目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,C...目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,CTP)梗死核心体积不匹配的影响因素及预后特征。方法:回顾性分析2019年10月—2023年8月449例行NCCT及CTP评估的前循环大血管闭塞型AIS患者的临床及影像资料。采用RAPID软件自动计算NCCT-ASPECTS和CTP梗死核心体积。“NCCT-CTP不匹配”定义为低NCCT-ASPECTS、小梗死核心体积(low ASPECTS and small ischemic core volume,LASC)(NCCT-ASPECTS<6分,CTP梗死核心体积<70 mL)以及高NCCT-ASPECTS、大梗死核心体积(high ASPECTS and large ischemic core volume,HALC)(NCCT-ASPECTS≥6分,CTP梗死核心体积≥70 m L)。采用血管内取栓治疗(endovascular thrombectomy,EVT)后90 d随访基线改良Rankin量表(mRS)评分0~2分定义预后良好。采用多因素逻辑回归分析NCCT-CTP不匹配的独立影响因素。结果:449例AIS患者中有145例出现NCCT-CTP不匹配,其中52例(35.9%)患者血管内取栓治疗(endovascular thrombectomy,EVT)后获得良好预后。多因素逻辑回归分析结果提示,影像评估前接受静脉溶栓(intravenous thrombolysis,IVT)(OR=1.833;95%CI:1.205~2.790,P=0.005)、更高的基线NIHSS评分(OR=1.055;95%CI:1.028~1.083,P<0.001)是AIS患者出现NCCT-CTP不匹配的独立影响因素。NCCT-CTP不匹配亚组分析提示,LASC患者卒中发病至基线影像检查的时间间隔大于HALC患者[306(219,482)min vs.125(63,307)min;P=0.004]。LASC患者EVT术后出血性脑梗死发生率高于HALC患者(66.9%vs.33.3%;P=0.021)。结论:约35%的NCCT-CTP不匹配患者可从EVT中获益。影像评估前接受IVT以及更高的基线NIHSS评分是出现NCCT-CTP不匹配的独立影响因素。展开更多
Chitosan(CTS)was grafted onto the surface of amino‑functionalized silver chloride silicon dioxide(AgCl@SiO_(2)‑NH_(2))cores to obtain AgCl@SiO_(2)/CTS hybrid nanoparticles.The as‑obtained AgCl@SiO_(2)/CTS nanoparticle...Chitosan(CTS)was grafted onto the surface of amino‑functionalized silver chloride silicon dioxide(AgCl@SiO_(2)‑NH_(2))cores to obtain AgCl@SiO_(2)/CTS hybrid nanoparticles.The as‑obtained AgCl@SiO_(2)/CTS nanoparticles were chlorinated by NaClO solution to get AgCl@SiO_(2)/CTS‑based chloramine nano‑hybrid materials,denoted as AgCl@SiO_(2)/CTS‑Cl.A transmission electron microscope was used to observe the morphology of the as‑prepared samples AgCl@SiO_(2)/CTS and AgCl@SiO_(2)/CTS‑Cl.At the same time,an X‑ray diffractometer and an infrared spectroscope were utilized to characterize their crystal and chemical structures.Besides,ζpotentials were measured to elucidate the surface modification of AgCl nanoparticles by—NH_(2),the antibacterial mechanism of AgCl@SiO_(2)/CTS‑Cl was investigated by scanning electron microscopy,and Escherichia coli(E.coli)and Staphylococcus aureus(S.aureus)were used as the to‑be‑tested strains to evaluate the antimicrobial activity of samples AgCl@SiO_(2)/CTS and AgCl@SiO_(2)/CTS‑Cl.Findings demonstrate that sample AgCl@SiO_(2)/CTS exhibits a chain‑like structure ascribed to the interaction between—NH_(2),and each AgCl@SiO_(2)/CTS hybrid nanoparticle contains several AgCl cores.In the meantime,sample AgCl@SiO_(2)/CTS‑Cl exhibits excellent antibacterial activity against E.coli and S.aureus,which is attributed to the synergistic antibacterial effect of Ag^(+)and Cl^(-).Sample AgCl@SiO_(2)/CTS‑Cl with a dosage of 640.00μg·mL^(-1) could completely kill the two kinds of tested bacteria in 12 h of incubation;it retains a high antibacterial efficiency even after 10 cycles of antibacterial tests.展开更多
There is a contradiction between the evolution rate of materials and the time resolution of SR-CT characterization in the in situ synchrotron radiation computed tomography(SR-CT)characterization of ultrafast evolution...There is a contradiction between the evolution rate of materials and the time resolution of SR-CT characterization in the in situ synchrotron radiation computed tomography(SR-CT)characterization of ultrafast evolution process.The sampling strategy of the ultra-sparse angle is an effective method for improving time resolution.Accurate reconstruction under sparse sampling conditions has always been a bottleneck problem.In recent years,convolutional neural networks have shown outstanding advantages in sparse-angle CT reconstruction given the development of deep learning.However,existing ideas did not consider the expression of high-frequency details in neural networks,limiting their application in accurate SR-CT characterization.A novel high-frequency information-constrained deep learning network(HFIC-Net)is proposed in response to this problem.Additional high-frequency information constraints are added to improve the accuracy of the reconstruction results.Further,a series of numerical reconstruction experiments are conducted to verify this new method,and the results indicate that the reconstruction results of HFIC-Net method effectively improve reconstruction quality.This new method uses only eight-angle projections to achieve the reconstruction effect of the filtered backprojection method(FBP)method in 360 projections.The results of the HFIC-Net method demonstrate clear boundaries and accurate detailed structures,correcting the misinformation caused by using other methods.For quantitative evaluation,the SSIM used to evaluate image structure similarity is increased from 0.1951,0.9212,and 0.9308 for FBP,FBP-Conv,and DDC-Net,respectively,to 0.9620 for HFIC-Net.Finally,the results of actual SR-CT experimental data indicate that the new method can suppress artifacts and achieve accurate reconstruction,and it is suitable for the in situ SR-CT accurate characterization of ultxafast evolution process.展开更多
Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This...Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.展开更多
Objective:To study the potential of Pituranthos chloranthus essential oil(PC)as a chemoprotective agent.Methods:In the in vitro study,cell proliferation were determined in CT26,SW620,and SW480 cells.Cells were exposed...Objective:To study the potential of Pituranthos chloranthus essential oil(PC)as a chemoprotective agent.Methods:In the in vitro study,cell proliferation were determined in CT26,SW620,and SW480 cells.Cells were exposed to in creasing concentrations of PC(0,6.25,12.5,25,50,100,and 200μg/mL).Combination index was calculated by applying the Chou-Talalay method,apoptopsis was analyzed by annexin V/propidium iodide staining,reactive oxygen species accumulation,and theΔψm drop were also assessed.In the in vivo study,mice were divided into 5 groups:the normal control group,the CT26 tumor-bearing group,the CT26 tumor-bearing mice+PC group,the CT26 tumor-bearing mice+cisplatin group,and the CT26 tumor-bearing mice+cisplatin+PC group.Organ coefficients and tumor volume were calculated.Alanine aminotransferase,aspartate aminotransferase,creatinine,and tumor necrosis factor-αlevels were assessed.Results:Cisplatin with PC induced a synergistic effect,allowing for reduced cisplatin dose while maintaining the same therapeutic efficacy.PC-cisplatin combinations inhibited cell viability by significantly inducing apoptosis,increasing reactive oxygen species accumulation and reducing mitochondrial membrane potential.Co-treatment with cisplatin and PC restored organ coefficients,reduced tumor volume,and alleviated nephrotoxicity in CT26 tumor-bearing mice by restoring kidney function markers and ameliorating kidney inflammation status.Conclusions:PC shows a chemoprotective potential by enhancing the antitumor effect of cisplatin while alleviating its side effects.展开更多
Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reduci...Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes.展开更多
Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value ...Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value of CT-FFR combined with CCTA–defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).Methods A retrospective pooled analysis of individual patient data was performed. Deep-learning-based vessel-specific CTFFR was calculated. All patients enrolled were followed-up for at least 5 years. Predictive abilities for major adverse cardiac events(MACE) were compared among three models(model 1), constructed using clinical variables;model 2, model 1+CCTA–derived atherosclerotic extent(Leiden risk score);and model 3, model 2+CT-FFR.Results A total of 480 diabetic patients [median age, 61(55–66) years;52.9% men] were included. During a median follow-up time of 2197(2126–2355) days, 55 patients(11.5%) experienced MACE. In multivariate-adjusted Cox models, Leiden risk score(HR: 1.06;95% CI: 1.01–1.11;P = 0.013) and CT-FFR ≤ 0.80(HR: 6.54;95% CI: 3.18–13.45;P < 0.001) were the independent predictors. The discriminant ability was higher in model 2 than in model 1(C-index, 0.75 vs. 0.63;P < 0.001) and was further promoted by adding CT-FFR to model 3(C-index, 0.81 vs. 0.75;P = 0.002). Net reclassification improvement(NRI) was 0.19(P = 0.009) for model 2 beyond model 1. Of note, adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI = 0.14;P = 0.011).Conclusion In diabetic patients with CAD, CT-FFR provides robust and incremental prognostic information for predicting longterm outcomes. The combined model exhibits improved prediction abilities, which is beneficial for risk stratification.展开更多
BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with ...BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.展开更多
文摘目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,CTP)梗死核心体积不匹配的影响因素及预后特征。方法:回顾性分析2019年10月—2023年8月449例行NCCT及CTP评估的前循环大血管闭塞型AIS患者的临床及影像资料。采用RAPID软件自动计算NCCT-ASPECTS和CTP梗死核心体积。“NCCT-CTP不匹配”定义为低NCCT-ASPECTS、小梗死核心体积(low ASPECTS and small ischemic core volume,LASC)(NCCT-ASPECTS<6分,CTP梗死核心体积<70 mL)以及高NCCT-ASPECTS、大梗死核心体积(high ASPECTS and large ischemic core volume,HALC)(NCCT-ASPECTS≥6分,CTP梗死核心体积≥70 m L)。采用血管内取栓治疗(endovascular thrombectomy,EVT)后90 d随访基线改良Rankin量表(mRS)评分0~2分定义预后良好。采用多因素逻辑回归分析NCCT-CTP不匹配的独立影响因素。结果:449例AIS患者中有145例出现NCCT-CTP不匹配,其中52例(35.9%)患者血管内取栓治疗(endovascular thrombectomy,EVT)后获得良好预后。多因素逻辑回归分析结果提示,影像评估前接受静脉溶栓(intravenous thrombolysis,IVT)(OR=1.833;95%CI:1.205~2.790,P=0.005)、更高的基线NIHSS评分(OR=1.055;95%CI:1.028~1.083,P<0.001)是AIS患者出现NCCT-CTP不匹配的独立影响因素。NCCT-CTP不匹配亚组分析提示,LASC患者卒中发病至基线影像检查的时间间隔大于HALC患者[306(219,482)min vs.125(63,307)min;P=0.004]。LASC患者EVT术后出血性脑梗死发生率高于HALC患者(66.9%vs.33.3%;P=0.021)。结论:约35%的NCCT-CTP不匹配患者可从EVT中获益。影像评估前接受IVT以及更高的基线NIHSS评分是出现NCCT-CTP不匹配的独立影响因素。
文摘Chitosan(CTS)was grafted onto the surface of amino‑functionalized silver chloride silicon dioxide(AgCl@SiO_(2)‑NH_(2))cores to obtain AgCl@SiO_(2)/CTS hybrid nanoparticles.The as‑obtained AgCl@SiO_(2)/CTS nanoparticles were chlorinated by NaClO solution to get AgCl@SiO_(2)/CTS‑based chloramine nano‑hybrid materials,denoted as AgCl@SiO_(2)/CTS‑Cl.A transmission electron microscope was used to observe the morphology of the as‑prepared samples AgCl@SiO_(2)/CTS and AgCl@SiO_(2)/CTS‑Cl.At the same time,an X‑ray diffractometer and an infrared spectroscope were utilized to characterize their crystal and chemical structures.Besides,ζpotentials were measured to elucidate the surface modification of AgCl nanoparticles by—NH_(2),the antibacterial mechanism of AgCl@SiO_(2)/CTS‑Cl was investigated by scanning electron microscopy,and Escherichia coli(E.coli)and Staphylococcus aureus(S.aureus)were used as the to‑be‑tested strains to evaluate the antimicrobial activity of samples AgCl@SiO_(2)/CTS and AgCl@SiO_(2)/CTS‑Cl.Findings demonstrate that sample AgCl@SiO_(2)/CTS exhibits a chain‑like structure ascribed to the interaction between—NH_(2),and each AgCl@SiO_(2)/CTS hybrid nanoparticle contains several AgCl cores.In the meantime,sample AgCl@SiO_(2)/CTS‑Cl exhibits excellent antibacterial activity against E.coli and S.aureus,which is attributed to the synergistic antibacterial effect of Ag^(+)and Cl^(-).Sample AgCl@SiO_(2)/CTS‑Cl with a dosage of 640.00μg·mL^(-1) could completely kill the two kinds of tested bacteria in 12 h of incubation;it retains a high antibacterial efficiency even after 10 cycles of antibacterial tests.
基金supported by the National Nature Science Foundation of China(Nos.12027901 and 12041202)Synchrotron Radiation Joint Fund of University of Science and Technology of China(Nos.KY2090000059 and KY2090000054)。
文摘There is a contradiction between the evolution rate of materials and the time resolution of SR-CT characterization in the in situ synchrotron radiation computed tomography(SR-CT)characterization of ultrafast evolution process.The sampling strategy of the ultra-sparse angle is an effective method for improving time resolution.Accurate reconstruction under sparse sampling conditions has always been a bottleneck problem.In recent years,convolutional neural networks have shown outstanding advantages in sparse-angle CT reconstruction given the development of deep learning.However,existing ideas did not consider the expression of high-frequency details in neural networks,limiting their application in accurate SR-CT characterization.A novel high-frequency information-constrained deep learning network(HFIC-Net)is proposed in response to this problem.Additional high-frequency information constraints are added to improve the accuracy of the reconstruction results.Further,a series of numerical reconstruction experiments are conducted to verify this new method,and the results indicate that the reconstruction results of HFIC-Net method effectively improve reconstruction quality.This new method uses only eight-angle projections to achieve the reconstruction effect of the filtered backprojection method(FBP)method in 360 projections.The results of the HFIC-Net method demonstrate clear boundaries and accurate detailed structures,correcting the misinformation caused by using other methods.For quantitative evaluation,the SSIM used to evaluate image structure similarity is increased from 0.1951,0.9212,and 0.9308 for FBP,FBP-Conv,and DDC-Net,respectively,to 0.9620 for HFIC-Net.Finally,the results of actual SR-CT experimental data indicate that the new method can suppress artifacts and achieve accurate reconstruction,and it is suitable for the in situ SR-CT accurate characterization of ultxafast evolution process.
基金supported by the National Science and Technology Major Project for the Prevention and Control of Emerging and Major Infectious Diseases[2025ZD01908702]Peking University Medicine Fund of Fostering Young Scholars’Scientific&Technological innovation[BMU2024YFJHP014]supported by Fundamental Research Funds for the Central Universities+1 种基金Key Clinical Projects of Peking University Third Hospital[BYSYZD2022014]Peking University Third Hospital[2025024].
文摘Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.
基金funded by The Tunisian Ministry of Research and Higher Education.
文摘Objective:To study the potential of Pituranthos chloranthus essential oil(PC)as a chemoprotective agent.Methods:In the in vitro study,cell proliferation were determined in CT26,SW620,and SW480 cells.Cells were exposed to in creasing concentrations of PC(0,6.25,12.5,25,50,100,and 200μg/mL).Combination index was calculated by applying the Chou-Talalay method,apoptopsis was analyzed by annexin V/propidium iodide staining,reactive oxygen species accumulation,and theΔψm drop were also assessed.In the in vivo study,mice were divided into 5 groups:the normal control group,the CT26 tumor-bearing group,the CT26 tumor-bearing mice+PC group,the CT26 tumor-bearing mice+cisplatin group,and the CT26 tumor-bearing mice+cisplatin+PC group.Organ coefficients and tumor volume were calculated.Alanine aminotransferase,aspartate aminotransferase,creatinine,and tumor necrosis factor-αlevels were assessed.Results:Cisplatin with PC induced a synergistic effect,allowing for reduced cisplatin dose while maintaining the same therapeutic efficacy.PC-cisplatin combinations inhibited cell viability by significantly inducing apoptosis,increasing reactive oxygen species accumulation and reducing mitochondrial membrane potential.Co-treatment with cisplatin and PC restored organ coefficients,reduced tumor volume,and alleviated nephrotoxicity in CT26 tumor-bearing mice by restoring kidney function markers and ameliorating kidney inflammation status.Conclusions:PC shows a chemoprotective potential by enhancing the antitumor effect of cisplatin while alleviating its side effects.
基金supported by a grant from Kom op tegen Kanker(Stand Up to Cancer,Belgium).
文摘Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes.
文摘Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value of CT-FFR combined with CCTA–defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).Methods A retrospective pooled analysis of individual patient data was performed. Deep-learning-based vessel-specific CTFFR was calculated. All patients enrolled were followed-up for at least 5 years. Predictive abilities for major adverse cardiac events(MACE) were compared among three models(model 1), constructed using clinical variables;model 2, model 1+CCTA–derived atherosclerotic extent(Leiden risk score);and model 3, model 2+CT-FFR.Results A total of 480 diabetic patients [median age, 61(55–66) years;52.9% men] were included. During a median follow-up time of 2197(2126–2355) days, 55 patients(11.5%) experienced MACE. In multivariate-adjusted Cox models, Leiden risk score(HR: 1.06;95% CI: 1.01–1.11;P = 0.013) and CT-FFR ≤ 0.80(HR: 6.54;95% CI: 3.18–13.45;P < 0.001) were the independent predictors. The discriminant ability was higher in model 2 than in model 1(C-index, 0.75 vs. 0.63;P < 0.001) and was further promoted by adding CT-FFR to model 3(C-index, 0.81 vs. 0.75;P = 0.002). Net reclassification improvement(NRI) was 0.19(P = 0.009) for model 2 beyond model 1. Of note, adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI = 0.14;P = 0.011).Conclusion In diabetic patients with CAD, CT-FFR provides robust and incremental prognostic information for predicting longterm outcomes. The combined model exhibits improved prediction abilities, which is beneficial for risk stratification.
文摘BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.
