RESUMO
Fusobacterium vincentii brain abscesses are relatively rare. Here, we report our treatment of an anaerobic brain abscess caused by a mixed infection of Parvimonas micra, Streptococcus constellatus, Fusobacterium vincentii, and Bacteroides heparinolyticus diagnosed by metagenomic next-generation sequencing (mNGS). This is the first reported case of Fusobacterium vincentii in a brain abscess. This case highlights the possibility that oral anaerobic microbes can cause a brain abscess and demonstrates that mNGS has the potential to be deployed to provide rapid infection diagnosis and rationalize antimicrobial therapy for brain abscesses.
RESUMO
BACKGROUND: The prevalence of hypertensive heart disease (HHD) is high and there is currently no easy way to detect early HHD. Explore the application of radiomics using cardiac magnetic resonance (CMR) non-enhanced cine sequences in diagnosing HHD and latent cardiac changes caused by hypertension. METHODS: 132 patients who underwent CMR scanning were divided into groups: HHD (42), hypertension with normal cardiac structure and function (HWN) group (46), and normal control (NOR) group (44). Myocardial regions of the end-diastolic (ED) and end-systolic (ES) phases of the CMR short-axis cine sequence images were segmented into regions of interest (ROI). Three feature subsets (ED, ES, and ED combined with ES) were established after radiomic least absolute shrinkage and selection operator feature selection. Nine radiomic models were built using random forest (RF), support vector machine (SVM), and naive Bayes. Model performance was analyzed using receiver operating characteristic curves, and metrics like accuracy, area under the curve (AUC), precision, recall, and specificity. RESULTS: The feature subsets included first-order, shape, and texture features. SVM of ED combined with ES achieved the highest accuracy (0.833), with a macro-average AUC of 0.941. AUCs for HHD, HWN, and NOR identification were 0.967, 0.876, and 0.963, respectively. Precisions were 0.972, 0.740, and 0.826; recalls were 0.833, 0.804, and 0.863, respectively; and specificities were 0.989, 0.863, and 0.909, respectively. CONCLUSIONS: Radiomics technology using CMR non-enhanced cine sequences can detect early cardiac changes due to hypertension. It holds promise for future use in screening for latent cardiac damage in early HHD.
Assuntos
Diagnóstico Precoce , Hipertensão , Imagem Cinética por Ressonância Magnética , Humanos , Feminino , Masculino , Imagem Cinética por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Hipertensão/diagnóstico por imagem , Hipertensão/complicações , Máquina de Vetores de Suporte , Cardiopatias/diagnóstico por imagem , Idoso , Adulto , Teorema de Bayes , Curva ROC , Interpretação de Imagem Assistida por Computador/métodos , RadiômicaRESUMO
Is the radiomic approach, utilizing diffusion-weighted imaging (DWI), capable of predicting the various pathological grades of intrahepatic mass-forming cholangiocarcinoma (IMCC)? Furthermore, which model demonstrates superior performance among the diverse algorithms currently available? The objective of our study is to develop DWI radiomic models based on different machine learning algorithms and identify the optimal prediction model. We undertook a retrospective analysis of the DWI data of 77 patients with IMCC confirmed by pathological testing. Fifty-seven patients initially included in the study were randomly assigned to either the training set or the validation set in a ratio of 7:3. We established four different classifier models, namely random forest (RF), support vector machines (SVM), logistic regression (LR), and gradient boosting decision tree (GBDT), by manually contouring the region of interest and extracting prominent radiomic features. An external validation of the model was performed with the DWI data of 20 patients with IMCC who were subsequently included in the study. The area under the receiver operating curve (AUC), accuracy (ACC), precision (PRE), sensitivity (REC), and F1 score were used to evaluate the diagnostic performance of the model. Following the process of feature selection, a total of nine features were retained, with skewness being the most crucial radiomic feature demonstrating the highest diagnostic performance, followed by Gray Level Co-occurrence Matrix lmc1 (glcm-lmc1) and kurtosis, whose diagnostic performances were slightly inferior to skewness. Skewness and kurtosis showed a negative correlation with the pathological grading of IMCC, while glcm-lmc1 exhibited a positive correlation with the IMCC pathological grade. Compared with the other three models, the SVM radiomic model had the best diagnostic performance with an AUC of 0.957, an accuracy of 88.2%, a sensitivity of 85.7%, a precision of 85.7%, and an F1 score of 85.7% in the training set, as well as an AUC of 0.829, an accuracy of 76.5%, a sensitivity of 71.4%, a precision of 71.4%, and an F1 score of 71.4% in the external validation set. The DWI-based radiomic model proved to be efficacious in predicting the pathological grade of IMCC. The model with the SVM classifier algorithm had the best prediction efficiency and robustness. Consequently, this SVM-based model can be further explored as an option for a non-invasive preoperative prediction method in clinical practice.
RESUMO
PURPOSE: To compare image quality, iodine intake, and radiation dose in overweight and obese patients undergoing abdominal computed tomography (CT) enhancement using different scanning modes and contrast medium. METHODS: Ninety overweight and obese patients (25âkg/m2≤body mass index (BMI)<â30âkg/m2 and BMI≥30âkg/m2) who underwent abdominal CT-enhanced examinations were randomized into three groups (A, B, and C) of 30 each and scanned using gemstone spectral imaging (GSI) +320âmgI/ml, 100âkVp + 370âmgI/ml, and 120âkVp + 370âmgI/ml, respectively. Reconstruct monochromatic energy images of group A at 50-70âkeV (5âkeV interval). The iodine intake and radiation dose of each group were recorded and calculated. The CT values, contrast-to-noise ratios (CNRs), and subjective scores of each subgroup image in group A versus images in groups B and C were by using one-way analysis of variance or Kruskal-Wallis H test, and the optimal keV of group A was selected. RESULTS: The dual-phase CT values and CNRs of each part in group A were higher than or similar to those in groups B and C at 50-60âkeV, and similar to or lower than those in groups B and C at 65âkeV and 70âkeV. The subjective scores of the dual-phase images in group A were lower than those of groups B and C at 50âkeV and 55âkeV, whereas no significant difference was seen at 60-70âkeV. Compared to groups B and C, the iodine intake in group A decreased by 12.5% and 13.3%, respectively. The effective doses in groups A and B were 24.7% and 25.8% lower than those in group C, respectively. CONCLUSION: GSI +320âmgI/ml for abdominal CT-enhanced in overweight patients satisfies image quality while reducing iodine intake and radiation dose, and the optimal keV was 60âkeV.
Assuntos
Meios de Contraste , Obesidade , Sobrepeso , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico por imagem , Sobrepeso/diagnóstico por imagem , Doses de Radiação , Intensificação de Imagem Radiográfica/métodos , Radiografia Abdominal/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso de 80 Anos ou maisRESUMO
OBJECTIVE: To establish a machine learning-based radiomics model to differentiate between glioma and solitary brain metastasis from lung cancer and its subtypes, thereby achieving accurate preoperative classification. MATERIALS AND METHODS: A retrospective analysis was conducted on MRI T1WI-enhanced images of 105 patients with glioma and 172 patients with solitary brain metastasis from lung cancer, which were confirmed pathologically. The patients were divided into the training group and validation group in an 8:2 ratio for image segmentation, extraction, and filtering; multiple layer perceptron (MLP), support vector machine (SVM), random forest (RF), and logistic regression (LR) were used for modeling; fivefold cross-validation was used to train the model; the validation group was used to evaluate and assess the predictive performance of the model, ROC curve was used to calculate the accuracy, sensitivity, and specificity of the model, and the area under curve (AUC) was used to assess the predictive performance of the model. RESULTS: The accuracy and AUC of the MLP differentiation model for high-grade glioma and solitary brain metastasis in the validation group was 0.992, 1.000, respectively, while the sensitivity and specificity were 1.000, 0.968, respectively. The accuracy and AUC for the MLP and SVM differentiation model for high-grade glioma and small cell lung cancer brain metastasis in the validation group was 0.966, 1.000, respectively, while the sensitivity and specificity were 1.000, 0.929, respectively. The accuracy and AUC for the MLP differentiation model for high-grade glioma and non-small cell lung cancer brain metastasis in the validation group was 0.982, 0.999, respectively, while the sensitivity and specificity were 0.958, 1.000, respectively. CONCLUSION: The application of machine learning-based radiomics has a certain clinical value in differentiating glioma from solitary brain metastasis from lung cancer and its subtypes. In the HGG/SBM and HGG/NSCLC SBM validation groups, the MLP model had the best diagnostic performance, while in the HGG/SCLC SBM validation group, the MLP and SVM models had the best diagnostic performance.
RESUMO
OBJECTIVE: To explore the value of applying computed tomography (CT) radiomics based on different CT-enhanced phases to determine the immunotherapeutic efficacy of non-small cell lung cancer (NSCLC). METHODS: 106 patients with NSCLC who underwent immunotherapy are randomly divided into training (74) and validation (32) groups. CT-enhanced arterial and venous phase images of patients before treatment are collected. Region-of-interest (ROI) is segmented on the CT-enhanced images, and the radiomic features are extracted. One-way analysis of variance and least absolute shrinkage and selection operator (LASSO) are used to screen the optimal radiomics features and analyze the association between radiomics features and immunotherapy efficacy. The area under receiver-operated characteristic curves (AUC) along with the sensitivity and specificity are computed to evaluate diagnostic effectiveness. RESULTS: LASSO regression analysis screens and selects 6 and 8 optimal features in the arterial and venous phases images, respectively. Applying to the training group, AUCs based on CT-enhanced arterial and venous phase images are 0.867 (95% CI:0.82-0.94) and 0.880 (95% CI:0.86-0.91) with the sensitivities of 73.91% and 76.19%, and specificities of 66.67% and 72.19%, respectively, while in validation group, AUCs of the arterial and venous phase images are 0.732 (95% CI:0.71-0.78) and 0.832 (95% CI:0.78-0.91) with sensitivities of 75.00% and 76.00%, and specificities of 73.07% and 75.00%, respectively. There are no significant differences between AUC values computed from arterial phases and venous phases images in both training and validation groups (Pâ<â0.05). CONCLUSION: The optimally selected radiomics features computed from CT-enhanced different-phase images can provide new imaging marks to evaluate efficacy of the targeted therapy in NSCLC with a high diagnostic value.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Tomografia Computadorizada por Raios X , Imunoterapia , Área Sob a Curva , Estudos RetrospectivosRESUMO
OBJECTIVES: To compare image quality, radiation dose, and iodine intake of coronary computed tomography angiography (CCTA) acquired by wide-detector using different tube voltages and different concentrations of contrast medium (CM) for overweight patients. MATERIALS AND METHODS: A total of 150 overweight patients (body mass index≥25âkg/m2) who underwent CCTA are enrolled and divided into three groups according to scan protocols namely, group A (120 kVp, 370 mgI/ml CM); group B (100 kVp, 350 mgI/ml CM); and group C (80 kVp, 320 mgI/ml CM). The CT values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure-of-merit (FOM) of all images are calculated. Images are subjectively assessed using a 5-point scale. In addition, the CT dose index volume (CTDIvol) and dose length product (DLP) of each patient are recorded. The effective radiation dose (ED) is also calculated. Above data are then statistically analyzed. RESULTS: The mean CT values, SNR, CNR, and subjective image quality of group A are significantly lower than those of groups B and C (Pâ<â0.001), but there is no significant difference between groups B and C (Pâ>â0.05). FOMs show a significantly increase trend from group A to C (Pâ<â0.001). The ED values and total iodine intake in groups B and C are 30.34% and 68.53% and 10.22% and 16.85% lower than those in group A, respectively (Pâ<â0.001). CONCLUSION: The lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in iodine load and radiation dose in CCTA for overweight patients comparing to routine scan protocols. It also enhances signal intensity of CCTA and maintains image quality.
Assuntos
Angiografia por Tomografia Computadorizada , Iodo , Humanos , Angiografia por Tomografia Computadorizada/métodos , Sobrepeso/diagnóstico por imagem , Doses de Radiação , Estudos de Viabilidade , Meios de Contraste , Estudos Prospectivos , Angiografia Coronária/métodos , Tomografia Computadorizada por Raios X/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodosRESUMO
[This corrects the article DOI: 10.3389/fonc.2022.723089.].
RESUMO
Objective: To investigate the value of diffusion-weighted imaging (DWI) combined with the hepatobiliary phase (HBP) Gd-BOPTA enhancement in differentiating intrahepatic mass-forming cholangiocarcinoma (IMCC) from atypical liver abscess. Materials and Methods: A retrospective analysis was performed on 43 patients with IMCCs (IMCC group) and 25 patients with atypical liver abscesses (liver abscess group). The DWI signal, the absolute value of the contrast noise ratio (âCNRâ) at the HBP, and visibility were analyzed. Results: A relatively high DWI signal and a relatively high peripheral signal were presented in 29 patients (67.5%) in the IMCC group, and a relatively high DWI signal was displayed in 15 patients (60.0%) in the atypical abscess group with a relatively high peripheral signal in only one (6.7%) patient and a relatively high central signal in 14 (93.3%, 14/15). A significant (P<0.001) difference existed in the pattern of signal between the two groups of patients. On T2WI, IMCC was mainly manifested by homogeneous signal (53.5%), whereas atypical liver abscesses were mainly manifested by heterogeneous signal and relatively high central signal (32%, and 64%), with a significant difference (P<0.001) in T2WI imaging presentation between the two groups. On the HBP imaging, there was a statistically significant difference in peripheral âCNRâ (P< 0.001) and visibility between two groups. The sensitivity of the HBP imaging was significantly (P=0.002) higher than that of DWI. The sensitivity and accuracy of DWI combined with enhanced HBP imaging were significantly (P=0.002 and P<0.001) higher than those of either HBP imaging or DWI alone. Conclusion: Intrahepatic mass-forming cholangiocarcinoma and atypical liver abscesses exhibit different imaging signals, and combination of DWI and hepatobiliary-phase enhanced imaging has higher sensitivity and accuracy than either technique in differentiating intrahepatic mass-forming cholangiocarcinoma from atypical liver abscesses.
RESUMO
OBJECTIVES: To compare image quality and radiation dose of computed tomography angiography (CTA) of the head and neck in patients using two Gemstone Spectral Imaging (GSI) scanning protocols. METHODS: A total of 100 patients who underwent head-neck CTA were divided into two groups (A and B) according to the scanning protocols, with 50 patients in each group. The patients in group A underwent GSI scanning protocol 1 (GSI profile: head and neck CTA), while those in group B underwent GSI scanning protocol 2 (GSI profile: chest 80âmm). All images were reconstructed using 40% and 70% pre- and post-adaptive level statistical iterative reconstruction V (pre-ASiR-V and post-ASiR-V) algorithms, respectively. The CT dose index (CTDIvol) and dose-length (DLP) product were recorded and the mean value was calculated and converted to the effective dose. CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of all images were calculated. Additionally, subjective image evaluation was conducted by two independent radiologists using a five-point scoring method. All data were statistically analyzed. RESULTS: There were no significant differences in the CT values, SNR, CNR, and subjective score between groups A and B (pâ>â0.05); however, the mean effective dose (1.2±0.1âmSv) in group B was 45.5% lower than that in group A (2.2±0.2âmSv) (pâ<â0.05). CONCLUSIONS: GSI scanning protocol 2 could more effectively reduce the radiation dose in head-neck CT angiography while maintaining image quality compared to GSI scanning protocol 1.
Assuntos
Angiografia por Tomografia Computadorizada , Interpretação de Imagem Radiográfica Assistida por Computador , Algoritmos , Cabeça , Humanos , Doses de Radiação , Razão Sinal-RuídoRESUMO
OBJECTIVE: To identify diffusion-weighted imaging (DWI) patterns and conspicuity discrepancies on hepatobiliary phase imaging (HBPI) to distinguish atypical hepatic abscesses from hepatic metastases. MATERIALS AND METHODS: This retrospective study recruited 31 patients with 43 atypical hepatic abscesses and 32 patients with 35 hepatic metastases who underwent gadobenate dimeglumine-enhanced magnetic resonance imaging. All lesions were confirmed by pathological or clinical diagnosis. For the qualitative and quantitative analyses, the signal intensity, DWI pattern, apparent diffusion coefficient, degree of perilesional edema, perilesional hyperemia, perilesional signal on HBPI, conspicuity, size discrepancy between sequences, contrast-to-noise ratio, signal-to-noise ratio, and relative enhancement ratio on dynamic phases were independently assessed by two radiologists. Significant findings for differentiating the two groups were identified via univariate and multivariate analyses with a nomogram for predicting atypical hepatic abscesses. The interobserver agreement was also analyzed for each variable. RESULTS: The multivariate analysis revealed that the conspicuity discrepancy (odds ratio [OR] 34.78, 95% confidence interval [CI] 2.09-579.47, p = 0.013) and non-peripheral high signal intensity (SI) rim on DWI (OR 67.46, 95% CI 2.64, 1723.20, p = 0.011) were significant independent factors for predicting atypical hepatic abscesses. They were also shown to be high predictor points on the nomogram. When any of the set criteria were satisfied, 97.7% of atypical hepatic abscesses were correctly identified, with a specificity of 65.7%. When both criteria were combined, the specificity was up to 100%, with a sensitivity of 44.9%. CONCLUSION: Conspicuity discrepancy and a non-peripheral high SI rim on DWI are reliable and meaningful features that can distinguish atypical hepatic abscesses from hepatic metastases.
RESUMO
Antibacterial activity and promoting wound healing are two important characteristics of ideal dressings. The previous work has successfully prepared a stem cell seeded polyvinyl alcohol (PVA) hydrogel dressing, which could promote wound healing by active factors secreted from the dressing. However, a lack of antibacterial activity might limit its better application. In this study, a photo-active gelatin (Az-Gel) modified stem cell seeded bilayer PVA hydrogel dressings with silver nanoparticles loaded poly(lactic-co-glycolic acid) (PLGA) electrospinning films (Ag-PLGA) in it is prepared. The physical properties of the dressings show the dressings are mechanically enhanced by the addition of Ag-PLGA film. The addition of Ag-PLGA film does not alter the moisture content of PVA, but extends the moisture of the dressing. Obviously, antibacterial activity is observed and Ag-PLGA/PVA scaffold is biocompatible and low toxic to murine dermal fibroblasts (NIH-3T3). When seeded with Adipose-derived stem cells (ADSCs), bioactive factors secreted by ADSCs could penetrate the dressing and promote cell growth and wound healing. It is speculated that the stem cells seeded bilayer dressing would be of great potential for skin tissue engineering, because of its antibacterial activity and safe application of stem cells.
Assuntos
Bandagens , Nanopartículas Metálicas/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/farmacologia , Álcool de Polivinil/farmacologia , Prata/farmacologia , Células-Tronco/citologia , Cicatrização/efeitos dos fármacos , Tecido Adiposo/citologia , Animais , Adesão Celular/efeitos dos fármacos , Contagem de Células , Proliferação de Células/efeitos dos fármacos , Fator 2 de Crescimento de Fibroblastos/farmacologia , Masculino , Camundongos , Células NIH 3T3 , Ratos Sprague-Dawley , Células-Tronco/efeitos dos fármacosRESUMO
RATIONALE AND OBJECTIVES: This prospective study aimed to evaluate the diagnostic performance of dual-input computed tomography perfusion technique (DI-CTP) in identifying the bronchial-pulmonary artery fistula in patients tuberculosis with massive hemoptysis. MATERIAL AND METHODS: Twenty patients with tuberculosis with massive hemoptysis were enrolled from January 2015 to December 2015. The association between DI-CTP parameters and the diagnostic outcomes of digital subtraction angiography was assessed. Diagnostic efficacy of DI-CTP was evaluated by receiver operating curve (ROC) analyses using the diagnostic outcomes of digital subtraction angiography, which is the gold standard for identifying bronchial-pulmonary artery fistula. RESULTS: Compared to lung segments with normal blood flow (n = 304), those with bronchial-pulmonary artery fistula (n = 164) had a reduced pulmonary flow value, perfusion index (PI) value, and an elevated bronchial artery (BF) value in the DI-CTP scan, which was further confirmed by multivariate logistic regression. ROC analysis showed that PI and bronchial artery has an excellent diagnostic performance (both area under the ROC curve > 0.9, P < .001) and high sensitivity and specificity (from 0.79 to 0.95 at the optimal cutoff). PI has the best diagnostic performance, with an overall diagnostic accuracy of 0.91. CONCLUSIONS: DI-CTP scan possesses the diagnostic value for detecting bronchial-pulmonary artery fistula in patients with tuberculosis with massive hemoptysis, providing an alternative diagnostic method.
Assuntos
Fístula Brônquica/diagnóstico por imagem , Hemoptise/microbiologia , Pulmão/irrigação sanguínea , Artéria Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Tuberculose Pulmonar/complicações , Fístula Vascular/diagnóstico por imagem , Adolescente , Adulto , Idoso , Angiografia Digital , Artérias Brônquicas/diagnóstico por imagem , Fístula Brônquica/microbiologia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Fístula Vascular/microbiologiaRESUMO
PURPOSE: To investigate the image quality (IQ) of reduced radiation dose (RRD) renal artery CT angiography (CTA) using iterative model reconstruction (IMR) algorithm at different tube voltage. METHODS: Renal artery CTA scans were acquired with a 256-MDCT scanner on 84 patients assigned into four groups. Group 4 was scanned as standard radiation dose (SRD) group: 120 kVp, automatic tube current modulation (ATCM) technique with an Image Quality Index of 20, and filtered back projection (FBP) algorithm. Tube voltage for three RRD groups was 80 kVp in group 1, 100 kVp in group 2, and 120 kVp in group 3, and all three groups were with image quality index of 18 and IMR algorithm. Image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured. Subjective evaluation including diagnostic confidence, vessel artifact and intravascular contrast were performed. The effective radiation dose was recorded. RESULTS: Effective radiation dose was reduced in three RRD groups compared to group 4. Intravascular contrast was significantly better in group 1 and 2 than in group 3, and artifacts decreased in group 2 than in group 3 (P < 0.05). Vascular SNR, CNR and image noise improved in three IMR groups than those in FBP group (P < 0.05). Furthermore, among three IMR groups, group 1 and 2 achieved better objective evaluation than group 3 (P < 0.05). CONCLUSIONS: IMR along with RRD for renal artery CTA improved image quality compared to SRD protocol using FBP. On top of that, lower tube voltage tended to be more optimal.