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To evaluate the potential role of histogram analysis of stretched exponential model (SEM) through whole-tumor volume for preoperative prediction of microvascular invasion (MVI) in single hepatocellular carcinoma (HCC). This study included 43 patients with pathologically proven HCCs by surgery who underwent multiple b-values diffusion-weighted imaging (DWI) and contrast-enhanced MRI. The histogram metrics of distributed diffusion coefficient (DDC) and heterogeneity index (α) from SEM were compared between HCCs with and without MVI, by using the independent t-test. Morphologic features of conventional MRI and clinical data were evaluated with chi-squared or Fisher's exact tests. Receiver operating characteristic (ROC) and multivariable logistic regression analyses were performed to evaluate the diagnostic performance of different parameters for predicting MVI. The tumor size and non-smooth tumor margin were significantly associated with MVI (all p < 0.05). The mean, fifth, 25th, 50th percentiles of DDC, and the fifth percentile of ADC between HCCs with and without MVI were statistically significant differences (all p < 0.05). The histogram parameters of α showed no statistically significant differences (all p > 0.05). At multivariate analysis,the fifth percentile of DDC was independent risk factor for MVI of HCC(p = 0.006). Histogram parameters DDC and ADC, but not the α value, are useful predictors of MVI. The fifth percentile of DDC was the most useful value to predict MVI of HCC. There is limited literature addressing the role of SEM for evaluating MVI of HCC. Our findings suggest that histogram analysis of SEM based on whole-tumor volume can be useful for MVI prediction. [ABSTRACT FROM AUTHOR]

Biomedical research is inseparable from the analysis of various histopathological images, and hematoxylin-eosin (HE)-stained images are one of the most basic and widely used types. However, at present, machine learning based approaches of the analysis of this kind of images are highly relied on manual labeling of images for training. Fully automated processing of HE-stained images remains a challenging task due to the high degree of color intensity, size and shape uncertainty of the stained cells. For this problem, we propose a fully automatic pixel-wise semantic segmentation method based on pseudo-labels, which concerns to significantly reduce the manual cell sketching and labeling work before machine learning, and guarantees the accuracy of segmentation. First, we collect reliable training samples in a unsupervised manner based on K-means clustering results; second, we use full mixup strategy to enhance the training images and to obtain the U-Net model for the nuclei segmentation from the background. The experimental results based on the meningioma pathology image dataset show that the proposed method has good performance and the pathological features obtained statistically based on the segmentation results can be used to assist in the clinical grading of meningiomas. Compared with other machine learning strategies, it can provide a reliable reference for clinical research more effectively. [ABSTRACT FROM AUTHOR]

Contrast-associated acute kidney injury (CA-AKI) can occur after percutaneous coronary intervention (PCI). The Mehran score is the gold standard for predicting CA-AKI risk, and it has recently been updated. The Mehran 2 CA-AKI risk score, based on existing variables in patients undergoing PCI, can accurately differentiate the risk of CA-AKI. This study aimed to verify whether the new Mehran score is applicable to the Asian PCI population. The study included the clinical data of 2487 patients undergoing PCI from August 2020 to February 2022. The goodness-of-fit test (Hosmer-Lemeshow) was used to evaluate the correction ability of the Mehran 2 score, and the area under the receiver operating characteristic curve (ROC) was used to evaluate the accuracy of the Mehran 2 score in predicting CA-AKI. CA-AKI occurred in 28 of 2487 patients, with an incidence rate of 1.12%. The proportion of high risk factors for AKI in the cohort was lower than that in the Mehran 2 cohort (a large contemporary PCI cohort to develop the Mehran 2 score). The Mehran 2 risk score had excellent goodness-of-fit (χ2 = 5.320, df = 6, P = 0.503) and high predictive accuracy (area under the ROC curve 0.836, P < 0.0001). The Mehran 2 score shows good predictive and correction performance in the Asian population and has good clinical application value. The inclusion of the Mehran 2 risk score in patients hospitalised for coronary angiography appears to be good practice. [ABSTRACT FROM AUTHOR]

Background: Multiple neurovascular contacts in patients with vascular compressive trigeminal neuralgia often challenge the diagnosis of responsible contacts. Purpose: To analyze the magnetic resonance imaging (MRI) features of responsible contacts and establish a predictive model to accurately pinpoint the responsible contacts. Material and Methods: Sixty-seven patients with unilateral trigeminal neuralgia were enrolled. A total of 153 definite contacts (45 responsible, 108 non-responsible) were analyzed for their MRI characteristics, including neurovascular compression (NVC) grading, distance from pons to contact (Dpons-contact), vascular origin of compressing vessels, diameter of vessel (Dvessel) and trigeminal nerve (Dtrigeminal nerve) at contact. The MRI characteristics of the responsible and non-responsible contacts were compared, and their diagnostic efficiencies were further evaluated using a receiver operating characteristic (ROC) curve. The significant MRI features were incorporated into the logistics regression analysis to build a predictive model for responsible contacts. Results: Compared with non-responsible contacts, NVC grading and arterial compression ratio (84.44%) were significantly higher, Dpons-contact was significantly lower at responsible contacts (P < 0.001, 0.002, and 0.033, respectively). NVC grading had a highest diagnostic area under the ROC curve (AUC) of 0.742, with a sensitivity of 64.44% and specificity of 75.00%. The logistic regression model showed a higher diagnostic efficiency, with an AUC of 0.808, sensitivity of 88.89%, and specificity of 62.04%. Conclusion: Contact degree and position are important MRI features in identifying the responsible contacts of the trigeminal neuralgia. The logistic predictive model based on Dpons-contact, NVC grading, and vascular origin can qualitatively improve the prediction of responsible contacts for radiologists. [ABSTRACT FROM AUTHOR]

Pathological grading of meningioma is insufficient to predict recurrence after resection and to guide individualized treatment strategies. One hundred and thirty-three patients with meningiomas who underwent total resection were enrolled in this retrospective study. Univariate analyses were conducted to evaluate the association between factors and recurrence. Least absolute shrinkage and selection operator (Lasso) was used to further select variables to build a logistic model. The predictive efficiency of the model and WHO grade was compared by using receiver operating characteristic curve (ROC), decision curve analysis (DCA), and net reclassification improvement (NRI). Patients were given a new risk layer based on a nomogram. The recurrence of meningioma in different groups was observed through the Kaplan-Meier curve. Univariate analysis demonstrated that 11 risk factors were associated with prognosis (P < 0.05). The result of ROC proved that the quantified risk-scoring system (AUC = 0.853) had a higher benefit than pathological grade (AUC = 0.689, P = 0.011). The incidence of recurrence of the high risk cohort (69%) was significantly higher than that of the low risk cohort (9%) by Kaplan-Meier analysis (P < 0.001). And all patients who did not relapse in the high risk group received adjuvant radiotherapy. The novel risk stratification algorithm has a significant value for the recurrence of meningioma and can help in optimizing the individualized design of clinical therapy. [ABSTRACT FROM AUTHOR]

Background: Presurgical grading is particularly important for selecting the best therapeutic strategy for meningioma patients.Purpose: To investigate the value of histogram analysis of diffusion kurtosis imaging (DKI) maps in the differentiation of grades and histological subtypes of meningiomas.Material and Methods: A total of 172 patients with histopathologically proven meningiomas underwent preoperative magnetic resonance imaging (MRI) and were classified into low-grade and high-grade groups. Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) histograms were generated based on solid components of the whole tumor. The following parameters of each histogram were obtained: 10th, 25th, 75th, and 90th percentiles, mean, median, maximum, minimum, and kurtosis, skewness, and variance. Comparisons of different grades and subtypes were made by Mann-Whitney U test, Kruskal-Wallis test, ROC curves analysis, and multiple logistic regression. Pearson correlation was used to evaluate correlations between histogram parameters and the Ki-67 labeling index.Results: Significantly higher maximum, skewness, and variance of MD, mean, median, maximum, variance, 10th, 25th, 75th, and 90th percentiles of MK were found in high-grade than low-grade meningiomas (all P < 0.05). DKI histogram parameters differentiated 7/10 pairs of subtype pairs. The 90th percentile of MK yielded the highest AUC of 0.870 and was the only independent indicator for grading meningiomas. Various DKI histogram parameters were correlated with the Ki-67 labeling index (P < 0.05).Conclusion: The histogram analysis of DKI is useful for differentiating meningioma grades and subtypes. The 90th percentile of MK may serve as an optimal parameter for predicting the grade of meningiomas. [ABSTRACT FROM AUTHOR]

We have previously shown that the transcript levels of Vegfc and its receptor Vegfr3 were high in spermatogonia and extremely low in spermatocytes and spermatids. However, it remains unknown about the functions and the mechanisms of VEGFC/VEGFR3 signaling in regulating the fate determinations of spermatogonia. To this end, here we explored the role and signaling pathways of VEGFC/VEGFR3 by using a cell line derived from immortalized mouse spermatogonia retaining markers of mitotic germ cells, namely GC-1 cells. VEGFR3 was expressed in mouse primary spermatogonia and GC-1 cells. VEGFC stimulated the proliferation and DNA synthesis of GC-1 cells and enhanced the phosphorylation of PI3K-AKT and MAPK, whereas LY294002 (an inhibitor for AKT) and CI-1040 (an inhibitor for MAPK) blocked the effect of VEGFC on GC-1 cell proliferation. Furthermore, VEGFC increased the transcripts of c-fos and Egr1 and protein levels of cyclin D1, PCNA and Bcl-2. Conversely, the blocking of VEGFC/VEGFR3 signaling by VEGFR3 knockdown reduced the phosphorylation of AKT/MAPK and decreased the levels of cyclin D1 and PCNA. Additionally, VEGFR3 knockdown not only resulted in more apoptosis of GC-1 cells but also led to a decrease of Bcl-2 and promoted the cleavage of Caspase-3/9 and PARP. Collectively, these data suggested that VEGFC/VEGFR3 signaling promotes the proliferation of GC-1 cells via the AKT /MAPK and cyclin D1 pathway and it inhibits the cell apoptosis through Caspase-3/9, PARP and Bcl-2. Thus, this study sheds a novel insight to the molecular mechanisms underlying the fate decisions of mammalian spermatogonia. [ABSTRACT FROM AUTHOR]

Objective: Histological type is important for determining the management of patients with suspicious lung cancers. In this study, PET/CT combined with serum tumor markers were used to evaluate the histological type of lung lesions. Materials and methods: Patients with suspicious lung cancers underwent 18F-FDG PET/CT and serum tumor markers detection. SUVmax of the tumor and serum levels of tumor markers were acquired. Differences in SUVmax and serum levels of tumor markers among different histological types of lung cancers and between EGFR mutation statues of adenocarcinoma were compared. The diagnostic efficiencies of SUVmax alone, each serum tumor marker alone, combined tumor markers and the combination of both methods were further assessed and compared. Results: SCC had the highest level of SUVmax, followed by SCLC and adenocarcinoma, and benign lesions had a lowest level. CYFRA21-1 and SCC-Ag were significantly higher in SCC, NSE was significantly higher in SCLC (P<0.001), and CEA was higher in adenocarcinoma (P = 0.343). The diagnostic efficiencies in evaluating histological types of suspicious lung cancers were insufficient when using each serum tumor marker or SUVmax alone. When combined, the AUC, sensitivity and specificity increased significantly (P<0.05 for all). Additionally, to adenocarcinoma, no significant difference was found between EGFR mutation statuses in SUVmax or serum tumor markers (P>0.05 for all). Conclusions: SUVmax and serum tumor markers show values in evaluating the histological types of suspicious lung cancers. When properly combined, the diagnostic efficiency can increase significantly. [ABSTRACT FROM AUTHOR]

The arterial morphology in patients with aberrant subclavian artery (ASA) and its association with type B aortic dissection are important for treatment and prevention. In the present study, we examined the arterial morphology of ASA patients with type B dissection and evaluated its association with type B dissection in vivo. Patients with aortic dissection who had undergone computed tomography angiography were screened for the presence of ASA and type B dissection from January 2011 to May 2021. The angles of ascending aorta, aortic arch, and aortic deviation and the diameters of the ascending aorta, aortic arch, ASA ostium, and middle ASA segment were measured on the computed tomography angiography scans of the ASA patients with type B dissection (group 1; n = 16), clinically matched counterparts without type B dissection (group 2; n = 32), and patients with clinically matched type B dissection without ASA (group 3, n = 32). The correlation between ASA morphology and type B dissection was analyzed using variance analysis or the Wallis H test. Compared with group 2, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 148.1° ± 7.8°; P =.001), a larger aortic deviation angle in plane 2 (28.2° ± 6.0° vs 22.1° ±7.2°; P =.005) and plane 3 (26.4° ±7.3° vs 21.8° ± 6.3°; P =.028). Similarly, group 1 had a greater diameter in the ascending aorta and aortic arch and the ostium and middle of the ASA (38.3 ± 4.1 mm vs 33.6 ± 4.5 mm [ P =.001]; 34.0 ± 9.3 mm vs 26.2 ± 2.9 mm [ P =.004]; 20.3 ± 9.3 mm vs 14.0 ± 3.2 mm [ P =.018]; 10.8 ± 2.3 mm vs 9.0 ± 1.5 mm [ P =.002], respectively), without a significant difference in the aortic arch angle. Compared with group 3, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 142.5° ± 11.7°; P =.026) and smaller aortic deviation angle in plane 1 (21.7° ± 6.2° vs 28.9° ± 6.2°; P =.04) and plane 3 (26.4° ± 7.3° vs 21.8° ± 6.3°; P =.007), although with no significant differences in the aortic arch angle, aortic deviation angle in plane 2, and ascending aortic diameter. The diameters of the ostium and middle segment of the ASA and ascending aorta and the angles of the ascending aorta and aortic deviation are potential risk factors for type B dissection in patients with ASA, which could provide new insights into the mechanism of type B dissection in patients with ASA. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the image quality and image consistency between 3D Breath-hold (BH)-MRCP with parallel imaging (3D-BH-PI-MRCP) and 3D-BH compressed sensing (CS)-MRCP (3D-BH-CS-MRCP) in patients with suspected pancreaticobiliary diseases, compared with 3D navigator-triggered (NT)-MRCP.Materials and Methods: The A total number of 109 patients who underwent 3D-NT-MRCP, 3D-BH-PI-MRCP and 3D-BH-CS-MRCP were prospectively enrolled in this study. The Friedman test was performed to compare quantitative values, image acquisition time, the presence of artifacts, overall image quality, and duct visualization among the three protocols. Additionally, we compared 3D-BH-PI-MRCP and 3D-BH-CS-MRCP with 3D-NT-MRCP in morphological consistency of main pancreatic duct and common bile duct (CBD) based on overall image quality score of = 4.Results: Three MRCP methods were successfully performed in all the patients. The contrast ratio, SNR and CNR of the CBD were significantly higher for 3D-BH-CS-MRCP than those for 3D-NT-MRCP and 3D-BH-PI-MRCP images. Overall image quality did differ significantly across the three sequences. Visualization of the CBD, RHD, LHD, anterior branch, posterior branch and cystic duct was similar with the 3D-BH-CS-MRCP and 3D-BH-PI-MRCP sequences. In contrast, segment 2 or 3 branch and main pancreatic duct visualization were significantly better with 3D-BH-PI-MRCP than with 3D-BH-CS-MRCP and 3D-NT-MRCP (p < 0.001).Conclusions: Both the two breath-hold approaches were considering the time-saving advantages without deterioration of image quality. Compared with 3D-BH-CS-MRCP, 3D-BH-PI-MRCP yielded significantly better visualization of the segment 2 and 3 branch of the intrahepatic duct and performed better consistency in main pancreatic duct and common bile duct morphology. [ABSTRACT FROM AUTHOR]

Purpose: An accurate differentiation between vestibular schwannomas (VS) and meningiomas is critical in determining treatment strategies and clinical prognoses. However, misdiagnoses may occur when typical imaging appearances are absent. The purpose of this study was to assess the performances of diffusion kurtosis imaging (DKI) and three-dimensional arterial spin labeling imaging (3D-ASL) in the differentiation of VS and meningiomas with atypical appearance.Materials and Methods: Thirty-eight patients with pathologically proven VS and meningiomas were consecutively enrolled. All patients had no typical appearance and underwent DKI and 3D-ASL scan. Then, the DKI and 3D-ASL parameters were measured. Statistical analyses were performed using independent-sample t-tests, Mann-Whitney U tests and receiver operating characteristic (ROC) curve analyses.Results: Mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), fractional anisotropy (FA) and cerebral blood flow (CBF) were significantly lower in VS than those in meningiomas, mean diffusivity (MD) were significantly higher in VS than that in meningiomas (all P < 0.05). ROC curve analyses showed that the diagnostic performance of kurtosis values outperformed those of other MR parameters. A cut-off RK value of 0.766 yielded a sensitivity of 91.67%, a specificity of 100.0%, and an accuracy of 94.74%, with an AUC of 0.988.Conclusion: DKI and 3D-ASL are useful for differentiating VS and meningiomas with atypical appearance, with kurtosis values of DKI have the best diagnostic efficiency. [ABSTRACT FROM AUTHOR]