Comparison between single-muscle evaluation and cross-sectional area muscle evaluation for predicting the prognosis in patients with oral squamous cell carcinoma: a retrospective cohort study.

Introduction: The most effective method of assessing sarcopenia has yet to be determined, whether by single muscle or by whole muscle segmentation. The purpose of this study was to compare the prognostic value of these two methods using computed tomography (CT) images in patients with oral squamous cell carcinoma (OSCC). Materials and methods: Sex- and age-adjusted Cox proportional hazards models were employed for each parameter of sarcopenia related to overall survival, disease-free survival, and disease-specific survival. Harrell's concordance index was calculated for each model to assess discriminatory power. Results: In this study including 165 patients, a significant correlation was found between the CT-based assessment of individual muscles and their cross-sectional area. Single muscle assessments showed slightly higher discriminatory power in survival outcomes compared to whole muscle assessments, but the difference was not statistically significant, as indicated by overlapping confidence intervals for the C-index between assessments. To further validate our measurements, we classified patients into two groups based on intramuscular adipose tissue content (P-IMAC) of the spinous process muscle. Analysis showed that the higher the P-IMAC value, the poorer the survival outcome. Conclusion: Our findings indicate a slight advantage of single-muscle over whole-muscle assessment in prognostic evaluation, but the difference between the two methods is not conclusive. Both assessment methods provide valuable prognostic information for patients with OSCC, and further studies involving larger, independent cohorts are needed to clarify the potential advantage of one method over the other in the prognostic assessment of sarcopenia in OSCC.

Chemical shift-encoded MRI with compressed sensing combined with parallel imaging for proton density fat fraction measurement of the lumbar vertebral bone marrow.

We aimed to investigate the accuracy of proton density fat fraction (PDFF) measurement of the lumbar vertebral bone marrow using chemical shift-encoded magnetic resonance imaging (CSE-MRI) with compressed sensing combined with parallel imaging (CSPI). This study recruited a commercially available phantom, and 43 patients. Fully sampled data without CSPI and under-sampled data with CSPI acceleration factors of 2.4, 3.6, and 4.8 were acquired using a 1.5T imaging system. The relationships between PDFF measurements obtained with the no-CSPI acquisition and those obtained with each CSPI acquisition were assessed using Pearson correlation coefficient (r), linear regression analyses, and Bland-Altman analysis. The intra- and inter-observer variabilities of the PDFF measurements were evaluated using the intraclass correlation coefficient. PDFF measurements obtained with all acquisitions showed a significant correlation and strong agreement with the reference PDFF measurement of the phantom. PDFF measurements obtained using CSE-MRI with and without CSPI were positively correlated (all acquisitions: r = 0.99; P < .001). The mean bias was -0.31% to -0.17% with 95% limits of agreement within ±2.02%. The intra- and inter-observer agreements were excellent (intraclass correlation coefficient: 0.988 and 0.981, respectively). A strong agreement and positive correlation were observed between the PDFF measurements obtained using CSE-MRI with and without CSPI. PDFF measurement of the lumbar vertebral bone marrow using CSE-MRI with CSPI can be acquired with a maximum reduction of approximately 75% in the acquisition time compared with a fully sampled acquisition.

[Segmentation of Mass in Mammogram Using Gaze Search Patterns].

PURPOSE: It is very difficult for a radiologist to correctly detect small lesions and lesions hidden on dense breast tissue on a mammogram. Therefore, recently, computer-aided detection (CAD) systems have been widely used to assist radiologists in interpreting images. Thus, in this study, we aimed to segment mass on the mammogram with high accuracy by using focus images obtained from an eye-tracking device. METHODS: We obtained focus images for two mammography expert radiologists and 19 mammography technologists on 8 abnormal and 8 normal mammograms published by the DDSM. Next, the auto-encoder, Pix2Pix, and UNIT learned the relationship between the actual mammogram and the focus image, and generated the focus image for the unknown mammogram. Finally, we segmented regions of mass on mammogram using the U-Net for each focus image generated by the auto-encoder, Pix2Pix, and UNIT. RESULTS: The dice coefficient in the UNIT was 0.64±0.14. The dice coefficient in the UNIT was higher than that in the auto-encoder and Pix2Pix, and there was a statistically significant difference (p<0.05). The dice coefficient of the proposed method, which combines the focus images generated by the UNIT and the original mammogram, was 0.66±0.15, which is equivalent to the method using the original mammogram. CONCLUSION: In the future, it will be necessary to increase the number of cases and further improve the segmentation.

Exercise Suppresses Head and Neck Squamous Cell Carcinoma Growth via Oncostatin M.

Major advances have been made in cancer treatment, but the prognosis for elderly cancer patients with sarcopenia and frailty remains poor. Myokines, which are thought to exert preventive effects against sarcopenia, have been reported to be associated with the prognosis of various cancers, but their effect on head and neck squamous cell carcinoma (HNSCC) is unknown. The aim of this study was to clarify the influence of exercise on the control of HNSCC and to examine the underlying mechanism involved. Mice were injected with HSC-3-M3 cells, a human cell line of highly metastatic and poorly differentiated tongue cancer, at the beginning of the study. Just prior to transplantation, blood was collected from the mice, and the levels of myokines were measured by ELISA. Oncostatin M (OSM), a selected myokine, was added to HSC-3-M3 cells, after which the cell proliferation ability, cell cycle, and protein expression were analyzed in vitro. Tumor cell viability was lower (control: 100%, exercise: 75%), tumors were smaller (control: 26.2 mm3, exercise: 6.4 mm3), and survival was longer in the exercise group than in the control group in vivo. OSM inhibited HSC-3-M3 cell proliferation in a concentration-dependent manner in vitro. The addition of OSM increased the proportion of cells in the G0/G1 phase, decreased the proportion of cells in the G2/M phase, and increased the expression of the CDK inhibitors p21 and p27. These results indicate that exercise may directly inhibit the proliferation of HNSCC cell lines via OSM.

Chemical Shift-Encoded MRI of the Lumbar Vertebral Bone Marrow for Detecting Osteoporosis With Low Trabecular Bone Quality in Patients With Breast Cancer Receiving Aromatase Inhibitors.

BACKGROUND: Osteoporosis with low trabecular bone quality (OLB) in patients with breast cancer receiving aromatase inhibitor (AI) therapy is associated with an increased risk of vertebral fractures. The capability of chemical shift-encoded MRI (CSE-MRI) in detecting OLB needs to be investigated. PURPOSE: To assess the diagnostic performance of proton density fat fraction (PDFF) and R2* measurements from CSE-MRI for detecting OLB in postmenopausal women with breast cancer undergoing AI therapy. STUDY TYPE: Prospective. POPULATION: 126 postmenopausal females (mean age: 69.5 ± 8.8 years) receiving AIs (average period: 41.6 ± 26.5 months) after breast cancer surgery. FIELD STRENGTH/SEQUENCE: 1.5-T, three-dimensional CSE-MRI (six echoes), T1-weighted Dixon, short tau inversion recovery, and diffusion-weighted images. ASSESSMENT: Both CSE-MRI and dual-energy x-ray absorptiometry were performed on the same day. Measurements included averaged PDFF, R2*, bone mineral density (BMD), and trabecular bone score (TBS) from L1 to L4 vertebrae. A T-score ≤ -2.5 from BMD measurements indicated osteoporosis, whereas T-scores of ≤ - 2.5 plus TBS ≤-3.7 indicated OLB. The diagnostic performance of PDFF, R2*, and the combination of PDFF and R2* for identifying osteoporosis or OLB was assessed. STATISTICAL TESTS: Student's t-test; Mann-Whitney U test; χ2 or Fisher exact tests; Pearson correlation; multivariate analysis; Receiver operating characteristic (ROC) analysis with the area under the curve (AUC); logistic regression model; intraclass correlation coefficient. A P-value <0.05 was considered statistically significant. RESULTS: For detecting osteoporosis, AUC values were 0.59 (PDFF), 0.66 (R2*), and 0.65 (combined PDFF and R2*). Significant mean differences were noted between patients with and without OLB for PDFF (66.11 ± 5.36 vs. 57.49 ± 6.43) and R2* (46.62 ± 9.24 vs. 63.36 ± 12.44). AUC values for detecting OLB were 0.75 (PDFF), 0.82 (R2*), and 0.84 (combined PDFF and R2*). DATA CONCLUSION: R2* may perform better than PDFF for identifying OLB in patients with breast cancer receiving AIs. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 4.

Comparative efficacy and safety of adjunctive drugs to levodopa for fluctuating Parkinson's disease - network meta-analysis.

It remains unclear which adjunctive drug for Parkinson's disease (PD) in combination with levodopa is more effective, tolerable, and safe. We aimed to compare the efficacy, tolerability, and safety among anti-PD drugs from several classes in patients with fluctuating PD who received levodopa through network meta-analysis (NMA). Twelve anti-PD drugs belonging to 4 different drug classes (dopamine agonists, monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, and an adenosine A2A receptor antagonist) were selected. We systematically searched PubMed, Embase, and the Cochrane Library for eligible randomized controlled trials (RCTs) comparing placebo with anti-PD drug or among anti-PD drugs in patients with PD who experienced motor fluctuations or wearing-off and received levodopa. We included 54 RCTs in the analysis. The NMA was performed under a frequentist framework using a random-effects model. The efficacy outcome was change in daily off-time, and the tolerability outcome was discontinuation due to all causes. Safety outcomes included discontinuation due to adverse events (AEs) and the incidence of AEs, dyskinesia, hallucination, and orthostatic hypotension. According to the surface under the cumulative ranking curve (SUCRA) in the NMA, ropinirole transdermal patch (SUCRA, 0.861) ranked the highest in efficacy, followed by pramipexole (0.762), ropinirole extended release (ER) (0.750), and safinamide (0.691). In terms of tolerability, ropinirole (0.954) ranked the highest, followed by pramipexole (0.857), safinamide (0.717), and ropinirole ER (0.708). Each anti-PD drug had different SUCRA ranking profiles for the safety outcomes. These findings suggest that ropinirole, pramipexole, and safinamide are well-balanced anti-PD drugs that satisfy both efficacy and tolerability outcomes.

Improving animal-specific radiotherapy quality assurance for kilovoltage X-ray radiotherapy using a 3D printed dog skull water phantom.

Background: Accurate dose assessment during animal radiotherapy is beneficial for veterinary medicine and medical education. Aim: To visualize the radiation treatment distribution of orthovoltage X-ray equipment in clinical practice using Monte Carlo simulations and create a dog skull water phantom for animal-specific radiotherapy. Methods: EGSnrc-based BEAMnrc and DOSXYZnrc codes were used to simulate orthovoltage dose distributions. At 10, 20, 30, 40, 50, and 80 mm in a water phantom, the depth dose was measured with waterproof Farmer dosimetry chambers, and the diagonal off-axis ratio was measured with Gafchromic EBT3 film to simulate orthovoltage dose distributions. Energy differences between orthovoltage and linear accelerated radiotherapy were assessed with a heterogeneous bone and tissue virtual phantom. The animal-specific phantom for radiotherapy quality assurance (QA) was created from CT scans of a dog and printed with a three-dimensional printer using polyamide 12 nylon, with insertion points for dosimetry chambers and Gafchromic EBT3 film. Results: Monte Carlo simulated and measured dose distributions differed by no more than 2.0% along the central axis up to a depth of 80 mm. The anode heel effect occurred in shallow areas. The orthovoltage radiotherapy percentage depth dose in bone was >40%. Build-up was >40%, with build-down after bone exit, whereas linear accelerator radiotherapy absorption changed little in the bone. A highly water-impermeable, animal-specific dog skull water phantom could be created to evaluate dose distribution. Conclusion: Animal-specific water phantoms and Monte Carlo simulated pre-treatment radiotherapy are useful QA for orthovoltage radiotherapy and yield a visually familiar phantom that will be useful for veterinary medical education.

WT1 Trio Peptide-Based Cancer Vaccine for Rare Cancers Expressing Shared Target WT1.

No standard treatment has been established for most rare cancers. Here, we report a clinical trial of a biweekly WT1 tri-peptide-based vaccine for recurrent or advanced rare cancers. Due to the insufficient number of patients available for a traditional clinical trial, the trial was designed for rare cancers expressing shared target molecule WT1. The recruitment criteria included WT1-expressing tumors as well as HLA-A*24:02 or 02:01. The primary endpoints were immunoglobulin G (IgG) antibody (Ab) production against the WT1-235 cytotoxic T lymphocyte (CTL) epitope and delayed-type hypersensitivity (DTH) skin reactions to targeted WT1 CTL epitopes. The secondary endpoints were safety and clinical efficacy. Forty-five patients received WT1 Trio, and 25 (55.6%) completed the 3-month protocol treatment. WT1-235 IgG Ab was positive in 88.0% of patients treated with WT1 Trio at 3 months, significantly higher than 62.5% of the weekly WT1-235 CTL peptide vaccine. The DTH positivity rate in WT1 Trio was 62.9%, which was not significantly different from 60.7% in the WT1-235 CTL peptide vaccine. The WT1 Trio safety was confirmed without severe treatment-related adverse events, except grade 3 myasthenia gravis-like symptoms observed in a patient with thymic cancer. Fifteen (33.3%) patients achieved stable disease after 3 months of treatment. In conclusion, the biweekly WT1 Trio vaccine containing the WT1-332 helper T lymphocyte peptide induced more robust immune responses targeting WT1 than the weekly WT1-235 CTL peptide vaccine. Therefore, WT1-targeted immunotherapy may be a potential therapeutic strategy for rare cancers.

Performance improvement in multi-label thoracic abnormality classification of chest X-rays with noisy labels.

PURPOSE: This study aimed at developing a deep learning-based method for multi-label thoracic abnormality classification on frontal view chest X-ray (CXR). To improve the performance of classification, issues of class imbalance, noisy labels and ensemble of networks are addressed in the paper. METHODS: The experiments were performed on a public dataset called Chest X-ray 14 (CXR14), which includes 112,120 frontal view CXRs from 30,805 patients. We came up with an ensemble learning framework to improve the classification and a noisy label detection method to detect the CXRs with noisy labels. The detected CXRs were reviewed by two board-certificated radiologists in a consensus fashion to evaluate detected noisy labels. The classification was assessed on CXR14 with area under the receiver operating characteristic curve (AUC). RESULTS: Report from the radiologists indicated that detected noisy labels had high possibility to be true positives. A notable improvement from baseline in performance of classification was observed with the ensemble learning framework. After removing the CXRs with detected noisy labels, 8 out of 14 abnormalities improved significantly on CXR14. The suggested framework achieved AUC score of 0.827 on CXR14. CONCLUSION: The methods of this study boost the classification on CXR with awareness of the label noise. Expanded experimental results show that all of them were able to improve multi-label thoracic abnormality classification performance, respectively. A new state-of-the-art is achieved in this study.

Prognostic value of inflammatory biomarkers in aged patients with oral squamous cell carcinoma.

Background: Better prognostic biomarkers for oral squamous cell carcinoma (OSCC) must be developed, particularly within the realm of clinically and frequently administered tests, to advise appropriate clinical therapy and follow-up. In this study, we retrospectively investigated which of the several inflammation-nutrition indicators might predict the prognosis of patients with OSCC. Methods: The preoperative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), controlling nutrition status (CONUT), and modified CONUT (mCONUT) were retrospectively evaluated using blood samples collected 1-5 days before surgery. To estimate the effect on the prognosis of tumor progression, the mean values of the markers between stages I/II and III/IV were used for subgroup analysis. The multivariate Cox proportional hazards model included all independent variables significantly associated with survival in the univariate analysis to determine the independent variables. Results: A total of 112 patients (69 males and 43 females) with primary OSCC who underwent surgical treatment at our hospital were included. There were statistically significant differences in the mean values of monocytes, platelets, and albumin between stages I/II and III/IV. According to the multivariate Cox proportional hazards regression, a low PNI was associated with shorter overall survival (OS) and disease-free survival (DFS); women were associated with shorter DFS. Conclusion: The pretreatment PNI had excellent predictive value for the 5-year OS and DFS of patients with OSCC. Future large-scale prospective studies with a high sample size are needed to verify our findings in OSCC patients.

Development of a novel detection method for changes in lung conditions during radiotherapy using a temporal subtraction technique.

We aimed to develop a novel method of detecting changes in lung conditions during radiotherapy using temporal subtraction technique. Twenty patients who underwent radiotherapy were retrospectively assessed by calculating optimal direct similarity error (ODSE) between initial and mid-treatment registered images. Patients were grouped according to region in tumor size and atelectasis for lung of < 20 or ≥ 20 cm3, which analyzed two field regions (1024 × 768 pixels, 512 × 512 pixels). Correlations between ODSE and changes in lung conditions were analyzed based on effect of radiation dose; receiver operating characteristic (ROC) analysis was performed to evaluate whether changes can be detected during treatment period. The ODSE of 1024 × 768 pixels was changed to 1.00 (0.28-3.48) for lung lesion size of < 20 cm3 and 1.86 (0.55-6.58) for the ≥ 20 cm3 lung lesion size. ODSE of 512 × 512 pixels was 1.03 (0.40-2.12) for the region in tumor size and atelectasis of < 20 cm3 and 1.90 (0.39-27.8) for the ≥ 20 cm3 lung lesion size. The region under the curve values from ROC analysis were 0.796 (1024 × 768 pixels) and 0.983 (512 × 512 pixels). A novel method can visually and numerically help to detect changes in lung condition at early treatment stages. Using this method, difference between plan and actual positional relationship for target and risk organs that cannot be predicted at the time of planning can be avoided, ensuring high safety and accuracy in lung radiotherapy.

Prognostic Role of Preoperative Sarcopenia Evaluation of Cervical Muscles with Long-Term Outcomes of Patients with Oral Squamous Cell Carcinoma.

Accumulating evidence has shown that sarcopenia in patients with oral squamous cell carcinoma (OSCC) is at a risk of poor prognosis. There is no universal consensus on how to assess sarcopenia in patients with OSCC in daily practice. It is important to validate the usefulness of sarcopenia assessment from cervical muscles, which are frequently used in routine clinical practice in patients with OSCC. In this study, we investigated whether preoperative lumbar (L3) skeletal muscle mass and adiposity in OSCC patients were associated with cervical (C3) skeletal muscle mass and adiposity from CT measurements. We also investigated whether skeletal muscle mass and adiposity in the C3 muscles were associated with survival rates in patients with OSCC. We demonstrated that both the quality and quantity of muscle between the C3 and L3 levels were positively correlated with each other. We also demonstrated that the survival rates in patients with low sternocleidomastoid muscle mass index, high processus spinosus muscle-intramuscular adipose tissue content, and the combination of both were significantly lower than those in the controls. These results suggest that the assessment of sarcopenia from multiple neck muscles by preoperative CT measurements may be useful in predicting the prognosis of patients with OSCC.

Radiomics-Based Machine Learning Classification for Glioma Grading Using Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging.

OBJECTIVE: The aim of this study was to evaluate various radiomics-based machine learning classification models using the apparent diffusion coefficient (ADC) and cerebral blood flow (CBF) maps for differentiating between low-grade gliomas (LGGs) and high-grade gliomas (HGGs). METHODS: Fifty-two glioma patients, including 18 LGGs (grade II) and 34 HGGs (grade III/IV), were examined using a 3.0-T magnetic resonance scanner. The ADC and CBF maps were obtained from diffusion-weighted imaging and pseudo-continuous arterial spin labeling perfusion-weighted imaging, respectively. A total of 91 radiomic features were extracted from each of the tumor volume on the ADC and CBF maps. We constructed 4 types of machine learning classifiers based on (1) least absolute shrinkage and selection operator regularized logistic regression (LASSO-LR), (2) random forest (RF), (3) support vector machine (SVM) with the radial basis function kernel (SVM-RBF), and (4) SVM with the linear kernel (SVM-L). A training set with 36 gliomas (70%) was used to select the important radiomic features and train each model using 5-fold cross-validation. The remaining 16 gliomas (30%) were used as a test set. Receiver operating characteristic analysis was performed to evaluate the model performance. RESULTS: A radiomic feature, ADC first-order-based skewness, was selected as an important variable in all classification models. According to the receiver operating characteristic analysis, the areas under the curve of the LASSO-LR, RF, SVM-RBF, and SVM-L models for the training set were 0.965, 1.000, 0.979, and 0.969, respectively. For the test set, the areas under the curve of the LASSO-LR, RF, SVM-RBF, and SVM-L models were 0.883, 0.917, 0.717, and 0.917, respectively. All classification models showed sufficient diagnostic performance on the test set. CONCLUSIONS: Radiomics-based machine learning classifiers using the quantitative ADC and CBF maps are useful for differentiating HGGs from LGGs.

PCP4/PEP19 and HER2 Are Novel Prognostic Markers in Mucoepidermoid Carcinoma of the Salivary Gland.

Mucoepidermoid carcinoma (MEC) is one of the most common malignant salivary gland carcinomas, but no effective treatment strategy has been established other than surgical resection. Purkinje cell protein (PCP) 4/peptide (PEP) 19 is a calmodulin-binding antiapoptotic peptide that is expressed and inhibits apoptosis in human breast cancer cells. Human epidermal growth factor receptor 2 (HER2) is an epidermal growth factor that has been implicated in the pathogenesis of many carcinomas, particularly breast and gastric carcinomas. In the present study, we performed immunohistochemical analyses of samples from 73 patients who underwent surgical resection for MEC of the salivary gland using antibodies against PCP4/PEP19 and HER2. PCP4/PEP19 expression was related to better prognosis, while HER2 expression was associated with worse prognosis. Patients that were PCP4/PEP19-positive and HER2-negative showed similar outcomes to PCP4/PEP19 and HER2 alone. Therefore, PCP4/PEP19 and HER2 are predicted to play important roles in the pathogenesis and progression of MEC.

Robustness of a Combined Modified Dixon and PROPELLER Sequence with Two Interleaved Echoes in Clinical Head and Neck MRI.

PURPOSE: The combination of modified Dixon (mDixon) and periodically rotated overlapping parallel lines with enhanced reconstruction sequence with two interleaved echoes, which promotes uniform fat-suppression and motion insensitivity, has recently become available for commercial magnetic resonance imaging (MRI) scanners. To compare the robustness of this combination sequence with that of standard Cartesian mDixon sequence for fat-suppressed T2-weighted imaging in clinical head and neck MRI. METHODS: Fifty patients with head and neck tumors were involved this study. All patients underwent MRI using both the combination and standard sequences. Two radiologists independently scored motion artifacts and water-fat separation error using a 4-point scale (1, unacceptable; 4, excellent). Furthermore, comprehensive comparative evaluation was performed using a 5-point scale (1, substantially inferior; 5, substantially superior). Data were statistically analyzed using the Wilcoxon signed-rank test. RESULTS: In the motion artifact assessment, ratings of 3 or 4 points were assigned to 45% (observer-1, 58.0%; observer-2, 32.0%) and 97% (100%; 94.0%) of images for the standard and combination sequences, respectively (P < 0.001). For the water-fat separation error assessment, ratings of 3 or 4 points were assigned to 100% (100%; 100%) and 85% (84.0%; 86.0%) of images, respectively (P < 0.001). In the comprehensive evaluation, of the 100 cases (observer-1, 50; observer-2, 50), 96 were rated at four or five points. In cases with slight or no motion artifacts and water-fat separation errors, the combination sequence was superior to the standard sequence in term of noise and sharpness, and equal in terms of contrast. CONCLUSION: Although water-fat separation errors increased significantly in the combination sequence, most of these were acceptable. The significantly decreased motion artifacts in the combination sequence significantly improved image quality overall.

Patient-specific radiotherapy quality assurance for estimating actual treatment dose.

This study aimed to evaluate the optimal method for planning computed tomography (CT) for prostate cancer radiotherapy to avoid a dose difference of ≥3% between the actual and planned treatments using multiple acquisition planning CT (MPCT). We calculated the 3-dimensional (3D) displacement error between the pelvic bone and matching fiducial marker on MPCT and cone-beam CT scans of 25 patients who underwent prostate volumetric-modulated arc therapy for prostate cancer. The correlation of the 3D displacement error and the dose difference between planned and actual treatments was calculated using least squares second-order polynomial model. The 3D displacement error showed a moderate correlation with differences between planned and accumulated treatment doses (r = 0.587, p < 0.0001). Moreover, the improvement rate of the minimum 3D displacement error showed a strong correlation with the relative error between each MPCT image (r = 0.793, p < 0.0001). Significant differences were observed between planned and actual treatment doses (p < 0.0001) in the relative 3D displacement errors of <1 mm, 1 to 3 mm, and >3 mm. The 3D displacement error on MPCT (as the selection estimation index for optimal planning CT) is useful for monitoring patient-specific intensity-modulated radiation therapy quality assurance. This new method allows to estimate dose differences from the planned dose before commencing treatment, thereby ensuring high-quality therapy. As radiotherapy quality is critical for patient outcome, these findings may contribute to better management of prostate cancer.

Impact of Preoperative Low Prognostic Nutritional Index and High Intramuscular Adipose Tissue Content on Outcomes of Patients with Oral Squamous Cell Carcinoma.

The impact of preoperative malnutrition and sarcopenia on survival in oral squamous cell carcinoma (OSCC) patients remains controversial. We investigated the effects of the preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. A retrospective study involving 103 patients with OSCC was conducted. Disease-specific survival (DSS) according to the preoperative psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) was evaluated. Univariate and multivariate analyses were performed to determine the predictive performance of the covariates with respect to DSS. The DSS rate in patients with high IMAC and low PMI was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC.

A Hidden Coordination-Bond Torsional Deformation as a Sign of Possible Spin Transition in Nickel(II)-Bis(nitroxide) Compounds.

Complex formation of nickel(II) tetrafluoroborate and tert-butyl 5-phenyl-2-pyridyl nitroxide (phpyNO) in the presence of sodium cyanate gave a discrete molecule [Ni(phpyNO)2(X)2] (X = NCO). The Ni-O-N-Csp2 torsion angles were reduced on heating; 33.5(5)° and 36.2(4)° at 100 K vs. 25.7(10)° and 32.3(11)° at 400 K. The magnetic behavior was almost diamagnetic below ca. 100 K, and the χmT value reached 1.04 cm3 K mol-1 at 400 K. An analysis using the van't Hoff equation indicates a possible spin transition at T1/2 >> 400 K. Density functional theory calculation shows that the singlet-quintet energy gap decreases as the structural change from 100 to 400 K. The geometry optimization results suggest that the diamagnetic state has the Ni-O-N-Csp2 torsion angles of 32.7° while the Stotal = 2 state has those of 11.9°. The latter could not be experimentally observed even at 400 K. After overviewing the results on the known X = Br, Cl, and NCS derivatives, the magnetic behavior is described in a common phase diagram. The Br and Cl compounds undergo the energy level crossing of the high-/low-spin states, but the NCS and NCO compounds do not in a conventional experimental temperature range. The spin transition mechanism in this series involves the exchange coupling switch between ferro- and antiferromagnetic interactions, corresponding to the high- and low-spin phases, respectively.

Odd-Even Effect on the Spin-Crossover Temperature in Iron(II) Complex Series Involving an Alkylated or Acyloxylated Tripodal Ligand.

In the context of magneto-structural study, a relatively short alkyl group was introduced to anionic spin-crossover (SCO) building blocks based on [Fe(py3CR)(NCS)3]-, where py3CR stands for tris(2-pyridyl)methyl derivatives. The linear alkyl and acyloxyl derivatives of Me4N[Fe(py3CR)(NCS)3] with R = CnH2n+1 (n = 1-7) and CnH2n+1CO2 (n = 1-6) were synthesized, and the magnetic study revealed that all the compounds investigated here exhibited SCO. The SCO temperature (T1/2) varied in 289-338 K for the alkylated compounds, and those of the acyloxylated ones were lower with a narrower variation width (T1/2 = 216-226 K). The crystal structures of the former with n = 3, 4, and 5 and the latter with n = 1, 4, 5, and 6 were determined, and various molecular arrangements were characterized. There is no structural evidence for a molecular fastener effect. The plots on T1/2 against n displayed a pronounced odd-even effect; the SCO temperatures of the homologues with even n are relatively higher than those of the homologues with odd n. The odd-even effect on T1/2 may be related with the entropy difference across the SCO, rather than crystal field modification or intermolecular interaction. The present work will help molecular design to fine-tune T1/2 by means of simple chemical modification like alkylation and acyloxylation.

A radiomics-based comparative study on arterial spin labeling and dynamic susceptibility contrast perfusion-weighted imaging in gliomas.

Radiomics has potential for reflecting the differences in glioma perfusion heterogeneity between arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) imaging. The aim of this study was to compare radiomic features of ASL and DSC imaging-derived parameters (cerebral blood flow, CBF) and assess radiomics-based classification models for low-grade gliomas (LGGs) and high-grade gliomas (HGGs) using their parameters. The ASL-CBF and DSC-relative CBF of 46 glioma patients were normalized (ASL-nCBF and DSC-nrCBF) for data analysis. For each map, 91 radiomic features were extracted from the tumor volume. Seventy-five radiomic features were significantly different (P < 0.00055) between ASL-nCBF and DSC-nrCBF. Positive correlations were observed in 75 radiomic features between ASL-nCBF and DSC-nrCBF. Even though ASL imaging underestimated CBF compared with DSC imaging, there were significant correlations (P < 0.00055) in the first-order-based mean, median, 90th percentile, and maximum. Texture analysis showed that ASL-nCBF and DSC-nrCBF characterized similar perfusion patterns, while ASL-nCBF could evaluate perfusion heterogeneity better. The areas under the curve of the ASL-nCBF and DSC-nrCBF radiomics-based classification models for gliomas were 0.888 and 0.962, respectively. Radiomics in ASL and DSC imaging is useful for characterizing glioma perfusion patterns quantitatively and for classifying LGGs and HGGs.