Skeletal Radiology最新文献

{"title":"Whole-body low-dose computed tomography in patients with newly diagnosed multiple myeloma predicts cytogenetic risk: a deep learning radiogenomics study.","authors":"Shahriar Faghani, Mana Moassefi, Udit Yadav, Francis K Buadi, Shaji K Kumar, Bradley J Erickson, Wilson I Gonsalves, Francis I Baffour","doi":"10.1007/s00256-024-04733-0","DOIUrl":"10.1007/s00256-024-04733-0","url":null,"abstract":"<p><strong>Objective: </strong>To develop a whole-body low-dose CT (WBLDCT) deep learning model and determine its accuracy in predicting the presence of cytogenetic abnormalities in multiple myeloma (MM).</p><p><strong>Materials and methods: </strong>WBLDCTs of MM patients performed within a year of diagnosis were included. Cytogenetic assessments of clonal plasma cells via fluorescent in situ hybridization (FISH) were used to risk-stratify patients as high-risk (HR) or standard-risk (SR). Presence of any of del(17p), t(14;16), t(4;14), and t(14;20) on FISH was defined as HR. The dataset was evenly divided into five groups (folds) at the individual patient level for model training. Mean and standard deviation (SD) of the area under the receiver operating curve (AUROC) across the folds were recorded.</p><p><strong>Results: </strong>One hundred fifty-one patients with MM were included in the study. The model performed best for t(4;14), mean (SD) AUROC of 0.874 (0.073). The lowest AUROC was observed for trisomies: AUROC of 0.717 (0.058). Two- and 5-year survival rates for HR cytogenetics were 87% and 71%, respectively, compared to 91% and 79% for SR cytogenetics. Survival predictions by the WBLDCT deep learning model revealed 2- and 5-year survival rates for patients with HR cytogenetics as 87% and 71%, respectively, compared to 92% and 81% for SR cytogenetics.</p><p><strong>Conclusion: </strong>A deep learning model trained on WBLDCT scans predicted the presence of cytogenetic abnormalities used for risk stratification in MM. Assessment of the model's performance revealed good to excellent classification of the various cytogenetic abnormalities.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"267-273"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470623","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":"Association of tibial slope alterations with anterior cruciate ligament (ACL) injury and mucoid degeneration.","authors":"Varun Ravi, Mahad Rehman, Shuda Xia, Avneesh Chhabra, Flavio Duarte Silva","doi":"10.1007/s00256-024-04744-x","DOIUrl":"10.1007/s00256-024-04744-x","url":null,"abstract":"<p><strong>Objective: </strong>To compare radiographic measurements of lateral tibial slope (LTS), medial TS (MTS), and coronal TS (CTS) in MRI-defined intact, injured, and mucoid-degenerated native ACL knees and determine inter-reader reliability.</p><p><strong>Materials and methods: </strong>Patient records from 2 years at tertiary care hospitals were reviewed for individuals aged 18-100 undergoing 3-Tesla knee MRI and radiographs. Two randomly selected cohorts, control, and pathologic ACLs on MRI with 86 patients each, were age, gender, and BMI-matched. A fellowship-trained musculoskeletal radiologist reevaluated curated images, characterizing ACL status. Two trained medical students independently collected clinical data and measured slopes on blinded radiographs. ICC, Cohen's kappa, and case-control matching were performed using SPSS statistical package, with ICC and ANOVA used for comparisons.</p><p><strong>Results: </strong>Among 172 patients with 172 MRIs and radiographs, there were 86 controls and 86 ACL lesions. There were 108/172 (62.79%) males and 64/172 (37.21%) females. ICCs were 0.966 for MTS, 0.975 for LTS, and 0.978 for CTS. Mucoid degeneration patients had a higher BMI and were older than control (p < .05) or completely torn (p < .001) ACL patients. There was no difference in TS between normal and pathologic ACLs; however, LTS-MTS differences were larger with partial tears (2.5 ± 4.9) than normal ACLs by 4.5° (± 1.2, p < .001), complete tears by 4.5° (± 1.3, p < .001), and mucoid degeneration by 4.9° (± 1.5, p = .001).</p><p><strong>Conclusion: </strong>Various TS measurements are reliable. LTS-MTS differences are associated with different ACL lesions compared to normal ACLs.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"325-334"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining morphological and functional imaging parameters to diagnose primary bone neoplasms in the skull base, spine and sacrum.","authors":"Vesna Miladinovic, Augustinus D G Krol, Johan L Bloem, Judith V M G Bovée, Suk Wai Lam, Wilco C Peul, Ana Navas Cañete, Berit M Verbist","doi":"10.1007/s00256-024-04742-z","DOIUrl":"10.1007/s00256-024-04742-z","url":null,"abstract":"<p><strong>Purpose: </strong>Morphological magnetic resonance (MR) and computed tomography (CT) features are used in combination with histology for diagnosis and treatment selection of primary bone neoplasms. Isolated functional MRI parameters have shown potential in diagnosis. Our goal is to facilitate diagnosis of primary bone neoplasms of the skull base, mobile spine and sacrum, by a comprehensive approach, combining morphological and functional imaging parameters.</p><p><strong>Materials and methods: </strong>Pre-treatment MR of 80 patients with histologically proven diagnosis of a primary bone neoplasm of the skull base, mobile spine and sacrum were retrospectively analyzed for morphological and functional MRI parameters. Functional parameters were measured in 4 circular regions of interest per tumor placed on non-adjacent scan slices. Differences in values of functional parameters between different histologies were analyzed with Dunn's test.</p><p><strong>Results: </strong>Chordomas were the predominant histology (60.0%). Most neoplasms (80.0%) originated in the midline and had geographical (78.2%) bone destruction. Amorphous-type calcification (pre-existing bone) was seen only in chordomas. Homogeneous contrast enhancement pattern was seen only in chondrosarcoma and plasmacytoma. Ktrans and Kep were significantly lower in both chordoma, and chondrosarcoma compared to giant cell tumor of the bone (p = 0.006 - 0.011), and plasmacytoma (p = 0.004 - 0.014). Highest diffusion-weighted MRI apparent diffusion coefficient (ADC) values corresponded to chondrosarcoma and were significantly higher to those of chordoma (p = 0.008).</p><p><strong>Conclusion: </strong>We identified the most discriminating morphological parameters and added functional MR parameters based on histopathological features that are useful in making a confident diagnosis of primary bone neoplasms in the skull base, mobile spine and sacrum.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"287-302"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535263","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":"Radiomics based on multiple machine learning methods for diagnosing early bone metastases not visible on CT images.","authors":"Huili Wang, Jianfeng Qiu, Weizhao Lu, Jindong Xie, Junchi Ma","doi":"10.1007/s00256-024-04752-x","DOIUrl":"10.1007/s00256-024-04752-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study utilizes [^99mTc]-methylene diphosphate (MDP) single photon emission computed tomography (SPECT) images as a reference standard to evaluate whether the integration of radiomics features from computed tomography (CT) and machine learning algorithms can identify microscopic early bone metastases. Additionally, we also determine the optimal machine learning approach.</p><p><strong>Materials and methods: </strong>We retrospectively studied 63 patients with early bone metastasis from July 2020 to March 2023. The ITK-SNAP software was used to delineate early bone metastases and normal bone tissue in SPECT images of each patient, which were then registered onto CT images to outline the volume of interest (VOI). The VOI includes 63 early bone metastasis volumes and 63 normal bone tissue volumes. 126 VOIs were randomly distributed in a 7:3 ratio between the training and testing groups, and 944 radiomics features were extracted from every VOI. We established 20 machine learning models using 5 feature selection algorithms and 4 classification methods. Evaluate the performance of the model using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Most machine learning models demonstrated outstanding discriminative capacity, with AUCs higher than 0.70. Notably, the K-Nearest Neighbors (KNN) classifier exhibited significant performance improvement compared to the other four classifiers. Specifically, the model constructed utilizing eXtreme Gradient Boosting (XGBoost) feature selection method integrated with KNN classifier achieved the maximum AUC, which is 0.989 in the training set and 0.975 in the testing set.</p><p><strong>Conclusions: </strong>Radiomics features integrated with machine learning methods can identify early bone metastases that are not visible on CT images. In our analysis, KNN is considered the optimal classification method.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"335-343"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative CT lumbar spine BMD cutpoint value for classifying osteoporosis among older Chinese men can be the same as that of older Chinese women, both much lower than the value for Caucasians.","authors":"Yì Xiáng J Wáng, Wing P Chan, Wei Yu, Ali Guermazi, James F Griffith","doi":"10.1007/s00256-024-04722-3","DOIUrl":"10.1007/s00256-024-04722-3","url":null,"abstract":"<p><p>For older Caucasian women and men, the QCT (quantitative CT) lumbar spine (LS) bone mineral density (BMD) threshold for classifying osteoporosis is 80 mg/ml. It was recently proposed that, for older East Asian women, the QCT LS BMD value equivalent to the Caucasian women's threshold of 80 mg/mL is about 45∼50 mg/ml. For a data of 328 cases of Chinese men (age: 73.6 ± 4.4 years) who had QCT LS BMD and DXA LS BMD at the same time and with the DXA BMD value of ≤ 0.613 g/cm² to classify osteoporosis, the corresponding QCT LS BMD threshold is 53 mg/ml. Osteoporotic-like vertebral fracture sum score (OLVFss) ≤ -2.5 has been proposed to diagnose osteoporosis. For 316 cases of Chinese men (age:73.7±4.5 years), OLVFss ≤ -2.5 defines an osteoporosis prevalence of 4.4%; to achieve this osteoporosis prevalence, the corresponding QCT LS BMD value is < 47.5 mg/ml. In the China Action on Spine and Hip Status study, a Genant grades 2/3 radiographic 'osteoporotic vertebral fracture' prevalence was 2.84% for Chinese men (total n = 1267, age: 62.77 ± 9.20 years); to achieve this osteoporosis prevalence, the corresponding BMD value was < 42.5 mg/ml. In a study of 357 Beijing older men, according to the clinical fragility fracture prevalence and femoral neck DXA T-score, the QCT LS BMD value to classify osteoporosis was between 39.45 mg/ml and 51.38 mg/ml. For older Chinese men (≥ 50 years), we recommend the cutpoint for the QCT LS BMD definition of osteoporosis to be 45∼50 mg/ml which is the same as the value for Chinese women.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"193-198"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432691","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":"Accuracy and precision of in vitro EOS imaging compared to digital radiographs in the measurement of intramedullary lengthening.","authors":"Akram Al Ramlawi, Nickolas Nahm, Michael Abdou, Hytham S Salem, John E Herzenberg, Philip McClure","doi":"10.1007/s00256-025-04879-5","DOIUrl":"https://doi.org/10.1007/s00256-025-04879-5","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate limb length measurement is essential during limb lengthening procedures to prevent neurologic and musculoskeletal complications. Magnetic intramedullary lengthening nails (MILN) rely on radiographs for measurement, but the optimal radiographic technique is not established. This study evaluated the precision and accuracy of EOS imaging versus digital radiography, including calibration techniques and measurement techniques for assessing intramedullary lengthening.</p><p><strong>Methods: </strong>An MILN was inserted into a Sawbones femur, and lengthening measurements from digital X-ray and EOS imaging were compared to external remote control (ERC) results. Measurements were taken with and without calibration using a magnification ball, nail width, or female nail length. Four observers measured the distraction gap, spindle length, full nail length, and male nail length at various hip flexion angles. Precision and accuracy were calculated for each technique.</p><p><strong>Results: </strong>From 576 measurements, EOS imaging demonstrated significantly higher accuracy than digital radiography (83.6% vs. 73.5% absolute accuracy; p < 0.001) when non-calibrated values were included. EOS maintained superior accuracy at 30 mm, 50 mm, and 70 mm of lengthening (p < 0.05), with no difference at 10 mm. Calibration did not affect EOS accuracy, whereas digital radiography was less accurate without calibration (p < 0.001). Distraction gap measurement was the most accurate for both modalities, and 0° hip flexion provided the highest precision. Overall, EOS was more precise (79.4% vs. 71.7% precision rates; p < 0.001).</p><p><strong>Conclusion: </strong>EOS imaging is recommended for limb lengthening measurements due to its superior precision and accuracy. For digital radiographs, careful calibration is essential to achieve accurate measurements.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck pain in a 32-year-old female.","authors":"Sheng Dai, Youwen Dong","doi":"10.1007/s00256-024-04789-y","DOIUrl":"10.1007/s00256-024-04789-y","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"383-384"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sclerosing well-differentiated liposarcoma: two diagnostically challenging mimicker cases and a literature review.","authors":"Ariella R Noorily, Syed T Hoda, Jose G Mantilla, Mohammad Samim","doi":"10.1007/s00256-024-04716-1","DOIUrl":"10.1007/s00256-024-04716-1","url":null,"abstract":"<p><p>Liposarcoma is a malignant soft tissue tumor with several subtypes, the most common of which is well-differentiated liposarcoma (WDL) or atypical lipomatous tumor (ALT). WDL/ALTs are further divided into three histological subtypes, including lipoma-like, sclerosing, and inflammatory. While the majority of these tumors are predominantly fatty, the sclerosing variant demonstrates diverse histologic and radiographic characteristics, including variable amounts of fibrosis and fat. Because of this histological variability and relative rarity, the sclerosing WDL/ALT can present diagnostic dilemmas. We present two cases of sclerosing WDL/ALT, both of which demonstrated high degrees of fibrosis and a paucity of fat, mimicking desmoid fibromatosis and other fibrotic soft tissue tumors. Thus, it is important for radiologists to be aware of the subtypes of liposarcoma and their unique characteristics, and to consider sclerosing WDL/ALT in cases of fibrotic soft tissue tumors.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"353-358"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin use and longitudinal bone marrow lesion burden: analysis of knees without osteoarthritis from the Osteoarthritis Initiative study.","authors":"Kamyar Moradi, Bahram Mohajer, Ali Guermazi, Roham Hadidchi, Soheil Mohammadi, Xu Cao, Mei Wan, Frank W Roemer, Shadpour Demehri","doi":"10.1007/s00256-025-04878-6","DOIUrl":"https://doi.org/10.1007/s00256-025-04878-6","url":null,"abstract":"<p><strong>Objectives: </strong>Knee subchondral bone marrow lesions (BMLs) are one of the hallmark features of structural osteoarthritis (OA) and are potential targets for statins' disease-modifying effect. We aimed to determine the association between statin use and longitudinal changes in magnetic resonance imaging (MRI)-based BML volume in participants without radiographic knee OA at baseline.</p><p><strong>Methods: </strong>Using the Osteoarthritis Initiative (OAI) cohort, we classified participants' knees into two categories: statin users (those who consistently used statins from baseline to the fourth year of the cohort) and non-users. We employed a 1:1 ratio propensity score (PS) matching method, adjusting for factors including age, sex, race, BMI, smoking, alcohol use, physical activity, abdominal obesity, and diabetes mellitus. We measured quantitative BML volume using a validated deep learning (DL) algorithm, applied to baseline, year-2, and year-4 intermediate-weighted fat-saturated knee MRIs. The outcome was determined by the differences in the BML volume change between statin users and non-users over the 4-year period.</p><p><strong>Results: </strong>After adjusting for potential confounders, 1502 knees were included (751 statin users and 751 non-users; mean age 63.5 ± 8.7 years, 44.5% female). A Multilevel linear mixed-effects regression model showed that statin use is associated with a smaller increase in BML volume over 4 years (time-treatment interaction effect estimates, 95% confidence interval (CI) - 14.88 mm³/year, - 23.04 to - 6.72, P < 0.001).</p><p><strong>Conclusion: </strong>In participants without baseline knee OA, continuous statin use is associated with a reduced longitudinal worsening of BML volume in the tibiofemoral joint, a known structural damage marker linked to downstream OA incidence.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-guided cryoablation for palliation of painful bone metastases: a systematic review and meta-analysis.","authors":"Sarah Torabi, Mohadese Ahmadzade, Hamed Ghorani, Masoumeh Sarvari, Hamidreza Rouientan, Kelly Trinh, Gita Manzari Tavakoli, Mahshad Afsharzadeh, Raul Nirmal Uppot, Mohammad Ghasemi-Rad","doi":"10.1007/s00256-025-04877-7","DOIUrl":"https://doi.org/10.1007/s00256-025-04877-7","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of cryoablation in controlling pain from metastatic bone lesions.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Embase, Scopus, Cochrane library, and Web of Science was conducted from inception to April 2024, focusing on cryoablation for palliation of painful bone metastases. The inclusion criteria were as follows: studies involving patients over 18 years of age who were affected by bone metastases; bone metastases treated with stand-alone cryoablation; studies reporting patients' pain levels before and at least at one time point after cryoablation; and studies published in English.</p><p><strong>Results: </strong>A total of 844 articles were initially screened, resulting in 12 articles involving 309 patients included. Pain assessments were conducted at various time points ranging from 1 day to 6 months after the cryoablation procedure. Included studies reported significant improvements in pain scores based on the visual analog scale (VAS), the numeric rating scale (NRS) and brief pain inventory-short form (BPI-SF) following treatment at 1, 4, 8 and 12 weeks. The most notable mean difference between pre- and post-procedure pain scores was observed at 12 weeks, with a standardized mean difference of -3.71 (95% confidence interval [CI]: -5.29 to -2.00; p < 0.001). Regarding pain relief outcomes, by the fourth week, the proportion of patients experiencing pain relief was 0.69 (95% CI: 0.62 to 0.75; p < 0.001).</p><p><strong>Conclusions: </strong>Cryoablation could be an effective method for palliation of painful bone metastases. Further studies are needed to compare its efficacy with other palliative methods and to define its role in cancer management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}