Prakash Shetty, Vikas Kumar Singh, Amit Choudhari, Aliasgar V Moiyadi
{"title":"Development of a Standardized Semantic Feature-Based Reporting Proforma for Intraoperative Ultrasound Findings in Brain Tumors and Application in High-Grade Gliomas - A Preliminary Study.","authors":"Prakash Shetty, Vikas Kumar Singh, Amit Choudhari, Aliasgar V Moiyadi","doi":"10.1055/a-1637-9550","DOIUrl":"https://doi.org/10.1055/a-1637-9550","url":null,"abstract":"<p><p><b>Purpose</b> A semantic feature-based reporting proforma for intraoperative ultrasound findings in brain tumors was devised to standardize reporting. It was applied as a pilot study on a cohort of histologically confirmed high-grade supratentorial gliomas (Grade 3 and 4) for internal validation. <b>Materials and Methods</b> This intraoperative semantic ultrasound proforma was used to evaluate 3D ultrasound volumes using Radiant DICOM software by 3 surgeons. The ultrasound semantic features were correlated with histological features like tumor grade, IDH status, and MIB index. <b>Results</b> 68 patients were analyzed using the semantic proforma. Irregular crenated was the most common margin (63.2%) and lesions were heterogeneously hyperechoic (95.6%). Necrosis was commonly seen and noted as single (67.6%) or multiple (13.2%) in over 80% cases. A separate perilesional zone, which was predominantly hyperechoic in 41.8% and both hypo and hyperechoic in 12.7%, could be identified in 54.5% of cases. Grade 4 tumors were more likely to have an irregular crenated margin (71.2%) with a single large area of necrosis, while Grade 3 tumors were likely to have smooth (31.3%) or non-characterizable margins (31.2%) with no or multiple areas of necrosis. IDH-negative tumors were more likely to have a single large focus of necrosis. Among the GBMs (52 cases), MIB labelling index of>15% was associated with poorly delineated, uncharacterizable margins, when compared with MIB labelling index<15% (23.5 vs. 0%), (p=0.046). <b>Conclusion</b> A detailed semantic proforma was developed for brain tumors and was internally validated. A few ultrasound sematic features were identified correlating with histological features in high-grade gliomas. It will require further external validation for refinement and acceptability.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 2","pages":"E55-E63"},"PeriodicalIF":3.2,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8598392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pheochromocytoma and Adrenocortical Carcinoma: Morphological Characteristics in Endoscopic Ultrasound Imaging.","authors":"Neslihan Özkul, Peter Herbert Kann","doi":"10.1055/a-1626-1678","DOIUrl":"https://doi.org/10.1055/a-1626-1678","url":null,"abstract":"<p><p><b>Purpose</b> Pheochromocytoma (PCC) and adrenocortical carcinoma (ACC) are two rare endocrine diseases. Early diagnosis is crucial to significantly reduce morbidity and mortality. In this study, we used endoscopic ultrasound (EUS) for high-resolution imaging to investigate the endosonographic morphology pattern of PCC and ACC. <b>Materials and Methods</b> This retrospective cohort study included 58 PCC/ACC lesions diagnosed by EUS imaging at two tertiary care centers between 1997 and 2015. The following groups were defined by histology or by the presence of a pheochromocytoma-associated syndrome without histological proof: bPCC (benign PCC), mPCC (malignant PCC), and ACC. <b>Results</b> In our cohort, mPCC tended to be larger at the time of diagnosis (n=5; 39.9±41.9 mm) than bPCC (n=46; 27.3 ±20.8 mm, P=0.548). ACC lesions were significantly larger (n=7; 50.6±14.8 mm) than bPCC and mPCC (n=51; 28.5±23.3 mm, P=0.002). In EUS, bPCC and ACC lesions frequently appeared to have a round shape and nodular structure. bPCC and ACC tended to be more hyperechoic (P=0.112 and P=0.558, respectively) and heterogeneous (P=0.501 and P=0.098, respectively) than mPCC. Compared to PCC, ACC did not show high hyperperfusion (P=0.022). In contrast to adenoma, all tumor entities showed hypo-/anechoic areas within the tumor (P<0.05). <b>Conclusion</b> No significant differences in EUS morphology were found to reliably distinguish benign from malignant PCC and ACC lesions. However, EUS may be a reasonable alternative or complementary method to conventional imaging techniques for the early detection of these tumor entities.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 2","pages":"E64-E70"},"PeriodicalIF":3.2,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/49/10-1055-a-1626-1678.PMC8598390.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial.","authors":"Guntram Lock","doi":"10.1055/a-1485-8014","DOIUrl":"https://doi.org/10.1055/a-1485-8014","url":null,"abstract":"<p><p>Dear Colleagues, It is a special pleasure to introduce the first issue of Ultrasound International Open in a still difficult year - a year, in which many of us had concerns and clinical tasks reaching far beyond basic or clinical science on ultrasonography (US). Thus, I am delighted to draw your attention to some interesting and important new papers teaching us on various aspects of our every day's US practice.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E1"},"PeriodicalIF":3.2,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/44/10-1055-a-1485-8014.PMC8555305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39585096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Elvira Soler, Nicolás López Hernández, I. Beltrán-Blasco, B. Serrano Serrano
{"title":"Double Reverse Flow of Orbitary Vessels Following Mechanical Thrombectomy in Acute Ischemic Stroke","authors":"Elena Elvira Soler, Nicolás López Hernández, I. Beltrán-Blasco, B. Serrano Serrano","doi":"10.1055/a-1714-0492","DOIUrl":"https://doi.org/10.1055/a-1714-0492","url":null,"abstract":"Duplex ultrasound is a noninvasive and rapid technique that offers information on cerebral vascular hemodynamics in real time, which is very useful in acute stroke. Specifically, the orbital study provides important information on collateralization in severe cases of cervical carotid stenosis, showing an inversion of the ophthalmic artery (OA). Less frequently evaluated, hemodynamic changes in the ophthalmic vein provide information on the presence of arteriovenous malformations or fistulas (Erickson SJ et al. Radiology 1989: 173 (2): 511–516). We report a case of ophthalmic artery and vein inversion simultaneously after mechanical thrombectomy (MT).","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"1 1","pages":"E71 - E73"},"PeriodicalIF":3.2,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80083374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tobias Bielow, Valentin Blank, Sabine Opitz, Holger Gößmann, Martin Hecker, Daniel Seehofer, Christoph Lübbert, Thomas Karlas
{"title":"Klebsiella Pneumoniae Liver Abscess Syndrome - A Challenge for Contrast-Enhanced Ultrasound.","authors":"Tobias Bielow, Valentin Blank, Sabine Opitz, Holger Gößmann, Martin Hecker, Daniel Seehofer, Christoph Lübbert, Thomas Karlas","doi":"10.1055/a-1471-6907","DOIUrl":"https://doi.org/10.1055/a-1471-6907","url":null,"abstract":"<p><p>Invasive liver abscess syndrome (ILAS) is caused by strains of hypervirulent Klebsiella pneumoniae (hvKp) and has emerged as the leading cause of liver abscesses in immuno-competent patients (L.K. Siu et al. Lancet Infect Dis 2012; 12: 881-87). ILAS is frequently associated with metastatic spread including the eyes, lungs, and the central nervous system. The morbidity and mortality of affected patients are increased compared to liver abscesses of other origin, especially in cases with concomitant diabetes mellitus (J. E. Choby et al. J Intern Med 2020; 287(3): 283-300). Immediate diagnosis and early intervention are essential for an optimal outcome. Therefore, ultrasound plays a crucial role if hvKp is suspected. However, experience with the characteristics of such abscesses on contrast-enhanced ultrasound (CEUS) is very limited.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E2-E5"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1471-6907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid Kvåle Nordaas, Trond Engjom, Odd Helge Gilja, Roald Flesland Havre, Dag André Sangnes, Ingfrid S Haldorsen, Georg Dimcevski
{"title":"Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison.","authors":"Ingrid Kvåle Nordaas, Trond Engjom, Odd Helge Gilja, Roald Flesland Havre, Dag André Sangnes, Ingfrid S Haldorsen, Georg Dimcevski","doi":"10.1055/a-1542-9146","DOIUrl":"https://doi.org/10.1055/a-1542-9146","url":null,"abstract":"<p><p><b>Purpose</b> Computed tomography (CT) is the most used imaging modality for diagnosing chronic pancreatitis (CP), but advances in transabdominal ultrasound (US) technology have given US a position as a viable alternative. We aimed to evaluate the diagnostic accuracy of abdominal CT and pancreatic US compared to the reference standard, a modified Mayo score. <b>Materials and Methods</b> CT, US, and endoscopic ultrasound (EUS) were performed in patients referred due to suspected CP. The modified Mayo score included EUS results, clinical presentation, and results from exocrine and endocrine pancreatic function tests. We scored CT findings according to the modified Cambridge classification and US findings according to the Rosemont classification. <b>Results</b> In total, 73 patients were included. 53 patients (73%) were categorized as CP and 20 (27%) as non-CP. CT and US yielded similar sensitivities (68% and 64%, respectively) and specificities (75 and 85%, respectively) and similar areas under the receiver operating characteristic curves for diagnosing CP. We found no significant differences between the areas under the receiver operating characteristic curves (AUROCs) for CT (AUROC 0.75, 95% CI 0.63-0.87) and US (AUROC 0.81, 95% CI 0.71-0.91). <b>Conclusion</b> We conclude that CT and US had comparable, moderate accuracy in diagnosing CP. Neither modality had high enough sensitivity to exclude the diagnosis as a standalone method.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E35-E44"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/5c/10-1055-a-1542-9146.PMC8384479.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arash Najafi, Michael Wildt, Nicolin Hainc, Joachim Hohmann
{"title":"Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study.","authors":"Arash Najafi, Michael Wildt, Nicolin Hainc, Joachim Hohmann","doi":"10.1055/a-1522-8969","DOIUrl":"10.1055/a-1522-8969","url":null,"abstract":"<p><p><b>Purpose</b> Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. <b>Materials and Methods</b> All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. <b>Results</b> There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. <b>Conclusion</b> CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E25-E34"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/f2/10-1055-a-1522-8969.PMC8315990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anders Batman Mjelle, Anesa Mulabecirovic, Edda Jonina Olafsdottir, Odd Helge Gilja, Roald Flesland Havre, Mette Vesterhus
{"title":"Controlled Attenuation Parameter in Healthy Individuals Aged 8-70 Years.","authors":"Anders Batman Mjelle, Anesa Mulabecirovic, Edda Jonina Olafsdottir, Odd Helge Gilja, Roald Flesland Havre, Mette Vesterhus","doi":"10.1055/a-1461-4714","DOIUrl":"https://doi.org/10.1055/a-1461-4714","url":null,"abstract":"Abstract Purpose Controlled attenuation parameter (CAP) is a non-invasive method to assess the presence of liver steatosis. It has been evaluated in children and adults, mainly in either the obese or in subjects with suspected liver disease. Our aim was to describe CAP in healthy non-obese subjects without suspected liver steatosis and to suggest cutoff levels for steatosis. Materials and Methods We prospectively recruited 187 individuals aged 8–70 years. All underwent clinical examination, including height and weight measurement. Body mass index (BMI) was calculated and converted into z-scores. To exclude liver pathology, B-mode ultrasound and liver stiffness measurements were performed in all prior to CAP measurement. Blood was drawn for liver biochemistry in adults. Results CAP was associated with BMI z-score across all ages. CAP started to rise alongside BMI z-score already in subjects with a BMI below average. CAP values were higher in adults than in children (p<0.001), and higher in adult males than adult females (p=0.014). CAP did not correlate with age within the adult or pediatric cohorts. CAP was highly correlated with the fatty liver index. 18 and 23% of subjects showed CAP above the suggested cutoff value for children and adults, respectively. Conclusion CAP was correlated with BMI z-score, even in individuals with a below-average BMI . We found CAP above published cutoff values in a substantial proportion of presumably healthy, non-obese children and adults, warranting further research to clarify whether this represents non-obese non-alcoholic fatty liver disease or if reference values need adjustment.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E6-E13"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1461-4714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38965219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Maconi, Trygve Hausken, Christoph F Dietrich, Nadia Pallotta, Ioan Sporea, Dieter Nurnberg, Klaus Dirks, Laura Romanini, Carla Serra, Barbara Braden, Zeno Sparchez, Odd Helge Gilja
{"title":"Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement.","authors":"Giovanni Maconi, Trygve Hausken, Christoph F Dietrich, Nadia Pallotta, Ioan Sporea, Dieter Nurnberg, Klaus Dirks, Laura Romanini, Carla Serra, Barbara Braden, Zeno Sparchez, Odd Helge Gilja","doi":"10.1055/a-1474-8013","DOIUrl":"https://doi.org/10.1055/a-1474-8013","url":null,"abstract":"<p><p>Abdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E14-E24"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1474-8013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leo Nygaard, Søren Rafael Rafaelsen, Jan Lindebjerg, Malene Roland Vils Pedersen
{"title":"Testicular Metastatic Sarcomatoid Carcinoma of Unknown Primary: A Case Report.","authors":"Leo Nygaard, Søren Rafael Rafaelsen, Jan Lindebjerg, Malene Roland Vils Pedersen","doi":"10.1055/a-1304-5731","DOIUrl":"https://doi.org/10.1055/a-1304-5731","url":null,"abstract":"Approximately 90–95 % of testicular cancers are divided into two main categories: seminomas and non-seminomas. Tumors often contain more than one type of tumor cell and are called mixed germ cell tumors. The main types of non-seminoma are embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. Other types are stromal tumors, Leydig cell tumors and Sertoli cell tumors. Secondary testicular cancers are lymphoma, leukemia, and metastases. Sarcomatoid carcinoma tumors in the testicles are very rare. Other case reports have described rare types of testicular cancer, e. g. testicular fusocellular rhabdomyosarcoma, paratesticular liposarcoma, testicular carcinoid, testicular sarcoidosis, testicular clear cell carcinoma, testicular chloroma, cutaneous mucinous carcinoma, and sarcomatoid yolk sac. When treating testicular tumors, surgery is the primary treatment and adjuvant chemotherapy and radiotherapy may be required. Owing to the aggressive nature of sarcomatoid carcinomas and the high probability of distant metastasis, the prognosis may not be favorable. No other cases of this entity have been reported in the English literature. We hereby present a case of a 62-year-old male patient diagnosed with a testicular metastatic sarcomatoid carcinoma of unknown primary.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E62-E65"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1304-5731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39149897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}