British Journal of Radiology最新文献

{"title":"Evaluating the role of LLMs in supporting patient education during the informed consent process for routine radiology procedures.","authors":"Eric Einspänner, Roland Schwab, Sebastian Hupfeld, Maximilian Thormann, Erelle Fuchs, Matthias Gawlitza, Jan Borggrefe, Daniel Behme","doi":"10.1093/bjr/tqaf225","DOIUrl":"https://doi.org/10.1093/bjr/tqaf225","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated three LLM chatbots (GPT-3.5-turbo, GPT-4-turbo, and GPT-4o) on their effectiveness in supporting patient education by answering common patient questions for CT, MRI, and DSA informed consent, assessing their accuracy and clarity.</p><p><strong>Methods: </strong>Two radiologists formulated 90 questions categorized as general, clinical, or technical. Each LLM answered every question five times. Radiologists then rated the responses for medical accuracy and clarity, while medical physicists assessed technical accuracy using a Likert scale. semantic similarity was analyzed with SBERT and cosine similarity.</p><p><strong>Results: </strong>Ratings improved with newer model versions. Linear mixed-effects models revealed that GPT-4 models were rated significantly higher than GPT-3.5 (p < 0.001) by both physicians and physicists. However, physicians' ratings for GPT-4 models showed a significant performance decrease for complex modalities like DSA and MRI (p < 0.01), a pattern not observed in physicists' ratings. SBERT analysis revealed high internal consistency across all models. SBERT analysis revealed high internal consistency across all models.</p><p><strong>Conclusion: </strong>Variability in ratings revealed that while models effectively handled general and technical questions, they struggled with contextually complex medical inquiries requiring personalized responses and nuanced understanding. Statistical analysis confirms that while newer models are superior, their performance is modality-dependent and perceived differently by clinical and technical experts.</p><p><strong>Advances in knowledge: </strong>This study evaluates the potential of LLMs to enhance informed consent in radiology, highlighting strengths in general and technical questions while noting limitations with complex clinical inquiries, with performance varying significantly by model type and imaging modality.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091153","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":"Beyond Green: Sustainability in Nuclear Medicine Practice.","authors":"Geoffrey M Currie","doi":"10.1093/bjr/tqaf226","DOIUrl":"https://doi.org/10.1093/bjr/tqaf226","url":null,"abstract":"<p><p>Sustainable nuclear medicine practice tends to focus on \"greener\" practices. A holistic framework requires a multi-dimensional approach that considers the entire nuclear medicine pipeline beyond \"green\" initiatives and through a global lens. There is a paucity of nuclear medicine sustainable literature although documented sustainability strategies in radiology provide transferability. For nuclear medicine practice, there are a number of interconnected sustainability domains. While AI may provide solutions for improved sustainability through workflow efficiencies, cost reductions and decreased carbon footprint, there are a number of other easy to implement strategies for waste reduction, energy consumption reduction, and improved efficiencies. Carbon offsets represent a potential strategy to create carbon neutrality of nuclear medicine services and represent a commitment to planetary health and global \"net zero by 2030\" sustainability targets.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091181","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":"Optimising Diagnostic Pathways through digital Multidisciplinary Team management of Patients with Cancer of Unknown Primary: a Retrospective Analysis.","authors":"J R J Willems, M J Lahaye, P Snaebjornsson, S Marchetti, M A Vollebergh, L W van Golen, W V Vogel, Z J Cheung, S Rostami, Z Bodalal, R G H Beets-Tan, D M J Lambregts","doi":"10.1093/bjr/tqaf228","DOIUrl":"https://doi.org/10.1093/bjr/tqaf228","url":null,"abstract":"<p><strong>Objectives: </strong>Diagnostic pathways for cancer of unknown primary (CUP) are often underdeveloped. At our tertiary referral centre for CUP, we recently introduced a new diagnostic workflow that includes digital discussion of CUP patients by a dedicated multidisciplinary team (MDT), centralised second opinion reviews, and an MDT-guided approach to further diagnostic steps. This study retrospectively assesses the outcomes of this optimised workflow on efficiency, diagnostic yield, and healthcare professional satisfaction.</p><p><strong>Methods: </strong>We retrospectively compared outcomes for 39 patients from period A(May 2021-April 2022) to 41 patients from period B(Dec 2022-Nov 2023) following workflow optimisation. Outcomes included time-to-diagnosis, diagnostic yield, impact of second opinion imaging reviews, and satisfaction levels among involved MDT members.</p><p><strong>Results: </strong>After workflow implementation, median time to diagnosis/treatment decreased from 36 to 28 days(p = 0.07). Second opinion imaging reviews led to the detection of new tumour lesions in 10% of cases. A primary tumour diagnosis was established 49% patients from period A versus 61% in period B(p = 0.37). Satisfaction among MDT members notably improved, especially regarding interdisciplinary communication and workflow efficiency.</p><p><strong>Conclusion: </strong>Our optimised CUP workflow with digital MDT-discussions and routine second opinion reviews of imaging and pathology data, improved diagnostic efficiency and satisfaction among physicians. These results highlight the value of a multidisciplinary, patient-centred approach focused on effective patient management in CUP.</p><p><strong>Advances in knowledge: </strong>Integrating digital MDT discussions and centralized second-opinion reviews in CUP care improves diagnostic efficiency and may enhance primary tumour detection rates. Radiologists and other diagnosticians play a key role in this multidisciplinary approach.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091139","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":"CT Imaging in Earthquake Trauma Patients with Different Levels of Creatine Kinase: Is There an Association with Renal Enhancement?","authors":"Sezer Nil Yılmazer Zorlu, Melahat Kul, Ayşegül Gürsoy Çoruh, Başak Gülpınar, Diğdem Kuru Öz, Ruhi Erdem Ergüden, Çağlar Uzun","doi":"10.1093/bjr/tqaf229","DOIUrl":"https://doi.org/10.1093/bjr/tqaf229","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate whether serum creatine kinase (CK) levels in patients with earthquake-related crush injuries are associated with alterations in renal enhancement patterns on contrast-enhanced computed tomography (CT), in the absence of overt acute kidney injury (AKI).</p><p><strong>Methods: </strong>We retrospectively analyzed contrast-enhanced abdominopelvic CT scans of 45 adult survivors with crush injuries sustained during the 2023 earthquakes. Based on CK levels, patients were stratified into low- and high-risk groups for AKI. A control group with normal renal function and no trauma history was included. Renal perfusion was assessed by calculating enhancement ratios-specifically, the cortex-to-aorta and normalized medulla-to-cortex ratios-derived from attenuation measurements of the renal cortex, medulla, and vascular reference points. Correlation analyses were conducted to assess associations with biochemical parameters.</p><p><strong>Results: </strong>Although none of the trauma patients developed AKI during follow-up, the cortex-to-aorta attenuation ratio was significantly lower in the high-risk group compared to controls (p = 0.042). A weak negative correlation was observed between serum CK levels and the cortex-to-aorta ratio (r = -0.295, p = 0.049). The normalized medulla-to-cortex ratio did not significantly differ between groups.</p><p><strong>Conclusions: </strong>Contrast-enhanced CT may detect subclinical reductions in renal cortical perfusion in crush injury patients with elevated CK, even without overt AKI. The cortex-to-aorta attenuation ratio may serve as a noninvasive imaging marker of early renal involvement and warrants further investigation.</p><p><strong>Advances in knowledge: </strong>Renal cortical hypoperfusion can be visualized on contrast-enhanced CT in asymptomatic crush injury patients, highlighting a novel radiologic marker for subclinical renal involvement.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091187","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":"Circulating tumor cells for the prediction of the response to radiation therapy in prostate cancer.","authors":"Camille Landry, Daria Klusa, Denis Cochonneau, Stéphane Supiot, Dominique Heymann","doi":"10.1093/bjr/tqaf224","DOIUrl":"https://doi.org/10.1093/bjr/tqaf224","url":null,"abstract":"<p><p>Circulating tumor cells (CTCs) have emerged as a promising biomarker for assessing prognosis and predicting therapeutic efficacy in various cancers, including metastatic prostate cancer. However, predicting patient response to treatment, including radiation therapy remains a significant clinical challenge. This review explores the value of CTCs as prognostic markers in radiation therapy for prostate cancer, discussing their detection methods, biological significance, clinical relevance, and future implications.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091200","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":"Epicardial and Pericardial Adipose Tissue: Anatomy, physiology, Imaging, Segmentation, and Treatment Effects.","authors":"Tristan T Demmert, Konstantin Klambauer, Lukas J Moser, Victor Mergen, Matthias Eberhard, Hatem Alkadhi","doi":"10.1093/bjr/tqaf223","DOIUrl":"https://doi.org/10.1093/bjr/tqaf223","url":null,"abstract":"<p><p>Epicardial (EAT) and pericardial adipose tissue (PAT) are increasingly recognized as distinct fat depots with implications for cardiovascular disease. This review discusses their anatomical and physiological characteristics, as well as their pathophysiological roles. EAT, in direct contact with the myocardium, exerts local inflammatory and metabolic effects on the heart, while PAT influences cardiovascular health rather systemically. We sought to discuss the currently used imaging modalities to assess these fat compartments-CT, MRI, and echocardiography-emphasizing their advantages, limitations, and the urgent need for standardization for both scanning and image reconstruction. Advances in image segmentation, particularly deep learning-based approaches, have improved the accuracy and reproducibility of EAT and PAT quantification. This review also explores the role of EAT and PAT as risk factors for cardiovascular outcomes, summarizing conflicting evidence across studies. Finally, we summarize the effects of medical therapy and lifestyle interventions on reducing EAT volume. Understanding and accurately quantifying EAT and PAT is essential for cardiovascular risk stratification and may open new pathways for therapeutic interventions.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091167","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":"Deep learning-based volume of interest imaging in helical CT for image quality improvement and radiation dose reduction.","authors":"Zhongxing Zhou, Akitoshi Inoue, Christian W Cox, Cynthia H McCollough, Lifeng Yu","doi":"10.1093/bjr/tqaf128","DOIUrl":"https://doi.org/10.1093/bjr/tqaf128","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a volume of interest (VOI) imaging technique in multi-detector-row helical CT to reduce radiation dose or improve image quality within the VOI.</p><p><strong>Methods: </strong>A deep-learning method based on a residual U-Net architecture, named VOI-Net, was developed to correct truncation artifacts in VOI helical CT. Three patient cases, a chest CT of interstitial lung disease and 2 abdominopelvic CT of liver tumour, were used for evaluation through simulation.</p><p><strong>Results: </strong>VOI-Net effectively corrected truncation artifacts (root mean square error [RMSE] of 5.97 ± 2.98 Hounsfield Units [HU] for chest, 3.12 ± 1.93 HU, and 3.71 ± 1.87 HU for liver). Radiation dose was reduced by 71% without sacrificing image quality within a 10-cm diameter VOI, compared to a full scan field of view (FOV) of 50 cm. With the same total energy deposited as in a full FOV scan, image quality within the VOI matched that at 350% higher radiation dose. A radiologist confirmed improved lesion conspicuity and visibility of small linear reticulations associated with ground-glass opacity and liver tumour.</p><p><strong>Conclusions: </strong>Focusing radiation on the VOI and using VOI-Net in a helical scan, total radiation can be reduced or higher image quality equivalent to those at higher doses in standard full FOV scan can be achieved within the VOI.</p><p><strong>Advances in knowledge: </strong>A targeted helical VOI imaging technique enabled by a deep-learning-based artifact correction method improves image quality within the VOI without increasing radiation dose.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091205","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":"Radiologists' Views on AI and the Future of Radiology: Insights from a U.S. National Survey.","authors":"Mohammad Alarifi","doi":"10.1093/bjr/tqaf222","DOIUrl":"https://doi.org/10.1093/bjr/tqaf222","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate U.S. radiologists' attitudes toward artificial intelligence (AI) in radiology, identify demographic factors influencing these perceptions, and analyze the potential challenges and opportunities AI integration presents in radiological practice.</p><p><strong>Methods: </strong>A cross-sectional survey of 322 board-certified radiologists was conducted using Amazon Mechanical Turk (MTurk) and Qualtrics. The survey collected demographic data (age, gender, experience, and subspecialty) and assessed attitudes toward AI integration in radiology. Pearson's chi-square tests were used to evaluate correlations between demographic variables and perceptions of AI's impact, confidence in its role, and anticipated adoption timelines.</p><p><strong>Results: </strong>The majority of radiologists (82.9%) indicated that AI would significantly impact radiology. Younger radiologists (<40 years) displayed higher optimism and greater familiarity with AI tools compared to their older counterparts. Statistical analysis revealed significant correlations between age and optimism (χ2 = 47.551, p < 0.001) and between gender and confidence in AI's role (χ2 = 21.982, p < 0.001). Subspecialty differences emerged, with 87.5% of emergency radiologists anticipating AI adoption within 3-5 years, whereas 26.3% of pediatric radiologists predicted adoption within 6-10 years. Notably, younger radiologists showed increased susceptibility to errors when evaluating misleading AI-generated outputs, underscoring the necessity for structured training programs.</p><p><strong>Conclusions: </strong>The integration of AI in radiology holds transformative potential but poses challenges, including overreliance, varying familiarity levels, and subspecialty-specific disparities. Structured education and robust regulatory frameworks are critical to optimize AI's adoption and minimize associated risks.</p><p><strong>Advances in knowledge: </strong>This study highlights significant demographic variations in radiologists' attitudes toward AI and underscores the importance of targeted training and interventions to support effective AI integration. These findings add to the existing research by emphasizing the necessity for structured AI training tailored to demographic and subspecialty needs.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091194","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":"Prospective Comparison of Ultra-high-resolution Photon-counting-detector CT Coronary Angiography versus Conventional CT.","authors":"Cynthia H McCollough, Aeden Davis, Nikki Weber, Holly Kasten, Elnata Melka, Kishore Rajendran, Rickey Carter, Shuai Leng","doi":"10.1093/bjr/tqaf220","DOIUrl":"10.1093/bjr/tqaf220","url":null,"abstract":"<p><strong>Objectives: </strong>Determine differences in quantitative stenosis severity measurements for ultra-high-resolution (UHR) photon-counting-detector (PCD) coronary CT angiography (cCTA) relative to energy-integrating-detector (EID) cCTA in a large patient cohort.</p><p><strong>Methods: </strong>Adult participants seen between November 2022 and March 2023 underwent a clinical dual-source EID-CT cCTA and a research dual-source PCD-CT cCTA on the same day. Percent diameter stenosis (PDS) was measured, and stenosis severity was assigned based on the PDS of the most severe lesion per patient to determine a coronary-artery-disease reporting and data system (CAD-RADS) score. Agreement between EID-CT and PCD-CT for PDS and CAD-RADS was determined.</p><p><strong>Results: </strong>A total of 112 participants were enrolled, yielding 82 subjects with at least 1 stenosis at PCD-CT (mean age, 68.0 ± 10.8 years; 69.5% (57/82) males). A total of 177 paired stenoses were quantified. The percent decrease in mean PDS from PCD-CT (24.3%) to EID-CT (29.4%) was 17.3% (median difference in PDS: -5.0%, 95% CI: -5.7% to -4.0%). The assigned CAD-RADS score changed 31/82 times. In 11/31 subjects, the most severe stenosis was missed at EID-CT due to partial volume averaging of a small calcification, yet PCD clearly identified stenosis at those locations. In 20/31 subjects, the CAD-RADS score decreased at PCD-CT due to the decreased calcium blooming resulting from the improved spatial resolution.</p><p><strong>Conclusions: </strong>UHR PCD cCTA decreases quantitative measures of stenosis severity when a stenosis is identified at EID, leading to decreases in CAD-RADS assignments.</p><p><strong>Advances in knowledge: </strong>With its improved spatial resolution, PCD-CT identifies stenoses missed on EID-CT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT scoring system to Defined Thrombus Distribution in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Lojain L Abdulaal, Michael M J Sharkey, Ahmed A Maiter, Samer S Alabed, Krit K Dwivedi, Smitha S Rajaram, Robin R Condliffe, David D G Kiely, Andrew A J Swift","doi":"10.1093/bjr/tqaf221","DOIUrl":"https://doi.org/10.1093/bjr/tqaf221","url":null,"abstract":"<p><strong>Objective: </strong>Characterisation of thrombus is important for guiding treatment in chronic thromboembolic pulmonary hypertension (CTEPH). This study presents a novel scoring system for visual assessment of CTEPH on CT pulmonary angiography (CTPA), incorporating both disease location and extent to determine the impact on survival outcomes.</p><p><strong>Methods: </strong>Patients with CTEPH were identified retrospectively from the ASPIRE registry. The scoring system emphasises disease based on their predominant location as central, segmental and distal disease. Survival analysis was conducted using Cox-regression and Kaplan-Meier survival curves.</p><p><strong>Results: </strong>208 patients with CTEPH were included (mean age 66 ± 13.6 years, 52.4% female). Mosaic perfusion and infarction were commonly seen in patients with distal disease (92% and 88%). Patients with central and distal disease had more severe pulmonary haemodynamics and lower gas transfer (TLCO) than patients with segmental disease. Central and distal disease showed similar survival, whereas survival was worse in central compared to segmental disease for all patients (p < 0.001), including those undergoing (p < 0.04) and not undergoing endarterectomy (p < 0.001). Central disease was an independent predictor of mortality in those not undergoing endarterectomy (hazard ratio 1.9, p < 0.01).</p><p><strong>Conclusion: </strong>Our scoring system showed excellent interobserver agreement. Thromboembolic disease location was shown to be a predictor of mortality, with central disease independently associated with shorter survival in patients not undergoing pulmonary endarterectomy.</p><p><strong>Advances in knowledge: </strong>This is a novel scoring system for characterising CTEPH on CTPA, considering disease location and extent. It provides disease location as a predictor of survival, introducing a new framework for patient stratification and clinical decision-making.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999776","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}