Bioengineering最新文献

{"title":"Multifunctional Roles of Magnesium Ions in Modulating Bone Regeneration-Related Cells.","authors":"Xiangcheng Lei, Ruipeng Li, Yangyi Nie, Deju Gao, Wei Zhang, Yuxiao Lai, Cairong Li","doi":"10.3390/bioengineering13091093","DOIUrl":"10.3390/bioengineering13091093","url":null,"abstract":"<p><p>Magnesium ions (Mg²⁺) play pivotal roles in bone regeneration by regulating the biological functions of multiple bone repair-related cells. However, the effective concentration ranges and optimal concentration of Mg²⁺ for different cell types remain incompletely defined, which limits the precise design of Mg-containing biomaterials with controllable ion release for repairing of bone defects. In this study, the concentration-dependent effects of Mg²⁺ on the biological functions of bone regeneration-related cells were systematically investigated. Human bone marrow mesenchymal stem cells (hBMSCs), human umbilical vein endothelial cells (HUVECs), rat Schwann cells (RSCs), and RAW264.7 macrophage were selected to evaluate the effective concentration of Mg²⁺ for promoting osteogenesis, angiogenesis, neuroregulation, and immunomodulation, respectively. The results demonstrated that Mg²⁺ concentrations ranging from to 16 mM, particularly 8 mM, significantly upregulated the expression of M2 macrophage-related markers, thereby promoting the polarization of RAW264.7 macrophages toward the anti-inflammatory M2 phenotype. Moreover, Mg²⁺ concentrations between 2 and 8 mM effectively enhanced the osteogenic activity of hBMSCs, the angiogenic activity of HUVECs, and the neuroregulatory function of RSCs, as confirmed by immunofluorescence staining and quantitative PCR analysis of osteogenic, angiogenic, and neuroregulation-related marker expression. These findings provide a comprehensive understanding of the concentration-dependent biological effects of Mg²⁺ on bone regeneration-related cells and establish a theoretical basis for the rational design of next-generation Mg²⁺-releasing biomaterials with precise biological regulation.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057744","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":"Multidimensional Quality Evaluation of Imaging Performance for Musculoskeletal Ultrasound Computed Tomography System.","authors":"Xiaoxue Bai, Li Zhao, Pan Zhou, Ge Bai, Longxin Xiao, Jianan Chen, Ye Yu, Weicheng Yan, Yang Xu","doi":"10.3390/bioengineering13091094","DOIUrl":"10.3390/bioengineering13091094","url":null,"abstract":"<p><p>Core parameters of the Musculoskeletal Ultrasound Computed Tomography System (MUCTS), such as spatial resolution, slice thickness, and three-dimensional reconstruction volume error, directly determine imaging performance and clinical diagnostic accuracy. To objectively and systematically assess the imaging quality and diagnostic reliability of this device, this study took the MUCTS developed by Weishi Medical Imaging Co., Ltd., as the test object. Multidimensional performance tests were carried out using standard ultrasound phantoms and polyurethane-based tissue-mimicking musculoskeletal phantoms. Under unified imaging and reconstruction parameters, key indicators, including effective detection radius, axial resolution, lateral resolution, imaging dead zone, slice thickness, geometric position accuracy, and three-dimensional reconstruction volume error, were quantitatively measured, and compliance verification was performed against product technical specifications. The test results demonstrated that the nominal center frequency was 3 MHz with a measured frequency deviation of 3%, and the effective detection radius reached 90 mm. Within the valid imaging range, the axial resolution was 0.5 mm, lateral resolution was 1 mm, imaging dead zone was 1 mm, and slice thickness was 3.2 mm. The relative error of geometric position accuracy was 3%, the relative deviations in perimeter and area measurements were both -1%, and the relative deviation in three-dimensional reconstructed volume was -8%. All indicators satisfied product technical requirements. Qualitative comparative experiments on tissue-mimicking phantoms confirmed that the system could reproduce multiscale and multi-contrast musculoskeletal anatomical features, and the acquired images showed favorable consistency with designed phantom targets. In conclusion, this musculoskeletal ultrasound tomographic system exhibits stable imaging performance and credible quantitative measurements, and can meet clinical and research demands for tomographic imaging and three-dimensional reconstruction of human musculoskeletal tissues.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057643","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":"From Geometry to Flow Allocation: A Physics-Based Framework for Interpretable Microvascular Hemodynamics.","authors":"Alexander Fiedler, Marius Drysch, Sonja Verena Schmidt, Pia Weskamp, Felix Reinkemeier, Flemming Puscz, Alexander Sogorski, Marcus Lehnhardt, Christoph Wallner","doi":"10.3390/bioengineering13091091","DOIUrl":"10.3390/bioengineering13091091","url":null,"abstract":"<p><p>Anastomotic angle and flow allocation change together in end-to-side junctions, complicating interpretation of angle-dependent wall shear. We used MITOS Flow Lab, a two-dimensional D2Q9 two-relaxation-time lattice-Boltzmann environment, to examine this coupling in steady, rigid-walled, Newtonian models at Re ≈ 91. Angles of 30-120° were compared under equal outlet pressures and at approximately matched branch-flow fractions of 0.25 and 0.21, achieved with angle-specific static outlet-pressure offsets. Under equal outlet pressures, the branch-flow fraction decreased from 0.356 to 0.151 across this angle range, while the minimum normalized signed recipient-floor shear increased from 0.140 to 0.450. Matching flow allocation substantially reduced angle-associated variation in this endpoint and in the sub-toe response, whereas sub-heel and sub-ostial responses remained angle dependent under the adjusted boundary conditions. This qualitative contrast persisted when the lumen resolution was increased from 32 to 64 nodes for the 0.25 target, although minimum-shear attenuation changed from approximately 83% to 74%. The 0.21 target was examined only on the production grid. These experiments demonstrate that the interpretation of angle-associated shear depends on the flow-allocation condition used for comparison. They do not identify a boundary-independent geometric effect or a causal mediation fraction. Absolute values and attenuation magnitudes remain sensitive to discretization and have not been independently validated. These controlled comparisons provide a framework for interpreting angle-associated shear together with achieved flow allocation and the specified outlet conditions.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057698","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":"TeleGlaukos: A Clinician-Led Adaptive Telemonitoring Platform for Hybrid Glaucoma Care.","authors":"Jeniffer Jesus, Pedro Cardoso-Teixeira, João Chibante Pedro, Dália Meira, Ignácio Rodriguez-Uña, João Melo Beirão, Luís Bastião Silva","doi":"10.3390/bioengineering13091090","DOIUrl":"10.3390/bioengineering13091090","url":null,"abstract":"<p><p>Glaucoma requires continuous surveillance, sustained treatment adherence, and timely recognition of postoperative or treatment-related complications. Conventional outpatient follow-up provides structured clinical assessment but offers limited visibility of symptoms between appointments. This study describes TeleGlaukos, a clinician-led adaptive telemonitoring platform designed for hybrid perioperative and therapeutic glaucoma care. Its principal innovation is a configurable protocol engine that transforms static symptom forms into patient-specific workflows through conditional questions, symptom-triggered branching, medication reminders, rule-based alerts, and bidirectional clinician-patient communication. The platform was implemented as a Progressive Web App connected to a modular Django backend through RESTful APIs and WebSocket-enabled communication. The clinical pilot cohort comprised 30 glaucoma patients followed between May 2025 and April 2026. The wider platform environment contained 95 registered accounts: 30 glaucoma patients, 10 ophthalmologists, 10 research or administrative users, 20 development and testing accounts, and 25 non-pilot registered users. Across the platform, 737 engaged sessions, 1329 events, 30 bidirectional messages, and 186 questionnaire responses were recorded. Structured monitoring identified suspected treatment-related adverse reactions in two patients, prompting earlier clinical reassessment and treatment adjustment. Usability was assessed in 22 respondents (18 patients and 4 ophthalmologists), yielding a mean System Usability Scale score of 79.43 ± 17.98 (95% CI: 71.46-87.40), corresponding to a Good adjective rating and an Acceptable usability range; internal consistency was high (Cronbach's alpha = 0.882). The artificial intelligence-assisted module remained exploratory and was not evaluated as an autonomous clinical component. TeleGlaukos demonstrated technical feasibility, favourable perceived usability, and the capacity of adaptive symptom workflows to surface clinically relevant signals between visits. Larger multicentre studies are required to evaluate effectiveness, safety, adherence, workflow burden, and cost-effectiveness.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057777","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":"Demographic Shortcuts Account for Most of the Apparent Accuracy of Four-Class Gait-Based Differential Diagnosis in Neurodegenerative Disease: An Interpretability-Driven Audit of Machine Learning on a Public Gait Benchmark.","authors":"Zheng Wang, Yitong Xia, Guifeng Zhang","doi":"10.3390/bioengineering13091092","DOIUrl":"10.3390/bioengineering13091092","url":null,"abstract":"<p><p>Machine-learning gait studies often report high accuracy for separating neurodegenerative diseases, but rarely test whether this reflects pathology or the demographic differences that accompany disease in convenience cohorts. We audited the PhysioNet Gait in Neurodegenerative Disease Database (63 subjects: controls, Parkinson's disease [PD], Huntington's disease [HD], amyotrophic lateral sclerosis [ALS]), classifying 37 stride-rhythm features under subject-disjoint nested leave-one-subject-out cross-validation. A random forest reached a macro-averaged one-vs-rest AUROC of 0.832 (95% CI 0.759-0.904; permutation <i>p</i> = 0.001). Four complementary audits-demographic-only baselines, confound adjustment, feature-family ablation, and age matching-show that this overstates gait-specific discrimination: five anthropometric variables alone reached an AUROC of 0.812, statistically indistinguishable from the gait model (<i>p</i> = 0.701), and the de-confounded gait model (0.755) fell further to 0.585 once age was matched across groups. HD was the exception, essentially unaffected by adjustment (0.812 → 0.804) and carried by variability and long-range-correlation measures. In an independent, age-matched cohort recorded with a different sensor (<i>n</i> = 110, PD versus control only), the same vulnerability reappeared through a different variable: the gait model (0.828) showed no statistically significant difference from walking speed alone (0.746, <i>p</i> = 0.11), while age and anthropometry fell to chance; this cohort contained no HD subjects, so the HD finding remains externally unvalidated. The shortcut vulnerability generalises across cohorts; the demographic variable that drives it does not. Four-class differential diagnosis is not demonstrated on this benchmark; HD gait arrhythmicity is the one signal that withstands internal sensitivity analysis. We recommend that accuracy claims from small, demographically imbalanced gait cohorts be accompanied by this kind of audit.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057853","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":"Extracellular Vesicles and Their Role in Osteogenesis.","authors":"Marcus Jäger, Andrea Sowislok","doi":"10.3390/bioengineering13091086","DOIUrl":"10.3390/bioengineering13091086","url":null,"abstract":"<p><p>Extracellular vesicles (EVs) have emerged as promising cell-free therapeutic agents for bone regeneration due to their ability to modulate osteogenesis, angiogenesis, and immune responses. This review summarizes the current knowledge on EV biology, including their classification, biogenesis, and molecular cargo, with a particular focus on their role in bone healing. EVs derived from mesenchymal stromal cells and other cell types promote osteoblast differentiation, inhibit osteoclast activity, enhance vascularization, and modulate inflammation through the transfer of bioactive proteins and non-coding RNAs. Recent advances in EV engineering, biomaterial-assisted delivery, and isolation techniques are discussed, together with their translational potential for the treatment of critical bone defects and avascular osteonecrosis. Although preclinical evidence is highly encouraging, clinical evidence remains limited, particularly in orthopedics, and clinical translation is challenged by EV heterogeneity, lack of dose standardization, limited understanding of biodistribution, scalable manufacturing, and regulatory requirements. Overall, EV-based therapies represent a promising future strategy for regenerative orthopedics and bone tissue engineering.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057621","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":"Computational and Experimental Evaluation of a Flow-Conditioning Anastomotic Device for Arteriovenous Fistula Maturation.","authors":"Keith Saum, Begoña Campos, Diego Celdran Bonafonte, Liran Oren, Albert Phillip Owens, Prabir Roy-Chaudhury","doi":"10.3390/bioengineering13091089","DOIUrl":"10.3390/bioengineering13091089","url":null,"abstract":"<p><p>The arteriovenous fistula (AVF) is the preferred method of vascular access for hemodialysis; however, 30-50% of AVFs undergo primary maturation failure and are unsuitable for clinical use. As disturbed hemodynamics initiate endothelial injury and intimal hyperplasia, we designed an endovascular flow-conditioning anastomotic device (FCAD) to directly improve AVF hemodynamics and protect the anastomotic region. Using computational fluid dynamics, we characterized the flow field and wall shear stress (WSS) profiles in idealized AVF models with and without the FCAD. Incorporation of the FCAD into a brachiocephalic AVF model reduced regions of oscillatory WSS and generated a symmetrical flow profile in the draining vein compared to a reference AVF. Parametric studies identified an FCAD geometry with a tab angle, height, and aspect ratio of 30°, 0.1 diameters, and 1.0 that increased time-averaged WSS along the inner venous wall and achieved a physiological WSS (1-3 Pa) without inducing regions of oscillatory flow throughout the cardiac cycle. Similar findings were observed with an in vitro model using particle image velocimetry. This study demonstrates the feasibility of the FCAD to normalize venous flow and WSS while imposing minimal resistance to blood flow. Restoring physiological WSS levels on the venous wall may help preserve endothelial function and improve AVF maturation.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057844","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":"3D-Printed and Biofabricated Scaffolds for Osteoporotic Bone Defect Repair: Mechanical Adaptation, Redox Control, Senescence Modulation and Osteoimmunomodulation.","authors":"Sedeek Mosaid, Yousif Jihad, Nuala Pepper, Mohamed Elnemr, Ashok Marudanayagam, Paul Lee","doi":"10.3390/bioengineering13091088","DOIUrl":"10.3390/bioengineering13091088","url":null,"abstract":"<p><p>Fragility fracture and osteoporotic bone loss represent an increasing global burden in ageing populations: the Global Burden of Disease Study 2021 estimated 172.79 million new fractures, 453.31 million prevalent cases, and 25.18 million years lived with disability in 2021, yet the resulting defects are still managed with grafts and scaffolds validated in healthy bone. Osteoporotic bone is not merely rarefied normal bone but a distinct regenerative microenvironment, in which we propose that oxidative stress, cellular senescence, and loss of osteogenesis-coupled type-H vasculature act as a mutually reinforcing triad, superimposed on an adipogenically biassed progenitor pool, blunted osteocyte mechanotransduction and immunosenescence. Additive manufacturing and biofabrication permit patient-specific geometry and spatial and temporal programming of mechanical and biological cues. This review appraises four interdependent design axes-mechanical adaptation through functionally graded, trabecular-mimetic architectures; redox regulation; senescence modulation; and osteoimmunomodulation coupled to vascularisation-distinguishing study type, disease specificity and author-proposed hypotheses. The most direct clinical signal is mechanical: in a retrospective cohort of 163 lumbar interbody fusion levels, printed porous titanium was associated with subsidence in 5.5% of levels versus 24.4% for solid titanium. By contrast, almost all redox, senescence and immunomodulatory scaffold evidence remains preclinical: osteoporosis-specific evidence relies heavily on ovariectomised rodents, and much of the rest comes from non-osteoporotic models. Within the searches described, we identified no completed clinical evaluation with reported results of a multifunctional scaffold in an osteoporosis-defined cohort. As the authors' proposed conceptual framework rather than an established result, we suggest that these axes be engaged sequentially rather than additively, and that timing, dose and spatial distribution may matter more than the number of bioactivities.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057791","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":"The Impact of Laser Energy Levels on In Situ Fenestrations of Aortic Stent Grafts: An On-Bench Study.","authors":"Teodora Ormandzhieva, Florian Elger, Marcello Silvano, Bernd Niemann, Eberhard Grambow","doi":"10.3390/bioengineering13091085","DOIUrl":"10.3390/bioengineering13091085","url":null,"abstract":"<p><p>(1) Background: Laser in situ fenestration (L-ISF) is an endovascular technique used to preserve target vessel patency in urgent or emergency endovascular aortic repair when fenestrated/branched solutions are unavailable or unsuitable, or as a bailout technique for fenestration or branch misalignment. This on-bench study compared different laser energy levels in five commercially available endografts to assess fabric damage and evaluate fenestration quality, dimensions, and recoil. (2) Methods: A total of 102 fenestrations were created using a 2.0 mm excimer laser catheter at low (45 mJ/mm²) or high (60 mJ/mm²) energy levels and dilated with a 6 mm plain balloon in five polyester endografts (Zenith Alpha, RelayPro, Endurant IIs, Valiant Captivia, Hercules). High-magnification microscopy assessed morphology and fabric damage after puncture, after dilation, and after 24 h. Quantitative measurements included diameters, area, and recoil under standardized study conditions. (3) Results: Valiant exhibited clearer puncture margins and no bulging; Hercules showed frequent tearing and more bulging and warp-aligned recoil at high energy. In Endurant IIs, low-energy L-ISF produced larger diameters and area but also greater recoil. RelayPro revealed stronger surface recoil with high energy. (4) Conclusion: Both low- and high-energy L-ISF were feasible across all tested grafts. A low-energy approach may be preferable for Endurant IIs, potentially reducing the risk of bridging stent graft stenosis.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057797","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":"Noninvasive Preoperative Stratification of Renal Tumors for Aggressiveness and Prognosis.","authors":"Jinglai Lin, Linpeng Yao, Jianbo Gao, Ning Xu, Ying Xiong, Qi Bai, Kang Wang, Qi Sun","doi":"10.3390/bioengineering13091084","DOIUrl":"10.3390/bioengineering13091084","url":null,"abstract":"<p><p>Accurate preoperative discrimination between indolent and aggressive renal lesions is essential for personalized risk-stratified management and improves the clinical outcomes of renal tumor patients. This study aimed to establish and externally validate a non-invasive computed tomography (CT)-derived radiomic model for identifying aggressive renal tumors and predicting long-term postoperative survival. A total of 3407 patients with pathologically confirmed renal tumors from multiple centers were retrospectively enrolled and divided into three independent cohorts: a training cohort (<i>n</i> = 1840), an internal validation cohort (<i>n</i> = 789), and an external test cohort (<i>n</i> = 778). Based on preoperative multiphasic CT images, a support vector machine (SVM)-based radiomic model was constructed to evaluate tumor aggressiveness. Cox proportional hazards regression analysis was performed to identify independent prognostic factors, and a comprehensive nomogram combining radiomic aggressiveness score and clinicopathological parameters was further developed for survival prediction. The established SVM radiomic model yielded stable discriminatory performance, with an area under the receiver operating characteristic curve (AUC) of 0.740 in the internal validation cohort and 0.763 in the external test cohort. Multivariate Cox regression analysis demonstrated that radiomics-predicted tumor aggressiveness remained an independent adverse prognostic factor for recurrence-free survival (HR = 3.656), overall survival (HR = 1.981), and disease-specific survival (HR = 3.673). Moreover, the integrated nomogram demonstrated favorable calibration for predicting 5-year and 8-year overall survival in the internal validation cohort. This novel CT-based radiomic model provides a robust non-invasive tool for preoperative differentiation of renal tumor aggressiveness. As an independent prognostic biomarker, it can assist clinicians in precise preoperative risk evaluation and facilitate individualized therapeutic decision-making for renal tumor patients.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 9","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13603619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057817","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}