CT whole lung radiomic nomogram: a potential biomarker for lung function evaluation and identification of COPD.

BACKGROUND: Computed tomography (CT) plays a great role in characterizing and quantifying changes in lung structure and function of chronic obstructive pulmonary disease (COPD). This study aimed to explore the performance of CT-based whole lung radiomic in discriminating COPD patients and non-COPD patients. METHODS: This retrospective study was performed on 2785 patients who underwent pulmonary function examination in 5 hospitals and were divided into non-COPD group and COPD group. The radiomic features of the whole lung volume were extracted. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied for feature selection and radiomic signature construction. A radiomic nomogram was established by combining the radiomic score and clinical factors. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to evaluate the predictive performance of the radiomic nomogram in the training, internal validation, and independent external validation cohorts. RESULTS: Eighteen radiomic features were collected from the whole lung volume to construct a radiomic model. The area under the curve (AUC) of the radiomic model in the training, internal, and independent external validation cohorts were 0.888 [95% confidence interval (CI) 0.869-0.906], 0.874 (95%CI 0.844-0.904) and 0.846 (95%CI 0.822-0.870), respectively. All were higher than the clinical model (AUC were 0.732, 0.714, and 0.777, respectively, P < 0.001). DCA demonstrated that the nomogram constructed by combining radiomic score, age, sex, height, and smoking status was superior to the clinical factor model. CONCLUSIONS: The intuitive nomogram constructed by CT-based whole-lung radiomic has shown good performance and high accuracy in identifying COPD in this multicenter study.

An original non-traumatic maneuver for repositioning migrated peritoneal dialysis catheters.

OBJECTIVE: To describe an original non-traumatic maneuver for repositioning a migrated peritoneal dialysis (PD) catheter. METHODS: First, tissues wrapping the PD catheter are dissociated, then a correct route is selected according to the position of the catheter, and finally the catheter is repositioned manually in 8 steps: pressing, palpating, vibrating, wave vibrating, rotating, back-pushing and vibrating, swaying, and compressing. RESULTS: Of 30 cases of PD catheter migration, repositioning was successful on the first attempt in 9 cases, on the third attempt in 10 cases, on the seventh attempt in 7 cases, and failed in 4 cases. The overall success rate was 86.7%. CONCLUSION: Manual repositioning of a migrated PD catheter is safe, painless, economical, and feasible. Repositioning of the migrated dialysis catheter may be attempted before referral for more invasive interventions.