Quantitative Imaging in Medicine and Surgery最新文献

{"title":"MVASA-HGN: multi-view adaptive semantic-aware heterogeneous graph network for <i>KRAS</i> mutation status prediction.","authors":"Wanting Yang, Shinichi Yoshida, Juanjuan Zhao, Wei Wu, Yan Qiang","doi":"10.21037/qims-24-1370","DOIUrl":"10.21037/qims-24-1370","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the treatment of advanced non-small cell lung cancer (NSCLC), the mutation status of the Kirsten rat sarcoma virus oncogene homolog (&lt;i&gt;KRAS&lt;/i&gt;) gene has been shown to be a key factor affecting the efficacy of immune checkpoint inhibitors (ICIs), which is an important guideline for physicians to develop personalized treatment strategies. However, existing mutation prediction studies have primarily focused on the feature representation of individual patient medical data, ignoring the complex semantic relationships among patients in diverse clinical features. This study aimed to accurately identify &lt;i&gt;KRAS&lt;/i&gt; gene status, which will not only assist physicians in accurately screening the patient population most likely to benefit from immunotherapy, but also reduce patient burden by avoiding unnecessary treatment attempts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multi-view adaptive semantics-aware heterogeneous graph framework (MVASA-HGN) based on multimodal medical data was developed to accurately predict &lt;i&gt;KRAS&lt;/i&gt; mutation status in NSCLC patients. The framework first parses the relational semantics through clinical feature clustering and constructs a heterogeneous graph by combining computed tomography (CT) image and clinical features. In the second step, the heterogeneous graph is split into relational subgraphs under multiple views, and the node representations are constructed and updated gradually through a two-stage strategy of single-view graph representation learning and multi-view heterogeneous information fusion. In the single-view phase, we enhance the node self-embedding and construct the adjacency embedding of neighbors with the same type of relationship to ensure that the relational subgraph under each semantic preserves the complete local structure. Two attention mechanisms are introduced in the multi-view fusion phase to capture the enriched semantics preserved in nodes and heterogeneous relations, respectively. Finally, a comprehensive node representation is obtained through adaptive aggregation of different view neighborhood information and enhanced node embedding without predefined meta-paths.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The classification results were evaluated on cooperative hospitals and The Cancer Imaging Archive (TCIA) datasets, and ablation experiments and comparison experiments were performed on the components of the framework, while exploring the framework's rationality and interpretability. Accuracy reached 85.29% and specificity reached 89.67% on the test set, indicating that our framework has significant advantages in deeply modeling complex heterogeneous semantics in local structures and fully exploiting and utilizing the rich semantic information preserved in heterogeneous relationships. The source code of MVASA-HGN is available at https://github.com/Yangwanter37/MVASA-HGN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our proposed MVASA-HGN framework provides a new perspective for multimoda","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1190-1211"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494537","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":"Insights from using biplanar intersection for freehand frontal ventriculostomy: a retrospective case-control study with virtual simulation.","authors":"Kailong Huang, Xu Zhan, Tinghui Xue, Ting Chen, Zhengjian Liao, Juantao Luo, Zongchao Yi, Wenyao Hong","doi":"10.21037/qims-24-1381","DOIUrl":"10.21037/qims-24-1381","url":null,"abstract":"<p><strong>Background: </strong>Frontal ventriculostomy (FV) is essential in neurosurgery; however, traditional freehand puncture methods have low accuracy, and ultrasound guidance is time consuming and expensive. To improve freehand puncture accuracy, this study introduced a biplanar intersection (BI) method, and analyzed the frontal-horn puncture mechanism. No related reports exist to date.</p><p><strong>Methods: </strong>Three-dimensional (3D) computed tomography (CT) reconstruction was performed using data from random patients, aged ≥18 years, who presented with enlarged lateral ventricles, and an Evans index >0.33, and had no signs of ventricular compression, deformation, displacement, or a history of craniectomy. This study was conducted at Fujian Provincial Hospital between May 2022 and May 2023. Using the principles of BI, we determined the location coordinates, and conducted a variance analysis. We simulated the puncture using the BI method and compared it with traditional methods. Differences between groups were evaluated using chi-squared tests and independent samples t-tests.</p><p><strong>Results: </strong>A total of 135 patients (110 males, 25 females; aged 18-78 years) were included in the study. The lateral projection was situated 13.3±1.5 mm anteriorly and 45.7±4.1 mm superiorly in relation to the intersection of the anterior margin of the tragus and the superior margin of the zygomatic arch. The anterior projection was located 13.8±2.4 mm above and 5.5±1.1 mm lateral to the glabella. The mean puncture depth was determined to be 56 mm (48-64 mm). In a sub-analysis of 36 patients, the BI method exhibited a significantly higher optimal puncture rate (36/36 versus 31/36, χ²=5.373, P=0.021<0.05) and reduced lateral deviation (2.69 versus 13.97 mm, <i>t</i>=-20.61, P<0.05).</p><p><strong>Conclusions: </strong>The BI method, which is founded on rigorous mathematical principles, was shown through simulations to have enhanced precision in puncture efficiency. However, further clinical research needs to be conducted to ascertain its effectiveness.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1669-1678"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494063","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":"Laparoscopic resection of gastric schwannoma: a case description.","authors":"Jin-Xing Fan, Yu-Peng Jiang, Min-Quan Yao","doi":"10.21037/qims-24-1217","DOIUrl":"10.21037/qims-24-1217","url":null,"abstract":"","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1705-1709"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494064","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":"Assessing left ventricular function in patients with hyperthyroidism across varied heart rates via press-strain loop analysis: a retrospective cross-sectional study.","authors":"Hui Su, Jun Wang, Zhi-Fen Wang, Zhe Yang, Yuan Ma","doi":"10.21037/qims-24-951","DOIUrl":"10.21037/qims-24-951","url":null,"abstract":"<p><strong>Background: </strong>In the early stages of hyperthyroidism (HTH), cardiovascular symptoms are not prominent, and heart function impairment may occur before structural changes. The non-invasive left ventricular (LV) pressure-strain loop (PSL) allows for early, quantitative assessment of changes in LV systolic function. However, previous studies have not grouped hyperthyroid patients based on the presence or absence of tachycardia. This study aimed to assess the LV function in individuals diagnosed with HTH who exhibit varying heart rates, utilizing the PSL technique.</p><p><strong>Methods: </strong>Seventy-eight hyperthyroid patients were recruited between December 2022 and September 2023 using a random method and then stratified into two groups based on the presence or absence of tachycardia, designated as HTH1 (tachycardia) group and HTH2 (non-tachycardia) group, respectively. Additionally, a control group comprising 38 healthy volunteers was included for comparison purposes. Standard echocardiographic parameters and LV global longitudinal strain (GLS) were quantified. Furthermore, LV myocardial work parameters, encompassing global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were assessed using the PSL technique. The main statistical methods included one-way analysis of variance, LSD-<i>t</i> test, Kruskal-Wallis <i>H</i> test, Bonferroni correction, and χ² test.</p><p><strong>Results: </strong>Compared to the control group, the systolic blood pressure (SBP), pulse pressure differential, serum free triiodothyronine (FT3) and free thyroxine (FT4) levels of HTH1 and HTH2 subgroups demonstrated elevation, whereas serum thyroid-stimulating hormone (TSH) levels exhibited reduction (P<0.05). Moreover, comparisons between the HTH1 and HTH2 subgroups revealed significantly higher SBP, pulse pressure differential, FT3, and FT4 concentrations in the former relative to the latter (P<0.05). LV ejection fraction (LVEF) exhibited a statistically significant increase in the HTH group compared to the control group (P<0.05). GLS, GWI, and GWE in the HTH group were less compared to the control group, while GWW exhibited an increase in the HTH group relative to the control group (P<0.05). Within the HTH group, both GWI and GWE were significantly lower in the HTH1 subgroup compared to the HTH2 subgroup.</p><p><strong>Conclusions: </strong>PSL method enables the quantitative assessment of LV myocardial work alterations in individuals with HTH exhibiting varying heart rates, which may help clinical physicians make an accurate early diagnosis and take timely treatment measures.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1632-1640"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494542","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":"Association of decreased visibility on deep medullary vein gray-matter volume mediated by increased extracellular fluid in the white matter of patients with cerebral small vessel disease.","authors":"Zhihua Xu, Miaomiao Yan, Songkuan Chen, Jieling Zhu, Panliang Zhao, Jiujiu Yang, Xinjie Yu","doi":"10.21037/qims-24-957","DOIUrl":"10.21037/qims-24-957","url":null,"abstract":"<p><strong>Background: </strong>The visibility and signal continuity of deep medullary veins (DMVs) play an important role in cerebral small vessel disease (CSVD). However, the relationship between DMV and gray-matter atrophy remains unclear. This study sought to investigate the link between DMV scores, extracellular fluid, and gray-matter atrophy in patients with CSVD.</p><p><strong>Methods: </strong>We reviewed the clinical and multimodal magnetic resonance imaging data from 123 patients diagnosed with CSVD between January and December 2022. The DMV score was assessed using a scoring system (0 to 3 points) based on DMV visibility on susceptibility-weighted images across six anatomical regions, yielding a final score from 0 to 18. Extracellular fluid was assessed through the metric of free water (FW) in normal-appearing white matter (NAWM). Normalized gray-matter volume (GM_N) was used to quantify the gray-matter volume, defined as the ratio of gray-matter volume to intracranial volume. Spearman correlation, general linear model, and mediation analyses were employed to evaluate the relationships among variables.</p><p><strong>Results: </strong>Spearman correlation analysis revealed a positive correlation between DMV score and FW in NAWM (r=0.603; P<0.001). General linear model analysis confirmed this association as independent [β=0.656, 95% confidence interval (CI) 0.521-0.790; P<0.001]. Conversely, FW in NAWM showed a negative correlation with GM_N (r=-0.485; P<0.001), with an independent association confirmed by general linear model analysis (β=-0.630, 95% CI: -0.769 to -0.491; P<0.001). Additionally, the DMV score was negatively correlated with GM_N (r=-0.390; P<0.001), as supported by a significant association in general linear model analysis (β=-0.502, 95% CI: -0.657 to 0.348; P<0.001). Mediation analysis indicated a significant indirect effect of FW in NAWM on the relationship between DMV score and GM_N (β=-0.346, 95% CI: -0.534 to -0.187; P<0.001). All associations were remained significant after adjustments were made for age, gender, vascular risk factors, normalized white-matter hyperintensity volume, and CSVD burden.</p><p><strong>Conclusions: </strong>The observed link between DMV disruption and FW in NAWM-GM_N suggests that DMV dysfunction may contribute to gray-matter atrophy in CSVD by increasing extracellular fluid. This identifies DMV changes as a key factor in CSVD pathology and supports the potential of targeting extracellular fluid as a therapeutic strategy to mitigate gray-matter loss.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1371-1382"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494545","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":"An automatic deep-learning approach for the prediction of post-stroke epilepsy after an initial intracerebral hemorrhage based on non-contrast computed tomography imaging.","authors":"Ziyi Wang, Haoli Xu, Jiachang Liu, Ru Lin, Dongyu He, Yunjun Yang, Xinshi Wang, Zhifang Pan","doi":"10.21037/qims-24-1345","DOIUrl":"10.21037/qims-24-1345","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke epilepsy (PSE) is a common and significant complication that often occurs after stroke, and affects patients' prognosis and overall quality of life. In recent years, non-contrast computed tomography (NCCT) has become the preferred method for the clinical diagnosis of intracerebral hemorrhage (ICH). This study aimed to develop and validate a triple deep-learning model, simply named, the post-stroke epilepsy network (PSENet), to predict PSE in ICH patients based on NCCT.</p><p><strong>Methods: </strong>A total of 1,130 patients (62 with PSE and 1,068 without PSE) who experienced an initial ICH at our hospital were enrolled in this study. Using five-fold cross-validation, all patients were randomly divided into training and validation sets at a ratio of 4:1. Next, the no-new-Net (nnU-Net) was used to automatically segment the ICH for the subsequent quantitative analysis. A triple deep-learning model was developed to extract the PSE-related features and incorporate the deep-learning features related to cortical involvement (FCI) and ICH volume to predict PSE. This model was compared with three clinical models constructed using random forest. Model performance was mainly evaluated using the area under the curve (AUC).</p><p><strong>Results: </strong>The nnU-Net had a high Dice score of 0.923. The proposed PSENet, which incorporated multiple features, showed excellent diagnostic performance, and had an accuracy of 0.876, a F1-score of 0.621, a recall of 0.716, a specificity of 0.897, and an AUC of 0.840, which significantly surpassed the AUC of the baseline clinical model (AUC =0.787).</p><p><strong>Conclusions: </strong>Based on our findings, the developed PSENet could be used to predict PSE quickly after the first ICH, especially in scenarios in which reliable clinical information is lacking on admission.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1175-1189"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494557","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":"Artificial intelligence-driven quantitative analysis of CT morphological differences between chronic thromboembolic pulmonary hypertension and chronic thromboembolic disease.","authors":"Wenqing Xu, Linfeng Xi, Yifei Ni, Jianping Wang, Haoyu Yang, Anqi Liu, Qian Gao, Xincao Tao, Qiang Huang, Xiaopeng Liu, Yanan Zhen, Wanmu Xie, Min Liu","doi":"10.21037/qims-24-1301","DOIUrl":"10.21037/qims-24-1301","url":null,"abstract":"<p><strong>Background: </strong>The morphological differences in the pulmonary vascular tree between chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic disease (CTED) are not yet fully understood. This study aimed to use artificial intelligence (AI) segmentation technology to identify morphological markers that can be used to differentiate CTEPH from CTED using computed tomography pulmonary angiography (CTPA).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study with consecutive patients diagnosed with CTEPH, CTED, and control subjects at the China-Japan Friendship Hospital from January 2019 to October 2023. The study involved the automatic quantification of the pulmonary blood volume (BV), tortuosity, and fractal dimension (FD) from CTPA images using an AI workstation. These morphological metrics were compared among the three groups using the Kruskal-Wallis test. Correlations between these metrics and the hemodynamic parameters were evaluated using Spearman's rank correlation coefficients. Additionally, a receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminative ability of pulmonary artery tortuosity to differentiate between each pair of groups.</p><p><strong>Results: </strong>A total of 190 participants [57 years, interquartile range (IQR), 49-65 years, 97 men], including 116 CTEPH patients, 54 CTED patients, and 20 controls, were enrolled in this study. Pulmonary artery tortuosity in the control, CTED, and CTEPH groups showed a progressively increasing trend [1.07 (IQR, 1.06-1.10) <i>vs.</i> 1.10 (IQR, 1.07-1.14) <i>vs.</i> 1.14 (IQR, 1.10-1.18), P<0.01]. The area under the curve (AUC) values of pulmonary arterial tortuosity for differentiating between the CTEPH patients and controls, CTED patients and controls, and CTEPH patients and CTED patients were 0.859, 0.712, and 0.663, respectively. There was a positive correlation between pulmonary artery tortuosity and mean pulmonary arterial pressure (mPAP) (r=0.44, P<0.01), and pulmonary vascular resistance (PVR) (r=0.47, P<0.01). Additionally, the volume of the small- and medium-sized pulmonary arteries was significantly higher in the CTED patients than the CTEPH patients (P<0.01). The pulmonary arterial FD among the three groups was comparable (P=0.36).</p><p><strong>Conclusions: </strong>Pulmonary arterial tortuosity on CTPA had auxiliary diagnostic value in differentiating between CTEPH patients and controls, but its value in differentiating between CTED and CTEPH patients requires further study. The reduced volume of small- and medium-sized pulmonary arteries in CTEPH patients could indicate impaired pulmonary hemodynamics.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1101-1113"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494561","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":"Clinical outcomes of complex rhegmatogenous retinal detachment treated with a 25-G, 10,000-cpm beveled-tip cutter probe.","authors":"Ruiping Gu, Jiajie Zhao, Jiemei Shi, Haohao Zhu, Chunhui Jiang","doi":"10.21037/qims-24-1460","DOIUrl":"10.21037/qims-24-1460","url":null,"abstract":"<p><strong>Background: </strong>Much effort has been exerted to improve the vitreous cutter probe. This study sought to investigate the clinical outcomes of using a novel 25-gauge (25-G), 10,000-cuts-per-minute (cpm) beveled-tip cutter probe (BTCP) to treat complex rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>The preoperative characteristics, intraoperative surgical information, and postoperative recovery data of a prospective case series of 60 consecutive eyes that underwent primary pars plana vitrectomy (PPV) for complex RRD between March and October 2021 were recorded, and the correlations among these factors were examined.</p><p><strong>Results: </strong>A total of 60 patients (25 female) with primary complex RRD were included in the study. Of the 60 eyes, 6 (10.00%) had RRD with a giant retinal tear, 15 (25.00%) had RRD with multiple retinal breaks involving more than one quadrant, 12 (20.00%) had macular holes (MHs), 14 (23.33%) had choroidal detachment, and 32 (53.33%) had proliferative vitreoretinopathy (PVR) grade C. The mean total surgical time was 59.22±14.85 min. Iatrogenic breaks occurred in 15 eyes. The total surgical time was correlated with the severity of PVR (P<0.05). Iatrogenic breaks were more likely to be detected in eyes with severe PVR and those that underwent longer surgical time. During the follow-up period, retinal re-detachment occurred in six eyes, which were re-treated. After a mean follow-up period of 6.31±2.24 months, the retina was attached in all 60 eyes (13 of which still contained silicone oil tamponades). The best-corrected visual acuity (BCVA) improved from the preoperative level in all eyes (P<0.001). The final BCVA appeared to be correlated with the duration of retinal detachment, the preoperative BCVA, macular involvement, and MHs.</p><p><strong>Conclusions: </strong>The primary results showed that the 25-G, 10,000-cpm BTCP combines the merits of high cutting speed, a large port, and a beveled-tip design, which allows the vitreous to be thoroughly cleared with great efficiency, and which is safe and effective for complex RRD surgery.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1613-1620"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494565","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":"Comparison of bone ingrowth and clinical outcome of a collagen-hydroxyapatite bone graft substitute versus autologous bone graft in posterior lumbar interbody fusion.","authors":"Marloes J M Peters, Arjan C Y Loenen, Liesbeth M C Jutten, Daan Loeffen, Roel Wierts, Toon F Boselie, Jacobus J Arts, Paul C Willems","doi":"10.21037/qims-24-755","DOIUrl":"10.21037/qims-24-755","url":null,"abstract":"<p><strong>Background: </strong>Posterior lumbar interbody fusion (PLIF) is a surgical procedure to treat painful unstable spinal segments using bone graft filled interbody cages and instrumentation. The graft can be autologous bone or a bone substitute. RegenOss is a porous, 3-dimensional composite bone substitute consisting of collagen fibers including hydroxyapatite. The aim of this cohort study was to evaluate RegenOss as graft material in PLIF patients, as compared to a historical cohort grafted with autologous bone.</p><p><strong>Methods: </strong>Fifteen patients were enrolled prospectively at the Maastricht University Medical Center between November 2016 and May 2019 in the RegenOss cohort (METC14-1-056) and were compared to 15 matched prospective patients from a historical autologous cohort collected at the Maastricht University Medical Center between October 2011 and January 2014 (METC10-1-025). During PLIF, interbody cages were filled with RegenOss bone substitute in the RegenOss cohort and with local autologous bone in the autologous cohort. Both cohorts were subjected to patient reported outcome measures (PROMs) [including Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), EuroQol-5D (EQ-5D)], 18F-fluoride positron emission tomography/computed tomography (PET/CT) at six weeks and one year. Interbody fusion was assessed on CT at one year and bone metabolism on 18F-fluoride PET/CT was assessed at six weeks and one year. Differences in patient demographics, clinical outcome, interbody fusion and bone metabolism were assessed between graft cohorts. Bone metabolism was also compared between follow-up moments.</p><p><strong>Results: </strong>Patient demographics were comparable between cohorts. At one-year follow-up, clinical outcome in both cohorts was similar (ODI: P=0.12, VAS: P=0.15, EQ-5D: P=0.22). Interbody fusion was considered comparable between cohorts; 7/15 RegenOss patients and 8/15 autologous patients were scored as completely fused on CT at one year. Similar findings in bone metabolism between follow-up moments were found for both cohorts; bone metabolism in the operated segment was significantly lower at one year compared to at six weeks (RegenOss cohort: P=0.003, P=0.005 for the upper and lower endplate respectively, autologous cohort: P=0.001, P=0.001). No differences in bone metabolism were observed between cohorts.</p><p><strong>Conclusions: </strong>Bony bridging, clinical outcome, bone metabolism were comparable for the RegenOss and the autologous bone graft PLIF cohorts.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1621-1631"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494567","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":"Diagnostic value of deep learning reconstruction-based subtraction CT-FFR in patients with calcified-related stenosis or stent implantation.","authors":"Cheng Xu, Yan Yi, Min Xu, Li-Miao Zou, Ming Wang, Yun Wang, Zheng-Yu Jin, Yi-Ning Wang","doi":"10.21037/qims-24-1366","DOIUrl":"10.21037/qims-24-1366","url":null,"abstract":"<p><strong>Background: </strong>The application of coronary computed tomography angiography-derived fractional flow reserve (CT-FFR) is limited due to severe coronary calcium burden or stent implantation. This study aimed to explore the diagnostic value of subtraction CT-FFR with deep learning reconstruction (DLR) or hybrid iterative reconstruction (HIR) in detecting calcified-related hemodynamically significant stenosis, and the feasibility in the application of coronary stents.</p><p><strong>Methods: </strong>Between March 2020 and January 2022, consecutive patients with calcified-related stenosis or previous stent treatment who had undergone subtraction coronary computed tomography angiography (CTA) and invasive fractional flow reserve (FFR) were included in this prospective study. CT image data were reconstructed using HIR and DLR. The diagnostic performance of CT-FFR, and subtraction CT-FFR were evaluated. An FFR value of 0.8 or less was considered hemodynamically significant.</p><p><strong>Results: </strong>A total of 30 patients with 52 calcified-related lesions and 14 coronary stents were included in this study. Subtraction CT-FFR outperformed the corresponding CT-FFR in detecting calcified-related hemodynamically significant stenosis and in the application of coronary stents, while there was no significant difference when subtraction CT-FFR_DLR was compared with subtraction CT-FFR_HIR (P>0.05). Lesion-based analysis showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for subtraction CT-FFR_DLR were 100.0%, 71.4%, 63.0%, 100% and 80.8%, respectively in detecting calcified-related hemodynamically significant stenosis, and were 100.0%, 83.3%, 88.9%, 100% and 92.9%, respectively in the application of coronary stents.</p><p><strong>Conclusions: </strong>Subtraction CT-FFR yielded optimal diagnostic performance for hemodynamically significant calcified-related stenosis, and the application of subtraction CT-FFR in the evaluation of coronary stents was feasible. The diagnostic performance of subtraction CT-FFR_DLR was better than that of subtraction CT-FFR_HIR, but there was no significant difference.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 2","pages":"1599-1612"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494587","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}