Effectivity and safety of trifocal intraocular lenses and capsular tension rings implantation for cataract patients with axial high myopia.

AIM: To assess effectivity and safety of trifocal intraocular lenses (IOLs) and capsular tension rings in treating cataract patients with axial high myopia. METHODS: A prospective nonrandomized controlled clinical trial was conducted. Totally 98 eyes (74 patients) who underwent femtosecond laser-assisted cataract surgery (FLACS) with trifocal IOLs were enrolled in the study and followed up for 2y after surgery: 46 eyes (33 patients) with capsular tension ring implantation in the long axial lengths (AL) group (260.05). The dysfunctional lens index and total modulation transfer function (MTF) average height were similar between the two groups. The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group (P<0.05). The total satisfaction score in the long AL group (91.32±2.76) was slightly higher than that in the normal AL group (90.36±3.47), but there was no difference (P=0.136). A statistically negative correlation was found between corrected distance visual acuity (CDVA) and dysfunctional lens index (r=-0.382, P=0.009), and between CDVA and the total MTF average height (r=-0.374, P=0.01). But there was no significant correlation between CDVA and total satisfaction score (r=0.059, P=0.696). Postoperative complications mainly presented as posterior capsular opacity (PCO), retinal detachment and cystoid macular edema. There was no difference in the incidence of fundus disease (6.5% vs 3.8%, P=0.663) or PCO (17.4% vs 7.7%, P=0.217) between the two groups at two years. CONCLUSION: The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS. This approach not only ensures excellent subjective feelings and objective visual quality, but also does not increase the incidence of postoperative complications.

Dual-Energy Computed Tomography in Detecting and Predicting Lymph Node Metastasis in Malignant Tumor Patients: A Comprehensive Review.

The accurate and timely assessment of lymph node involvement is paramount in the management of patients with malignant tumors, owing to its direct correlation with cancer staging, therapeutic strategy formulation, and prognostication. Dual-energy computed tomography (DECT), as a burgeoning imaging modality, has shown promising results in the diagnosis and prediction of preoperative metastatic lymph nodes in recent years. This article aims to explore the application of DECT in identifying metastatic lymph nodes (LNs) across various cancer types, including but not limited to thyroid carcinoma (focusing on papillary thyroid carcinoma), lung cancer, and colorectal cancer. Through this narrative review, we aim to elucidate the clinical relevance and utility of DECT in the detection and predictive assessment of lymph node metastasis in malignant tumors, thereby contributing to the broader academic discourse in oncologic radiology and diagnostic precision.

One deep learning local-global model based on CT imaging to differentiate between nodular cryptococcosis and lung cancer which are hard to be diagnosed.

OBJECTIVES: We aim to evaluate a deep learning (DL) model and radiomic model for preoperative differentiation of nodular cryptococcosis from solitary lung cancer in patients with malignant features on CT images. MATERIALS AND METHODS: We retrospectively recruited 319 patients with solitary pulmonary nodules and suspicious signs of malignancy from three hospitals. All lung nodules were resected, and one by one radiologic-pathologic correlation was performed. A three-dimensional DL model was used for tumor segmentation and extraction of three-dimensional radiomic features. We used the Max-Relevance and Min-Redundancy algorithm and the eXtreme Gradient Boosting algorithm to select the nodular radiomics features. We proposed a DL local-global model, a DL local model and radiomic model to preoperatively differentiate nodular cryptococcosis from solitary lung cancer. The DL local-global model includes information of both nodules and the whole lung, while the DL local model only includes information of solitary lung nodules. Five-fold cross-validation was used to select and validate these models. The prediction performance of the model was evaluated using receiver operating characteristic curve (ROC) and calibration curve. A new loss function was applied in our deep learning framework to optimize the area under the ROC curve (AUC) directly. RESULTS: 295 patients were enrolled and they were non-symptomatic, with negative tumor markers and fungus markers in blood tests. These patients have not been diagnosed by the combination of CT imaging, laboratory results and clinical data. The lung volume was slightly larger in patients with lung cancers than that in patients with cryptococcosis (3552.8 ± 1184.6 ml vs 3491.9 ± 1017.8 ml). The DL local-global model achieved the best performance in differentiating between nodular cryptococcosis and lung cancer (area under the curve [AUC] = 0.88), which was higher than that of the DL local model (AUC = 0.84) and radiomic (AUC = 0.79) model. CONCLUSION: The DL local-global model is a non-invasive diagnostic tool to differentiate between nodular cryptococcosis and lung cancer nodules which are hard to be diagnosed by the combination of CT imaging, laboratory results and clinical data, and overtreatment may be avoided.

Brain neurometabolites differences in individuals with subjective cognitive decline plus: a quantitative single- and multi-voxel proton magnetic resonance spectroscopy study.

BACKGROUND: Subjective cognitive decline plus could be an extremely early phase of Alzheimer's disease; however, changes of N-acetylaspartate, myoinositol, and N-acetylaspartate/myoinositol is still unknown at this stage. This study aimed to explore brain neurometabolic alterations in patients with subjective cognitive decline plus using quantitative single-voxel and multi-voxel 1H-magnetic resonance spectroscopy. METHODS: A total of 91 participants were enrolled and underwent a GE 3.0-T magnetic resonance imaging, including 33 elderly controls, 27 patients with subjective cognitive decline plus, and 31 patients with amnestic mild cognitive impairment (MCI). Single-voxel and multi-voxel 1H-magnetic resonance spectroscopy were used to investigate the differences in neurometabolite levels among the three groups. RESULTS: Compared with elderly controls, patients with subjective cognitive decline plus showed significant decline in N-acetylaspartate and N-acetylaspartate/myoinositol values in multiple regions, and amnestic MCI participants demonstrated more significant decreased N-acetylaspartate and N-acetylaspartate/myoinositol levels in multiple regions. The combined concentrations of N-acetylaspartate with myoinositol showed an excellent discrimination between those with subjective cognitive decline plus and elderly controls as compared to that obtained using N-acetylaspartate/myoinositol ratios with the area under the receiver operating characteristic curve of 0.895 and 0.860, respectively. Likewise, the combined area under the curve for differentiating patients with subjective cognitive decline plus from amnestic MCI was obtained using the combined levels of N-acetylaspartate with myoinositol was 0.892. This was also higher than the combined area under the curve of 0.836 obtained using N-acetylaspartate/myoinositol ratios. Moreover, N-acetylaspartate levels in the left hippocampus and left posterior cingulate cortex (PCC) was positively related to the Auditory Verbal Learning Test delayed recall scores in patients with subjective cognitive decline plus, whereas only the N-acetylaspartate/myoinositol ratio was positively related to this scale scores in the left hippocampus. CONCLUSIONS: Quantitative single-voxel and multi-voxel 1H-magnetic resonance spectroscopy can provide valuable information to detect alterative brain neurometabolites characteristics in patients with subjective cognitive decline plus. N-acetylaspartate concentrations may be used as one of the earliest neuroimaging markers at this stage, while N-acetylaspartate/myoinositol ratio could be more suitable for monitoring Alzheimer's disease progression.

Value of Magnetic Resonance Cholangiopancreatography in Santorinicele and Wirsungocele.

BACKGROUND: Former studies showed that magnetic resonance cholangiopancreatography (MRCP) is useful in diagnosing the presence of santorinicele; however, few studies have evaluated MRCP in diagnosing wirsungocele and the association between pancreatitis and santorinicele or wirsungocele. The purpose of the study was to explore the performance of MRCP in diagnosing santorinicele and wirsungocele and investigate the potential association among pancreatitis, pancreas divisum, and santorinicele or wirsungocele. METHODS: Sixty-five patients (mean age, 55.68 years; range, 11-82 years) with santorinicele or wirsungocele were included and sorted into two groups: the santorinicele group (n = 48) and the wirsungocele group (n = 17). All patients underwent MRCP. The images were evaluated for the appearance and size of santorinicele or wirsungocele. The diagnostic sensitivity of MRCP was assessed. Additionally, whether two groups are correlated with pancreas divisum or pancreatitis were investigated. RESULTS: The sensitivity of MRCP in detecting santorinicele and wirsungocele showed no difference (68.8% and 76.5%, respectively). The proportion of patients who developed pancreatitis in santorinicele and wirsungocele groups were 60.4% and 11.8%, respectively (p < 0.05). Pancreas divisum accounted for 77.1% and 11.8% of the patients in the santorinicele and wirsungocele groups, respectively (p < 0.05). Patients with santorinicele and pancreas divisum tended to be older when they acquired pancreatitis. CONCLUSION: MRCP could be an alternative imaging method to detect cystic dilation of the pancreatic duct. Pancreatitis is more common in patients with santorinicele than in those with wirsungocele. Moreover, santorinicele is more closely associated with pancreatitis than with pancreas divisum.

Abdominal visceral adipose tissue is associated with unsuspected pulmonary embolism on routine CT scans in patients with gastrointestinal cancer.

OBJECTIVE: Unsuspected pulmonary embolism (UPE) has been increasingly diagnosed as an incidental finding on CT scans for routine staging in cancer patients. Previous studies suggest that obesity is an independent risk factor for venous thromboembolism in patients with malignant tumors. In this study, we aimed to investigate the association between abdominal adipose tissue, especially visceral adipose tissue (VAT) and the occurrence of UPE in hospitalized patients with gastrointestinal cancer. METHODS: Routine contrast-enhanced chest and abdominal CT scans of 1974 patients were retrospectively assessed for the presence of UPE, of which 58 patients were identified with UPE and 108 non-UPE patients were selected as the non-UPE control group based on several matching criteria. Abdominal adipose tissue was measured by volumes of VAT and subcutaneous adipose tissue (SAT) at the navel level. RESULTS: VAT, SAT, indwelling venous catheters, surgery, chemotherapy, and bed rest or immobilization were associated with the occurrence of UPE. Higher VAT volumes were associated with increased risk of UPE (odds ratio: 1.96; 95% confidence interval: 1.25, 3.06; p = 0.003) adjusting body mass index (BMI), bed rest or immobilization, surgery, chemotherapy and smoking, while SAT was not associated with UPE adjusting the same confounders (p = 0.117). No statistical association was found between BMI and UPE (p = 0.102). CONCLUSION: Higher VAT rather than SAT is associated with an increased risk of unsuspected pulmonary embolism on routine CT scans in hospitalized gastrointestinal cancer patients. ADVANCES IN KNOWLEDGE: Our findings indicate that VAT is a stronger risk factor for unsuspected pulmonary embolism than BMI and SAT in hospitalized patients with gastrointestinal cancer.