Diagnostics最新文献

{"title":"Reply to Hårdemark, B. Misconceptions Yield Misleading Results. Comment on \"Wong et al. Comparative Study of Eclipse and RayStation Multi-Criteria Optimization-Based Prostate Radiotherapy Treatment Planning Quality. <i>Diagnostics</i> 2024, <i>14</i>, 465\".","authors":"John Y K Wong, Vincent W S Leung, Rico H M Hung, Curtise K C Ng","doi":"10.3390/diagnostics15121494","DOIUrl":"10.3390/diagnostics15121494","url":null,"abstract":"<p><p>Thank you for the opportunity to reply to the comment raised by Hårdemark [...].</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis.","authors":"Paola Arena, Vittorio Fasulo, Fabrizia Gelardi, Nicola Frego, Jelena Jandric, Davide Maffei, Pier Paolo Avolio, Marco Paciotti, Giuseppe Chiarelli, Fabio De Carne, Filippo Dagnino, Andrea Piccolini, Egesta Lopci, Rodolfo Hurle, Alberto Saita, Arturo Chiti, Massimo Lazzeri, Laura Evangelista, Nicolò Maria Buffi, Paolo Casale, Giovanni Lughezzani","doi":"10.3390/diagnostics15121492","DOIUrl":"10.3390/diagnostics15121492","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). <b>Methods</b>: We retrospectively reviewed prospectively collected data on patients referred to our hospital from October 2020 to January 2023. We included all patients who underwent [68Ga]Ga-PSMA-11 or [18F]F-PSMA-1007 PET/CT for primary staging and subsequently had RARP with concomitant LND. The maximum standard uptake value (SUVmax) for lymph nodes (LNs) and the SUV node-to-background ratio were reported. Two different cut-off values for the SUV node-to-background ratio (i.e., ≥2 vs. <2 and ≥15.5 vs. <15.5) were used to evaluate the diagnostic performance of both tracers. The first cut-off was empirically chosen, while the second was based on Liu's method. <b>Results</b>: A total of 156 patients were included (median age: 67 years). Among them, 83 underwent [68Ga]Ga-PSMA-11 and 73 underwent [18F]F-PSMA-1007 PET/CT. Suspicious lymph nodes were identified in 21 patients (13.5%). Pathological nodal involvement (pN1) was confirmed in 25 cases (16%). Of the 21 patients with suspicious pathological lymph nodes on PSMA PET/CT, 9 (42.9%) had positive nodes on the final pathology report. With an SUV node-to-background ratio cut-off of ≥2, [68Ga]Ga-PSMA-11 showed 37.5% sensitivity (SE) and 98.5% specificity(SP), while [18F]F-PSMA-1007 demonstrated 33.3% SE and 100% SP. Using the ≥15.5 cut-off, SE and SP were 31.3% and 100% for [68Ga]Ga-PSMA-11 and 11.1% and 100% for [18F]F-PSMA-1007, respectively. <b>Conclusions</b>: [18F]F-PSMA-1007 PET/CT showed, even if not statistically significantly, slightly lower SE and higher SP for nodal staging compared to [68Ga]Ga-PSMA-11 PET/CT, irrespective of the SUV ratio used.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Tidal Volume Ventilation in Percutaneous Liver Ablations: Preliminary Experience on 10 Patients.","authors":"Francesco Giurazza, Francesco Coletta, Antonio Tomasello, Fabio Corvino, Silvio Canciello, Claudio Carrubba, Vincenzo Schettini, Francesca Schettino, Romolo Villani, Raffaella Niola","doi":"10.3390/diagnostics15121495","DOIUrl":"10.3390/diagnostics15121495","url":null,"abstract":"<p><p><b>Objectives:</b> Low tidal volume ventilation (LTVV) is a ventilatory strategy with the advantages of minimizing diaphragm movements and reducing hypercapnia and barotrauma risks. This preliminary study aims to report on the safety and effectiveness of LTVV applied during percutaneous US-guided liver ablations of focal malignancies. <b>Methods:</b> Patients affected by focal liver malignancies treated with percutaneous microwaves ablation were retrospectively included in this single-center analysis. Arterial gas analysis was performed immediately before and after ablation to evaluate the arterial pH, partial pressure of carbon dioxide (pCO₂), partial pressure of oxygen (pO₂), and plasma lactate levels. The primary endpoint of this study was to evaluate the safety and efficacy of LTVV during percutaneous liver cancer ablation. The secondary endpoint was to assess the procedural technical success in terms of correct needle probe targeting without the need for repositioning. <b>Results:</b> Ten patients affected by a single liver lesion had been analyzed. The ASA score was three in all patients, with three patients also suffering from COPD. The procedural technical success was 100%: ablations were performed with a single liver puncture without the need for changing access or repositioning the needle. No variations in post-ablation arterial gas analysis requiring anesthesiological management remodulation occurred. Lactate levels remained stable and hemodynamic balance was preserved during all procedures. No switch to standard volume ventilation was required. <b>Conclusions:</b> In this preliminary study, LTVV was a safe and effective anesthesiological protocol in patients treated with percutaneous ablations of liver malignancies, offering an ideal balance between patient safety and percutaneous needle probe positioning precision. Larger prospective studies are needed to confirm these findings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Axial Juvenile Spondyloarthropathy Criteria in Turkish Juvenile Spondyloarthropathy Patients.","authors":"Dilara Unal, Cansu Ayten Tatar, Erdal Sag, Yagmur Bayindir, Emil Aliyev, Veysel Cam, Hulya Ercan Emreol, Mehmet Orhan Erkan, Ozge Basaran, Yelda Bilginer, Seza Ozen","doi":"10.3390/diagnostics15121498","DOIUrl":"10.3390/diagnostics15121498","url":null,"abstract":"<p><p><b>Background:</b> Juvenile spondyloarthritis (JSpA) is a heterogeneous group of diseases. An international consensus group developed the axial juvenile SpA (AxJSpA) classification criteria for this purpose, defining a homogeneous group of patients diagnosed with jSpA and experiencing axial symptoms before the age of 18 years. <b>Aim:</b> To validate this new set of criteria in our pediatric SpA patients. <b>Methods</b>: This study was held in the Hacettepe University Department of Pediatric Rheumatology. Juvenile SpA patients suspected of axial disease diagnosed and followed at the same center between 2005 and 2024 were included. Patients who had other etiologies for axial symptoms, including chronic nonbacterial osteomyelitis, mechanical back pain-overuse injuries, amplified pain/growing pains, and SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) served as the control group. <b>Results:</b> In total, 123 JSpA patients and 74 controls were included in this study. The sensitivity/specificity of the new criteria were 61%/77% with an area under curve value of 0.75 (95% CI: 0.68-0.83) in our cohort. Among different criteria sets, European Spondyloarthropathy Study Group (ESSG) criteria were the most sensitive (sensitivity/specificity 91%/68%), and ASAS peripheral criteria (Assessment of SpondyloArthritis International Society) were the most specific (sensitivity/specificity 67%/84%) in our cohort when compared to ASAS axial criteria (sensitivity/specificity 74%/65%), ILAR (International League of Associations for Rheumatology) (sensitivity/specificity 85%/81%), and ILAR + SI (sacroiliitis) (sensitivity/specificity 67%/74%) criteria. <b>Conclusions:</b> The area under the curve of the new AxJSpA criteria was similar to that of the original report; however, both sensitivity and specificity were lower in our cohort, possibly due to factors like earlier disease presentation and a lower prevalence of chronic structural changes on MRI.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diagnostic Accuracy of an Abbreviated vs. a Full MRI Breast Protocol in Detecting Breast Lobular Carcinoma: A Single-Center ROC Study.","authors":"Francis Zarb, Deborah Mizzi, Paul Bezzina, Leanne Galea","doi":"10.3390/diagnostics15121497","DOIUrl":"10.3390/diagnostics15121497","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Abbreviated breast MRI protocols have been proposed as a faster and more cost-effective alternative to standard full protocols for breast cancer detection. This study aimed to compare the diagnostic accuracy of an abbreviated protocol with that of a full protocol in identifying lobular breast carcinoma using Breast Imaging Reporting and Data System (BI-RADS) classification. The diagnostic performance was evaluated against a gold standard comprising biopsy-proven lobular carcinoma or negative follow-up imaging, using Receiver Operating Characteristic (ROC) analysis and performance metrics such as sensitivity and specificity. <b>Methods:</b> A retrospective analysis was conducted on 35 breast MRI examinations performed between January 2019 and December 2021. Of these, 20 cases had biopsy-confirmed lobular carcinoma, and 15 were determined to be normal based on at least 12 months of negative follow-up imaging. Two radiologists independently reviewed the images using only the abbreviated protocol, blinded to the original reports. Their findings were then compared with the initial full-protocol MRI reports. BI-RADS categories 1 and 2 were considered negative for malignancy, while BI-RADS categories 3, 4, and 5 were considered positive. <b>Results:</b> The area under the ROC curve (AUC) was 1.0 for the full protocol and 0.920 and 0.922 for Radiologists A and B, respectively, using the abbreviated protocol. All malignant lesions were correctly identified by both radiologists across both protocols, resulting in a sensitivity of 100%. However, the abbreviated protocol demonstrated significantly lower specificity (73.3% for Radiologist A and 53.5% for Radiologist B) compared to 100% specificity with the full protocol (<i>p</i> < 0.05). Lymph node involvement was correctly identified in 6-7 of 7 cases, though Radiologist A reported four false positives. Lesion laterality and count matched histopathology in 75-90% of cancer cases depending on protocol. Lesion localization was accurate in 60-80% of cases using the abbreviated protocol, though size comparisons were limited due to the incomplete radiological documentation of dimensions. <b>Conclusions:</b> While the abbreviated MRI protocol achieved diagnostic accuracy and sensitivity comparably to the full protocol, it demonstrated reduced specificity. These findings suggest that abbreviated MRI breast protocol may be a viable screening tool, although the higher false-positive rate should be considered in clinical decision-making.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"19-Gauge Versus 22-Gauge Franseen Needles, Comparison of the Histological Diagnostic Capability of Endoscopic Ultrasound-Guided Fine-Needle Biopsy for Autoimmune Pancreatitis: A Multicenter Retrospective Cohort Study.","authors":"Shota Iwata, Takuji Iwashita, Yosuke Ohashi, Akihiko Senju, Ryuichi Tezuka, Shinya Uemura, Kensaku Yoshida, Akinori Maruta, Yuhei Iwasa, Mitsuru Okuno, Keisuke Iwata, Tatsuhiko Miyazaki, Masahito Shimizu","doi":"10.3390/diagnostics15121496","DOIUrl":"10.3390/diagnostics15121496","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is a useful procedure for obtaining histological specimens. However, its utility in diagnosing autoimmune pancreatitis (AIP) has not yet been well studied. This study aimed to assess the diagnostic capability of EUS-FNB for AIP by comparing a 19-gauge Franseen needle (19FR) and a 22-gauge Franseen needle (22FR). <b>Methods</b>: This study included patients with a final diagnosis of AIP undergoing EUS-FNB for pancreatic lesions between January 2014 and February 2023. All patients underwent EUS-FNB with either 19FR or 22FR. Histological findings were evaluated according to the International Consensus Diagnostic Criteria (ICDC). The primary outcome was the diagnostic yield of Level 1 (≥3 ICDC items) or Level 2 (2 ICDC items). <b>Results</b>: The 19FR group included 31 patients, and the 22FR group included 36 patients. The Level 1 diagnostic rate was significantly higher in the 19FR group than in the 22FR group (90.3% vs. 61.1%, <i>p</i> = 0.010). No significant difference was observed in the Level 2 diagnostic rate. The 19FR group yielded significantly larger histological tissue samples than the 22FR group (median area: 9.19 mm²/session vs. 3.36 mm²/session, <i>p</i> < 0.001). The analysis demonstrated a positive correlation between tissue area and the number of histological diagnostic items obtained. <b>Conclusions</b>: EUS-FNB performed with the 19FR provided larger histological specimens and a higher histological diagnostic yield than the 22FR in the diagnosis of AIP. Obtaining a larger amount of tissue may facilitate a definitive diagnosis of AIP.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Breast Tumor Heterogeneity Through IVIM-DWI Parameters and Signal Decay Analysis.","authors":"Si-Wa Chan, Chun-An Lin, Yen-Chieh Ouyang, Guan-Yuan Chen, Chein-I Chang, Chin-Yao Lin, Chih-Chiang Hung, Chih-Yean Lum, Kuo-Chung Wang, Ming-Cheng Liu","doi":"10.3390/diagnostics15121499","DOIUrl":"10.3390/diagnostics15121499","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives:&lt;/b&gt; This research presents a novel analytical method for breast tumor characterization and tissue classification by leveraging intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) combined with hyperspectral imaging techniques and deep learning. Traditionally, dynamic contrast-enhanced MRI (DCE-MRI) is employed for breast tumor diagnosis, but it involves gadolinium-based contrast agents, which carry potential health risks. IVIM imaging extends conventional diffusion-weighted imaging (DWI) by explicitly separating the signal decay into components representing true molecular diffusion (D) and microcirculation of capillary blood (pseudo-diffusion or D*). This separation allows for a more comprehensive, non-invasive assessment of tissue characteristics without the need for contrast agents, thereby offering a safer alternative for breast cancer diagnosis. The primary purpose of this study was to evaluate different methods for breast tumor characterization using IVIM-DWI data treated as hyperspectral image stacks. Dice similarity coefficients and Jaccard indices were specifically used to evaluate the spatial segmentation accuracy of tumor boundaries, confirmed by experienced physicians on dynamic contrast-enhanced MRI (DCE-MRI), emphasizing detailed tumor characterization rather than binary diagnosis of cancer. &lt;b&gt;Methods:&lt;/b&gt; The data source for this study consisted of breast MRI scans obtained from 22 patients diagnosed with mass-type breast cancer, resulting in 22 distinct mass tumor cases analyzed. MR images were acquired using a 3T MRI system (Discovery MR750 3.0 Tesla, GE Healthcare, Chicago, IL, USA) with axial IVIM sequences and a bipolar pulsed gradient spin echo sequence. Multiple b-values ranging from 0 to 2500 s/mm&lt;sup&gt;2&lt;/sup&gt; were utilized, specifically thirteen original b-values (0, 15, 30, 45, 60, 100, 200, 400, 600, 1000, 1500, 2000, and 2500 s/mm&lt;sup&gt;2&lt;/sup&gt;), with the last four b-value images replicated once for a total of 17 bands used in the analysis. The methodology involved several steps: acquisition of multi-b-value IVIM-DWI images, image pre-processing, including correction for motion and intensity inhomogeneity, treating the multi-b-value data as hyperspectral image stacks, applying hyperspectral techniques like band expansion, and evaluating three tumor detection methods: kernel-based constrained energy minimization (KCEM), iterative KCEM (I-KCEM), and deep neural networks (DNNs). The comparisons were assessed by evaluating the similarity of the detection results from each method to ground truth tumor areas, which were manually drawn on DCE-MRI images and confirmed by experienced physicians. Similarity was quantitatively measured using the Dice similarity coefficient and the Jaccard index. Additionally, the performance of the detectors was evaluated using 3D-ROC analysis and its derived criteria (&lt;i&gt;AUC&lt;sub&gt;OD&lt;/sub&gt;&lt;/i&gt;, &lt;i&gt;AUC&lt;sub&gt;TD&lt;/sub&gt;&lt;/i&gt;, &lt;i&gt;AUC&lt;sub&gt;BS&lt;/sub&gt;&lt;/i&gt;, &lt;i&gt;AUC&lt;sub&gt;","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nature-Inspired Multi-Level Thresholding Integrated with CNN for Accurate COVID-19 and Lung Disease Classification in Chest X-Ray Images.","authors":"Wafa Gtifa, Ayoub Mhaouch, Nasser Alsharif, Turke Althobaiti, Anis Sakly","doi":"10.3390/diagnostics15121500","DOIUrl":"10.3390/diagnostics15121500","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Accurate classification of COVID-19 from chest X-rays is critical but remains limited by overlapping features with other lung diseases and the suboptimal performance of current methods. This study addresses the diagnostic gap by introducing a novel hybrid framework for precise segmentation and classification of lung conditions. <b>Methods</b>: The approach combines multi-level thresholding with the advanced metaheuristic optimization algorithms animal migration optimization (AMO), electromagnetism-like optimization (EMO), and the harmony search algorithm (HSA) to enhance image segmentation. A convolutional neural network (CNN) is then employed to classify segmented images into COVID-19, viral pneumonia, or normal categories. <b>Results</b>: The proposed method achieved high diagnostic performance, with 99% accuracy, 99% sensitivity, and 99.5% specificity, confirming its robustness and effectiveness in clinical image classification tasks. <b>Conclusions</b>: This study offers a novel and technically integrated solution for the automated diagnosis of COVID-19 and related lung conditions. The method's high accuracy and computational efficiency demonstrate its potential for real-world deployment in medical diagnostics.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Survival Analysis of Patients with Supraclavicular Fossa Lymphadenopathy.","authors":"Yi-Jou Kao, Wan-Lun Hsu, Yong-Chen Chen, Wu-Chia Lo, Ping-Chia Cheng, Li-Jen Liao","doi":"10.3390/diagnostics15121480","DOIUrl":"10.3390/diagnostics15121480","url":null,"abstract":"<p><p><b>Background:</b> Supraclavicular lymph nodes (SCLNs) are often indicative of malignancy, but the effectiveness of ultrasound (US) and hematological parameters in their assessment and the prognosis of patients with malignant SCLNs need further study. <b>Methods</b>: We retrospectively reviewed 348 patients with SCLNs from July 2007 to June 2023, including patients over 18 years of age who underwent fine needle aspiration (FNA) or core needle biopsy (CNB). Our analysis focused on clinical characteristics, US features and hematological parameters to differentiate between benign and malignant SCLNs and to assess their prognostic value, especially in the Asian population. <b>Results</b>: The malignancy rate was 49%, with lung cancer (22%) and lymphoma (16%) being the most common. The malignant nodes were larger and had a greater short-to-long axis ratio, irregular margins, and abnormal vascular patterns (<i>p</i> < 0.01). The 5-year survival rate for patients with malignant SCLNs was 40%. Blood markers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) (SII ≥ 970), were significant prognostic factors for overall survival (OS). Compared with lymphoma patients, patients with malignancies of supraclavicular and infraclavicular origins had significantly worse OS. <b>Conclusions</b>: Our findings highlight the importance of ultrasound in evaluating SCLNs. Furthermore, hematological markers (NLR, PLR, and SII) and the origin of SCLNs have important prognostic value.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal Biopsy Audit: Relative Frequency of Diagnoses, Key Words on Request Forms Indicating Severe Pathology, and Potential Diagnoses for Intraepithelial Lymphocytosis, as a Foundation for Developing Artificial Intelligence Diagnostic Approaches.","authors":"Vrinda Shenoy, Jessica L James, Amelia B Williams-Walker, Nasyen P R Madhan Mohan, Kim N Luu Hoang, Josephine Williams, Florian Jaeckle, Shelley C Evans, Elizabeth J Soilleux","doi":"10.3390/diagnostics15121483","DOIUrl":"10.3390/diagnostics15121483","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Understanding the diagnostic landscape is essential prior to developing artificial intelligence (AI)-based diagnostic strategies for automating the diagnosis of duodenal biopsies. This study aims to (1) determine the frequencies of different diagnoses seen in endoscopic duodenal biopsies in a large, tertiary referral centre; (2) identify key words on histopathology request forms that could indicate that a biopsy may contain a serious pathology and should not be diagnosed by an AI system; and (3) investigate the proportion of cases described as showing \"intraepithelial lymphocytosis\" that might be coeliac disease. <b>Methods</b>: To achieve this, we audited 18 months' worth of duodenal biopsy reports in our centre. <b>Results</b>: A total of 6245 duodenal biopsies were identified, of which 73.76% were normal and at least 8.84% fell within the spectrum of coeliac disease. Additionally, 6.47% were classified as showing non-specific inflammation, 1.86% were adenomas, 0.45% were carcinomas, 0.06% were neuroendocrine tumours, 0.10% were lymphomas, and 0.03% were cases of flat dysplasia, giving a total of 0.64% of dysplastic or malignant diagnoses. Rarer diagnoses included ulceration, <i>Helicobacter pylori</i> infection, giardiasis, lymphangiectasia, transplant rejection, and lymphoma. Furthermore, 227 biopsies (3.63%) showed isolated intraepithelial lymphocytosis, of which 33 cases (14.5%) gave an overall clinicopathological picture of coeliac disease. <b>Conclusions</b>: We present the first long-term audit of all endoscopic duodenal biopsies received by the histopathology department of a tertiary-care facility. The results indicate that a fully automated diagnostic histopathology reporting system able to identify normal duodenal biopsies and biopsies within the spectrum of coeliac disease-associated enteropathy could decrease pathologists' endoscopic duodenal biopsy workload by up to 80%.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 12","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}