Despite the key-role of the Prostate Imaging and Reporting and Data System (PI-RADS) in the diagnosis and characterization of prostate cancer (PCa), this system remains to be affected by several ...limitations, primarily associated with the interpretation of equivocal PI-RADS 3 lesions and with the debated role of Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI), which is only used to upgrade peripheral PI-RADS category 3 lesions to PI-RADS category 4 if enhancement is focal. We aimed at investigating the usefulness of radiomics for detection of PCa lesions (Gleason Score ≥ 6) in PI-RADS 3 lesions and in peripheral PI-RADS 3 upgraded to PI-RADS 4 lesions (upPI-RADS 4). Multiparametric MRI (mpMRI) data of patients who underwent prostatic mpMRI between April 2013 and September 2018 were retrospectively evaluated. Biopsy results were used as gold standard. PI-RADS 3 and PI-RADS 4 lesions were re-scored according to the PI-RADS v2.1 before and after DCE-MRI evaluation. Radiomic features were extracted from T2-weighted MRI (T2), Apparent diffusion Coefficient (ADC) map and DCE-MRI subtracted images using PyRadiomics. Feature selection was performed using Wilcoxon-ranksum test and Minimum Redundancy Maximum Relevance (mRMR). Predictive models were constructed for PCa detection in PI-RADS 3 and upPI-RADS 4 lesions using at each step an imbalance-adjusted bootstrap resampling (IABR) on 1000 samples. 41 PI-RADS 3 and 32 upPI-RADS 4 lesions were analyzed. Among 293 radiomic features, the top selected features derived from T2 and ADC. For PI-RADS 3 stratification, second order model showed higher performances (Area Under the Receiver Operating Characteristic Curve-AUC- = 80%), while for upPI-RADS 4 stratification, first order model showed higher performances respect to superior order models (AUC = 89%). Our results support the significant role of T2 and ADC radiomic features for PCa detection in lesions scored as PI-RADS 3 and upPI-RADS 4. Radiomics models showed high diagnostic efficacy in classify PI-RADS 3 and upPI-RADS 4 lesions, outperforming PI-RADS v2.1 performance.
The relationship between the unique characteristics of nanodiamonds (NDs) and the fluorescence properties of nitrogen-vacancy (NV) centers has lead to a tool with quantum sensing capabilities and ...nanometric spatial resolution; this tool is able to operate in a wide range of temperatures and pressures and in harsh chemical conditions. For the development of devices based on NDs, a great effort has been invested in researching cheap and easily scalable synthesis techniques for NDs and NV-NDs. In this review, we discuss the common fluorescent NDs synthesis techniques as well as the laser-assisted production methods. Then, we report recent results regarding the applications of fluorescent NDs, focusing in particular on sensing of the environmental parameters as well as in catalysis. Finally, we underline that the highly non-equilibrium processes occurring in the interactions of laser-materials in controlled laboratory conditions for NDs synthesis present unique opportunities for investigation of the phenomena occurring under extreme thermodynamic conditions in planetary cores or under warm dense matter conditions.
Kidney structural abnormalities are common features of Bardet-Biedl syndrome (BBS) patients that lead to a progressive decline in renal function. Magnetic resonance diffusion tensor imaging (DTI) ...provides useful information on renal microstructures but it has not been applied to these patients. This study investigated using DTI to detect renal abnormalities in BBS patients with no overt renal dysfunction. Ten BBS subjects with estimated glomerular filtration rates over 60 ml/min/1.73m
and 14 individuals matched for age, gender, body mass index and renal function were subjected to high-field DTI. Fractional anisotropy (FA), and mean, radial and axial diffusivity were evaluated from renal cortex and medulla. Moreover, the corticomedullary differentiation of each DTI parameter was compared between groups. Only cortical FA statistically differed between BBS patients and controls (p = 0.033), but all the medullary DTI parameters discriminated between the two groups with lower FA (p < 0.001) and axial diffusivity (p = 0.021) and higher mean diffusivity (p = 0.043) and radial diffusivity (p < 0.001) in BBS patients compared with controls. Corticomedullary differentiation values were significantly reduced in BBS patients. Thus, DTI is a valuable tool for investigating microstructural alterations in renal disorders when kidney functionality is preserved.
Neoadjuvant chemotherapy (NAC) is becoming the standard of care for locally advanced breast cancer, aiming to reduce tumor size before surgery. Unfortunately, less than 30% of patients generally ...achieve a pathological complete response and approximately 5% of patients show disease progression while receiving NAC. Accurate assessment of the response to NAC is crucial for subsequent surgical planning. Furthermore, early prediction of tumor response could avoid patients being overtreated with useless chemotherapy sections, which are not free from side effects and psychological implications. In this review, we first analyze and compare the accuracy of conventional and advanced imaging techniques as well as discuss the application of artificial intelligence tools in the assessment of tumor response after NAC. Thereafter, the role of advanced imaging techniques, such as MRI, nuclear medicine, and new hybrid PET/MRI imaging in the prediction of the response to NAC is described in the second part of the review. Finally, future perspectives in NAC response prediction, represented by AI applications, are discussed.
Objective
The aim of this study was to evaluate the prognostic value of combined positron emission tomography (PET)/magnetic resonance imaging (MRI) parameters provided by simultaneous ...18F-fluorodeoxyglucose (FDG) PET/MRI in patients with locally advanced oropharyngeal and hypopharyngeal squamous cell carcinomas (OHSCC).
Methods
Forty-five patients with locally advanced OHSCC who underwent simultaneous FDG PET/MRI before (chemo)radiotherapy were retrospectively enrolled. Peak standardized uptake value (SULpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion were obtained on PET data. On MRI scans, primary tumor size, diffusion and perfusion parameters were assessed using pre-contrast and high-resolution post-contrast images. Ratios between metabolic/metabolo-volumetric parameters and ADC were calculated. Comparisons between groups were performed by Student’s
t
test. Survival analysis was performed by univariate Cox proportional hazard regression analysis. Overall survival curves were obtained by the Kaplan–Meier method and compared with the log-rank test. Survivors were censored at the time of the last clinical control.
p
< 0.05 was considered statistically significant
Results
During follow-up (mean 31.4 ± 21 months), there were 15 deaths. Univariate analysis shows that SULpeak and SULpeak/ADCmean were significant predictors of overall survival (OS). At multivariate analysis, only SULpeak remained a significant predictor of OS. Kaplan–Meier survival analyses showed that patients with higher SULpeak had poorer outcome compared to those with lower values (HR: 3.7,
p
= 0.007).
Conclusion
Pre-therapy SULpeak of the primary site was predictive of overall survival in patients with oropharyngeal or hypopharyngeal cancer treated with (chemo)radiotherapy.
Purpose
Recently brown adipose tissue (BAT) activation has been proposed to have a possible role in breast cancer. The aim of this study was to evaluate BAT activation in patients with breast cancer ...and its relationship with molecular characteristics of tumor.
Procedures
The study group comprised 79 patients with histologically proven ductal breast carcinoma (51 ± 13 years). Data on distribution, intensity (SUVmax), and total metabolic activity (TMA) of BAT were obtained from
18
F FDG-PET/CT. Clinical and biochemical data were obtained from the database.
Results
BAT activation was present in 12 of the 79 patients (15.2 %). Patients with BAT activation were younger and had a lower body mass index (BMI) (
p
< 0.05 and
p
< 0.0005, respectively) and showed less frequently metastasis (
p
< 0.05). No significant differences were found in estrogen receptor (ER), progesterone receptor (PgR), Ki67, grade, and in molecular subtypes. In patients younger than 55 years and with a BMI < 26, no significant differences were observed between patients with and without BAT activation. In the 12 patients with BAT activation, a significant inverse correlation was observed between TMA and BMI (
r
= − 0.64,
p
< 0.05). TMA and SUVmax were higher in grade 2 than in grade 3 patients. No significant differences were found in both TMA and SUVmax between patients with and without lymph node metastases. A significant difference in both TMA and SUVmax was observed among different molecular types, with luminal B patients showing higher values.
Conclusions
In conclusion, the present study suggests a relation between BAT activation and positive known prognostic factor in breast cancer, such as intermediate tumor grade and luminal B cancer type.
Rhinoplasty and surgical reconstruction of cartilaginous structures still remain a great challenge today. This study aims to identify an imaging strategy in order to merge the information from CT ...scans and magnetic resonance imaging (MRI) acquisitions and build a 3D printed model true to the patient’s anatomy, for better surgical planning. Using MRI, information can be obtained about the cartilage structures of which the nose is composed. Ten rhinoplasty candidate patients underwent both a low-dose protocol CT scan and a specific MRI for characterization of nasal structures. Bone and soft tissue segmentations were performed in CT, while cartilage segmentations were extrapolated from MRI and validated by both an expert radiologist and surgeon. Subsequently, a 3D model was produced in materials and colors reproducing the density of the three main structures (bone, soft tissue, and cartilage), useful for pre-surgical evaluation. This study has highlighted that the optimization of a CT and MR dedicated protocol has allowed to reduce the CT radiation dose up to 60% compared to standard acquisitions with the same machine, and MR acquisition time of about 20%. Patient-tailored 3D models and pre-surgical planning have reduced the mean operative time by 20 minutes.
Hematopoietic stem/progenitor cells (HSPCs) are capable of supporting the lifelong production of blood cells exerting a wide spectrum of functions. Lentiviral vector HSPC gene therapy generates a ...human hematopoietic system stably marked at the clonal level by vector integration sites (ISs). Using IS analysis, we longitudinally tracked >89,000 clones from 15 distinct bone marrow and peripheral blood lineages purified up to 4 years after transplant in four Wiskott-Aldrich syndrome patients treated with HSPC gene therapy. We measured at the clonal level repopulating waves, populations' sizes and dynamics, activity of distinct HSPC subtypes, contribution of various progenitor classes during the early and late post-transplant phases, and hierarchical relationships among lineages. We discovered that in-vitro-manipulated HSPCs retain the ability to return to latency after transplant and can be physiologically reactivated, sustaining a stable hematopoietic output. This study constitutes in vivo comprehensive tracking in humans of hematopoietic clonal dynamics during the early and late post-transplant phases.
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•Hematopoietic reconstitution occurs in two distinct clonal waves•A few thousand HSPC clones stably sustain multilineage blood cell production•Steady-state hematopoiesis after transplant is maintained by both HSCs and MPPs•Natural killer clones have closer relationships to myeloid cells than to lymphoid cells
Biasco et al. report a clonal tracking study on the dynamics and nature of hematopoietic reconstitution in humans after transplant. Using integration sites as molecular tags, they measured, in gene therapy patients, repopulating waves, population size and dynamics, activity of progenitor subtypes during the early and late post-transplant phases, and hierarchical relationships among lineages.
Background and Purpose:
Quantification of hepatic virtual iron content (VIC) by using Multidetector Dual Energy Computed Tomography (DECT) has been recently investigated since this technique could ...offer a good compromise between accuracy and non-invasiveness for liver iron content quantification. The aim of our study is to investigate differences in VIC at different DECT time points (namely baseline and arterial, venous and tardive phases), identifying the most reliable and also exploring the underlying temporal trend of these values.
Materials and Methods:
Eleven patients who underwent DECT examination and were characterized by low liver fat content were included in this retrospective study. By using the Syngo.via Frontier–DE IronVNC tool, regions of interest (ROI) were placed on the VIC images at 3 hepatic levels, both in left and right liver lobes, at each DECT time point. Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test for post-hoc analysis was performed to assess differences between DECT timepoints. Page’s L test was performed to test the temporal trend of VIC across the 4 examined timepoints.
Results:
For both liver lobes, Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test revealed that VIC values differed significantly when extracted from ROIs placed at the 4 different timepoints. The Page’s L test for multiple comparison revealed a significant growing trend for VIC, from baseline acquisition to the fourth and last time point post-contrast agent injection.
Conclusions:
The extraction of hepatic VIC in healthy subjects was found to be significantly influenced by the DECT time point chosen for the extrapolation of the VIC values.
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