A novel anti-cytomegalovirus (CMV) agent, letermovir (LMV), could reportedly improve the outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) recipients because of its high potential ...to prevent CMV reactivation. Therefore, 685 Japanese allo-HCT recipients, of whom ~80% had a high risk of CMV reactivation, were retrospectively analyzed to assess the impacts of prophylactic LMV on the incidence of clinically significant CMV (csCMV) infection as well as their transplant outcome. By comparing 114 patients who received LMV prophylaxis for a median 92 days to 571 patients without prophylaxis, we observed that prophylactic LMV could significantly (1) reduce the 180-day cumulative incidence of csCMV infection (44.7 vs. 72.4%, p < 0.001), (2) delay the median time until initiation of CMV antigenemia-guided preemptive therapy (90 vs. 36 days, p < 0.001), (3) shorten the duration of anti-CMV preemptive treatment (21 vs. 25 days, p = 0.006), and (4) improve the overall survival rate at 180 days after transplant (80.4 vs. 73.0%, p = 0.033) with a trend of lower non-relapse mortality (8.9 vs. 14.9%, p = 0.052). Our findings demonstrate that prophylactic LMV treatment is highly effective in preventing the development of csCMV infection and ultimately reduces transplant-related mortality.
•Finite element method approach is proposed to achieve highly accurate registration from a healthcare perspective.•CAD construction is proposed by generating CT temporal subtraction images using ...high-precision registration.•A solution to the problem of artifacts on temporal images is proposed by using FEM in selected local regions.•FEM in selected local regions is proposed that can control increase of the processing cost.
To optimize the early diagnosis and detection of lung cancer, computer-aided diagnostic (CAD) systems have been a useful tool for analyzing medical images. The temporal subtraction technique, which is a CAD system, performs the subtraction operation between the current image and the previous image on the same patient, and supports observation by emphasizing the temporal changes. However, the temporal subtraction technique for 3D images, such as thoracic CT images, has not yet been established. There is a need to develop efficient and highly accurate 3D nonrigid registration techniques to reduce subtraction artifacts. This study aims to develop a 3D nonrigid registration technique to establish a 3D temporal subtraction technique. In particular, we focus on the Finite Element Method, which is versatile, applicable to a wide range of fields, and capable of handling any shape. Our new method was examined on 46 clinical cases with multidetector row computed tomography images. As a result, the proposed method improved by 6.93% (p = 3.0 × 10−6) compared to the conventional methods in terms of the rate of reduction of artifacts, and the effectiveness was verified. Therefore, this study contributes to the literature on early detection and treatment.
Purpose
To develop a support vector machine (SVM) classifier using CT texture-based analysis in differentiating focal-type autoimmune pancreatitis (AIP) and pancreatic duct carcinoma (PD), and to ...assess the radiologists’ diagnostic performance with or without SVM.
Materials and methods
This retrospective study included 50 patients (20 patients with focal-type AIP and 30 patients with PD) who underwent dynamic contrast-enhanced CT. Sixty-two CT texture-based features were extracted from 2D images of the arterial and portal phase CTs. We conducted data compression and feature selections using principal component analysis (PCA) and produced the SVM classifier. Four readers participated in this observer performance study and the statistical significance of differences with and without the SVM was assessed by receiver operating characteristic (ROC) analysis.
Results
The SVM performance indicated a high performance in differentiating focal-type AIP and PD (AUC = 0.920). The AUC for all 4 readers increased significantly from 0.827 to 0.911 when using the SVM outputs (
p
= 0.010). The AUC for inexperienced readers increased significantly from 0.781 to 0.905 when using the SVM outputs (
p
= 0.310). The AUC for experienced readers increased from 0.875 to 0.912 when using the SVM outputs, however, there was no significant difference (
p
= 0.018).
Conclusion
The use of SVM classifier using CT texture-based features improved the diagnostic performance for differentiating focal-type AIP and PD on CT.
Carpal tunnel steroid injection is a nonoperative intervention for the treatment for idiopathic carpal tunnel syndrome (CTS). The antifibrotic, anti-inflammatory, and antiedematous properties of ...steroids account for their therapeutic effects in the context of CTS; however, their relative contribution has not been clarified.
Fibroblasts from subsynovial connective tissues (SSCT) were intraoperatively collected from patients with idiopathic CTS and were incubated with or without the steroid triamcinolone acetonide (TA) for 1, 3, and 7 days; the expression of fibrosis-related genes and inflammatory cytokines was evaluated using quantitative reverse transcription-polymerase chain reaction. A clinical prospective study was conducted with patients who received carpal tunnel TA injections. We performed clinical and electrophysiological evaluations before and 1, 3, and 5 months after TA injection; and we compared the median nerve, flexor tendon, and SSCT areas and the median nerve flattening ratio before and 1 month after TA injection using 3-T magnetic resonance imaging (MRI).
TA induced downregulation of the fibrosis-related genes Col1A1 (collagen type I alpha 1 chain), Col1A2, and Col3A1 but not the inflammation-related genes. The nerve flattening ratio did not change after TA injection according to the MRI-based observation of the median nerve, flexor tendon, and SSCT areas.
The therapeutic effects of injected TA are apparently mediated by its antifibrotic rather than its anti-inflammatory and antiedematous properties. TA probably alters the properties but not the morphology of SSCT.
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
To evaluate the usefulness of temporal subtraction using the bone suppression method in digital chest radiography for the detection of pulmonary lesions.
The images of 31 patients with pulmonary ...lesions and 19 normal cases were included in the study. Conventional and bone suppression temporal subtraction were performed in the 50 cases selected and used for an observer performance study. Five radiologists participated in the study, and the differences between using conventional and bone suppression temporal subtraction were assessed using jackknife free-response receiver operating characteristic analysis.
The average figure-of-merit values for all radiologists increased significantly using the bone suppression method, from 0.619 (conventional) to 0.696 (p = 0.032). The average sensitivity for detecting pulmonary lesions improved from 67.9% to 75.4%, and the average number of false-positive per case decreased from 0.336 to 0.252 using bone suppression temporal subtraction.
Bone suppression temporal subtraction processing can assist with the detection of subtle pulmonary lesions in digital chest radiographs.
•Even expert radiologists occasionally miss pulmonary lesions in chest radiographs.•Temporal subtraction using bone suppression reduces artifacts in conventional temporal subtraction.•Temporal subtraction using bone suppression improves the observer performance for pulmonary disease detection.•Temporal subtraction using bone suppression was useful for pulmonary diseases that were difficult to detect.
Francium (Fr), which is the alkali atom in the 7th period, can be obtained as ultracold atoms with laser cooling and trapping techniques, and could be employed for the experiments on searches for the ...permanent electric dipole moment (EDM) of an electron. In order to improve the sensitivity of the electron EDM search, development of a high-intensity source of Fr atoms is essential. We demonstrated a production of a high intensity
210
Fr ion beam with a rate of
5
×
10
6
ions/s by a fusion reaction with bombardment of an accelerated
18
O beam onto a fixed gold target in RIKEN. The Fr products inside the gold target were extracted from the gold surface as an ion beam focused with an electrostatic field. We also discussed the method to produce
221
Fr by
α
-decay of
225
Ac. A neutron-rich
221
Fr isotope can be obtained as a daughter nucleus of this decay.
Although high-resolution computed tomography (HRCT) is useful for the characterization of minute morphological changes in the lungs, no study has investigated risk factors for lung involvement ...detected by HRCT in patients with Sjögren's syndrome with or without respiratory symptoms. The aim of the current study was to investigate risk factors for lung involvement in patients with primary Sjögren's syndrome detected by HRCT, with a particular focus on airway and interstitial lung diseases.
We performed a retrospective cohort study of patients with primary Sjögren's syndrome and investigated risk factors for lung involvement detected by HRCT. A total of 101 patients with primary Sjögren's syndrome with initial HRCT examinations were enrolled.
Higher age, dry mouth, and higher labial gland biopsy focus scores (≥4) were risk factors for airway diseases (odds ratio OR 1.064 confidence interval CI 1.026–1.102, OR 8.795 CI 2.317–33.378 and OR 3.261 CI 1.100–9.675, respectively) in the multivariable analysis. Higher age, male sex, and higher labial gland biopsy focus scores (≥4) were risk factors for interstitial lung diseases (OR 1.078 CI 1.032–1.127, OR 12.178 CI 1.121–132.307 and OR 3.954 CI 1.423–10.987, respectively) in the multivariable analysis. The presence of anti-T-lymphotropic virus type 1 antibodies was significantly more common in patients with airway diseases.
This study showed significant associations of labial gland biopsy focus scores and dry mouth with pulmonary manifestations in patients with primary Sjögren's syndrome. Focus scores as well as dry mouth may reflect lymphoproliferative activity in the lungs in patients with primary Sjögren's syndrome.
•Lymphocytic focus score was related to airway diseases in primary Sjögren's Syndrome.•Focus score was related to interstitial lung diseases in primary Sjögren's Syndrome.•Dry mouth was related to airway diseases in primary Sjögren's Syndrome.
Purpose
To evaluate the potential of full-iterative reconstruction (IR) for improving image quality of the cystic artery on CT angiography and to assess observer performance.
Methods
Thirty patients ...who underwent both liver dynamic CT and conventional angiography were included in this retrospective study. All CT data were reconstructed through filtered back projection (FBP), adaptive iterative dose reduction 3D (AIDR3D), and forward-projected, model-based, iterative reconstruction solution (FIRST), respectively. In objective study, we analyzed mean ΔCT numbers (the difference between the HU peak of the vessel and the background) and full-width at tenth-maximum (FWTM) of three parts of the cystic artery by profile curve method comparing the three reconstructions. Subjectively, visualization was evaluated using a four-point scale performed by two blinded observers. ANOVA was used for statistical analysis.
Results
In all parts of the cystic artery, the mean ΔCT number of FIRST was shown to be significantly better than that of FBP and AIDR3D (
p
< 0.05). FWTM in FIRST was the smallest in all of the vessels. The mean visualization score was significantly better with FIRST than with other CT reconstructions (
p
< 0.05).
Conclusions
The FIRST algorithm led to improved CTA visualization of the cystic artery.
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