BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging....BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.展开更多
BACKGROUND It is unclear whether the Japan Narrow-Band Imaging Expert Team(JNET)classification and pit pattern classification are applicable for diagnosing neoplastic lesions in patients with ulcerative colitis(UC).AI...BACKGROUND It is unclear whether the Japan Narrow-Band Imaging Expert Team(JNET)classification and pit pattern classification are applicable for diagnosing neoplastic lesions in patients with ulcerative colitis(UC).AIM To clarify the diagnostic performance of these classifications for neoplastic lesions in patients with UC.METHODS This study was conducted as a single-center,retrospective case-control study.Twenty-one lesions in 19 patients with UC-associated neoplasms(UCAN)and 23 lesions in 22 UC patients with sporadic neoplasms(SN),evaluated by magnifying image-enhanced endoscopy,were retrospectively and separately assessed by six endoscopists(three experts,three non-experts),using the JNET and pit pattern classifications.The results were compared with the pathological diagnoses to evaluate the diagnostic performance.Inter-and intra-observer agreements were calculated.RESULTS In this study,JNET type 2 A and pit pattern typeⅢ/Ⅳwere used as indicators of low-grade dysplasia,JNET type 2 B and pit pattern typeⅥlow irregularity were used as indicators of highgrade dysplasia to shallow submucosal invasive carcinoma,JNET type 3 and pit pattern typeⅥhigh irregularity/VN were used as indicators of deep submucosal invasive carcinoma.In the UCAN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a low positive predictive value(PPV;50.0%and 40.0%,respectively);however,they had a high negative predictive value(NPV;94.7%and 100%,respectively).Conversely,in the SN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a high PPV(100%for both)but a low NPV(63.6%and 77.8%,respectively).In both groups,JNET type 3 and pit pattern typeⅥ-high irregularity/VN showed high specificity.The interobserver agreement of JNET classification and pit pattern classification for UCAN among experts were 0.401 and 0.364,in the same manner for SN,0.666 and 0.597,respectively.The intra-observer agreements of JNET classification and pit pattern classification for UCAN among experts were 0.387,0.454,for SN,0.803 and 0.567,respectively.CONCLUSION The accuracy of endoscopic diagnosis using both classifications was lower for UCAN than for SN.Endoscopic diagnosis of UCAN tended to be underestimated compared with the pathological results.展开更多
BACKGROUND Although contrast-enhanced magnetic resonance imaging(MRI)using gadoxetic acid has been shown to have higher accuracy,sensitivity,and specificity for the detection and characterization of hepatic metastases...BACKGROUND Although contrast-enhanced magnetic resonance imaging(MRI)using gadoxetic acid has been shown to have higher accuracy,sensitivity,and specificity for the detection and characterization of hepatic metastases compared with other modalities,the long examination time would limit the broad indication.Several abbreviated enhanced MRI(Ab-MRI)protocols without dynamic phases have been proposed to achieve equivalent diagnostic performance for the detection of colorectal liver metastases.However,an optimal protocol has not been established,and no studies have assessed the diagnostic performance of Ab-MRI combined with contrast-enhanced computed tomography(CE-CT),which is the preoperative imaging of colorectal cancer staging in clinical settings,to determine the best therapeutic strategy.AIM To compare the diagnostic performance of two kinds of Ab-MRI protocol with the standard MRI protocol and a combination of the Ab-MRI protocol and CE-CT for the detection of colorectal liver metastases.METHODS Study participants comprised 87 patients(51 males,36 females;mean age,67.2±10.8 years)who had undergone gadoxetic acid-enhanced MRI and CE-CT during the initial work-up for colorectal cancer from 2010 to 2021.Each exam was independently reviewed by two readers in three reading sessions:(1)Only single-shot fast spin echo(FSE)T2-weighted or fat-suppressed-FSE-T2-weighted,diffusion-weighted,and hepatobiliary-phase images(Ab-MRI protocol 1 or 2);(2)all acquired MRI sequences(standard protocol);and(3)a combination of an Ab-MRI protocol(1 or 2)and CE-CT.Diagnostic performance was then statistically analyzed.RESULTS A total of 380 Lesions were analyzed,including 195 metastases(51.4%).Results from the two Ab-MRI protocols were similar.The sensitivity,specificity,and positive and negative predictive values from Ab-MRI were non-inferior to those from standard MRI(P>0.05),while those from the combination of Ab-MRI protocol and CE-CT tended to be higher than those from Ab-MRI alone,although the difference was not significant(P>0.05),and were quite similar to those from standard MRI(P>0.05).CONCLUSION The diagnostic performances of two Ab-MRI protocols were non-inferior to that of the standard protocol.Combining Ab-MRI with CE-CT provided better diagnostic performance than Ab-MRI alone.展开更多
<b><span style="font-family:Verdana;">Background and Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> The hepati...<b><span style="font-family:Verdana;">Background and Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> The hepatitis C prevalence rate is among the highest the world. Thus, in the context of transfusion safety, WHO has made it compulsory to screen blood bags by rapid diagnostic orientation tests (TROD) validated in regions that do not have the capacity to use more sophisticated technologies. The purpose of this study is to assess the performance of the TRODs commonly used in Kinshasa. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a cross-sectional and analytical study carried out from August 26, 2019 to January 20, 2020 in 200 voluntary blood donors at the University Clinics of Kinshasa (CUK). The detection of anti-HCV antibodies was carried out by Mindray (gold standard) and the SD Bioline, Encode, Fortress and Accurate tests. The diagnostic performance of TRODs was evaluated compared to the Mindray test. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Of a total of 200 donors, 112 (56.0%) were male versus 88 (44.0%) female with a sex ratio of 1M: 1F. HCV seroprevalences by Mindray, and other tests were 29.5%, 28.0%, 27.0%, 27.0% and 31.5%, respectively;the Se, Sp, VPP, VPN, SD Bioline, Accurate, Fortress and Encode were 74.6%, 92.9%, 81.5%, 89.7%, respectively;74.6%, 92.9%, 81.5%, 89.7%;74.6%, 91.4%, 78.6%, 89.6%;69.5%, 70.0%, 65.1%, 84.4%. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The diagnostic performance of TRODs evaluated in this study does not meet European Union standards (Se = 100%;Sp</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">> 99.5%). The Ministry of Health should promote large-scale validation of TRODs based on World Health Organization guidelines.展开更多
Objective To investigate the effect of CT-derived fractional flow reserve(CT-FFR)measurement sites on the values and the diagnostic performance,and to determine the optimal measurement site for CT-FFR using invasive F...Objective To investigate the effect of CT-derived fractional flow reserve(CT-FFR)measurement sites on the values and the diagnostic performance,and to determine the optimal measurement site for CT-FFR using invasive FFR as the reference standard.Methods This study was part of the CT-FFR CHINA clinical trial.展开更多
Background The current diagnostic strategy for hepatitis C virus(HCV)infection involves a two-step approach:antibody HCV screening followed by confirmatory nucleic acid testing.This study aimed to evaluate the diagnos...Background The current diagnostic strategy for hepatitis C virus(HCV)infection involves a two-step approach:antibody HCV screening followed by confirmatory nucleic acid testing.This study aimed to evaluate the diagnostic performance of the Abbott ARCHITECT HCV Ag assay in serum/plasma samples as a potential one-step alterna-tive for diagnosing active HCV infection in people living with hepatitis B virus(PLWHB)through a systematic review and meta-analysis.Methods A systematic review and meta-analysis were conducted following PRISMA-DTA guidelines.This protocol was registered on PROSPERO(CRD42023402093).A comprehensive search of electronic databases identified studies published up to 1 November 2024,comparing the ARCHITECT HCV Ag assay to an HCV-RNA reference standard.Sen-sitivity,specificity,and likelihood ratios were pooled using a random-effects model within the MIDAS module of Stata software.Study quality was assessed using QUADAS-2.Heterogeneity was evaluated using the Q statistic,quantified using the I2,and further explored through meta-regression.Results Ten studies(n=494 participants)met inclusion criteria.The Abbott ARCHITECT HCV Ag assay demonstrated high sensitivity[91%,95%confidence interval(CI):76-97%]and specificity(99%,95%CI:99-100%).The positive likeli-hood ratio(PLR)was 81.20(95%CI:12.34-534.36),and the negative likelihood ratio(NLR)was 0.09(95%CI:0.03-0.27).The area under the summary receiver operating characteristic curve(AUC-SROC)was 99%(95%CI 98-100%).In regions with high HCV prevalence(≥10%),the test accurately confirmed active HCV infection in over 90%of cases.However,confirmatory testing remains necessary in low-prevalence settings(≤5%).The assay demonstrated an excel-lent ability to identify individuals without HCV infection,with a low false-negative rate(≤2%)regardless of HCV prevalence.Heterogeneity analysis revealed moderate to substantial variation in test performance(I2=72.09%for sensitivity,35.47%for PLR,and 78.33%for NLR).QUADAS-2 applicability concerns predicted heterogeneity,but dif-ferences were likely insignificant due to minimal variations and limited studies.Conclusions The Abbott ARCHITECT HCV Ag assay exhibited promising accuracy in detecting active HCV infection among PLWHB.This test might help diagnose active HCV infection in high-prevalence scenarios(≥10%)but needs further confirmation in low-prevalence settings(≤5%).展开更多
Background Non-invasive computed tomography angiography(CTA)-based fractional flow reserve(CT-FFR)could become a gatekeeper to invasive coronary angiography.Deep learning(DL)-based CT-FFR has shown promise when compar...Background Non-invasive computed tomography angiography(CTA)-based fractional flow reserve(CT-FFR)could become a gatekeeper to invasive coronary angiography.Deep learning(DL)-based CT-FFR has shown promise when compared to invasive FFR.To evaluate the performance of a DL-based CT-FFR technique,DeepVessel FFR(DVFFR).Methods This retrospective study was designed for iScheMia Assessment based on a Retrospective,single-center Trial of CTFFR(SMART).Patients suspected of stable coronary artery disease(CAD)and undergoing both CTA and invasive FFR examinations were consecutively selected from the Beijing Anzhen Hospital between January 1,2016 to December 30,2018.FFR obtained during invasive coronary angiography was used as the reference standard.DVFFR was calculated blindly using a DL-based CTFFR approach that utilized the complete tree structure of the coronary arteries.Results Three hundred and thirty nine patients(60.5±10.0 years and 209 men)and 414 vessels with direct invasive FFR were included in the analysis.At per-vessel level,sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of DVFFR were 94.7%,88.6%,90.8%,82.7%,and 96.7%,respectively.The area under the receiver operating characteristics curve(AUC)was 0.95 for DVFFR and 0.56 for CTA-based assessment with a significant difference(P<0.0001).At patient level,sensitivity,specificity,accuracy,PPV and NPV of DVFFR were 93.8%,88.0%,90.3%,83.0%,and 95.8%,respectively.The computation for DVFFR was fast with the average time of 22.5±1.9 s.Conclusions The results demonstrate that DVFFR was able to evaluate lesion hemodynamic significance accurately and effectively with improved diagnostic performance over CTA alone.Coronary artery disease(CAD)is a critical disease in which coronary artery luminal narrowing may result in myocardial ischemia.Early and effective assessment of myocardial ischemia is essential for optimal treatment planning so as to improve the quality of life and reduce medical costs.展开更多
Objective To evaluate the diagnostic performance of galactomannan(GM)detection in serum and BALF for invasive pulmonary aspergillosis(IPA)in non-neutropenic hosts.Methods A prospective study was performed for 1 356 no...Objective To evaluate the diagnostic performance of galactomannan(GM)detection in serum and BALF for invasive pulmonary aspergillosis(IPA)in non-neutropenic hosts.Methods A prospective study was performed for 1 356 non-neutropenic hosts admitted to the Department of Pulmonary and Critical Care Medicine of展开更多
In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance i...In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance imaging(WB-MRI)techno-logy,its current clinical applications,and the challenges that must be addressed to fully realize its potential in oncological imaging.WB-MRI has emerged as a pivotal tool in oncological imaging,offering comprehensive disease assessment without ionizing radiation.Its applications span the detection of bone metastases,evaluation of hematologic malignancies,and staging of a wide range of cancers,including lymphoma,prostate,and breast cancers.Advanced techniques such as diffusion-weighted imaging have enhanced its diagnostic performance by pro-viding superior lesion-to-background contrast and quantitative metrics.Despite its diagnostic strengths,WB-MRI faces challenges in standardization,patient acceptance,and integration into clinical workflows.Variability in acquisition pro-tocols,hardware differences,and patient-related factors,such as anxiety and motion artifacts,have limited widespread adoption.Emerging guidelines like MET-RADS-P and ONCO-RADS aim to address these issues by promoting stan-dardized protocols tailored to specific clinical needs.This editorial explores the advancements in WB-MRI technology,its current clinical applications,and the barriers that must be overcome to maximize its utility.By addressing these cha-llenges and embracing standardization,WB-MRI holds the potential to redefine the landscape of oncological imaging,aligning diagnostic precision with modern treatment goals of reducing long-term patient risk.展开更多
Objective Exosomal long noncoding RNAs(lnc RNAs) are the key to diagnosing and treating various diseases. This study aimed to investigate the diagnostic value of plasma exosomal lnc RNAs in white matter hyperintensiti...Objective Exosomal long noncoding RNAs(lnc RNAs) are the key to diagnosing and treating various diseases. This study aimed to investigate the diagnostic value of plasma exosomal lnc RNAs in white matter hyperintensities(WMH).Methods We used high-throughput sequencing to determine the differential expression(DE) profiles of lnc RNAs in plasma exosomes from WMH patients and controls. The sequencing results were verified in a validation cohort using q RT-PCR. The diagnostic potential of candidate exosomal lnc RNAs was proven by binary logistic analysis and receiver operating characteristic(ROC) curves. The diagnostic value of DE exo-lnc RNAs was determined by the area under the curve(AUC). The WMH group was then divided into subgroups according to the Fazekas scale and white matter lesion site, and the correlation of DE exo-lnc RNAs in the subgroup was evaluated.Results In our results, four DE exo-lnc RNAs were identified, and ROC curve analysis revealed that exolnc_011797 and exo-lnc_004326 exhibited diagnostic efficacy for WMH. Furthermore, WMH subgroup analysis showed exo-lnc_011797 expression was significantly increased in Fazekas 3 patients and was significantly elevated in patients with paraventricular matter hyperintensities.Conclusion Plasma exosomal lnc RNAs have potential diagnostic value in WMH. Moreover, exolnc_011797 is considered to be a predictor of the severity and location of WMH.展开更多
BACKGROUND Intrapancreatic accessory spleen(IPAS)shares similar imaging findings with hypervascular pancreatic neuroendocrine tumors(PNETs),which may lead to unnecessary surgery.AIM To investigate and compare the diag...BACKGROUND Intrapancreatic accessory spleen(IPAS)shares similar imaging findings with hypervascular pancreatic neuroendocrine tumors(PNETs),which may lead to unnecessary surgery.AIM To investigate and compare the diagnostic performance of absolute apparent diffusion coefficient(ADC)and normalized ADC(lesion-to-spleen ADC ratios)in the differential diagnosis of IPAS from PNETs.METHODS A retrospective study consisting of 29 patients(16 PNET patients vs 13 IPAS patients)who underwent preoperative contrast-enhanced magnetic resonance imaging together with diffusion-weighted imaging/ADC maps between January 2017 and July 2020 was performed.Two independent reviewers measured ADC on all lesions and spleens,and normalized ADC was calculated for further analysis.The receiver operating characteristics analysis was carried out for evaluating the diagnostic performance of both absolute ADC and normalized ADC values in the differential diagnosis between IPAS and PNETs by clarifying sensitivity,specificity,and accuracy.Inter-reader reliability for the two methods was evaluated.RESULTS IPAS had a significantly lower absolute ADC(0.931±0.773×10^(-3)mm^(2)/s vs 1.254±0.219×10^(-3)mm^(2)/s)and normalized ADC value(1.154±0.167 vs 1.591±0.364)compared to PNET.A cutoff value of 1.046×10^(-3)mm^(2)/s for absolute ADC was associated with 81.25%sensitivity,100%specificity,and 89.66%accuracy with an area under the curve of 0.94(95%confidence interval:0.8536-1.000)for the differential diagnosis of IPAS from PNET.Similarly,a cutoff value of 1.342 for normalized ADC was associated with 81.25%sensitivity,92.31%specificity,and 86.21%accuracy with an area under the curve of 0.91(95%confidence interval:0.8080-1.000)for the differential diagnosis of IPAS from PNET.Both methods showed excellent inter-reader reliability with intraclass correlation coefficients for absolute ADC and ADC ratio being 0.968 and 0.976,respectively.CONCLUSION Both absolute ADC and normalized ADC values can facilitate the differentiation between IPAS and PNET.展开更多
Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the...Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent cohort.Methods:The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for inclusion.All participants were invited to receive a traditional examination[referring to AFP plus US],and ctDNA methylation,respectively.The sensitivity and specificity of different diagnostic tools were calculated.The logistic regression model was applied to estimate the area under the curve(AUC),which was further validated by 10-fold internal cross-validation.Results:A total of 1,205 individuals were recruited in our study,and 39 participants were diagnosed with liver cancer.The sensitivity of AFP,US,US plus AFP,and the combination of US,AFP,and ctDNA methylation was33.33%,56.41%,66.67%,and 87.18%,respectively.The corresponding specificity of AFP,US,US plus AFP,and the combination of all modalities was 98.20%,99.31%,97.68%,and 97.68%,respectively.The AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 65.77%,77.86%,82.18%,and92.43%,respectively.The internally validated AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 67.57%,83.26%,86.54%,and 93.35%,respectively.Conclusions:The ctDNA methylation is a good complementary to AFP and US for the detection of liver cancer.展开更多
BACKGROUND Hepatic artery occlusion(HAO)after liver transplantation(LT)is a devastating complication,resulting in early graft loss and reduced overall survival.Ultra-sound is an established assessment method for HAO i...BACKGROUND Hepatic artery occlusion(HAO)after liver transplantation(LT)is a devastating complication,resulting in early graft loss and reduced overall survival.Ultra-sound is an established assessment method for HAO in patients following LT,especially those with complex hepatic artery reconstruction.METHODS We retrospectively analyzed the ultrasound characteristics and the clinic risk factors associated with HAO in 400 adult LT patients who were enrolled and treated at the Third People's Hospital of Shenzhen between November 2016 and July 2022.Fourteen patients diagnosed with acute HAO(A-HAO)by surgery and fifteen diagnosed with chronic HAO(C-HAO)were included.A control group of 33 patients without HAO complications during the same period were randomly selected using a random number table.All patients underwent an ultrasono-graphy examination.Parameters including resistance index(RI),peak systolic velocity(PSV),and portal vein velocity(PVV)were compared across the groups.Additionally,basic clinical data were collected for all patients,including gender,age,primary diagnosis,D-dimer concentration,total operation time,cold ischemia time,hot ischemia time,intraoperative blood loss and transfusion,intraoperative urine volume,infusion,model for end-stage liver disease(MELD)score,and whether complex hepatic artery reconstructions were performed.Furthermore,risk factors influencing HAO formation after LT were analyzed.RESULTS Compared to the non-HAO group,PVV and RI were higher in the A-HAO group,while PSV was lower.Conversely,both PSV and RI were lower in the C-HAO group compared to the non-HAO group.The proportion of patients undergoing complex hepatic artery reconstructions and the gamma-glutamyltransferase(GGT)level before occlusion were significantly higher in the A-HAO group compared to the non-HAO group.However,there were no distinct differences between the two groups in D-dimer,MELD score,pre-occlusion alanine transaminase and aspartate transaminase levels,or intraoperative conditions.CONCLUSION Ultrasound features of the hepatic artery before occlusion are significantly associated with postoperative HAO development.Additionally,complex hepatic artery reconstructions,defined as revascularization of the graft requiring additional anastomosis between donor hepatic arteries,constitute a risk factor for A-HAO.Besides,abnormal pre-occlusion GGT elevation is an important biochemical indicator.Therefore,ultrasound examination serves as an important tool for screening HAO,especially in patients with the identified risk factors.展开更多
Objective:Our research aims to evaluate the diagnostic accuracy of colposcopy-guided biopsy(CGB)in detecting high-grade cervical lesions and explore how human papilloma virus(HPV)integration status and other factors a...Objective:Our research aims to evaluate the diagnostic accuracy of colposcopy-guided biopsy(CGB)in detecting high-grade cervical lesions and explore how human papilloma virus(HPV)integration status and other factors affect its performance.Methods:A retrospective cohort analysis involving 550 patients was conducted to evaluate whether the HPV integration plays a role in identifying high-grade cervical lesions and cervical cancer.Logistic regression models and area under the curve(AUC)calculations were employed.Results:Our findings revealed that 53.5%of CGB/surgery pairs demonstrated congruent diagnoses,whereas 17.1%showed underestimation and 29.5%overestimation.Furthermore,multivariate logistic regression analysis identified several key predictors for cervical intraepithelial neoplasia(CIN)2+and CIN3+according to surgical pathology.Notably,a CGB confirming CIN2+[odds ratio(OR)=6.0,95%confidence interval(CI):3.9–9.1,P<0.001],high-grade cytology(OR=2.6,95%CI:1.4–4.9,P=0.003),and HPV integration positivity(OR=2.2,95%CI:1.3–3.5,P<0.001)emerged as significant factors for CIN2+.Similarly,for CIN3+identification,CGB confirming CIN2+(OR=5.3,95%CI:3.4–8.3,P<0.001),high-grade cytology(OR=2.6,95%CI:1.5–4.7,P=0.001),and HPV integration positivity(OR=2.0,95%CI:1.3–3.1,P=0.003)were independent predictors.Conclusion:Our study highlights the innovative role of HPV integration testing as a pivotal adjunct to CGB and cytology,offering a comprehensive approach that may enhance the diagnostic precision for high-grade cervical lesions,ultimately achieving more precise management strategies.展开更多
Faecal immunochemical tests(FITs)are the most widely colorectal cancer(CRC)diagnostic biomarker available.Many population screening programmes are based on this biomarker,with the goal of reducing CRC mortality.Moreov...Faecal immunochemical tests(FITs)are the most widely colorectal cancer(CRC)diagnostic biomarker available.Many population screening programmes are based on this biomarker,with the goal of reducing CRC mortality.Moreover,in recent years,a large amount of evidence has been produced on the use of FIT to detect CRC in patients with abdominal symptoms in primary healthcare as well as in surveillance after adenoma resection.The aim of this review is to highlight the available evidence on these two topics.We will summarize the evidence on diagnostic yield in symptomatic patients with CRC and significant colonic lesion and the different options to use this(thresholds,brands,number of determinations,prediction models and combinations).We will include recommendations on FIT strategies in primary healthcare proposed by regulatory bodies and scientific societies and their potential effects on healthcare resources and CRC prognosis.Finally,we will show information regarding FIT-based surveillance as an alternative to endoscopic surveillance after high-risk polyp resection.To conclude,due to the coronavirus disease 2019 pandemic,FIT-based strategies have become extremely relevant since they enable a reduction of colonoscopy demand and access to the healthcare system by selecting individuals with the highest risk of CRC.展开更多
Hepatitis C virus(HCV)-cirrhotic patients have the highest threat of developing hepatocellular carcinoma(HCC)and may be at risk of extra hepatic cancer.The present study was designed to investigate CD133 and CK19 in H...Hepatitis C virus(HCV)-cirrhotic patients have the highest threat of developing hepatocellular carcinoma(HCC)and may be at risk of extra hepatic cancer.The present study was designed to investigate CD133 and CK19 in HCV(genotype-4)-cirrhotic patients with/without HCC or extra hepatic cancer,to assess the degree of their correlation with cell cycle abnormalities and finally to assess the role of their combination as diagnostic tool for discrimination of cirrhotic patients with HCC from those with extra hepatic cancer.The study included 77 HCV-cirrhotic patients and 20 healthy non-disease control group.Patients were categorized histo-pathologically into:24 have only liver cirrhosis,26 with HCC,and 27 patients with extra hepatic cancer.Cell cycle abnormalities,CD133 and CK19 were determined by flow cytometry technique.CD133 and CK19 showed marked elevation in HCC and extra hepatic cancer compared with liver cirrhosis and control subjects(p<0.0001).Positive associations were noted between CK19,CD133 and G2/M.They were gradually increased with progression from liver cirrhosis to HCC.Combination of the three showed the best AUC(0.978)and accuracy(92.5%)for discrimination of HCC from extra hepatic cancer.Combined CD133 with G2/M and CK19 comprises an excellent diagnostic panel for discrimination of HCV-cirrhotic patients with HCC from those with extra hepatic cancer.展开更多
Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours A...Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours ABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor in the non-access arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for at least 3 months and informed consent) attending 3 hemodialysis centers in Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell product criteria. ROC curve method was used to assess the performance of dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P 0.05 defined the level of statistical significance. Results: Whatever the method of BP measurement, all the SBP values were related to ECG-LVH with similar AUC and overlapping 95% CI;however, they were not significantly different from each other. 24-hours interdialytic ambulatory SBP (AUC 0.748;95% CI 0.58 - 0.94) had the highest area under the curve. Conclusion: The present study showed that although all the two BP measurement methods equally detected ECG-LVH, 24-hours ABPM tended to have the highest diagnostic performance.展开更多
Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 202...Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected.All patients underwent both 64-slice spiral CT and digital subtraction angiography(DSA).DSA is considered the gold standard for diagnosis,so it was used to analyze the diagnostic performance of 64-slice spiral CT.Results:(1)The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other.The 64-slice spiral CT had an accuracy of 96.67%(29/30),a sensitivity 96.55%(28/29),and a specificity of 100.00%(1/1)in diagnosing coronary artery stenosis.(2)There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion,the positive detection rate of left main lesion,the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion(P>0.05).(3)There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis,moderate stenosis,and severe stenosis of coronary arteries(P>0.05).Conclusion:64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries,which allows for the accurate diagnosis of coronary artery stenosis.展开更多
Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms...Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms have been introduced to improve CD4+cell enumeration,aiming to enhance the performance of diagnostic devices and bring the service closer to patients.These advancements are particularly critical for low-resource settings and point-of-care applications,where the excellent performance of flow cytometry is hindered by its unsuitability in such environments.This work presents an innovative electrochemical microfluidic device that,with further development,could be applied for HIV management in low resource settings.The setup integrates an electrochemical sensor within a PDMS microfluidic structure,allowing for on-chip electrode functionalization and cell detection.Using electrochemical impedance spectroscopy,the biosensor demonstrates a linear detection range from 1.25×105 to 2×106 cells/mL,with a detection limit of 1.41×105 cells/mL for CD4+cells isolated from blood samples,aligning with clinical ranges for both healthy and HIV+patients.The biosensor shows specificity towards CD4+cells with negligible response to monocytes,neutrophils,and bovine serum albumin.Its integration with a microfluidic chip for sensor fabrication and cell detection,compact size,minimal manual handling,ease of fabrication,electrochemical detection capability,and potential for multiplexing together with the detection range make the device particularly advantageous for use in low-resource settings,standing out among other devices described in the literature.This study also investigates the integration of a microfluidic Dean Flow Fractionation(DFF)chip for cell separation.展开更多
Background:Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function.Efficient and precise AI algorithms may play a significant role in ...Background:Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function.Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia.In this study,we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts.Methods:We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend(WCHAT)study.For external validation,we used the Xiamen Aging Trend(XMAT)cohort.We compared the support vector machine(SVM),random forest(RF),eXtreme Gradient Boosting(XGB),and Wide and Deep(W&D)models.The area under the receiver operating curve(AUC)and accuracy(ACC)were used to evaluate the diagnostic efficiency of the models.Results:The WCHAT cohort,which included a total of 4057 participants for the training and testing datasets,and the XMAT cohort,which consisted of 553 participants for the external validation dataset,were enrolled in this study.Among the four models,W&D had the best performance(AUC=0.916±0.006,ACC=0.882±0.006),followed by SVM(AUC=0.907±0.004,ACC=0.877±0.006),XGB(AUC=0.877±0.005,ACC=0.868±0.005),and RF(AUC=0.843±0.031,ACC=0.836±0.024)in the training dataset.Meanwhile,in the testing dataset,the diagnostic efficiency of the models from large to small was W&D(AUC=0.881,ACC=0.862),XGB(AUC=0.858,ACC=0.861),RF(AUC=0.843,ACC=0.836),and SVM(AUC=0.829,ACC=0.857).In the external validation dataset,the performance of W&D(AUC=0.970,ACC=0.911)was the best among the four models,followed by RF(AUC=0.830,ACC=0.769),SVM(AUC=0.766,ACC=0.738),and XGB(AUC=0.722,ACC=0.749).Conclusions:The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness.It could be widely used in primary health care institutions or developing areas with an aging population.Trial Registration:Chictr.org,ChiCTR 1800018895.展开更多
文摘BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.
文摘BACKGROUND It is unclear whether the Japan Narrow-Band Imaging Expert Team(JNET)classification and pit pattern classification are applicable for diagnosing neoplastic lesions in patients with ulcerative colitis(UC).AIM To clarify the diagnostic performance of these classifications for neoplastic lesions in patients with UC.METHODS This study was conducted as a single-center,retrospective case-control study.Twenty-one lesions in 19 patients with UC-associated neoplasms(UCAN)and 23 lesions in 22 UC patients with sporadic neoplasms(SN),evaluated by magnifying image-enhanced endoscopy,were retrospectively and separately assessed by six endoscopists(three experts,three non-experts),using the JNET and pit pattern classifications.The results were compared with the pathological diagnoses to evaluate the diagnostic performance.Inter-and intra-observer agreements were calculated.RESULTS In this study,JNET type 2 A and pit pattern typeⅢ/Ⅳwere used as indicators of low-grade dysplasia,JNET type 2 B and pit pattern typeⅥlow irregularity were used as indicators of highgrade dysplasia to shallow submucosal invasive carcinoma,JNET type 3 and pit pattern typeⅥhigh irregularity/VN were used as indicators of deep submucosal invasive carcinoma.In the UCAN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a low positive predictive value(PPV;50.0%and 40.0%,respectively);however,they had a high negative predictive value(NPV;94.7%and 100%,respectively).Conversely,in the SN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a high PPV(100%for both)but a low NPV(63.6%and 77.8%,respectively).In both groups,JNET type 3 and pit pattern typeⅥ-high irregularity/VN showed high specificity.The interobserver agreement of JNET classification and pit pattern classification for UCAN among experts were 0.401 and 0.364,in the same manner for SN,0.666 and 0.597,respectively.The intra-observer agreements of JNET classification and pit pattern classification for UCAN among experts were 0.387,0.454,for SN,0.803 and 0.567,respectively.CONCLUSION The accuracy of endoscopic diagnosis using both classifications was lower for UCAN than for SN.Endoscopic diagnosis of UCAN tended to be underestimated compared with the pathological results.
基金approved by our institutional review board(No.20210035).
文摘BACKGROUND Although contrast-enhanced magnetic resonance imaging(MRI)using gadoxetic acid has been shown to have higher accuracy,sensitivity,and specificity for the detection and characterization of hepatic metastases compared with other modalities,the long examination time would limit the broad indication.Several abbreviated enhanced MRI(Ab-MRI)protocols without dynamic phases have been proposed to achieve equivalent diagnostic performance for the detection of colorectal liver metastases.However,an optimal protocol has not been established,and no studies have assessed the diagnostic performance of Ab-MRI combined with contrast-enhanced computed tomography(CE-CT),which is the preoperative imaging of colorectal cancer staging in clinical settings,to determine the best therapeutic strategy.AIM To compare the diagnostic performance of two kinds of Ab-MRI protocol with the standard MRI protocol and a combination of the Ab-MRI protocol and CE-CT for the detection of colorectal liver metastases.METHODS Study participants comprised 87 patients(51 males,36 females;mean age,67.2±10.8 years)who had undergone gadoxetic acid-enhanced MRI and CE-CT during the initial work-up for colorectal cancer from 2010 to 2021.Each exam was independently reviewed by two readers in three reading sessions:(1)Only single-shot fast spin echo(FSE)T2-weighted or fat-suppressed-FSE-T2-weighted,diffusion-weighted,and hepatobiliary-phase images(Ab-MRI protocol 1 or 2);(2)all acquired MRI sequences(standard protocol);and(3)a combination of an Ab-MRI protocol(1 or 2)and CE-CT.Diagnostic performance was then statistically analyzed.RESULTS A total of 380 Lesions were analyzed,including 195 metastases(51.4%).Results from the two Ab-MRI protocols were similar.The sensitivity,specificity,and positive and negative predictive values from Ab-MRI were non-inferior to those from standard MRI(P>0.05),while those from the combination of Ab-MRI protocol and CE-CT tended to be higher than those from Ab-MRI alone,although the difference was not significant(P>0.05),and were quite similar to those from standard MRI(P>0.05).CONCLUSION The diagnostic performances of two Ab-MRI protocols were non-inferior to that of the standard protocol.Combining Ab-MRI with CE-CT provided better diagnostic performance than Ab-MRI alone.
文摘<b><span style="font-family:Verdana;">Background and Purpose:</span></b><span style="font-family:""><span style="font-family:Verdana;"> The hepatitis C prevalence rate is among the highest the world. Thus, in the context of transfusion safety, WHO has made it compulsory to screen blood bags by rapid diagnostic orientation tests (TROD) validated in regions that do not have the capacity to use more sophisticated technologies. The purpose of this study is to assess the performance of the TRODs commonly used in Kinshasa. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a cross-sectional and analytical study carried out from August 26, 2019 to January 20, 2020 in 200 voluntary blood donors at the University Clinics of Kinshasa (CUK). The detection of anti-HCV antibodies was carried out by Mindray (gold standard) and the SD Bioline, Encode, Fortress and Accurate tests. The diagnostic performance of TRODs was evaluated compared to the Mindray test. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Of a total of 200 donors, 112 (56.0%) were male versus 88 (44.0%) female with a sex ratio of 1M: 1F. HCV seroprevalences by Mindray, and other tests were 29.5%, 28.0%, 27.0%, 27.0% and 31.5%, respectively;the Se, Sp, VPP, VPN, SD Bioline, Accurate, Fortress and Encode were 74.6%, 92.9%, 81.5%, 89.7%, respectively;74.6%, 92.9%, 81.5%, 89.7%;74.6%, 91.4%, 78.6%, 89.6%;69.5%, 70.0%, 65.1%, 84.4%. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The diagnostic performance of TRODs evaluated in this study does not meet European Union standards (Se = 100%;Sp</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">> 99.5%). The Ministry of Health should promote large-scale validation of TRODs based on World Health Organization guidelines.
文摘Objective To investigate the effect of CT-derived fractional flow reserve(CT-FFR)measurement sites on the values and the diagnostic performance,and to determine the optimal measurement site for CT-FFR using invasive FFR as the reference standard.Methods This study was part of the CT-FFR CHINA clinical trial.
基金supported by grants from Instituto de Salud Carlos III(ISCII,grant#PI20CIII/00004 to SR,PI19CIII/00009 to IM,and PI23CIII/00018 to DSC and IM)and Gilead Science(grant#GLD20_0144 to SR)This research was also supported by CIBER‑Consorcio Centro de Investigación Biomédica en Red‑(CB 2021)+2 种基金Instituto de Salud Carlos III,Ministerio de Ciencia e Innovación and Unión Europea-NextGenerationEU(CB21/13/00044)DSC is a‘Miguel Servet’researcher from ISCIII(grant#CP23CIII/00004)AT‑N is a Ph.D.student in the Biomedical Sciences and Public Health program at the UNED International Doctoral School.
文摘Background The current diagnostic strategy for hepatitis C virus(HCV)infection involves a two-step approach:antibody HCV screening followed by confirmatory nucleic acid testing.This study aimed to evaluate the diagnostic performance of the Abbott ARCHITECT HCV Ag assay in serum/plasma samples as a potential one-step alterna-tive for diagnosing active HCV infection in people living with hepatitis B virus(PLWHB)through a systematic review and meta-analysis.Methods A systematic review and meta-analysis were conducted following PRISMA-DTA guidelines.This protocol was registered on PROSPERO(CRD42023402093).A comprehensive search of electronic databases identified studies published up to 1 November 2024,comparing the ARCHITECT HCV Ag assay to an HCV-RNA reference standard.Sen-sitivity,specificity,and likelihood ratios were pooled using a random-effects model within the MIDAS module of Stata software.Study quality was assessed using QUADAS-2.Heterogeneity was evaluated using the Q statistic,quantified using the I2,and further explored through meta-regression.Results Ten studies(n=494 participants)met inclusion criteria.The Abbott ARCHITECT HCV Ag assay demonstrated high sensitivity[91%,95%confidence interval(CI):76-97%]and specificity(99%,95%CI:99-100%).The positive likeli-hood ratio(PLR)was 81.20(95%CI:12.34-534.36),and the negative likelihood ratio(NLR)was 0.09(95%CI:0.03-0.27).The area under the summary receiver operating characteristic curve(AUC-SROC)was 99%(95%CI 98-100%).In regions with high HCV prevalence(≥10%),the test accurately confirmed active HCV infection in over 90%of cases.However,confirmatory testing remains necessary in low-prevalence settings(≤5%).The assay demonstrated an excel-lent ability to identify individuals without HCV infection,with a low false-negative rate(≤2%)regardless of HCV prevalence.Heterogeneity analysis revealed moderate to substantial variation in test performance(I2=72.09%for sensitivity,35.47%for PLR,and 78.33%for NLR).QUADAS-2 applicability concerns predicted heterogeneity,but dif-ferences were likely insignificant due to minimal variations and limited studies.Conclusions The Abbott ARCHITECT HCV Ag assay exhibited promising accuracy in detecting active HCV infection among PLWHB.This test might help diagnose active HCV infection in high-prevalence scenarios(≥10%)but needs further confirmation in low-prevalence settings(≤5%).
文摘Background Non-invasive computed tomography angiography(CTA)-based fractional flow reserve(CT-FFR)could become a gatekeeper to invasive coronary angiography.Deep learning(DL)-based CT-FFR has shown promise when compared to invasive FFR.To evaluate the performance of a DL-based CT-FFR technique,DeepVessel FFR(DVFFR).Methods This retrospective study was designed for iScheMia Assessment based on a Retrospective,single-center Trial of CTFFR(SMART).Patients suspected of stable coronary artery disease(CAD)and undergoing both CTA and invasive FFR examinations were consecutively selected from the Beijing Anzhen Hospital between January 1,2016 to December 30,2018.FFR obtained during invasive coronary angiography was used as the reference standard.DVFFR was calculated blindly using a DL-based CTFFR approach that utilized the complete tree structure of the coronary arteries.Results Three hundred and thirty nine patients(60.5±10.0 years and 209 men)and 414 vessels with direct invasive FFR were included in the analysis.At per-vessel level,sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of DVFFR were 94.7%,88.6%,90.8%,82.7%,and 96.7%,respectively.The area under the receiver operating characteristics curve(AUC)was 0.95 for DVFFR and 0.56 for CTA-based assessment with a significant difference(P<0.0001).At patient level,sensitivity,specificity,accuracy,PPV and NPV of DVFFR were 93.8%,88.0%,90.3%,83.0%,and 95.8%,respectively.The computation for DVFFR was fast with the average time of 22.5±1.9 s.Conclusions The results demonstrate that DVFFR was able to evaluate lesion hemodynamic significance accurately and effectively with improved diagnostic performance over CTA alone.Coronary artery disease(CAD)is a critical disease in which coronary artery luminal narrowing may result in myocardial ischemia.Early and effective assessment of myocardial ischemia is essential for optimal treatment planning so as to improve the quality of life and reduce medical costs.
文摘Objective To evaluate the diagnostic performance of galactomannan(GM)detection in serum and BALF for invasive pulmonary aspergillosis(IPA)in non-neutropenic hosts.Methods A prospective study was performed for 1 356 non-neutropenic hosts admitted to the Department of Pulmonary and Critical Care Medicine of
文摘In this editorial,we comment on the article by Lambert et al,published in the recent issue of the World Journal of Radiology.The focus of the editorial is to explore the advancements in whole-body magnetic resonance imaging(WB-MRI)techno-logy,its current clinical applications,and the challenges that must be addressed to fully realize its potential in oncological imaging.WB-MRI has emerged as a pivotal tool in oncological imaging,offering comprehensive disease assessment without ionizing radiation.Its applications span the detection of bone metastases,evaluation of hematologic malignancies,and staging of a wide range of cancers,including lymphoma,prostate,and breast cancers.Advanced techniques such as diffusion-weighted imaging have enhanced its diagnostic performance by pro-viding superior lesion-to-background contrast and quantitative metrics.Despite its diagnostic strengths,WB-MRI faces challenges in standardization,patient acceptance,and integration into clinical workflows.Variability in acquisition pro-tocols,hardware differences,and patient-related factors,such as anxiety and motion artifacts,have limited widespread adoption.Emerging guidelines like MET-RADS-P and ONCO-RADS aim to address these issues by promoting stan-dardized protocols tailored to specific clinical needs.This editorial explores the advancements in WB-MRI technology,its current clinical applications,and the barriers that must be overcome to maximize its utility.By addressing these cha-llenges and embracing standardization,WB-MRI holds the potential to redefine the landscape of oncological imaging,aligning diagnostic precision with modern treatment goals of reducing long-term patient risk.
文摘Objective Exosomal long noncoding RNAs(lnc RNAs) are the key to diagnosing and treating various diseases. This study aimed to investigate the diagnostic value of plasma exosomal lnc RNAs in white matter hyperintensities(WMH).Methods We used high-throughput sequencing to determine the differential expression(DE) profiles of lnc RNAs in plasma exosomes from WMH patients and controls. The sequencing results were verified in a validation cohort using q RT-PCR. The diagnostic potential of candidate exosomal lnc RNAs was proven by binary logistic analysis and receiver operating characteristic(ROC) curves. The diagnostic value of DE exo-lnc RNAs was determined by the area under the curve(AUC). The WMH group was then divided into subgroups according to the Fazekas scale and white matter lesion site, and the correlation of DE exo-lnc RNAs in the subgroup was evaluated.Results In our results, four DE exo-lnc RNAs were identified, and ROC curve analysis revealed that exolnc_011797 and exo-lnc_004326 exhibited diagnostic efficacy for WMH. Furthermore, WMH subgroup analysis showed exo-lnc_011797 expression was significantly increased in Fazekas 3 patients and was significantly elevated in patients with paraventricular matter hyperintensities.Conclusion Plasma exosomal lnc RNAs have potential diagnostic value in WMH. Moreover, exolnc_011797 is considered to be a predictor of the severity and location of WMH.
基金Supported by the National Natural Science foundation of China,No. 82202135, and No. 82171925Foundation of Excellent Young Doctor of Jiangsu Province Hospital of Chinese Medicine,No. 2023QB0112+1 种基金Innovative Development Foundation of Department in Jiangsu Hospital of Chinese Medicine,No. Y2021CX19Developing Program for High-level Academic Talent in Jiangsu Hospital of TCM,No. y2021rc03
文摘BACKGROUND Intrapancreatic accessory spleen(IPAS)shares similar imaging findings with hypervascular pancreatic neuroendocrine tumors(PNETs),which may lead to unnecessary surgery.AIM To investigate and compare the diagnostic performance of absolute apparent diffusion coefficient(ADC)and normalized ADC(lesion-to-spleen ADC ratios)in the differential diagnosis of IPAS from PNETs.METHODS A retrospective study consisting of 29 patients(16 PNET patients vs 13 IPAS patients)who underwent preoperative contrast-enhanced magnetic resonance imaging together with diffusion-weighted imaging/ADC maps between January 2017 and July 2020 was performed.Two independent reviewers measured ADC on all lesions and spleens,and normalized ADC was calculated for further analysis.The receiver operating characteristics analysis was carried out for evaluating the diagnostic performance of both absolute ADC and normalized ADC values in the differential diagnosis between IPAS and PNETs by clarifying sensitivity,specificity,and accuracy.Inter-reader reliability for the two methods was evaluated.RESULTS IPAS had a significantly lower absolute ADC(0.931±0.773×10^(-3)mm^(2)/s vs 1.254±0.219×10^(-3)mm^(2)/s)and normalized ADC value(1.154±0.167 vs 1.591±0.364)compared to PNET.A cutoff value of 1.046×10^(-3)mm^(2)/s for absolute ADC was associated with 81.25%sensitivity,100%specificity,and 89.66%accuracy with an area under the curve of 0.94(95%confidence interval:0.8536-1.000)for the differential diagnosis of IPAS from PNET.Similarly,a cutoff value of 1.342 for normalized ADC was associated with 81.25%sensitivity,92.31%specificity,and 86.21%accuracy with an area under the curve of 0.91(95%confidence interval:0.8080-1.000)for the differential diagnosis of IPAS from PNET.Both methods showed excellent inter-reader reliability with intraclass correlation coefficients for absolute ADC and ADC ratio being 0.968 and 0.976,respectively.CONCLUSION Both absolute ADC and normalized ADC values can facilitate the differentiation between IPAS and PNET.
基金the National Natural Science Foundation of China(No.81974492)。
文摘Objective:Circulating tumor DNA(ctDNA)and alpha-fetoprotein(AFP)plus ultrasound(US)have been considered to have high diagnostic accuracy for cancer detection,however,the efficacy of ctDNA methylation combined with the traditional detection modality of liver cancer has not been tested in a Chinese independent cohort.Methods:The high-risk individuals aged between 35 and 70 years who were diagnosed with liver cirrhosis or had moderate and severe fatty liver were eligible for inclusion.All participants were invited to receive a traditional examination[referring to AFP plus US],and ctDNA methylation,respectively.The sensitivity and specificity of different diagnostic tools were calculated.The logistic regression model was applied to estimate the area under the curve(AUC),which was further validated by 10-fold internal cross-validation.Results:A total of 1,205 individuals were recruited in our study,and 39 participants were diagnosed with liver cancer.The sensitivity of AFP,US,US plus AFP,and the combination of US,AFP,and ctDNA methylation was33.33%,56.41%,66.67%,and 87.18%,respectively.The corresponding specificity of AFP,US,US plus AFP,and the combination of all modalities was 98.20%,99.31%,97.68%,and 97.68%,respectively.The AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 65.77%,77.86%,82.18%,and92.43%,respectively.The internally validated AUCs of AFP,US,US plus AFP,and the combination of AFP,US,and ctDNA methylation were 67.57%,83.26%,86.54%,and 93.35%,respectively.Conclusions:The ctDNA methylation is a good complementary to AFP and US for the detection of liver cancer.
基金Supported by The National Natural Science Foundation of China,No.82172563The Research Program Foundation of Shenzhen,No.JCYJ20210324131809027.
文摘BACKGROUND Hepatic artery occlusion(HAO)after liver transplantation(LT)is a devastating complication,resulting in early graft loss and reduced overall survival.Ultra-sound is an established assessment method for HAO in patients following LT,especially those with complex hepatic artery reconstruction.METHODS We retrospectively analyzed the ultrasound characteristics and the clinic risk factors associated with HAO in 400 adult LT patients who were enrolled and treated at the Third People's Hospital of Shenzhen between November 2016 and July 2022.Fourteen patients diagnosed with acute HAO(A-HAO)by surgery and fifteen diagnosed with chronic HAO(C-HAO)were included.A control group of 33 patients without HAO complications during the same period were randomly selected using a random number table.All patients underwent an ultrasono-graphy examination.Parameters including resistance index(RI),peak systolic velocity(PSV),and portal vein velocity(PVV)were compared across the groups.Additionally,basic clinical data were collected for all patients,including gender,age,primary diagnosis,D-dimer concentration,total operation time,cold ischemia time,hot ischemia time,intraoperative blood loss and transfusion,intraoperative urine volume,infusion,model for end-stage liver disease(MELD)score,and whether complex hepatic artery reconstructions were performed.Furthermore,risk factors influencing HAO formation after LT were analyzed.RESULTS Compared to the non-HAO group,PVV and RI were higher in the A-HAO group,while PSV was lower.Conversely,both PSV and RI were lower in the C-HAO group compared to the non-HAO group.The proportion of patients undergoing complex hepatic artery reconstructions and the gamma-glutamyltransferase(GGT)level before occlusion were significantly higher in the A-HAO group compared to the non-HAO group.However,there were no distinct differences between the two groups in D-dimer,MELD score,pre-occlusion alanine transaminase and aspartate transaminase levels,or intraoperative conditions.CONCLUSION Ultrasound features of the hepatic artery before occlusion are significantly associated with postoperative HAO development.Additionally,complex hepatic artery reconstructions,defined as revascularization of the graft requiring additional anastomosis between donor hepatic arteries,constitute a risk factor for A-HAO.Besides,abnormal pre-occlusion GGT elevation is an important biochemical indicator.Therefore,ultrasound examination serves as an important tool for screening HAO,especially in patients with the identified risk factors.
文摘Objective:Our research aims to evaluate the diagnostic accuracy of colposcopy-guided biopsy(CGB)in detecting high-grade cervical lesions and explore how human papilloma virus(HPV)integration status and other factors affect its performance.Methods:A retrospective cohort analysis involving 550 patients was conducted to evaluate whether the HPV integration plays a role in identifying high-grade cervical lesions and cervical cancer.Logistic regression models and area under the curve(AUC)calculations were employed.Results:Our findings revealed that 53.5%of CGB/surgery pairs demonstrated congruent diagnoses,whereas 17.1%showed underestimation and 29.5%overestimation.Furthermore,multivariate logistic regression analysis identified several key predictors for cervical intraepithelial neoplasia(CIN)2+and CIN3+according to surgical pathology.Notably,a CGB confirming CIN2+[odds ratio(OR)=6.0,95%confidence interval(CI):3.9–9.1,P<0.001],high-grade cytology(OR=2.6,95%CI:1.4–4.9,P=0.003),and HPV integration positivity(OR=2.2,95%CI:1.3–3.5,P<0.001)emerged as significant factors for CIN2+.Similarly,for CIN3+identification,CGB confirming CIN2+(OR=5.3,95%CI:3.4–8.3,P<0.001),high-grade cytology(OR=2.6,95%CI:1.5–4.7,P=0.001),and HPV integration positivity(OR=2.0,95%CI:1.3–3.1,P=0.003)were independent predictors.Conclusion:Our study highlights the innovative role of HPV integration testing as a pivotal adjunct to CGB and cytology,offering a comprehensive approach that may enhance the diagnostic precision for high-grade cervical lesions,ultimately achieving more precise management strategies.
基金Supported by Spain’s Carlos III Health Care Institute by Means of Project(Co-funded by European Regional Development Fund/European Social Fund"A way to make Europe"/"Investing in your future"),No.PI17/00837。
文摘Faecal immunochemical tests(FITs)are the most widely colorectal cancer(CRC)diagnostic biomarker available.Many population screening programmes are based on this biomarker,with the goal of reducing CRC mortality.Moreover,in recent years,a large amount of evidence has been produced on the use of FIT to detect CRC in patients with abdominal symptoms in primary healthcare as well as in surveillance after adenoma resection.The aim of this review is to highlight the available evidence on these two topics.We will summarize the evidence on diagnostic yield in symptomatic patients with CRC and significant colonic lesion and the different options to use this(thresholds,brands,number of determinations,prediction models and combinations).We will include recommendations on FIT strategies in primary healthcare proposed by regulatory bodies and scientific societies and their potential effects on healthcare resources and CRC prognosis.Finally,we will show information regarding FIT-based surveillance as an alternative to endoscopic surveillance after high-risk polyp resection.To conclude,due to the coronavirus disease 2019 pandemic,FIT-based strategies have become extremely relevant since they enable a reduction of colonoscopy demand and access to the healthcare system by selecting individuals with the highest risk of CRC.
文摘Hepatitis C virus(HCV)-cirrhotic patients have the highest threat of developing hepatocellular carcinoma(HCC)and may be at risk of extra hepatic cancer.The present study was designed to investigate CD133 and CK19 in HCV(genotype-4)-cirrhotic patients with/without HCC or extra hepatic cancer,to assess the degree of their correlation with cell cycle abnormalities and finally to assess the role of their combination as diagnostic tool for discrimination of cirrhotic patients with HCC from those with extra hepatic cancer.The study included 77 HCV-cirrhotic patients and 20 healthy non-disease control group.Patients were categorized histo-pathologically into:24 have only liver cirrhosis,26 with HCC,and 27 patients with extra hepatic cancer.Cell cycle abnormalities,CD133 and CK19 were determined by flow cytometry technique.CD133 and CK19 showed marked elevation in HCC and extra hepatic cancer compared with liver cirrhosis and control subjects(p<0.0001).Positive associations were noted between CK19,CD133 and G2/M.They were gradually increased with progression from liver cirrhosis to HCC.Combination of the three showed the best AUC(0.978)and accuracy(92.5%)for discrimination of HCC from extra hepatic cancer.Combined CD133 with G2/M and CK19 comprises an excellent diagnostic panel for discrimination of HCV-cirrhotic patients with HCC from those with extra hepatic cancer.
文摘Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours ABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor in the non-access arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for at least 3 months and informed consent) attending 3 hemodialysis centers in Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell product criteria. ROC curve method was used to assess the performance of dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P 0.05 defined the level of statistical significance. Results: Whatever the method of BP measurement, all the SBP values were related to ECG-LVH with similar AUC and overlapping 95% CI;however, they were not significantly different from each other. 24-hours interdialytic ambulatory SBP (AUC 0.748;95% CI 0.58 - 0.94) had the highest area under the curve. Conclusion: The present study showed that although all the two BP measurement methods equally detected ECG-LVH, 24-hours ABPM tended to have the highest diagnostic performance.
文摘Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected.All patients underwent both 64-slice spiral CT and digital subtraction angiography(DSA).DSA is considered the gold standard for diagnosis,so it was used to analyze the diagnostic performance of 64-slice spiral CT.Results:(1)The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other.The 64-slice spiral CT had an accuracy of 96.67%(29/30),a sensitivity 96.55%(28/29),and a specificity of 100.00%(1/1)in diagnosing coronary artery stenosis.(2)There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion,the positive detection rate of left main lesion,the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion(P>0.05).(3)There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis,moderate stenosis,and severe stenosis of coronary arteries(P>0.05).Conclusion:64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries,which allows for the accurate diagnosis of coronary artery stenosis.
基金funding from Santander postgraduate mobility awards and Department of Electronic&Electrical Engineering,University of BathR.S.was funded through UK Engineering and Physical Sciences Research Council grant number EP/V040189/1.
文摘Since the onset of the HIV epidemic,assessing CD4+T-cells has become a routine procedure for evaluating immune deficiency,with flow cytometry established as the gold standard.Over time,various strategies and platforms have been introduced to improve CD4+cell enumeration,aiming to enhance the performance of diagnostic devices and bring the service closer to patients.These advancements are particularly critical for low-resource settings and point-of-care applications,where the excellent performance of flow cytometry is hindered by its unsuitability in such environments.This work presents an innovative electrochemical microfluidic device that,with further development,could be applied for HIV management in low resource settings.The setup integrates an electrochemical sensor within a PDMS microfluidic structure,allowing for on-chip electrode functionalization and cell detection.Using electrochemical impedance spectroscopy,the biosensor demonstrates a linear detection range from 1.25×105 to 2×106 cells/mL,with a detection limit of 1.41×105 cells/mL for CD4+cells isolated from blood samples,aligning with clinical ranges for both healthy and HIV+patients.The biosensor shows specificity towards CD4+cells with negligible response to monocytes,neutrophils,and bovine serum albumin.Its integration with a microfluidic chip for sensor fabrication and cell detection,compact size,minimal manual handling,ease of fabrication,electrochemical detection capability,and potential for multiplexing together with the detection range make the device particularly advantageous for use in low-resource settings,standing out among other devices described in the literature.This study also investigates the integration of a microfluidic Dean Flow Fractionation(DFF)chip for cell separation.
基金National Key R&D Program of China(No.2020YFC2005600)
文摘Background:Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function.Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia.In this study,we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts.Methods:We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend(WCHAT)study.For external validation,we used the Xiamen Aging Trend(XMAT)cohort.We compared the support vector machine(SVM),random forest(RF),eXtreme Gradient Boosting(XGB),and Wide and Deep(W&D)models.The area under the receiver operating curve(AUC)and accuracy(ACC)were used to evaluate the diagnostic efficiency of the models.Results:The WCHAT cohort,which included a total of 4057 participants for the training and testing datasets,and the XMAT cohort,which consisted of 553 participants for the external validation dataset,were enrolled in this study.Among the four models,W&D had the best performance(AUC=0.916±0.006,ACC=0.882±0.006),followed by SVM(AUC=0.907±0.004,ACC=0.877±0.006),XGB(AUC=0.877±0.005,ACC=0.868±0.005),and RF(AUC=0.843±0.031,ACC=0.836±0.024)in the training dataset.Meanwhile,in the testing dataset,the diagnostic efficiency of the models from large to small was W&D(AUC=0.881,ACC=0.862),XGB(AUC=0.858,ACC=0.861),RF(AUC=0.843,ACC=0.836),and SVM(AUC=0.829,ACC=0.857).In the external validation dataset,the performance of W&D(AUC=0.970,ACC=0.911)was the best among the four models,followed by RF(AUC=0.830,ACC=0.769),SVM(AUC=0.766,ACC=0.738),and XGB(AUC=0.722,ACC=0.749).Conclusions:The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness.It could be widely used in primary health care institutions or developing areas with an aging population.Trial Registration:Chictr.org,ChiCTR 1800018895.
