European Radiology最新文献

{"title":"Reduction of biopsy rate in BI-RADS4 breast lesions: potential of an abbreviated advanced DWI protocol.","authors":"Mariko Goto, Denis Le Bihan, Koji Sakai, Kei Yamada","doi":"10.1007/s00330-025-11604-2","DOIUrl":"10.1007/s00330-025-11604-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared the diagnostic performance of diffusion biomarkers estimated from an abbreviated diffusion-weighted imaging (DWI) protocol and assessed their potential to reduce unnecessary biopsies of benign BI-RADS 4 lesions identified on dynamic contrast-enhanced (DCE) MRI.</p><p><strong>Methods: </strong>A retrospective study was conducted from 2019 to 2023. All patients underwent abbreviated DWI at 3 T with four b-values (0 s/mm², 200 s/mm², 800 s/mm², and 1500 s/mm²). Regions of interest were manually placed on DWI, and biomarkers, including the apparent diffusion coefficient (ADC_0-800), perfusion fraction intravoxel incoherent motion, non-Gaussian diffusion (ADC₀ and kurtosis [K]), signature index (S-index), and shifted ADC (sADC), were estimated. Diagnostic performance and the potential to reduce unnecessary biopsies were evaluated for each parameter.</p><p><strong>Results: </strong>In total, 168 female patients (mean age ± standard deviation, 56.2 ± 13.5 years) with 178 BI-RADS 4 lesions on DCE MRI were analyzed. The median ADC_0-800, sADC, and ADC₀ were significantly lower in malignant lesions, while S-index and K were significantly higher (all p ≤ 0.001). The diagnostic performance to reclassify lesions as benign or malignant was identical for ADC_0-800 (area under the curve = 0.67), sADC (0.69), S-index (0.69), ADC₀ (0.68), and K (0.66). Applying an ad-hoc threshold cutoff, all parameters reduced unnecessary biopsies (around 16%), while K resulted in a slightly higher reduction rate than ADC_0-800 (20.5% vs 15.9%, p = 0.317) without reducing sensitivity.</p><p><strong>Conclusion: </strong>Diffusion MRI biomarkers obtained using an abbreviated DWI protocol reduced unnecessary biopsies in BI-RADS 4 lesions, with K performing slightly better than ADC.</p><p><strong>Key points: </strong>Question MRI BI-RADS category 4 includes a substantial number of benign lesions, and reducing unnecessary biopsies remains a critical clinical concern. Findings The parameters from abbreviated DWI show lesion differentiation comparable to ADC and have greater potential to reduce unnecessary biopsies. Clinical relevance This study underscores the potential of imaging biomarkers from abbreviated DWI for assessing breast MRI BI-RADS 4 lesions. These biomarkers may be comparable or superior to standard ADC in reducing unnecessary biopsies and could aid in improving patient management decisions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6421-6432"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic yield of thyroid CT in differentiated thyroid carcinoma according to treatment response.","authors":"Yun Hwa Roh, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee","doi":"10.1007/s00330-025-11613-1","DOIUrl":"10.1007/s00330-025-11613-1","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic yield of thyroid CT in patients with post-treatment differentiated thyroid carcinoma (DTC) stratified by treatment response.</p><p><strong>Materials and methods: </strong>This retrospective study included DTC patients who underwent total thyroidectomy and radioactive iodine ablation, followed by thyroid CT. Patients were categorized into response assessment groups according to the American Thyroid Association guidelines: excellent response (ER), biochemical incomplete response (BIR), indeterminate response (IR), and structural incomplete response (SIR). Diagnostic yield was defined as the proportion of patients with recurrent tumors among all patients. The yields of ER, BIR, and IR were compared. For IR, subgroup analyses were performed based on the presence of indeterminate lesions on ultrasound (US). Chi-squared tests with Bonferroni correction were used to compare the diagnostic yields between groups.</p><p><strong>Results: </strong>A total of 450 patients (mean age, 44.9 ± 13.4 years; 164 men) were included. The overall diagnostic yield of thyroid CT was 15.3% (69/450; 95% confidence interval [CI]: 12.3-19%). Yields for the ER, BIR, and IR groups were 2% (4/201; 95% CI: 0.6-5.2%), 23.1% (12/52; 95% CI: 13.6-36.3%), and 26.9% (53/197; 95% CI: 21.2-33.5%), respectively. Among IR patients, the yield was significantly lower in US-negative patients (7.5%, 7/93; 95% CI: 3.5-15%) compared to those with indeterminate US lesions (44.2%, 46/104; 95% CI: 35.1-53.8%) (p < 0.001).</p><p><strong>Conclusion: </strong>The diagnostic yield of thyroid CT varies according to the treatment response; it was low in ER and US-negative IR but higher in BIR and IR with indeterminate US lesions.</p><p><strong>Key points: </strong>Question Guidelines recommend considering CT for follow-up in DTC based on treatment response, but the diagnostic yield of CT remains underexplored. Findings The diagnostic yield of CT was low in an ER and US-negative IR but higher in BIR and US-positive IR. Clinical relevance The diagnostic yield of thyroid CT varies according to treatment response. Utilizing CT based on treatment response may enhance the detection of recurrent tumors or clarify unclear findings on US.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5935-5943"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor: Reevaluating DECT in early spondylodiscitis for comprehensive diagnosis.","authors":"Jia-Ning Cui, Rong-Jie Bai, Dao-Feng Wang, Dan Shan","doi":"10.1007/s00330-024-11309-y","DOIUrl":"10.1007/s00330-024-11309-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6612-6614"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of abdominal MRI features associated with histopathological severity and treatment response in autoimmune hepatitis.","authors":"Xiao Han, Dawei Yang, Yu Su, Qianyi Wang, Min Li, Nianhao Du, Jiahui Jiang, Xin Tian, Jimin Liu, Jidong Jia, Zhenghan Yang, Xinyan Zhao, Hong Ma","doi":"10.1007/s00330-025-11578-1","DOIUrl":"10.1007/s00330-025-11578-1","url":null,"abstract":"<p><p>To identify abdominal contrast magnetic resonance imaging (MRI) features associated with histopathological severity, and treatment response in autoimmune hepatitis (AIH).</p><p><strong>Patients and methods: </strong>AIH patients who had abdominal contrast MRI within 3 months of liver biopsy were retrospectively enrolled. Histopathological severity, liver volume, MRI features, laboratory tests, and treatment response were collected. MRI and serum models were constructed through stepwise univariate and multivariate logistic regression for diagnosing severe histopathology and predicting insufficient response (IR).</p><p><strong>Results: </strong>One hundred AIH patients were included (median age: 57.0 years, 79.0% female). For diagnosing severe portal inflammation, reticular fibrosis and volume ratio of segment V-VIII to total liver (SV-SVIII/TLV) achieved an area under the receiver operating characteristic curve (AUROC) of 0.765 (95% CI 0.670-0.860). Severe confluent necrosis was modeled using hepatic fissure widening, reticular fibrosis, and volume ratio of segment I-III to segments IV-VIII, achieving an AUROC of 0.796 (95% CI 0.708-0.885). Severe histological activity was modeled using ascites, and SV-SVIII/TLV achieved an AUROC of 0.748 (95% CI 0.649-0.847). To diagnose cirrhosis, ascites, reticular fibrosis, and the volume ratio of segment I to the total liver were employed, yielding an AUROC of 0.833 (95% CI 0.716-0.949); IR (transaminases and/or immunoglobulin G remaining unnormal after 6 months of immunosuppressive treatment) was modeled using ascites, gallbladder wall edema, and transient hepatic attenuation difference, achieving an AUROC of 0.796 (95% CI 0.691-0.902).</p><p><strong>Conclusion: </strong>The MRI models demonstrated relatively good performance in evaluating histopathological severity and treatment response. Combining MRI and serum models could enhance diagnostic and prognostic efficacy.</p><p><strong>Key points: </strong>Question Abdominal contrast MRI may help clinicians better evaluate the histopathological severity and treatment response of autoimmune hepatitis (AIH), but there is currently limited research. Findings Models based on MRI features perform well in diagnosing severe portal inflammation, confluent necrosis, histological activity, and cirrhosis, as well as predicting insufficient response. Clinical relevance Abdominal contrast MRI, combined with serological parameters, provides a new and stronger noninvasive method for clinically assessing AIH progression and treatment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6005-6019"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye lens dose saving in diagnostic cerebral angiography: a different way to use the filter.","authors":"Antti Pekkarinen","doi":"10.1007/s00330-025-11701-2","DOIUrl":"10.1007/s00330-025-11701-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"5994-5995"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: Translating MRI-detected extranodal extension into clinical practice in prostate cancer-practical considerations and future directions.","authors":"Aline Araújo Naves, Gabriel de Lion Gouvea, Camila V B Machado, Leandro Machado Colli, Fernando Chahud, Rodolfo B Reis, Valdair F Muglia","doi":"10.1007/s00330-025-11811-x","DOIUrl":"10.1007/s00330-025-11811-x","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6033-6034"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESGAR consensus statement on MR imaging in primary sclerosing cholangitis.","authors":"Davide Ippolito, Cesare Maino, Lionel Arrivé, Ahmed Ba-Ssalamah, Roberto Cannella, Alessandro Furlan, Aristeidis Grigoriadis, Martina Pezzullo, Sarah Pöetter Lang, Sabine Schmidt Kobbe, Federica Vernuccio, Maria Antonietta Bali","doi":"10.1007/s00330-025-11583-4","DOIUrl":"10.1007/s00330-025-11583-4","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a consensus statement and recommendations on MR imaging in primary sclerosing cholangitis (PSC).</p><p><strong>Methods: </strong>The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) convened a multinational European panel of experts selected based on a literature review and their leadership in the field. A modified Delphi process was adopted to draft a list of statements. For each statement, the panelists indicated the level of agreement using a 5-point Likert scale, where 1 means \"no agreement,\" 2 means \"poor agreement,\" 3 means \"slight agreement,\" 4 means \"fair agreement,\" and 5 means \"complete agreement.\" The median score for each statement was collected. The level of evidence was reported according to the Oxford Centre for Evidence-Based Medicine. Descriptive statistics were used to rate agreement levels and the consensus' internal reliability.</p><p><strong>Results: </strong>The 12 voting committee members were from Italy (n = 4, 33.4%), Austria (n = 2, 16.7%), Sweden (n = 1, 8.3%), France (n = 1, 8.3%), the United States (n = 1, 8.3%), Switzerland (n = 1, 8.3%), and Belgium (n = 2, 16.7%). The final questionnaire consisted of 55 statements. The agreement reached by the expert panel was complete for 23 statements (41.8%), fair for 16 (29.1%), slight for 15 (27.2%), and poor for 1 (1.9%). Statements that received complete agreement were used to structure a reporting template.</p><p><strong>Conclusions: </strong>This statement paper recommends how and when to perform MRI in PSC patients. A structured reporting template has been created to improve quality care and communication among radiologists and clinicians.</p><p><strong>Key points: </strong>Question A standard MR protocol and the most common imaging features to be reported are fundamental for the correct evaluation of primary sclerosing cholangitis (PSC) patients. Findings Twelve expert radiologists reported which are the most important imaging features and how and when to perform MR in PSC patients. Clinical relevance The identified statements reported in this paper and the structured reporting template are useful for radiologists and clinicians to help correctly manage PSC patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"6495-6506"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Spectral computed tomography-based quantitative parameters combined with extracellular volume fraction to predict lymph node metastases in gastric cancer.","authors":"Xiuling Zhang, Leping Peng, Fang Ma, Fan Zhang, Xiaoyue Zhang, Xiaoqin Liang, Zhaokun Wei, Xinli Li, Yaqiong Ma, Gang Huang, Lili Wang","doi":"10.1007/s00330-025-11908-3","DOIUrl":"https://doi.org/10.1007/s00330-025-11908-3","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to integrate O-RADS MRI scores with clinical and imaging criteria to predict histopathological subtypes.","authors":"Marie Florin, Yohann Dabi, Marc Bazot, Andrea Rockall, Leo Razakamanantsoa, Isabelle Thomassin-Naggara","doi":"10.1007/s00330-025-11937-y","DOIUrl":"https://doi.org/10.1007/s00330-025-11937-y","url":null,"abstract":"<p><strong>Objective: </strong>To enhance diagnostic precision by integrating the O-RADS MRI score with clinical and imaging criteria for histopathological subtyping.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed data from the EURAD (EURopean ADnexal study) database between 2013 and 2018. Univariate and multivariate logistic regression analyses were performed to identify features potentially associated with presumed final histology.</p><p><strong>Results: </strong>The study encompassed 869 adnexal lesions from 651 patients (mean age: 49.7, STD: 16.1). On multivariate analysis, the presence of fatty content (OR = 126.5, CI_95% [43.6-367.1]) and multiple different signal T1W/T2W signals of cystic component (OR = 4.0, CI_95% [1.8-8.8]) were strongly associated with mature cystic teratomas. Endometriomas were predicted by endometriotic fluid (OR = 20.7, CI_95% [10.5-40.7]) and ADC values (× 10^-3 mm²/s) of cystic component (ADC_CT) < 2 (OR = 3.8, CI_95% [1.7-8.7]). Similarly, voluminous multilocular cysts with > 10 loculi (OR = 4.3, CI_95% [1.7-10.7]) were indicative of benign mucinous cystadenomas. The analysis also highlighted the significance of ADC values in distinguishing between benign and infiltrative lesions. Unilocular cysts with ADC_CT > 2 (OR = 11.1, CI_5% [3.8-32.8]) were strongly associated with benign serous cystadenomas. ADC of solid tissue (ADC_ST) with mural nodule morphology < 1.08 (OR = 3.3, 95%, CI_95% [1.5-7.5]) was predictive of primary invasive tumors, whereas ADC_ST > 1.08 (OR = 3.6, CI_95% [1.2-10.7]) with papillary projection was predictive of borderline tumors.</p><p><strong>Conclusion: </strong>Combining the O-RADS MRI score with morphology, size, type of solid tissue and cystic component, including ADC values, enhances the precision of diagnosing presumed histological subtypes.</p><p><strong>Key points: </strong>Question Does integrating the O-RADS MRI score with clinical and imaging criteria improve diagnostic precision for histopathological subtyping? Findings Combining the O-RADS MRI score with specific clinical or imaging features improved the prediction of borderline, primary invasive, or metastatic tumors. Clinical relevance Combining the O-RADS MRI score with morphological and clinical features can help differentiate ovarian tumors thereby improving patient management, as this can help guide treatment decisions, avoid unnecessary surgeries, and streamline the referral process to specialized care.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greenhouse gas emissions due to long-term data storage of CT with reformats and strategies for mitigation.","authors":"Yifan Jia, Michael Deng, Rebecca Burger, Sarah Sheard, Kate Hanneman, Moran Drucker Iarovich, Evis Sala, Giacomo Avesani, Rowland O Illing, Andrea G Rockall","doi":"10.1007/s00330-025-12023-z","DOIUrl":"https://doi.org/10.1007/s00330-025-12023-z","url":null,"abstract":"<p><strong>Objectives: </strong>Medical image data storage and associated greenhouse gas (GHG) emissions are increasing. We aimed to measure non-essential storage and model mitigation strategies.</p><p><strong>Materials and methods: </strong>The proportion of stored post-processed series (reformats and reconstructions) was retrospectively recorded in 183 baseline staging CT chest-abdomen-pelvis studies (CT-CAP) for endometrial cancer in a UK referral centre between 2013 and 2016 (Cohort A). File size (megabytes, MB) of each series was recorded for 30 studies (Cohort B) and compared with 100 Canadian studies (Cohort C), contextualised by a survey of protocols across 17 global centres (including Cohort C). Storage-associated GHG emissions were modelled over 20 years for various mitigation strategies.</p><p><strong>Results: </strong>Post-processed series were stored in 179/183 (97%) of cohort A, 29/30 (97%) of cohort B and 16/17 (94%) of global centres. Median file size was 787 MB (IQR 460, 1257) for the entire CT study (all stored series) and 290 MB (224, 355) for the acquired axial series alone. On-premises storage of all series for new UK endometrial cancer baseline studies 2020-2040 is estimated to generate 381 metric tons CO₂ equivalent (MTCO₂e). Over this period, modelled mitigation strategies achieved emission reductions of 69% by storing only acquired axial series (117MTCO₂e), 82% combining axial-only with cloud storage (70MTCO₂e), 81% combining axial-only with an 8-year data retention policy (72MTCO₂e), and 89% combining all three strategies (43MTCO₂e).</p><p><strong>Conclusion: </strong>CT data storage has a large environmental cost, necessitating global action. Various mitigation strategies are achievable in reducing storage-related emissions by up to 89%.</p><p><strong>Key points: </strong>Question Storage of non-essential post-processed CT image series contributes significantly to the accumulating image data storage-associated GHG emissions burden. Findings Modelling predicts emission savings of 69% by avoiding non-essential series storage in staging CTs of UK endometrial cancer patients, with comparable savings globally, based on current practice. Clinical relevance GHG emissions can be substantially reduced by not storing non-essential CT reformats, a mitigation that can be implemented immediately by radiologists. Further GHG mitigation is achievable using cloud storage and data-retention policies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}