RESUMEN
Prostate cancer (PCa) is the second most common cancer worldwide and the fifth leading cause of cancer deaths in men. Magnetic resonance imaging (MRI), with its high sensitivity and specificity in detecting PCa, is currently the most widely used imaging technique for tumor localization and staging. MRI plays a significant role in risk stratification of patients with neoplasm, surveillance of low-risk patients, and monitoring of recurrence after treatment. Radiomics is an emerging and promising tool that allows quantitative assessment of tumors in images by converting digital images into mineable high-dimensional data. Imaging histology aims to increase the number of features that can be used to detect PCa, avoid unnecessary biopsies, determine tumor aggressiveness and monitor recurrence after treatment. Artificial intelligence integration of imaging histology data, including those of different imaging modalities (e.g., PET-CT) as well as other clinical and histopathological data, can improve the prediction of tumor aggressiveness and guide clinical decision-making and patient management. The aim of this review is to present current research applications of AI-assisted radiomics in PCa MRI images.
Asunto(s)
Inteligencia Artificial , Imagen por Resonancia Magnética , Neoplasias de la Próstata , Humanos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Masculino , Imagen por Resonancia Magnética/métodos , Sensibilidad y Especificidad , RadiómicaRESUMEN
BACKGROUND: Insulin resistance (IR) is involved in the development of erectile dysfunction (ED). The purpose of this study was to assess the correlation between the metabolic score for IR (METS-IR) index and risk of erectile dysfunction in US adults. METHODS: This study selected individuals from the National Health and Nutrition Examination Survey (NHANES). Logistic regression analysis, subgroup analysis, and dose-response curve analysis were carried out to assess the relationship between the METS-IR index and ED prevalence. RESULTS: This study ultimately included 1759 participants aged ≥ 20 years, of whom 512 self-reported a history of ED. After adjusting for all confounders, each unit increase in METS-IR index was associated with a 3% increase in erectile dysfunction prevalence (OR = 1.03, 95% CI: 1.01-1.04). In almost all subgroups, an increased METS-IR index was associated with a higher prevalence of ED. The dose-response curve displayed a positive non-linear connection between METS-IR value and the prevalence of ED. CONCLUSION: The study found a positive association between the METS-IR index and ED. METS-IR is useful as a simplified IR evaluation index for early identification of people with high risk of ED.
Asunto(s)
Disfunción Eréctil , Resistencia a la Insulina , Humanos , Masculino , Disfunción Eréctil/epidemiología , Estudios Transversales , Prevalencia , Estados Unidos/epidemiología , Adulto , Persona de Mediana Edad , Síndrome Metabólico/epidemiología , Síndrome Metabólico/complicaciones , Encuestas Nutricionales , Adulto Joven , AncianoRESUMEN
BACKGROUND: Erectile dysfunction is a condition with a high incidence among adult men. Lycopene has been shown to lower blood glucose and reduce weight in diabetic patients because of its antioxidant and anti-inflammatory properties. However, the association between lycopene and the incidence of erectile dysfunction is unclear. OBJECTIVE: The aim of this study was to examine the dietary lycopene intake and its association with erectile dysfunction risk in the US population. MATERIALS AND METHODS: We investigated the lycopene intake of adult participants with complete information on clinical variables from the National Health and Nutrition Examination Survey between 2001 and 2004. Dose-response curve analysis was applied to explore the association between lycopene intake and erectile dysfunction. Logistic regression models were used to adjust for confounders. Different ethnicities, body mass index level, hypertension status, diabetes status, and smoking status were analyzed as subgroups. Propensity score matching was employed to eliminate the effects of potential confounders to confirm the reliability of the results. RESULTS: A total of 3265 participants with lycopene consumption data were included in our study, including 931 individuals with erectile dysfunction and 2334 without erectile dysfunction during National Health and Nutrition Examination Survey 2001-2004. We found more consumption of lycopene in the non-erectile dysfunction group than in the erectile dysfunction group. Dose-response curve analysis revealed a significant negative association between lycopene intake and erectile dysfunction prevalence. After adjusting for age, race, cigarette smoking, body mass index, annual family income, education, physical activity, hypertension, diabetes, depression, and testosterone level, we found that increased lycopene intake reduced the odds ratio of erectile dysfunction. Low lycopene intake was positively related to erectile dysfunction in almost all subgroups, especially in Mexican American, non-Hispanic white, body mass index <25, hypertension positive, diabetes mellitus negative, and smoke negative. Furthermore, the results were confirmed in the 1:1 matched group. CONCLUSION: Our national data suggest that lower dietary lycopene intake is positively associated with an increased risk of erectile dysfunction in US men.
Asunto(s)
Diabetes Mellitus , Disfunción Eréctil , Hipertensión , Masculino , Adulto , Humanos , Disfunción Eréctil/etiología , Encuestas Nutricionales , Licopeno , Reproducibilidad de los Resultados , Diabetes Mellitus/epidemiología , Hipertensión/complicaciones , Hipertensión/epidemiologíaRESUMEN
Maintaining erectile function is an important quality of life issue for patients with localized prostate cancer treated with robotic-assisted radical prostatectomy (RARP). However, most existing studies are retrospective and inherently weak and cannot conclude which NS approach is most effective in restoring function in patients. We therefore performed a consistent and objective assessment of sexual function outcomes in RARP using different nerve-sparing methods to optimize postoperative outcomes. A systematic review and meta-analysis was performed based on PRISMA and STROBE statement criteria. Statistical analysis was performed using StataMP software version 14. The Newcastle-Ottawa scale was used to assess the risk of bias. This single-arm meta-analysis included 3 randomized controlled trials and 14 cohort studies with a total of 3756 patients. Our meta-analysis found that patients had the highest efficiency rate of 0.86 (0.78, 0.93) after the NS technique using the retrograde method. Overall, there are significant differences between RARP NS techniques and outcomes, and the ideal technical strategy to optimize outcomes remains controversial. However, there is consensus on the importance of careful separation, dissection of the NVB, reduction of traction and thermal injury, and preservation of the fascia around the prostate. We still need more well-designed randomized controlled trials with videos describing the details of the different surgical techniques before they can be replicated.