Functional MRI radiomics-based assessment of pelvic bone marrow changes after concurrent chemoradiotherapy for cervical cancer.

OBJECTIVES: To quantify the dose-response relationship of changes in pelvic bone marrow (PBM) functional MR radiomic features (RF) during concurrent chemoradiotherapy (CCRT) for patients with cervical cancer and establish the correlation with hematologic toxicity to provide a basis for PBM sparing. METHODS: A total of 54 cervical cancer patients who received CCRT were studied retrospectively. Patients underwent MRI IDEAL IQ and T2 fat suppression (T2fs) scanning pre- and post-CCRT. The PBM RFs were extracted from each region of interest at dose gradients of 5-10 Gy, 10-15 Gy, 15-20 Gy, 20-30 Gy, 30-40 Gy, 40-50 Gy, and > 50 Gy, and changes in peripheral blood cell (PBC) counts during radiotherapy were assessed. The dose-response relationship of RF changes and their correlation with PBC changes were investigated. RESULTS: White blood cell, neutrophils (ANC) and lymphocyte counts during treatment were decreased by 49.4%, 41.4%, and 76.3%, respectively. Most firstorder features exhibited a significant dose-response relationship, particularly FatFrac IDEAL IQ, which had a maximum dose-response curve slope of 10.09, and WATER IDEAL IQ had a slope of - 7.93. The firstorder-Range in FAT IDEAL IQ and firstorder-10Percentile in T2fs, showed a significant correlation between the changes in ANC counts under the low dose gradient of 5-10 Gy (r = 0.744, -0.654, respectively, p < 0.05). CONCLUSION: Functional MR radiomics can detect microscopic changes in PBM at various dose gradients and provide an objective reference for bone marrow sparing and dose limitation in cervical cancer CCRT.

A personalized 3D-printed plate for tibiotalocalcaneal arthrodesis: Design, fabrication, biomechanical evaluation and postoperative assessment.

Personalized plates (P-Plates) could provide improved clinical outcomes in joint fusion by enabling perfect geometric matching between irregular bone and implants. However, there is no unified application framework for P-Plates for joint fusion. The objective of this study was to develop such a framework for P-Plates for tibiotalocalcaneal arthrodesis. A patient-specific bone model was constructed based on CT images, and the P-Plate was preliminarily designed to match the bones. Finite element method was used to optimize the stress distribution and to evaluate the biomechanical performance of the P-Plate by comparing it with a traditional plate (T-Plate). Then, the P-Plate was manufactured via electron beam melting and implanted into the foot of a patient. Increasing the size of the preliminary designed plate alleviated the stress concentration and reduced the risk of failure. The maximum stresses of the plate and screw (214.3 MPa, 99.05 MPa) and the maximum tensile force of the screw in the P-Plate (181.4 N) fixation system were lower than those in the T-Plate (217.4 MPa, 255.4 MPa, and 230.1 N, respectively). The P-Plate was well-matched to the bone, and no complications occurred. The P-Plate achieved American Orthopaedic Foot & Ankle Society and Short-Form-36 scores of 64 and 75, respectively, 36 months post operation, which suggests that it could improve clinical outcomes. The design and fabrication methods, as well as mechanical and postoperative performance evaluation methods, for the P-Plate were systematically developed and provide a reference for constructing a unified application framework for P-Plate use in tibiotalocalcaneal arthrodesis.

68Ga-NOTA PET imaging for gastric emptying assessment in mice.

BACKGROUND: Positron emission tomography (PET) has the potential for visualization and quantification of gastric emptying (GE). The traditional Chinese medicine (TCM) has been recognized promising for constipation. This study aimed to establish a PET imaging method for noninvasive GE measurement and to evaluate the efficacy of a TCM on delayed GE caused by constipation using PET imaging. METHODS: [68Ga]Ga-NOTA was synthesized as the tracer and sesame paste with different viscosity were selected as test meals. The dynamic PET scans were performed after [68Ga]Ga-NOTA mixed with test meals were administered to normal mice. Two methods were utilized for the quantification of PET imaging. A constipation mouse model was treated with maren chengqi decoction (MCD), and the established PET imaging scans were performed after the treatment. RESULTS: [68Ga]Ga-NOTA was synthesized within 20 min, and its radiochemical purity was > 95%. PET images showed the dynamic process of GE. %ID/g, volume, and total activity correlated well with each other. Among which, the half of GE time derived from %ID/g for 4 test meals were 3.92 ± 0.87 min, 13.1 ± 1.25 min, 17.8 ± 1.31 min, and 59.7 ± 3.11 min, respectively. Constipation mice treated with MCD showed improved body weight and fecal conditions as well as ameliorated GE measured by [68Ga]Ga-NOTA PET. CONCLUSIONS: A PET imaging method for noninvasive GE measurement was established with stable radiotracer, high image quality, and reliable quantification methods. The efficacy of MCD on delayed GE was demonstrated using PET.

MRI assessment and histopathologic evaluation of subchondral bone remodeling in temporomandibular joint osteoarthritis: a retrospective study.

OBJECTIVE: The aim of the study was to characterize subchondral bone remodeling by using magnetic resonance imaging (MRI) and histopathologic assessment of temporomandibular joint osteoarthritis (TMJOA) and to analyze the correlations between them. STUDY DESIGN: The retrospective study was based on 153 joints of 100 patients. These patients had undergone MRI and had been diagnosed with temporomandibular joint internal derangement Wilkes stage IV-V, followed by the failure of conservative or arthroscopic/anchorage treatment. We evaluated and compared 136 joints based on MRI and histopathologic observation. According to the modified Osteoarthritis Research Society International system and the Diagnostic Criteria for Temporomandibular Disorders system, the scores of histopathology and MRI were compared by using kappa categorical agreement analysis. RESULTS: MRI showed subchondral bone changes in 153 joints, 136 of which had been subjected to surgical treatment and histopathologic assessment. Statistical tests revealed substantial agreement between MRI and histopathology (κ value: 0.779). CONCLUSIONS: MRI is an effective technique to evaluate the pathologic changes of TMJOA. Our histopathologic grading criteria contributed to the clarification of the occurrence and developmental process of TMJOA. Therefore, the evidence of MRI should be seen as a reference standard for the choice of nonsurgical or surgical therapy in the management of TMJOA.