Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible ligh...Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light,whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals.This direct conversion allows photon-counting detectors to sort photons into discrete energy levels,thereby enhancing image quality through superior noise reduction,improved spatial and contrast resolution,and reduced artifacts.In pediatric applications,PCCT offers substantial benefits,including lower radiation doses,which may help reduce the risk of malignancy in pediatric patients,with perhaps greater potential to benefit those with repeated exposure from a young age.Enhanced spatial resolution facilitates better visualization of small structures,vital for diagnosing congenital heart defects.Additionally,PCCT’s spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images,which enhance soft-tissue contrast and potentially reduce contrast media doses.Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conven-tional CT,particularly in challenging pediatric cardiovascular cases.As PCCT technology matures,further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices,ensuring optimized diagnostic outcomes and patient safety.展开更多
Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth a...Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth and the extension of GI caustic injury,but also to guide the appropriate treatment.Intriguingly,contrast-enhanced computed tomography(CECT)has recently emerged as a promising non-invasive and more accurate alternative to endoscopy in this setting.However,to date,evidence concerning the role of CECT as an alternative or complementary diagnostic tool to endoscopy in caustic ingestion is still limited.The aim of our review was to summarize and discuss the current evidence concerning the role of CECT in the emergency diagnosis of caustic ingestion and its value in assessing injury severity among non-pediatric patients.展开更多
The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an ...The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.展开更多
BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significan...BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.展开更多
Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposi...Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.展开更多
BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are ne...BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are necessary.However,due to differences in race and sex,people’s body shapes vary.According to European guidelines,the patch should measure 10 cm×15 cm.If any part of the MPO is dissected,injury to the nerves,vascular network,or organs may occur during surgery,thereby leading to inguinal discomfort,pain,and seroma formation after surgery.Therefore,accurate localization and measurement of the boundary of the MPO are crucial for selecting the optimal patch for inguinal hernia repair.AIM To compare the size of the MPO measured on three-dimensional multislice spiral computed tomography(CT)with that measured via laparoscopy and explore the relevant factors influencing the size of the MPO.METHODS Clinical data from 74 patients who underwent laparoscopic tension-free inguinal hernia repair at the General Surgery Department of the First Affiliated Hospital of Anhui University of Science and Technology between September 2022 and July 2024 were collected and analyzed retrospectively.Transabdominal preperitoneal was performed.Sixty-four males and 10 females,with an average age of 58.30±12.32 years,were included.The clinical data of the patients were collected.The boundary of the MPO was measured on three-dimensional CT images before surgery and then again during transabdominal preperitoneal.All the preoperative and intraoperative data were analyzed via paired t-tests.A t-test was used for comparisons of age,body mass index,and sex between the groups.In the comparative analysis,a P value less than 0.05 indicated a significant difference.RESULTS The boundaries of the MPO on 3-dimensional CT images measured 7.05±0.47 cm and 6.27±0.61 cm,and the area of the MPO was 19.54±3.33 cm^(2).The boundaries of the MPO during surgery were 7.18±0.51 cm and 6.17±0.40 cm.The errors were not statistically significant.However,the intraoperative BD(the width of the MPO,P=0.024,P<0.05)and preoperative AC(the length of the MPO,P=0.045,P<0.05)significantly differed according to sex.The AC and BD measurements before and during surgery were not significantly different according to age,body mass index,hernia side or hernia type(P>0.05).CONCLUSION The application of this technology can aid in determining the most appropriate dissection range and patch size.展开更多
Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and signifi...Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and significant manual intervention.This study aims to optimize CT scanning parameters to enhance the accuracy of measuring crack widths and rebar volumes in reinforced concrete.Nine sets of specimens,each with varying rebar diameters and concrete cover thicknesses,were scanned before and after corrosion using an Optima CT scanner,followed by three-dimensional reconstructions using Avizo software.The effects of threshold values and“Erosion”coefficients on measurement accuracy were evaluated.The results demonstrated that an optimal lower threshold of 2950,combined with an‘Erosion’coefficient of 6,effectively limits the measurement error of rebar volumes to within 1%.The optimal threshold for measuring crack widths was influenced by the crack width,rebar diameter,and concrete cover thickness.Additionally,an optimized formula for determining crack measurement thresholds was proposed.This study significantly improves the accuracy of CT-based non-destructive testing(NDT)techniques,providing valuable insights for structural health monitoring(SHM).展开更多
BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor inva...BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor invasion depth and LN metastasis in CC remains challenging.As the intestinal tumor develops,the fat density in the mesentery increases.METHODS Patients,who were diagnosed with CC and underwent surgery,were included and divided into the training and validation cohorts.CT-T values of the mesen-tery were extracted from the CT images.Cutoff points were determined using the receiver operating characteristic(ROC)curve,and the area under the ROC curve was employed to assess the performance of the CT-T value for tumor invasion depth and LN status prediction.RESULTS Cutoff values of 11.83 and 17.17 were identified to discriminate T1/2 vs T3/4 and N0 vs N1/2,respectively.With a cutoff CT-T value of 11.83,the total diagnostic accuracy for T stage was 83.1%(81.5%for the training cohort and 86.2%for the validation cohort).With a cutoff CT-T value of 17.17,the total diagnostic accuracy for N stage was 77.3%(75.8%for the training cohort and 80.1%for the validation cohort),which was higher than that of CT-reported LN metastasis.CONCLUSION In this study,we explored an efficient method for predicting preoperative T and N stages using the tumor-contributed CT value of the mesentery in CC,which displayed superior predictive accuracy.展开更多
BACKGROUND Gastric bezoars are masses of indigestible material that accumulate in the stomach,causing nausea,abdominal pain,and vomiting.Persimmon bezoars(diospyrobezoars),which comprise tannins and fibers from persim...BACKGROUND Gastric bezoars are masses of indigestible material that accumulate in the stomach,causing nausea,abdominal pain,and vomiting.Persimmon bezoars(diospyrobezoars),which comprise tannins and fibers from persimmons,are relatively rare but may cause significant gastric complications,including gastric outlet obstruction or ileus.Although computed tomography(CT)is a useful ima-ging tool,diagnosing bezoars can be challenging because their density is similar to that of food debris and gastric content.CASE SUMMARY Here,we report the case of a 72-year-old woman with a persimmon bezoar that was diagnosed using serial CT imaging and confirmed by endoscopy.CT perfor-med over several months revealed changes in the internal structure and density of the bezoar,suggesting progressive hardening.The patient had a history of a par-tial gastrectomy and excessive persimmon consumption,both of which are risk factors for bezoar formation.Endoscopic fragmentation of the bezoar successfully resolved symptoms.CONCLUSION Gastric bezoars,particularly persimmon bezoars,present diagnostic challenges because of their variable imaging characteristics.Serial CT can document tem-poral changes in bezoar density,potentially reflecting changes in hardness.Early diagnosis and endoscopic treatment are essential for effective management,particularly in patients with predisposing factors.This case underscores the im-portance of considering bezoars in the differential diagnosis of gastric masses,and highlights the value of CT for monitoring changes in bezoar characteristics over time.展开更多
BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosi...BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosis and management planning,though clinicians must carefully balance its benefits against radiation exposure concerns and resource allocation constraints.AIM To comprehensively evaluate the diagnostic accuracy,utility and clinical implications of CT in patients with acute lower abdominal pain,emphasizing rare anatomical variations,pregnancy-related issues,and practical limitations of other imaging modalities in emergency settings in Japan.METHODS This retrospective review included 230 patients who underwent CT scans for acute lower abdominal pain at Juntendo University Shizuoka Hospital throughout 2014.CT findings were systematically correlated with the final clinical diagnoses.Cases with diagnostic uncertain underwent independent reviewed by two experienced radiologists.The CT protocols included portal venous-phase imaging with selective arterial-phase acquisition when clinically indicated.RESULTS Idiopathic pain was the most common diagnosis(104 cases,45.2%),followed by appendicitis(46 cases,20.0%)and diverticulitis(27 cases,11.7%).Right lower quadrant pain predominantly revealed appendicitis(20.2%),whereas left lower quadrant pain frequently indicated diverticulitis(12.1%).Nonspecific pain cases have diverse etiologies.Rare conditions included situs inversus(one case)and intestinal malrotation(one case).Pregnancy-related diagnoses included acute appendicitis and uterine fibroid degeneration.CONCLUSION CT significantly aids in the diagnosis of lower abdominal pain,especially given limited access to ultrasonography and MRI during emergency hours in Japan.Awareness of the anatomical variations and pregnancy-related constraints is crucial.Diagnosis-specific protocols for CT based on pain location can optimize clinical management and resource utilization.展开更多
BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imagin...BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imaging features that may aid in predicting LNM.AIM To investigate the potential value of a computed tomography(CT)-based radiomics model in prediction of LNM in PC.METHODS A retrospective analysis was performed on 168 pathologically confirmed PC patients who underwent contrast-enhanced-CT.Among them,107 cases had no LNM,while 61 cases had confirmed LNM.These patients were randomly divided into a training cohort(n=135)and a validation cohort(n=33).A total of 792 radiomics features were extracted,comprising 396 features from the arterial phase and another 396 from the portal venous phase.The Minimum Redundancy Maximum Relevance and Least Absolute Shrinkage and Selection Operator methods were used for feature selection and Radiomics model construction.The receiver operating characteristic curve was employed to assess the diagnostic potential of the model,and DeLong test was used to compare the area under the curve(AUC)values of the model.RESULTS Six radiomics features from the arterial phase and nine from the portal venous phase were selected.The Radscore model demonstrated strong predictive performance for LNM in both the training and test cohorts,with AUC values ranging from 0.86 to 0.94,sensitivity between 66.7% and 91.7%,specificity from 71.4% to 100.0%,accuracy between 78.8%and 91.1%,PPV ranging from 64.7% to 100.0%,and negative predictive value between 84.0% and 93.8%.No significant differences in AUC values were observed between the arterial and portal venous phases in either the training or test set.CONCLUSION The preoperative CT-based radiomics model exhibited robust predictive capability for identifying LNM in PC.展开更多
Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is...Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is to discuss computed tomography(CT)and magnetic resonance imaging findings for both typical and atypical renal AMLs,along with their associated complications.AMLs are typically defined as solid triphasic tumors composed of varying amounts of dysmorphic and tortuous blood vessels,smooth muscle components and adipose tissue.In an adult,a classical renal AML appears as a solid,heterogeneous renal cortical mass with macroscopic fat.However,up to 5%of AMLs contain minimal fat and cannot be reliably diagnosed by imaging.Fat-poor AMLs can appear as hyperattenuating masses on unenhanced CT and as hypointense masses on T2WI;other AMLs may be isodense or exhibit cystic components.Hemorrhage is the most common complication,and AMLs with hemorrhage can mimic other tumors,making their diagnosis challenging.Understanding the variable and heterogeneous nature of this neoplasm to correctly classify renal AMLs and to avoid misdiagnosis of other renal lesions is crucial.展开更多
Colorectal cancer(CRC)is one of the most prevalent cancers globally,with a high recurrence rate following curative surgery,especially within the first 3 to 5 years.Post-surgical follow-up plays a vital role in detecti...Colorectal cancer(CRC)is one of the most prevalent cancers globally,with a high recurrence rate following curative surgery,especially within the first 3 to 5 years.Post-surgical follow-up plays a vital role in detecting local and distant recurrences,significantly influencing survival rates.However,despite established guidelines recommending surveillance strategies,discrepancies persist regarding the optimal surveillance modality and patient adherence to follow protocols.Sala-Miquel et al’s study emphasize the superiority of computed tomography in detecting metastasis and recurrence,while also shedding light on the critical role of adherence to surveillance protocols in improving patient outcomes.This editorial discusses the implications of these findings for clinical practice,providing a comprehensive overview of the current landscape of CRC surveillance and the path forward for improving patient outcomes.展开更多
BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM T...BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.展开更多
BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate th...BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate the predictive factors of liver abscess liquefaction and develop a predictive model to guide optimal timing of percutaneous drainage.METHODS This retrospective study included 110 patients with pyogenic liver abscesses who underwent percutaneous catheter drainage.Patients were divided into a poor liquefaction group(n=28)and a well liquefaction group(n=82)based on the ratio of postoperative 24-hour drainage volume to abscess volume,using a cutoff value of 0.3.Clinical characteristics,laboratory indicators,and computed tomography imaging features were compared.A predictive model was constructed using logistic regression and evaluated using receiver operating characteristic curves and five-fold cross-validation.RESULTS Independent predictive factors for good liquefaction included the absence of diabetes[odds ratio(OR)=0.339,P=0.044],absence of pneumonia(OR=0.218,P=0.013),left-lobe abscess location(OR=4.293,P=0.041),cystic features(OR=5.104,P=0.025),and elevated preoperative serum alanine aminotransferase(ALT)levels(OR=1.013,P=0.041).The logistic regression model based on these factors demonstrated an area under the curve of 0.814,with a sensitivity of 90.24%and specificity of 67.86%.Five-fold cross-validation yielded an average accuracy of 83.61%and a kappa coefficient of 0.5209.CONCLUSION Pneumonia,diabetes,abscess location,abscess composition,and preoperative serum ALT levels are significant predictors of liver abscess liquefaction.The model can guide clinical decision-making.展开更多
BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radio...BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radiomic feature extraction and machine learning algorithms have paved the way for innovative diagnostic approaches to assess IIH more effectively.AIM To devise a sophisticated radiomic-clinical model to evaluate bowel resection risks in IIH patients,thereby enhancing clinical decision-making processes.METHODS This single-center retrospective study analyzed 214 IIH patients randomized into training(n=161)and test(n=53)sets(3:1).Radiologists segmented hernia sac-trapped bowel volumes of interest(VOIs)on computed tomography images.Radiomic features extracted from VOIs generated Rad-scores,which were combined with clinical data to construct a nomogram.The nomogram’s performance was evaluated against standalone clinical and radiomic models in both cohorts.RESULTS A total of 1561 radiomic features were extracted from the VOIs.After dimensionality reduction,13 radiomic features were used with eight machine learning algorithms to develop the radiomic model.The logistic regression algorithm was ultimately selected for its effectiveness,showing an area under the curve(AUC)of 0.828[95%confidence interval(CI):0.753-0.902]in the training set and 0.791(95%CI:0.668-0.915)in the test set.The comprehensive nomogram,incorporating clinical indicators showcased strong predictive capabilities for assessing bowel resection risks in IIH patients,with AUCs of 0.864(95%CI:0.800-0.929)and 0.800(95%CI:0.669-0.931)for the training and test sets,respectively.Decision curve analysis revealed the integrated model’s superior performance over standalone clinical and radiomic approaches.CONCLUSION This innovative radiomic-clinical nomogram has proven to be effective in predicting bowel resection risks in IIH patients and has substantially aided clinical decision-making.展开更多
With the rapid development of computed tomography(CT)technology,the widespread use of CT examinations in the evaluation of chest diseases in pediatrics has raised extensive concerns about radiation issues.This review ...With the rapid development of computed tomography(CT)technology,the widespread use of CT examinations in the evaluation of chest diseases in pediatrics has raised extensive concerns about radiation issues.This review first systematically summarizes the factors influencing radiation dose(detector,tube voltage,tube current-time product,field of view,and reconstruction algorithms)in pediatric chest computed tomography examinations.Methods to reduce radia-tion dose are also discussed,including the utilization of filters,automatic tube current modulation,automatic tube voltage selection,and organ dose modulation.Finally,the methods for individualized radiation dose calculation in pediatric chest CT examinations:effective dose,CT dosimetry software,Size-Specific Dose Estimate,and the Monte Carlo method are reviewed.Radiation exposure re-duction is a multifaceted issue.This review aims to provide an optimal scanning scheme for pediatric chest CT from different perspectives.展开更多
BACKGROUND Colorectal cancer(CRC)is a leading cause of cancer-related death globally,with the tumor immune microenvironment(TIME)influencing prognosis and immunotherapy response.Current TIME evaluation relies on invas...BACKGROUND Colorectal cancer(CRC)is a leading cause of cancer-related death globally,with the tumor immune microenvironment(TIME)influencing prognosis and immunotherapy response.Current TIME evaluation relies on invasive biopsies,limiting its clinical application.This study hypothesized that computed tomography(CT)-based deep learning(DL)radiomics models can non-invasively predict key TIME biomarkers:Tumor-stroma ratio(TSR),tumor-infiltrating lymphocytes(TILs),and immune score(IS).AIM To develop a non-invasive DL approach using preoperative CT radiomics to evaluate TIME components in CRC patients.METHODS In this retrospective study,preoperative CT images of 315 pathologically confirmed CRC patients(220 in training cohort and 95 in validation cohort)were analyzed.Manually delineated regions of interest were used to extract DL features.Predictive models(DenseNet-121/169)for TSR,TILs,IS,and TIME classification were constructed.Performance was evaluated via receiver operating characteristic curves,calibration curves,and decision curve analysis(DCA).RESULTS The DL-DenseNet-169 model achieved area under the curve(AUC)values of 0.892[95%confidence interval(CI):0.828-0.957]for TSR and 0.772(95%CI:0.674-0.870)for TIME score.The DenseNet-121 model yielded AUC values of 0.851(95%CI:0.768-0.933)for TILs and 0.852(95%CI:0.775-0.928)for IS.Calibration curves demonstrated strong prediction-observation agreement,and DCA confirmed clinical utility across threshold probabilities(P<0.05 for all models).CONCLUSION CT-based DL radiomics provides a reliable non-invasive method for preoperative TIME evaluation,enabling personalized immunotherapy strategies in CRC management.展开更多
BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in a...BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in advanced cases.However,individual responses to treatment vary widely,and current imaging methods often fall short in accurately predicting efficacy.Advanced imaging techniques,such as computed tomography(CT)3D reconstruction and texture analysis,offer potential for more precise assessment of therapeutic response.AIM To explore the application value of CT 3D reconstruction volume change rate,texture feature analysis,and visual features in assessing the efficacy of neoadjuvant chemotherapy for advanced GC.METHODS A retrospective analysis was conducted on the clinical and imaging data of 97 patients with advanced GC who received S-1 plus Oxaliplatin combined chemotherapy regimen neoadjuvant chemotherapy from January 2022 to March 2024.CT texture feature analysis was performed using MaZda software,and ITK-snap software was used to measure the tumor volume change rate before and after chemotherapy.CT visual features were also evaluated.Using postoperative pathological tumor regression grade(TRG)as the gold standard,the correlation between various indicators and chemotherapy efficacy was analyzed,and a predictive model was constructed and internally validated.RESULTS The minimum misclassification rate of texture features in venous phase CT images(7.85%)was lower than in the arterial phase(13.92%).The volume change rate in the effective chemotherapy group(75.20%)was significantly higher than in the ineffective group(41.75%).There was a strong correlation between volume change rate and TRG grade(r=-0.886,P<0.001).Multivariate analysis showed that gastric wall peristalsis(OR=0.286)and thickness change rate≥40%(OR=0.265)were independent predictive factors.Receiver operating characteristic curve analysis indicated that the volume change rate[area under the curve(AUC)=0.885]was superior to the CT visual feature model(AUC=0.795).When the cutoff value was 82.56%,the sensitivity and specificity were 85.62%and 96.45%,respectively.CONCLUSION The CT 3D reconstruction volume change rate can serve as a preferred quantitative indicator for evaluating the efficacy of neoadjuvant chemotherapy in GC.Combining it with a CT visual feature predictive model can further improve the accuracy of efficacy evaluation.展开更多
BACKGROUND The computed tomography(CT)-based preoperative risk score was developed to predict recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma(PDAC)in South Korea.However,w...BACKGROUND The computed tomography(CT)-based preoperative risk score was developed to predict recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma(PDAC)in South Korea.However,whether it performs well in other countries remains unknown.AIM To externally validate the CT-based preoperative risk score for PDAC in a country outside South Korea.METHODS Consecutive patients with PDAC who underwent upfront surgery from January 2016 to December 2019 at our institute in a country outside South Korea were retrospectively included.The study utilized the CT-based risk scoring system,which incorporates tumor size,portal venous phase density,tumor necrosis,peripancreatic infiltration,and suspicious metastatic lymph nodes.Patients were categorized into prognosis groups based on their risk score,as good(risk score<2),moderate(risk score 2-4),and poor(risk score≥5).RESULTS A total of 283 patients were evaluated,comprising 170 males and 113 females,with an average age of 63.52±8.71 years.Follow-up was conducted until May 2023,and 76%of patients experienced tumor recurrence with median recurrence-free survival(RFS)of 29.1±1.9 months.According to the evaluation results of Reader 1,the recurrence rates were 39.0%in the good prognosis group,82.1%in the moderate group,and 84.5%in the poor group.In comparison,Reader 2 reported recurrence rates of 50.0%,79.5%,and 88.9%,respectively,across the same prognostic categories.The study validated the effectiveness of the risk scoring system,demonstrating better RFS in the good prognosis group.CONCLUSION This research validated that the CT-based preoperative risk scoring system can effectively predict RFS in patients with PDAC,suggesting that it may be valuable in diverse populations.展开更多
文摘Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light,whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals.This direct conversion allows photon-counting detectors to sort photons into discrete energy levels,thereby enhancing image quality through superior noise reduction,improved spatial and contrast resolution,and reduced artifacts.In pediatric applications,PCCT offers substantial benefits,including lower radiation doses,which may help reduce the risk of malignancy in pediatric patients,with perhaps greater potential to benefit those with repeated exposure from a young age.Enhanced spatial resolution facilitates better visualization of small structures,vital for diagnosing congenital heart defects.Additionally,PCCT’s spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images,which enhance soft-tissue contrast and potentially reduce contrast media doses.Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conven-tional CT,particularly in challenging pediatric cardiovascular cases.As PCCT technology matures,further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices,ensuring optimized diagnostic outcomes and patient safety.
文摘Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth and the extension of GI caustic injury,but also to guide the appropriate treatment.Intriguingly,contrast-enhanced computed tomography(CECT)has recently emerged as a promising non-invasive and more accurate alternative to endoscopy in this setting.However,to date,evidence concerning the role of CECT as an alternative or complementary diagnostic tool to endoscopy in caustic ingestion is still limited.The aim of our review was to summarize and discuss the current evidence concerning the role of CECT in the emergency diagnosis of caustic ingestion and its value in assessing injury severity among non-pediatric patients.
基金Funded by Chinese National Natural Science Foundation of China(No.U2006224)。
文摘The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.
基金Supported by Natural Science Foundation of Anhui Medical University,No.2023xkj130.
文摘BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
文摘Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.
基金Supported by the 2022 Provincial Quality Engineering Project for Higher Education Institutions,No.2022sx031the 2023 Provincial Quality Engineering Project for Higher Education Institutions,No.2023jyxm1071.
文摘BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are necessary.However,due to differences in race and sex,people’s body shapes vary.According to European guidelines,the patch should measure 10 cm×15 cm.If any part of the MPO is dissected,injury to the nerves,vascular network,or organs may occur during surgery,thereby leading to inguinal discomfort,pain,and seroma formation after surgery.Therefore,accurate localization and measurement of the boundary of the MPO are crucial for selecting the optimal patch for inguinal hernia repair.AIM To compare the size of the MPO measured on three-dimensional multislice spiral computed tomography(CT)with that measured via laparoscopy and explore the relevant factors influencing the size of the MPO.METHODS Clinical data from 74 patients who underwent laparoscopic tension-free inguinal hernia repair at the General Surgery Department of the First Affiliated Hospital of Anhui University of Science and Technology between September 2022 and July 2024 were collected and analyzed retrospectively.Transabdominal preperitoneal was performed.Sixty-four males and 10 females,with an average age of 58.30±12.32 years,were included.The clinical data of the patients were collected.The boundary of the MPO was measured on three-dimensional CT images before surgery and then again during transabdominal preperitoneal.All the preoperative and intraoperative data were analyzed via paired t-tests.A t-test was used for comparisons of age,body mass index,and sex between the groups.In the comparative analysis,a P value less than 0.05 indicated a significant difference.RESULTS The boundaries of the MPO on 3-dimensional CT images measured 7.05±0.47 cm and 6.27±0.61 cm,and the area of the MPO was 19.54±3.33 cm^(2).The boundaries of the MPO during surgery were 7.18±0.51 cm and 6.17±0.40 cm.The errors were not statistically significant.However,the intraoperative BD(the width of the MPO,P=0.024,P<0.05)and preoperative AC(the length of the MPO,P=0.045,P<0.05)significantly differed according to sex.The AC and BD measurements before and during surgery were not significantly different according to age,body mass index,hernia side or hernia type(P>0.05).CONCLUSION The application of this technology can aid in determining the most appropriate dissection range and patch size.
文摘Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and significant manual intervention.This study aims to optimize CT scanning parameters to enhance the accuracy of measuring crack widths and rebar volumes in reinforced concrete.Nine sets of specimens,each with varying rebar diameters and concrete cover thicknesses,were scanned before and after corrosion using an Optima CT scanner,followed by three-dimensional reconstructions using Avizo software.The effects of threshold values and“Erosion”coefficients on measurement accuracy were evaluated.The results demonstrated that an optimal lower threshold of 2950,combined with an‘Erosion’coefficient of 6,effectively limits the measurement error of rebar volumes to within 1%.The optimal threshold for measuring crack widths was influenced by the crack width,rebar diameter,and concrete cover thickness.Additionally,an optimized formula for determining crack measurement thresholds was proposed.This study significantly improves the accuracy of CT-based non-destructive testing(NDT)techniques,providing valuable insights for structural health monitoring(SHM).
基金Supported by National Natural Science Foundation of China,No.82303785and Medical Scientific Research Foundation of Guangdong Province,No.A2024096.
文摘BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor invasion depth and LN metastasis in CC remains challenging.As the intestinal tumor develops,the fat density in the mesentery increases.METHODS Patients,who were diagnosed with CC and underwent surgery,were included and divided into the training and validation cohorts.CT-T values of the mesen-tery were extracted from the CT images.Cutoff points were determined using the receiver operating characteristic(ROC)curve,and the area under the ROC curve was employed to assess the performance of the CT-T value for tumor invasion depth and LN status prediction.RESULTS Cutoff values of 11.83 and 17.17 were identified to discriminate T1/2 vs T3/4 and N0 vs N1/2,respectively.With a cutoff CT-T value of 11.83,the total diagnostic accuracy for T stage was 83.1%(81.5%for the training cohort and 86.2%for the validation cohort).With a cutoff CT-T value of 17.17,the total diagnostic accuracy for N stage was 77.3%(75.8%for the training cohort and 80.1%for the validation cohort),which was higher than that of CT-reported LN metastasis.CONCLUSION In this study,we explored an efficient method for predicting preoperative T and N stages using the tumor-contributed CT value of the mesentery in CC,which displayed superior predictive accuracy.
文摘BACKGROUND Gastric bezoars are masses of indigestible material that accumulate in the stomach,causing nausea,abdominal pain,and vomiting.Persimmon bezoars(diospyrobezoars),which comprise tannins and fibers from persimmons,are relatively rare but may cause significant gastric complications,including gastric outlet obstruction or ileus.Although computed tomography(CT)is a useful ima-ging tool,diagnosing bezoars can be challenging because their density is similar to that of food debris and gastric content.CASE SUMMARY Here,we report the case of a 72-year-old woman with a persimmon bezoar that was diagnosed using serial CT imaging and confirmed by endoscopy.CT perfor-med over several months revealed changes in the internal structure and density of the bezoar,suggesting progressive hardening.The patient had a history of a par-tial gastrectomy and excessive persimmon consumption,both of which are risk factors for bezoar formation.Endoscopic fragmentation of the bezoar successfully resolved symptoms.CONCLUSION Gastric bezoars,particularly persimmon bezoars,present diagnostic challenges because of their variable imaging characteristics.Serial CT can document tem-poral changes in bezoar density,potentially reflecting changes in hardness.Early diagnosis and endoscopic treatment are essential for effective management,particularly in patients with predisposing factors.This case underscores the im-portance of considering bezoars in the differential diagnosis of gastric masses,and highlights the value of CT for monitoring changes in bezoar characteristics over time.
文摘BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosis and management planning,though clinicians must carefully balance its benefits against radiation exposure concerns and resource allocation constraints.AIM To comprehensively evaluate the diagnostic accuracy,utility and clinical implications of CT in patients with acute lower abdominal pain,emphasizing rare anatomical variations,pregnancy-related issues,and practical limitations of other imaging modalities in emergency settings in Japan.METHODS This retrospective review included 230 patients who underwent CT scans for acute lower abdominal pain at Juntendo University Shizuoka Hospital throughout 2014.CT findings were systematically correlated with the final clinical diagnoses.Cases with diagnostic uncertain underwent independent reviewed by two experienced radiologists.The CT protocols included portal venous-phase imaging with selective arterial-phase acquisition when clinically indicated.RESULTS Idiopathic pain was the most common diagnosis(104 cases,45.2%),followed by appendicitis(46 cases,20.0%)and diverticulitis(27 cases,11.7%).Right lower quadrant pain predominantly revealed appendicitis(20.2%),whereas left lower quadrant pain frequently indicated diverticulitis(12.1%).Nonspecific pain cases have diverse etiologies.Rare conditions included situs inversus(one case)and intestinal malrotation(one case).Pregnancy-related diagnoses included acute appendicitis and uterine fibroid degeneration.CONCLUSION CT significantly aids in the diagnosis of lower abdominal pain,especially given limited access to ultrasonography and MRI during emergency hours in Japan.Awareness of the anatomical variations and pregnancy-related constraints is crucial.Diagnosis-specific protocols for CT based on pain location can optimize clinical management and resource utilization.
基金Supported by National Natural Science foundation of China,No.82202135,No.82371919,No.82372017,and No.82171925China Postdoctoral Science Foundation,No.2023M741808+4 种基金Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine,No.2024-QNRC2-B16Jiangsu Provincial Key Research and Development Program,No.BE2023789Young Elite Scientists Sponsorship Program by Jiangsu Association for Science and Technology,No.JSTJ-2023-WJ027Project funded by Nanjing Postdoctoral Science Foundation,Natural Science Foundation of Nanjing University of Chinese Medicine,No.XZR2023036Foundation of Excellent Young Doctor of Jiangsu Province Hospital of Chinese Medicine,No.2023QB0112.
文摘BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imaging features that may aid in predicting LNM.AIM To investigate the potential value of a computed tomography(CT)-based radiomics model in prediction of LNM in PC.METHODS A retrospective analysis was performed on 168 pathologically confirmed PC patients who underwent contrast-enhanced-CT.Among them,107 cases had no LNM,while 61 cases had confirmed LNM.These patients were randomly divided into a training cohort(n=135)and a validation cohort(n=33).A total of 792 radiomics features were extracted,comprising 396 features from the arterial phase and another 396 from the portal venous phase.The Minimum Redundancy Maximum Relevance and Least Absolute Shrinkage and Selection Operator methods were used for feature selection and Radiomics model construction.The receiver operating characteristic curve was employed to assess the diagnostic potential of the model,and DeLong test was used to compare the area under the curve(AUC)values of the model.RESULTS Six radiomics features from the arterial phase and nine from the portal venous phase were selected.The Radscore model demonstrated strong predictive performance for LNM in both the training and test cohorts,with AUC values ranging from 0.86 to 0.94,sensitivity between 66.7% and 91.7%,specificity from 71.4% to 100.0%,accuracy between 78.8%and 91.1%,PPV ranging from 64.7% to 100.0%,and negative predictive value between 84.0% and 93.8%.No significant differences in AUC values were observed between the arterial and portal venous phases in either the training or test set.CONCLUSION The preoperative CT-based radiomics model exhibited robust predictive capability for identifying LNM in PC.
文摘Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is to discuss computed tomography(CT)and magnetic resonance imaging findings for both typical and atypical renal AMLs,along with their associated complications.AMLs are typically defined as solid triphasic tumors composed of varying amounts of dysmorphic and tortuous blood vessels,smooth muscle components and adipose tissue.In an adult,a classical renal AML appears as a solid,heterogeneous renal cortical mass with macroscopic fat.However,up to 5%of AMLs contain minimal fat and cannot be reliably diagnosed by imaging.Fat-poor AMLs can appear as hyperattenuating masses on unenhanced CT and as hypointense masses on T2WI;other AMLs may be isodense or exhibit cystic components.Hemorrhage is the most common complication,and AMLs with hemorrhage can mimic other tumors,making their diagnosis challenging.Understanding the variable and heterogeneous nature of this neoplasm to correctly classify renal AMLs and to avoid misdiagnosis of other renal lesions is crucial.
基金Supported by Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06.
文摘Colorectal cancer(CRC)is one of the most prevalent cancers globally,with a high recurrence rate following curative surgery,especially within the first 3 to 5 years.Post-surgical follow-up plays a vital role in detecting local and distant recurrences,significantly influencing survival rates.However,despite established guidelines recommending surveillance strategies,discrepancies persist regarding the optimal surveillance modality and patient adherence to follow protocols.Sala-Miquel et al’s study emphasize the superiority of computed tomography in detecting metastasis and recurrence,while also shedding light on the critical role of adherence to surveillance protocols in improving patient outcomes.This editorial discusses the implications of these findings for clinical practice,providing a comprehensive overview of the current landscape of CRC surveillance and the path forward for improving patient outcomes.
基金Supported by the National Natural Science Foundation of China,No.82101985.
文摘BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.
文摘BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate the predictive factors of liver abscess liquefaction and develop a predictive model to guide optimal timing of percutaneous drainage.METHODS This retrospective study included 110 patients with pyogenic liver abscesses who underwent percutaneous catheter drainage.Patients were divided into a poor liquefaction group(n=28)and a well liquefaction group(n=82)based on the ratio of postoperative 24-hour drainage volume to abscess volume,using a cutoff value of 0.3.Clinical characteristics,laboratory indicators,and computed tomography imaging features were compared.A predictive model was constructed using logistic regression and evaluated using receiver operating characteristic curves and five-fold cross-validation.RESULTS Independent predictive factors for good liquefaction included the absence of diabetes[odds ratio(OR)=0.339,P=0.044],absence of pneumonia(OR=0.218,P=0.013),left-lobe abscess location(OR=4.293,P=0.041),cystic features(OR=5.104,P=0.025),and elevated preoperative serum alanine aminotransferase(ALT)levels(OR=1.013,P=0.041).The logistic regression model based on these factors demonstrated an area under the curve of 0.814,with a sensitivity of 90.24%and specificity of 67.86%.Five-fold cross-validation yielded an average accuracy of 83.61%and a kappa coefficient of 0.5209.CONCLUSION Pneumonia,diabetes,abscess location,abscess composition,and preoperative serum ALT levels are significant predictors of liver abscess liquefaction.The model can guide clinical decision-making.
基金Supported by the National Natural Science Foundation of China,No.82000482China Postdoctoral Science Foundation funded,No.2023M741858China Crohn’s and Colitis Foundation,No.CCCF-QF-2023C18-3.
文摘BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radiomic feature extraction and machine learning algorithms have paved the way for innovative diagnostic approaches to assess IIH more effectively.AIM To devise a sophisticated radiomic-clinical model to evaluate bowel resection risks in IIH patients,thereby enhancing clinical decision-making processes.METHODS This single-center retrospective study analyzed 214 IIH patients randomized into training(n=161)and test(n=53)sets(3:1).Radiologists segmented hernia sac-trapped bowel volumes of interest(VOIs)on computed tomography images.Radiomic features extracted from VOIs generated Rad-scores,which were combined with clinical data to construct a nomogram.The nomogram’s performance was evaluated against standalone clinical and radiomic models in both cohorts.RESULTS A total of 1561 radiomic features were extracted from the VOIs.After dimensionality reduction,13 radiomic features were used with eight machine learning algorithms to develop the radiomic model.The logistic regression algorithm was ultimately selected for its effectiveness,showing an area under the curve(AUC)of 0.828[95%confidence interval(CI):0.753-0.902]in the training set and 0.791(95%CI:0.668-0.915)in the test set.The comprehensive nomogram,incorporating clinical indicators showcased strong predictive capabilities for assessing bowel resection risks in IIH patients,with AUCs of 0.864(95%CI:0.800-0.929)and 0.800(95%CI:0.669-0.931)for the training and test sets,respectively.Decision curve analysis revealed the integrated model’s superior performance over standalone clinical and radiomic approaches.CONCLUSION This innovative radiomic-clinical nomogram has proven to be effective in predicting bowel resection risks in IIH patients and has substantially aided clinical decision-making.
基金Supported by the Key Natural Science Project of the Anhui Provincial Education Department Under,No.KJ2021A0746.
文摘With the rapid development of computed tomography(CT)technology,the widespread use of CT examinations in the evaluation of chest diseases in pediatrics has raised extensive concerns about radiation issues.This review first systematically summarizes the factors influencing radiation dose(detector,tube voltage,tube current-time product,field of view,and reconstruction algorithms)in pediatric chest computed tomography examinations.Methods to reduce radia-tion dose are also discussed,including the utilization of filters,automatic tube current modulation,automatic tube voltage selection,and organ dose modulation.Finally,the methods for individualized radiation dose calculation in pediatric chest CT examinations:effective dose,CT dosimetry software,Size-Specific Dose Estimate,and the Monte Carlo method are reviewed.Radiation exposure re-duction is a multifaceted issue.This review aims to provide an optimal scanning scheme for pediatric chest CT from different perspectives.
基金Supported by the National Natural Science Foundation of China,No.81860047the Natural Science Foundation of Gansu Province,No.22JR5RA650+1 种基金Key Science and Technology Program in Gansu Province,No.21YF5FA016Gansu Provincial Hospital Scientific Research Foundation,No.23GSSYD-12.
文摘BACKGROUND Colorectal cancer(CRC)is a leading cause of cancer-related death globally,with the tumor immune microenvironment(TIME)influencing prognosis and immunotherapy response.Current TIME evaluation relies on invasive biopsies,limiting its clinical application.This study hypothesized that computed tomography(CT)-based deep learning(DL)radiomics models can non-invasively predict key TIME biomarkers:Tumor-stroma ratio(TSR),tumor-infiltrating lymphocytes(TILs),and immune score(IS).AIM To develop a non-invasive DL approach using preoperative CT radiomics to evaluate TIME components in CRC patients.METHODS In this retrospective study,preoperative CT images of 315 pathologically confirmed CRC patients(220 in training cohort and 95 in validation cohort)were analyzed.Manually delineated regions of interest were used to extract DL features.Predictive models(DenseNet-121/169)for TSR,TILs,IS,and TIME classification were constructed.Performance was evaluated via receiver operating characteristic curves,calibration curves,and decision curve analysis(DCA).RESULTS The DL-DenseNet-169 model achieved area under the curve(AUC)values of 0.892[95%confidence interval(CI):0.828-0.957]for TSR and 0.772(95%CI:0.674-0.870)for TIME score.The DenseNet-121 model yielded AUC values of 0.851(95%CI:0.768-0.933)for TILs and 0.852(95%CI:0.775-0.928)for IS.Calibration curves demonstrated strong prediction-observation agreement,and DCA confirmed clinical utility across threshold probabilities(P<0.05 for all models).CONCLUSION CT-based DL radiomics provides a reliable non-invasive method for preoperative TIME evaluation,enabling personalized immunotherapy strategies in CRC management.
文摘BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in advanced cases.However,individual responses to treatment vary widely,and current imaging methods often fall short in accurately predicting efficacy.Advanced imaging techniques,such as computed tomography(CT)3D reconstruction and texture analysis,offer potential for more precise assessment of therapeutic response.AIM To explore the application value of CT 3D reconstruction volume change rate,texture feature analysis,and visual features in assessing the efficacy of neoadjuvant chemotherapy for advanced GC.METHODS A retrospective analysis was conducted on the clinical and imaging data of 97 patients with advanced GC who received S-1 plus Oxaliplatin combined chemotherapy regimen neoadjuvant chemotherapy from January 2022 to March 2024.CT texture feature analysis was performed using MaZda software,and ITK-snap software was used to measure the tumor volume change rate before and after chemotherapy.CT visual features were also evaluated.Using postoperative pathological tumor regression grade(TRG)as the gold standard,the correlation between various indicators and chemotherapy efficacy was analyzed,and a predictive model was constructed and internally validated.RESULTS The minimum misclassification rate of texture features in venous phase CT images(7.85%)was lower than in the arterial phase(13.92%).The volume change rate in the effective chemotherapy group(75.20%)was significantly higher than in the ineffective group(41.75%).There was a strong correlation between volume change rate and TRG grade(r=-0.886,P<0.001).Multivariate analysis showed that gastric wall peristalsis(OR=0.286)and thickness change rate≥40%(OR=0.265)were independent predictive factors.Receiver operating characteristic curve analysis indicated that the volume change rate[area under the curve(AUC)=0.885]was superior to the CT visual feature model(AUC=0.795).When the cutoff value was 82.56%,the sensitivity and specificity were 85.62%and 96.45%,respectively.CONCLUSION The CT 3D reconstruction volume change rate can serve as a preferred quantitative indicator for evaluating the efficacy of neoadjuvant chemotherapy in GC.Combining it with a CT visual feature predictive model can further improve the accuracy of efficacy evaluation.
文摘BACKGROUND The computed tomography(CT)-based preoperative risk score was developed to predict recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma(PDAC)in South Korea.However,whether it performs well in other countries remains unknown.AIM To externally validate the CT-based preoperative risk score for PDAC in a country outside South Korea.METHODS Consecutive patients with PDAC who underwent upfront surgery from January 2016 to December 2019 at our institute in a country outside South Korea were retrospectively included.The study utilized the CT-based risk scoring system,which incorporates tumor size,portal venous phase density,tumor necrosis,peripancreatic infiltration,and suspicious metastatic lymph nodes.Patients were categorized into prognosis groups based on their risk score,as good(risk score<2),moderate(risk score 2-4),and poor(risk score≥5).RESULTS A total of 283 patients were evaluated,comprising 170 males and 113 females,with an average age of 63.52±8.71 years.Follow-up was conducted until May 2023,and 76%of patients experienced tumor recurrence with median recurrence-free survival(RFS)of 29.1±1.9 months.According to the evaluation results of Reader 1,the recurrence rates were 39.0%in the good prognosis group,82.1%in the moderate group,and 84.5%in the poor group.In comparison,Reader 2 reported recurrence rates of 50.0%,79.5%,and 88.9%,respectively,across the same prognostic categories.The study validated the effectiveness of the risk scoring system,demonstrating better RFS in the good prognosis group.CONCLUSION This research validated that the CT-based preoperative risk scoring system can effectively predict RFS in patients with PDAC,suggesting that it may be valuable in diverse populations.
