved with conservative treatment, and another had self-limited skin rashes.

Conclusion
Yttrium-90 hydroxyapatite radionuclide synovectomy proved to be an effective and safe treatment for improving joint functionality in patients with drug-resistant inflammatory arthritis of the knee for up to 6 months.
Synergistic effects of doxorubicin and coumarin on colorectal cancer cell proliferation and EMT modulation: in silico and in vitro study
Authors: Khakbaraghi Mahsa , Nejati Majid , Abed Atena , Karimi Merat , Heydari Azhdar , Mirzaei Hamed 
Published: January 2025

Background
Colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer-related deaths globally. Doxorubicin (DOX), an anti-metabolite and anti-cancer agent, has shown promise in CRC treatment, while coumarin, a natural antioxidant, may help slow CRC growth. Although the combination of coumarin and DOX has been studied in other cancer types, its effectiveness in CRC remains unexamined. This study explores the impact of DOX and coumarin, individually and combined, on CRC cell growth and death, specifically focusing on C26 cells in vitro.

Methods
The MTT assay was used to assess cell proliferation, and RT-qPCR was employed to measure the expression of β-catenin, Twist, Cyclin D1, and ZEB-1.

Results
Both DOX and coumarin independently inhibited C26 cell growth, and their combination had a synergistic effect. RT-qPCR analysis indicated a reduction in Twist, Cyclin D1, and ZEB-1 expression following combination treatment, suggesting these molecules are involved in the observed anti-cancer effects. Molecular docking revealed that coumarin can target Twist, Cyclin D1, and ZEB-1 at the protein level.

Conclusion
Our findings validate the synergistic effect of DOX and coumarin in inhibiting the proliferation of C26 cells and propose the involvement of the Wnt pathway as a downstream mediator in this treatment. Future research is required to confirm the clinical applicability of this combined treatment for CRC and to elucidate its mechanisms within the body.
Trochanteric hip fractures treated surgically—outcome in a ten-year cohort of 46,121 patients from the Swedish National Hip Fracture Registry
Authors: Borg Tomas , Forssten Maximilian Peter , Mohammad Ismail Ahmad , Cao Yang , Mohseni Shahin 
Published: January 2025

Abstract

Objectives:
To compare postoperative mortality regarding 2 techniques in the treatment of trochanteric hip fractures (THFs).

Design:
Retrospective cohort study.

Setting:
National databases.

Patients:
All consecutive surgically treated THF cases between 2008 and 2017 were included. Pathological fractures or patients younger than 60 years were excluded.

Intervention:
Patients were grouped based on the surgical technique: sliding hip screw (SHS) or intramedullary (IM) nail. This data set was cross-referenced with a National Board of Health and Welfare's patient registry and a Cause of Death registry.

Main outcome measurements:
Mortality, comorbidities, and length of stay (LOS).

Results:
Forty-six thousand one hundred twenty-one cases were included. Twenty-five thousand eight hundred seventy-seven patients received a SHS, and 20,244 received an IM nail. Patients in the IM group were more often female (71.8% vs. 69.2%, P < 0.001), slightly less fit for surgery (American Society of Anesthesiologists score ≥3: 61.2% vs. 60.1%, P = 0.003), and more frail (Orthopedic Frailty Score ≥2: 54.2% vs. 52.8%, P = 0.005). Multifragment fractures were more prevalent in the IM nail group (66.6% vs. 32.0%, P < 0.001), which suffered from a higher comorbidity burden. After adjusting for potential confounders, no clinically significant differences in 7-day, 30-day, 90-day, or 1-year postoperative mortality were observed. Subgroup analyses focusing on 2-fragment and multifragment fractures could not detect any difference in mortality. LOS was 1 day shorter for the IM nail group as a whole.

Conclusions:
Based on 10 years of data including 46,121 patients with THF managed with SHS or IM nail, no difference was observed in mortality up to 1 year postoperatively, when comparing surgical technique. LOS was shorter for the IM nail group.
Assessment of a New CT Detector and Filtration Technology: Part 1 — X-ray Beam Characterization and Radiation Dosimetry
Authors: Barreto Izabella , Correa Nathalie , Moser Patricia , Tuna Ibrahim , Massini Tara , Rill Lynn , Arreola Manuel 
Published: January 2025

Purpose:
This study evaluated beam quality and radiation dosimetry of a CT scanner equipped with a novel detector and filtration technology called PureVision Optics (PVO). PVO features miniaturized electronics, a detector cut with microblade technology, and increased filtration in order to increase x-ray detection and reduce image noise.

Methods:
We assessed the performance of two similar 320-detector CT scanners: one equipped with PVO and one without. Beam quality was measured by determining the half-value layer (HVL) and effective energy (E
eff) for both scanners using all tube voltages (80 kV, 100 kV, 120 kV, 135 kV) and bowtie filters (small, medium, large) available. Energy correction factors were identified for optically stimulated luminescent dosimeters (OSLDS) compared to a calibrated ionization chamber. Surface and internal doses were measured for an anthropomorphic CT angiography head phantom and a cadaver head scanned with CTDIvol matched as close as possible at the conventional (55.1 mGy) and PVO (55.4 mGy) CT scanners.

Results:
For all scan settings, the PVO scanner showed significantly higher HVL (range, 4.33–11.02 mm Al) and effective energy (range, 39.4–68.0 keV) values compared to the conventional scanner (HVL, 4.19–8.25 mm Al; effective energy, 38.4–55.2 keV). For equivalent CTDIvol values, the energy-corrected surface skin and lens doses were on average 6.7% lower with the PVO scanner than the conventional scanner (P < 0.01).

Conclusions:
PVO technology yielded higher HVL and effective energies and, for the same CTDIvol, resulted in lower surface organ doses, indicating a potential for reduced patient radiation exposure in clinical settings.
Assessment of a New CT Detector and Filtration Technology: Part 2—Image Quality in Phantoms, Cadavers, and Patients
Authors: Barreto Izabella , Stoddard Graham , Heshmat Anahita , Massini Tara , Tuna Ibrahim , Rill Lynn , Arreola Manuel 
Published: January 2025

Purpose:
The purpose of this work was to evaluate the image quality of a commercial CT scanner equipped with a novel detector and filtration technology called PureVision Optics (PVO).

Methods:
CT number, noise, contrast-to-noise ratio (CNR), modulation transfer function (MTF), and noise power spectrum (NPS) were assessed using the ACR CT Accreditation phantom scanned with various acquisitions at 80 kV, 100 kV, 120 kV, and 135 kV, each with multiple CTDIvol values of 20 mGy, 40 mGy, and 65 mGy. Artifacts were evaluated in an anthropomorphic head phantom, a cadaver head, and in patient studies. Two neuroradiologists assessed image quality features in various patients who were examined with unenhanced brain CT on both scanners.

Results:
Compared with the conventional scanner, for the same CTDIvol, the PVO scanner produced 20.3% less image noise (P < 0.001), 18.9% higher CNR (P < 0.01), and 24.6% higher spatial resolution (P < 0.001). Streak artifacts were less severe with the PVO scanner for the phantom, cadaver, and patient scans (P < 0.05). Radiologists scored the PVO scanner as significantly better for visualization of the cerebrospinal fluid space over the cerebral sulci in high convexity, image noise in gray and white matter, and artifacts in the posterior fossa. They also significantly preferred the PVO scanner for visualization of the border between brain gray and white matter, cerebrospinal fluid space around the mesencephalon, and overall diagnostic acceptability.

Conclusions:
For matched CTDIvol values, the scanner equipped with PVO technology produced better objective and subjective image quality metrics in brain CT imaging compared with a conventional CT scanner without PVO. In clinical settings, PVO may allow for lower doses while enhancing imaging through dense areas, improving visualization of subtle details, and offering more effective options for examining obese patients.
This research received financial support from Canon Medical Systems USA. The study design and data were fully controlled by the coauthors, of which none are employees or consultants of Canon Medical Systems USA.
High-resolution 0.25 mm Detector CT Has Limited Impact on Right Adrenal Vein Detectability in Preprocedural Contrast Enhanced CT for Adrenal Venous Sampling
Authors: Morisaka Hiroyuki , Imaizumi Akira , Wumu Tihan , Ii Takanori , Araki Takuji , Onishi Hiroshi 
Published: January 2025

Objective:
This study aims to identify factors associated with the detectability of the right adrenal vein (RAV) on preoperative contrast-enhanced CT scans of adrenal venous sampling (AVS) in the era of high-resolution CT (HRCT).

Materials and Methods:
In this retrospective study, 36 patients (15 men and 21 women; mean age, 56 y) who underwent preoperative contrast-enhanced CT [11 patients in HRCT with 0.25 mm detector matrix (Cannon Medical Systems) and 25 patients in conventional multidetector CT with 0.5 mm matrix] were included. A contrast agent dose of 600 mgI/kg was injected, and CT images were acquired at a fixed scan delay of 50 and 80 seconds. Adrenal venography and venous sampling were performed for the diagnosis of suspected primary hyperaldosteronism. The qualitative detectability of RAV on preoperative CT was assessed with adrenal venography as a reference. Clinical and imaging factors associated with a good detectability of RAV were analyzed via regression analysis. Optimal acquisition timing was assessed by analyzing the time-intensity curve and contrast enhancement pattern of the inferior vena cava using CT data from a separate cohort (n=5).

Results:
The qualitative detectability of RAV was deemed good in 15 patients and poor in 21 patients. Regression analysis revealed that only heterogeneous enhancement of inferior vena cava with bolus high attenuation, corresponding to an optimal acquisition timing from time-intensity curve analysis, was associated with a good detectability of RAV (odds ratio, 5.06). The use of HRCT was not statistically significant.

Conclusions:
Optimal acquisition timing is a crucial factor for the detectability of RAV in preprocedural CT for AVS, while high-resolution 0.25 detector CT appears to have limited significance.
Triangular Margin: Reliable Imaging Feature of Fibrous Dysplasia in Long Bones?
Authors: El Kandoussi Amine , Staffa Steven J. , Ömeroğlu Emre , Hung Yin P. , Bauer Fabian , Lozano-Calderon Santiago , Chang Connie Y. 
Published: January 2025

Objective:
To determine the utility of a triangular margin as an imaging diagnostic feature for fibrous dysplasia.

Materials and Methods:
We retrospectively reviewed all surgically biopsied or managed benign and malignant bone tumors by a single orthopedic oncologist over 19 years (2003 to 2022). A musculoskeletal radiologist and an orthopedic oncologist, both with >10 years of experience, retrospectively evaluated all imaging in consensus. Groups were compared using the χ2 test.

Results:
There were a total of 152 subjects [mean age 49±21 (range 7.8 to 91) years]; 80 (53%) females and 72 (47%) males. There were 52 subjects with fibrous dysplasia, 31 subjects with other benign bone tumors, and 69 subjects with malignant bone tumors. The sensitivity and specificity of a triangular margin for distinguishing fibrous dysplasia from other benign or malignant bone tumors were 74% and 96% on radiographs, 73% and 100% on CT, and 78% and 91% on MRI, respectively. The triangular margin was more prevalent in fibrous dysplasia (85%) versus benign (16%) and malignant (1.6%) primary bone tumors in all 3 modalities (P<0.001). Multivariate analysis of the aggregated imaging data suggests that if a lesion has a triangular margin, it is 14 times more likely to be a fibrous dysplasia than another benign bone tumor (P=0.012).

Conclusions:
The presence of a triangular margin could increase a radiologist’s confidence that a bone tumor is fibrous dysplasia.
Deep Learning–Based Precontrast CT Parcellation for MRI-Free Brain Amyloid PET Quantification
Authors: Choo Kyobin , Joo Jaehoon , Lee Sangwon , Kim Daesung , Lim Hyunkeong , Kim Dongwoo , Kang Seongjin , Hwang Seong Jae , Yun Mijin 
Published: January 2025

Purpose
This study aimed to develop a deep learning (DL) model for brain region parcellation using CT data from PET/CT scans to enable accurate amyloid quantification in 18F-FBB PET/CT without relying on high-resolution MRI.

Patients and Methods
A retrospective dataset of PET/CT and T1-weighted MRI pairs from 226 individuals (157 with mild cognitive impairment or dementia and 69 healthy controls) was used. The dataset was split into training/validation (60%) and test (40%) sets. Utilizing auto-generated segmentation labels, 3 UNets were independently trained for multiplanar brain parcellation on CT and subsequently ensembled. Amyloid load was measured across 46 volumes of interest (VOIs), derived from the Desikan-Killiany-Tourville atlas. Dice similarity coefficient between the proposed CT-based DL model and MRI-based (FreeSurfer) method was calculated, with SUVR comparison using linear regression analysis and intraclass correlation coefficient. Global SUVRs were also compared within groups with clinical dementia ratings (CDRs) of 0, 0.5, and 1.

Results
The DL-based CT parcellation achieved mean Dice similarity coefficients of 0.80 for all 46 VOIs, 0.72 for 16 cortical and limbic VOIs, and 0.83 for 30 subcortical VOIs. For regional and global SUVR comparisons, the linear regression yielded a slope, y-intercept, and R
2 of 1 ± 0.027, 0 ± 0.040, and ≧0.976, respectively (P < 0.001), and the intraclass correlation coefficient was ≧0.988 (P < 0.001). For global SUVRs in each CDR group, these values were 1 ± 0.020, 0 ± 0.026, ≧0.993, and ≧0.996, respectively (P < 0.001). Both MRI-based and CT-based global SUVR showed a consistent increase as the CDR score increased.

Conclusions
The DL-based CT parcellation agrees strongly with MRI-based methods for amyloid PET quantification.
Frontal Sinus Volume in Normocephalic Nonsyndromic Sagittal Craniosynostosis: A Comparative Study
Authors: Velazquez Alexander , Lebhar Michael S. , Roux Jeffrey , Tramel Sarah , Metildi Marisa , Nichols Todd , Humphries Laura S. , Hoppe Ian C. 
Published: January 2025

Purpose:
This study aimed to investigate frontal sinus volume as a potential indicator of cranial compensatory growth in unoperated normocephalic nonsyndromic sagittal craniosynostosis (NNSC) patients compared with age-matched and sex-matched controls. Previous studies have suggested that frontal sinus volume is suppressed in unoperated craniosynostosis and may be an intracranial space conservation phenomenon.

Methods:
Head computed tomographies (CTs) from 22 unoperated NNSC patients at our institution were utilized in this study and matched with age-matched and sex-matched control subjects. Frontal sinus volumes were measured using Syngo.Via, and statistical analysis was performed. Inclusion criteria for patients included the presence of a frontal sinus with unoperated sagittal craniosynostosis, whereas inclusion criteria for controls included the presence of a frontal sinus and no craniofacial trauma. Pearson correlation coefficient and significance values were calculated to evaluate the relationship between frontal sinus volume and craniosynostosis.

Results:
Six of 22 patients with NNSC were found to have the presence of a frontal sinus volume, compared with controls where all patients had the presence of a frontal sinus. When compared with age-sex matched controls, our analysis revealed a Pearson correlation coefficient of 0.993 and a high significance of P < 0.001, indicating a strong association between decreased-to-absent frontal sinus volume in unoperated NNSC patients.

Conclusion:
The findings of this study demonstrate a correlation between decreased-to-absent frontal sinus volume in patients with NNSC in comparison to normal controls. These findings highlight the potential utility of frontal sinus volume as a diagnostic tool in identifying the degree of compensation that the skull has undergone in nonsyndromic sagittal craniosynostosis.