Eva Peschke , Mariya S. Pravdivtseva , Olav Jansen , Naomi Larsen , Jan-Bernd Hövener
{"title":"Black-blood MRI at 7T using 2D RARE MRI: In vitro testing and in vivo demonstration","authors":"Eva Peschke , Mariya S. Pravdivtseva , Olav Jansen , Naomi Larsen , Jan-Bernd Hövener","doi":"10.1016/j.zemedi.2024.11.002","DOIUrl":"10.1016/j.zemedi.2024.11.002","url":null,"abstract":"<div><div>Vessel walls play a crucial role in many inflammatory vascular diseases. Vessel wall imaging (VWI) using mangnetic resonance imaging (MRI) is one of the few methods by which vessel walls and inflammation can be visualized noninvasively, in vivo, and without ionizing radiation. VWI is based on black-blood (BB) MRI, where the signal from flowing blood is suppressed and contrast agent accumulation in the (inflamed) vessel wall is highlighted. Here, high resolution, T1 weighting, suppression of fat and flowing spins is essential. Whereas VWI is often applied in humans, only very few reports describe its use in small animals.</div><div>Here, we investigated whether BB MRI for rodents can be implemented using a state-of-the-art, but commercially available, preclinical MRI system and imaging sequence. We identified 2D spin-echo (RARE)-based BB-MRI as a promising sequence that is widely available and not vendor dependent. First, we investigated the properties of the sequence in vitro with respect to image contrast, resolution, the suppression of signal of flowing spins and fat using a newly developed, 3D-printed model setup (cylindrical model with exchangeable nuclear magnetic resonance tubes and flow tube in agarose, printed with stereolithography). For example, good signal-to-noise ratio, BB and T1 contrast were obtained for TE = 5 ms for slice thickness equal or below 0.352 mm or slice thickness = 0.8 mm with TE at least 25 ms. In vivo, we obtained a pronounced BB effect for both intracranial and abdominal vessels of healthy rats down to a 0.25 mm diameter in no more than 1:36 min with TE = 12 ms, TR = 750 ms, voxel 156 × 156 × 800 <em>µ</em>m<sup>3</sup>, and 11 slices. Compared to in vitro, we were able to reduce TE without apparent artifacts likely because the flow was faster in vivo than in vitro. Additionally, we needed to increase the resolution to image small vessels.</div><div>Thus, we found that BB-MRI with 2D spin-echo sequences is feasible on rodents with state-of-the-art, commercially available preclinical MRI systems. We believe that these results will facilitate the development and application of rodent VWI in longitudinal studies, which, in comparison to histology, may reduce the number of needed animals and intersubject variability at the same time.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"36 1","pages":"Pages 99-113"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Buschmann , Harald Herrmann , Manuela Gober , Aleksandra Winkler , Nicole Eder-Nesvacil , Franziska Eckert , Joachim Widder , Dietmar Georg , Petra Trnková
{"title":"Development of an MR-only radiotherapy treatment planning workflow using a commercial synthetic CT generator for brain and head & neck tumor patients","authors":"Martin Buschmann , Harald Herrmann , Manuela Gober , Aleksandra Winkler , Nicole Eder-Nesvacil , Franziska Eckert , Joachim Widder , Dietmar Georg , Petra Trnková","doi":"10.1016/j.zemedi.2025.01.003","DOIUrl":"10.1016/j.zemedi.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>In magnetic resonance (MR)-only radiotherapy (RT) workflows, synthetic computed tomography images (sCT) are needed as a surrogate for a dose calculation. Commercial and certified sCT algorithms became recently available, but many have not been evaluated in a clinical setting, especially in the head and neck tumor (HN) region. In this study, an MRI-only workflow using a commercial sCT generator for photon beam therapy in brain and HN body sites was evaluated in terms of dose calculation accuracy, modelling of immobilization devices, as well as usability for autosegmentation.</div></div><div><h3>Methods</h3><div>For 13 brain and 10 HN cancer patients, MR scans using T1W mDIXON sequences were retrospectively collected. Four brain and all HN patients were scanned in RT treatment position with immobilization devices. All MRIs were converted to a sCT using the MRCAT algorithm (Philips, Eindhoven, The Netherlands).</div><div>All patients underwent standard planning CT (pCT) for clinical segmentation and VMAT treatment planning. The sCT was rigidly registered to the pCT and clinical contours were transferred to the sCT. For dosimetric evaluation of sCT based dose calculation, all VMAT plans were recalculated on the sCT. D<sub>1%</sub> and D<sub>mean</sub> were compared for all structures between pCT and sCT, but D<sub>95%</sub>, D<sub>98%</sub> for targets only. For MR-invisible RT immobilization device modelling, MR-visible markers were placed into sCT and a geometric robustness analysis was performed based on the same target dose-volume parameters. For organs-at-risk (OARs) autosegmentation, both pCT and sCT were autosegmented with a clinically established CT-based autocontouring software. The agreement of contours on pCT and sCT was analyzed by similar dose-volume parameters and dice similarity (DSC) and Hausforff distance (HD).</div></div><div><h3>Results</h3><div>The overall median deviation (± interquartile range) of dosimetric parameters between sCT and pCT including the immobilization model was 1.1 ± 0.4% for brain target volumes, 1.3 ± 1.2% for brain OAR, 0.4 ± 0.7% for HN target volumes and 0.4 ± 0.9% for HN OAR. The median geometric agreement over all sCT autocontours compared to pCT autocontours resulted in DSC = 0.82 for brain OAR and DSC = 0.79 for HN OAR.</div></div><div><h3>Conclusion</h3><div>MR-only RT planning using MRCAT software package was feasible for brain and HN tumors, with acceptable clinical accuracy. The MR-invisible immobilization devices could be modelled in the planning system and the autosegmentation on sCTs using a CT-based autosegmentation tool was feasible.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"36 1","pages":"Pages 71-83"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannes A. Loebner , Raphael Joost , Jenny Bertholet , Stavroula Mougiakakou , Michael K. Fix , Peter Manser
{"title":"DeepSMCP – Deep-learning powered denoising of Monte Carlo dose distributions within the Swiss Monte Carlo Plan","authors":"Hannes A. Loebner , Raphael Joost , Jenny Bertholet , Stavroula Mougiakakou , Michael K. Fix , Peter Manser","doi":"10.1016/j.zemedi.2025.02.004","DOIUrl":"10.1016/j.zemedi.2025.02.004","url":null,"abstract":"<div><div>This work demonstrated the development of a fast, deep-learning framework (DeepSMCP) to mitigate noise in Monte Carlo dose distributions (MC-DDs) of photon treatment plans with high statistical uncertainty (SU) and its integration into the Swiss Monte Carlo Plan (SMCP). To this end, a two-channel input (MC-DD and computed tomography (CT) scan) 3D U-net was trained, validated and tested (80%/10%/10%) on high/low-SU MC-DD-pairs of 106 clinically-motivated VMAT arcs for 29 available CTs, augmented to 3074 pairs. The model was integrated into SMCP to enable a “one-click” workflow of calculating and denoising MC-DDs of high SU to obtain MC-DDs of low SU. The model accuracy was evaluated on the test set using Gamma passing rate (2% global, 2 mm, 10% threshold) comparing denoised and low-SU MC-DD. Calculation time for the whole workflow was recorded. Denoised MC-DDs match low-SU MC-DDs with average (standard deviation) Gamma passing rate of 82.9% (4.7%). Additional application of DeepSMCP to 12 unseen clinically-motivated cases of different treatment sites, including treatment sites not present during training, resulted in an average Gamma passing rate of 91.0%. Denoised DDs were obtained on average in 35.1 s, a 340-fold efficiency gain compared to low-SU MC-DD calculation. DeepSMCP presented a first seamlessly integrated promising denoising framework for MC-DDs.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"36 1","pages":"Pages 36-46"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patente in der Medizinphysik am Beispiel der Magnetresonanztomographie","authors":"Oliver Koppel","doi":"10.1016/j.zemedi.2025.09.002","DOIUrl":"10.1016/j.zemedi.2025.09.002","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"36 1","pages":"Pages 2-4"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominik Kornek , Cordelia Hoinkis , Natasa Milickovic , Ailine Lange , Alena Knak , Manuel März , Mieke L. Möller , Markus Buchgeister
{"title":"Systematizing the risk management process in clinical radiotherapy practice: Recommendations of the working group on risk management of the DGMP","authors":"Dominik Kornek , Cordelia Hoinkis , Natasa Milickovic , Ailine Lange , Alena Knak , Manuel März , Mieke L. Möller , Markus Buchgeister","doi":"10.1016/j.zemedi.2024.11.001","DOIUrl":"10.1016/j.zemedi.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The <em>Deutsche Gesellschaft für Medizinische Physik</em> [German Society of Medical Physics] has recently published two coherent reports, No. 25 and No. 28, detailing the design and implementation of a risk management (RM) process for German radiotherapy (RT) departments. This study offers an overview and background of the efforts behind these reports.</div></div><div><h3>Methods and Materials</h3><div>For three years, up to nine medical physicists (MPs) with practical RM experience held weekly meetings to develop recommendations for a clinical RM process. Care was taken to ensure that the recommendations were equally applicable to RT departments of various sizes. A process-based method derived from the failure mode and effects analysis (FMEA) was created to identify and address risks from unintentional radiation exposure. This method was applied to exemplarily analyze the hazardous scenarios in breast RT using surface guidance and deep inspiration breath hold (DIBH) techniques. Three common criticality methods—risk matrix, risk priority number, and action priority—were applied, and each step was schematically explained for first-time users. Each report was peer-reviewed by two radiation oncologists and 11 MPs.</div></div><div><h3>Results</h3><div>In report No. 25, basic requirements were outlined for running the RM process, conducting risk assessments, and monitoring clinical procedures. A three-year plan-do-check-act cycle was proposed for continuous improvement. In report No. 28, general process lists for external beam radiotherapy (EBRT), brachytherapy, and radionuclide therapy were designed. Based on the EBRT process list, 45 hazardous scenarios in the surface-guided breast RT in DIBH were identified. Two scenarios were used to illustrate handling instructions for the three criticality methods.</div></div><div><h3>Conclusions</h3><div>The recommendations provide clinical MPs and other health professionals with a pragmatic approach to RM, balancing both the needs of smaller practices and larger clinics in Germany. The risk of unintended exposures of patients is viewed acceptable once it has been lowered to a state that is as low as reasonably achievable.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 401-407"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of iterative reconstruction implementations for multislice helical CT","authors":"Zsolt Adam Balogh , Zsofia Barna , Eva Majoros","doi":"10.1016/j.zemedi.2024.04.001","DOIUrl":"10.1016/j.zemedi.2024.04.001","url":null,"abstract":"<div><div>The most mature image reconstruction algorithms in multislice helical computed tomography are based on analytical and iterative methods. Over the past decades, several methods have been developed for iterative reconstructions that improve image quality by reducing noise and artifacts. In the regularization step of iterative reconstruction, noise can be significantly reduced, thereby making low-dose CT. The quality of the reconstructed image can be further improved by using model-based reconstructions. In these reconstructions, the main focus is on modeling the data acquisition process, including the behavior of the photon beams, the geometry of the system, etc.</div><div>In this article, we propose two model-based reconstruction algorithms using a virtual detector for multislice helical CT. The aim of this study is to compare the effect of using a virtual detector on image quality for the two proposed algorithms with a model-based iterative reconstruction using the original detector model. Since the algorithms are implemented using multiple GPUs, the merging of separately reconstructed volumes can significantly affect image quality. This issue is often referred to as the ”long object” problem, for which we also present a solution that plays an important role in the proposed reconstruction processes.</div><div>The algorithms were evaluated using mathematical and physical phantoms, as well as patient cases. The SSIM, MS-SSIM and <span><math><mrow><msub><mrow><mi>L</mi></mrow><mrow><mn>1</mn></mrow></msub></mrow></math></span> metrics were utilized to evaluate the image quality of the mathematical phantom case. To demonstrate the effectiveness of the algorithms, we used the CatPhan 600 phantom. Additionally, anonymized patient scans were used to showcase the improvements in image quality on real scan data.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 438-451"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Yang , Mehrgan Shahryari , Tom Meyer , Stephan Rodrigo Marticorena Garcia , Steffen Görner , Mahsa Salimi Majd , Jing Guo , Jürgen Braun , Ingolf Sack , Heiko Tzschätzsch
{"title":"Explorative study using ultrasound time-harmonic elastography for stiffness-based quantification of skeletal muscle function","authors":"Yang Yang , Mehrgan Shahryari , Tom Meyer , Stephan Rodrigo Marticorena Garcia , Steffen Görner , Mahsa Salimi Majd , Jing Guo , Jürgen Braun , Ingolf Sack , Heiko Tzschätzsch","doi":"10.1016/j.zemedi.2024.03.001","DOIUrl":"10.1016/j.zemedi.2024.03.001","url":null,"abstract":"<div><div>Time-harmonic elastography (THE) is an emerging ultrasound imaging technique that allows full-field mapping of the stiffness of deep biological tissues. THE's unique ability to rapidly capture stiffness in multiple tissues has never been applied for imaging skeletal muscle. Therefore, we addressed the lack of data on temporal changes in skeletal muscle stiffness while simultaneously covering stiffness of different muscles.</div><div>Acquiring repeated THE scans every five seconds we quantified shear-wave speed (SWS) as a marker of stiffness of the long head (LHB) and short head (SHB) of biceps brachii and of the brachialis muscle (B) in ten healthy volunteers. SWS was continuously acquired during a 3-min isometric preloading phase, a 3-min loading phase with different weights (4, 8, and 12 kg), and a 9-min postloading phase. In addition, we analyzed temporal SWS standard deviation (SD) as a marker of muscle contraction regulation.</div><div>Our results (median [min, max]) showed both SWS at preloading (LHB: 1.04 [0.94, 1.12] m/s, SHB: 0.86 [0.78, 0.94] m/s, B: 0.96 [0.87, 1.09] m/s, <em>p</em> < 0.001) and the increase in SWS with loading weight to be muscle-specific (LHB: 0.010 [0.002, 0.019] m/s/kg, SHB: 0.022 [0.017, 0.042] m/s/kg, B: 0.039 [0.019, 0.062] m/s/kg, <em>p</em> < 0.001). Additionally, SWS during loading increased continuously over time by 0.022 [0.004, 0.051] m/s/min (<em>p</em> < 0.01). Using an exponential decay model, we found an average relaxation time of 27 seconds during postloading. Analogously, SWS SD at preloading was also muscle-specific (LHB: 0.018 [0.011, 0.029] m/s, SHB: 0.021 [0.015, 0.027] m/s, B: 0.024 [0.018, 0.037] m/s, <em>p</em> < 0.05) and increased by 0.005 [0.003, 0.008] m/s/kg (<em>p</em> < 0.01) with loading. SWS SD did not change over loading time and decreased immediately in the postloading phase.</div><div>Taken together, THE of skeletal muscle is a promising imaging technique for in vivo quantification of stiffness and stiffness changes in multiple muscle groups within seconds. Both the magnitude of stiffness changes and their temporal variation during isometric exercise may reflect the functional status of skeletal muscle and provide additional information to the morphological measures obtained by conventional imaging modalities.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 470-482"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lidia Strigari , David Menichelli , Elisa Lodi Rizzini , Arber Golemi , Gian Mauro Sacchetti , Lucia Leva , Cristina Nanni , Paolo Castelucci , Stefano Fanti , Alessio Giuseppe Morganti , Roberta Matheoud
{"title":"Advancing risk management in nuclear medicine diagnostic and therapy through incident-driven risk management tools","authors":"Lidia Strigari , David Menichelli , Elisa Lodi Rizzini , Arber Golemi , Gian Mauro Sacchetti , Lucia Leva , Cristina Nanni , Paolo Castelucci , Stefano Fanti , Alessio Giuseppe Morganti , Roberta Matheoud","doi":"10.1016/j.zemedi.2025.03.004","DOIUrl":"10.1016/j.zemedi.2025.03.004","url":null,"abstract":"<div><div>Accidental or unintended exposures in nuclear medicine present significant risks, demanding proactive and systematic risk management strategies. This study explores the development and implementation of a novel software tool that integrates Failure Modes and Effects Analysis (FMEA) and Fault Tree Analysis (FTA) into a unified platform tailored for nuclear medicine. The tool addresses the complexities of risk assessment across diagnostic and therapeutic workflows, offering customizable templates and a streamlined process for identifying, prioritizing, and mitigating failure modes.</div><div>A multicenter study involving nuclear medicine departments of various sizes demonstrated the tool’s efficacy in standardizing risk analysis and enhancing interdisciplinary collaboration. Key scenarios, such as errors in radiopharmaceutical preparation and administration, were assessed, with rankings assigned based on a refined Risk Priority Number (RPN) system.</div><div>The results underscore the transformative potential of combining FMEA and FTA in nuclear medicine, addressing the limitations of standalone methodologies. This approach improves workflow efficiency and ensures a robust framework for patient safety. Future directions include expanding the tool’s applications, refining templates, and fostering a proactive culture of risk assessment. These advancements pave the way for safer, more efficient practices in nuclear medicine, benefiting patients and professionals alike.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 416-422"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johannes Melcher , Martin Dierolf , Benedikt Günther , Klaus Achterhold , Daniela Pfeiffer , Franz Pfeiffer
{"title":"High-energy X-ray diffraction experiment employing a compact synchrotron X-ray source based on inverse Compton scattering","authors":"Johannes Melcher , Martin Dierolf , Benedikt Günther , Klaus Achterhold , Daniela Pfeiffer , Franz Pfeiffer","doi":"10.1016/j.zemedi.2024.03.003","DOIUrl":"10.1016/j.zemedi.2024.03.003","url":null,"abstract":"<div><div>X-ray diffraction (XRD) is an important material analysis technique with a widespread use of laboratory systems. These systems typically operate at low X-ray energies (from 5 keV to 22 keV) since they rely on the small bandwidth of K-lines like copper. The narrow bandwidth is essential for precise measurements of the crystal structure in these systems. Inverse Compton X-ray source (ICS) could pave the way to XRD at high X-ray energies in a laboratory setting since these sources provide brilliant energy-tunable and partially coherent X-rays. This study demonstrates high-energy XRD at an ICS with strongly absorbing mineralogical samples embedded in soft tissue. A quantitative comparison of the measured XRD patterns with calculations of their expected shapes validates the performance of ICSs for XRD. This analysis was performed for two types of kidney stones of different materials. Since these stones are not isolated in a human body, the influence of the surrounding soft tissue on the XRD pattern is investigated and a correction for this soft tissue contribution is introduced.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 428-437"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}