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Abstract Background Historically, women have been shown to underestimate their abilities, while men often assess themselves more accurately or overestimate. This study aims to determine self-assessment accuracy during online Objective Structured Clinical Examinations (OSCEs) according to gender. Methods A prospective study was conducted among fourth-year medical students at Paris Cité University during faculty training OSCEs, utilizing Zoom® software for remote participation. Students and evaluators assessed performances using 5-point Likert scales for medical knowledge, interpersonal skills, and overall performance. Additionally, students predicted their grade out of twenty. The assessment covered three independent stations. Results This study included 259 medical students (177 women, 81 men, one non-binary (excluded from further analyses)) evaluated by 130 physicians. Evaluator scores did not differ according to students’ gender (total score out of 20: men: 10.25 ± 3.45, women: 10.23 ± 3.44 p = 0.817) nor students’ self-assessments (total score out of 20: men: 11.22 ± 3.02, women: 11.00 ± 3.03; p = 0.466) whatever the domains and stations (all p > 0.05). The difference (delta) between self-assessment and evaluator scores for medical knowledge (men: 0.73 ± 1.00, women: 0.64 ± 1.02; p = 0.296), interpersonal skills (men: 1.02 ± 1.06, women: 0.93 ± 1.09; p = 0.296), and total score (men: 0.98 ± 3.41, women: 0.68 ± 3.42; p = 0.296) showed no gender differences. Further analysis categorized students based on their self-assessment accuracy, revealing that both men and women displayed a high ratio of accurate self-assessments (78.1% for overall performance across all stations), with minimal overestimation observed in both genders (20.9% for overall performance across all stations). Instances of overestimation or underestimation were rare and not consistent over the 3 stations, indicating that such misjudgments are likely situational rather than inherent traits. Discussion This study reveals similar self-assessment accuracy according to gender in online training OSCEs suggesting a shift towards gender-equitable self-perceptions among medical students compared to previous studies. Research remains necessary to corroborate these results and explore the underlying factors contributing to this shift in self-perception.

Abstract Background Percutaneous cryoablation (PCA), having shown effectiveness in treating liver, lung, prostate, breast, and kidney tumors, is now gaining attention for the treatment of soft tissue tumors. PCA functions by freezing tissue, which induces ice crystal formation and cell death without damaging collagen structures. Technical considerations include the selection and handling of cryoprobes and cryogenic agents, procedural duration, and choice of image guidance for precision. This review aims to synthesize the mechanisms, applications, and technical aspects of PCA in the treatment of soft tissue tumors. Methods Adhering to PRISMA 2020 guidelines, a review was conducted of studies published prior to March 2024 that investigated PCA of soft tissue tumors. The review focused on technical and procedural aspects of cryoablation, cryobiological principles, cellular and tissue responses to extreme cold, intra- and post-procedure physiological mechanisms during and post-procedure, and main clinical applications. Results PCA is efficient in treating soft tissue tumors, including desmoid tumors, vascular malformations, and abdominal wall endometriosis. Several cryobiological mechanisms are involved, notably ice crystal formation, cellular dehydration, osmotic effects, and the inflammatory response, all of which contribute to its efficacy. Key technical aspects include the choice of cryoprobes, cryogenic agents (argon gas or liquid nitrogen), and the duration and control of freezing/thawing cycles. PCA also frequently outperformed traditional treatments like surgery and radiotherapy in terms of pain reduction, tumor size reduction, and patient outcomes. Moreover, its nerve sideration properties make it effective under local anesthesia. Conclusion Demonstrating substantial pain reduction, tumor size decrease, and high technical success rates, PCA offers a promising and minimally invasive alternative for soft tissue tumor treatment. Critical relevance statement Percutaneous cryoablation provides a minimally invasive, precise alternative for soft tissue tumor management, advancing clinical radiology by offering effective treatment with reduced patient risk and enhanced outcomes through image-guided procedures. Key Points Percutaneous cryoablation (PCA) offers a promising, minimally invasive alternative for managing soft tissue tumors. PCA employs image-guided techniques to accurately target and treat tumors, ensuring high precision and control. PCA preserves structures like collagen, reduces pain, decreases tumor size, and generally enhances patient outcomes. Graphical Abstract

Abstract Purpose To investigate over 10 years the safety and efficacy of percutaneous cryoablation for the treatment of abdominal wall endometriosis (AWE). Methods A systematic review was conducted of literature published between March 2014 and March 2024. Inclusion criteria focused on treatment efficacy studies, while exclusion criteria targeted case reports and studies lacking pertinent outcome data. Methodological quality was assessed using the Newcastle-Ottawa Scale for cohort studies. Results A total of eight studies were included. Local pain scores decreased from a median of 8/10 (interquartile range (IQR) 7–9) on the visual analog scale to 1/10 (IQR 0–2) at the last follow-up (p

Artificial intelligence (AI) and image processing are revolutionising the diagnosis and management of liver cancer. Recent advancements showcase AI’s ability to analyse medical imaging data, like computed tomography scans and magnetic resonance imaging, accurately detecting and classifying liver cancer lesions for early intervention. Predictive models aid prognosis estimation and recurrence pattern identification, facilitating personalised treatment planning. Image processing techniques enhance data analysis by precise segmentation of liver structures, fusion of information from multiple modalities, and feature extraction for informed decision-making. Despite progress, challenges persist, including the need for standardised datasets and regulatory considerations.

Abstract Background Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent hereditary kidney disease, characterized by enlarged kidneys with numerous cysts, high blood pressure, and a variety of extrarenal complications. This disease is a significant cause of renal failure and requires accurate differentiation from other cystic kidney diseases, especially when family history does not clearly indicate ADPKD. This is crucial due to differences in prognosis, treatment, and familial implications. Advanced molecular genetics and imaging techniques are employed to diagnose and assess the prognosis of patients and their families. Case presentation The case study revolves around three patients from the same family—two sisters and one daughter—referred to a nephrology department for ADPKD management. The initial proband, a 42-year-old woman, experienced abdominal discomfort leading to an ultrasound that suggested ADPKD. However, MRI findings indicated standard-sized kidneys with bilateral parapelvic cysts, and no genetic markers for ADPKD were found. Her sister, presenting with controlled hypertension and similar ultrasound findings, also had her initial ADPKD diagnosis refuted by MRI and genetic testing, which revealed no significant mutations. The daughter, however, exhibited a different scenario with enlarged kidneys and multiple cysts characteristic of early-stage ADPKD. Genetic testing confirmed a deleterious PKD1 mutation, suggesting a de novo mutation, as her father showed no signs of the disease. Conclusion This study highlights the complexity and necessity of thorough diagnostic processes in suspected ADPKD cases to prevent misdiagnosis. The initial symptoms and imaging might misleadingly suggest ADPKD, as seen in the cases of the two older patients. Still, further detailed imaging and genetic analyses revealed no ADPKD, preventing inappropriate treatment and stress. In contrast, the younger patient's distinctive clinical and genetic profile confirmed ADPKD, illustrating the variability within even closely related individuals. Such detailed assessments are crucial in guiding correct treatment decisions and providing accurate familial counseling, emphasizing the importance of considering a broader spectrum of renal cystic disorders before confirming a diagnosis of ADPKD.

Immune reconstitution inflammatory syndrome (IRIS) has been reported in immunocompromised patients with disseminated Mycobacterium genavense. Management relies on high-dose corticosteroids.We describe two cases of late-onset corticosteroid-refractory IRIS related to disseminated infection in a HIV-positive patient and a renal transplant patient who had a favorable outcome with a monoclonal TNF-α blocker.

Objective: To compare the laboratory tests conducted in real-life settings for patients with anemia with the expected prescriptions derived from an optimal checkup. Methods: A panel of experts formulated an “optimal laboratory test assessment'' specific to each anemia profile. A retrospective analysis was done of the laboratory tests conducted according to the type of anemia (microcytic, normocytic or macrocytic). Using an algorithmic system, the laboratory tests performed in real-life practice were compared with the recommendations suggested in the “optimal laboratory test assessment” and with seemingly “unnecessary” laboratory tests. Results: In the analysis of the “optimal laboratory test assessment”, of the 1179 patients with microcytic anemia, 269 (22.8%) had had one of the three tests recommended by the expert system, and only 33 (2.8%) had all three tests. For normocytic anemia, 1054 of 2313 patients (45.6%) had one of the eleven recommended tests, and none had all eleven. Of the 384 patients with macrocytic anemia, 196 (51%) had one of the four recommended tests, and none had all four. In the analysis of “unnecessary laboratory tests'', one lab test was unnecessarily done in 727/3876 patients (18.8%), i.e. 339 of 1179 (28.8%) microcytic, 171 of 2313 (7.4%) normocytic, and 217 of 384 (56.5 %) macrocytic anemias. Conclusion: Laboratory investigations of anemia remain imperfect as more than half of the cases did not receive the expected tests. Analyzing other diagnostic domains, the authors are currently developing an artificial intelligence system to assist physicians in enhancing the efficiency of their laboratory test prescriptions.

Abstract Background Separating benign from malignant soft-tissue masses often requires a biopsy. The objective of this study was to assess whether shear-wave elastography (SWE) helped to separate benign from malignant soft-tissue masses. Methods In 2015–2016, we prospectively included patients with soft-tissue masses deemed by our multidisciplinary sarcoma board to require a diagnostic biopsy. All patients underwent ultrasonography (US) followed by SWE to measure elasticity. We compared benign and malignant tumors, overall and after separating tumors with vs. without a fatty component. The biopsy findings, and surgical-specimen histology when available, served as the reference standard. Results We included 136 patients, 99 with non-fatty and 37 with fatty soft-tissue masses. Mean elasticity and tumor-to-fat elasticity ratio (T/F) values were significantly lower for the benign than the malignant soft-tissue masses in the overall cohort (30.9 vs. 50.0 kilopascals (kPa), P = 0.03; and 2.55 vs. 4.30, P = 0.046) and in the non-fatty subgroup (37.8 ± 31.9 vs. 58.9 ± 39.1 kPa, P = 0.049 and 2.89 ± 5.25 vs. 5.07 ± 5.41, P = 0.046). Data for fatty tumors were non relevant due to lack of conclusive results. By receiver operating characteristics curve analysis, a T/F cutoff of 3.5 had 46% sensitivity and 84% specificity for separating benign and malignant soft-tissue masses. Conclusions SWE had good specificity and poor sensitivity for separating benign from malignant soft-tissue masses.

Summary: Background: Estimation of glomerular function is necessary to diagnose kidney diseases. However, the study of glomeruli in the clinic is currently done indirectly through urine and blood tests. A recent imaging technique called Ultrasound Localization Microscopy (ULM) has appeared. It is based on the ability to record continuous movements of individual microbubbles in the bloodstream. Although ULM improved the resolution of vascular imaging up to tenfold, the imaging of the smallest vessels had yet to be reported. Methods: We acquired ultrasound sequences from living humans and rats and then applied filters to divide the data set into slow-moving and fast-moving microbubbles. We performed a double tracking to highlight and characterize populations of microbubbles with singular behaviors. We decided to call this technique “sensing ULM” (sULM). We used post-mortem micro-CT for side-by-side confirmation in rats. Findings: In this study, we report the observation of microbubbles flowing in the glomeruli in living humans and rats. We present a set of analysis tools to extract quantitative information from individual microbubbles, such as remanence time or normalized distance. Interpretation: As glomeruli play a key role in kidney function, it would be possible that their observation yields a deeper understanding of the kidney. It could also be a tool to diagnose kidney diseases in patients. More generally, it will bring imaging capabilities closer to the functional units of organs, which is a key to understand most diseases, such as cancer, diabetes, or kidney failures. Funding: This study was funded by the European Research Council under the European Union Horizon H2020 program (ERC Consolidator grant agreement No 772786-ResolveStroke).

Objective: : To realize a tool for automatic segmentation and detection of lumbar disc degenerative disease and fractures in MRI images using convolutional neural networks. Material and methods: : We developed, on one hand, a Picture Archiving and Communication System (PACS) with a DICOM viewer (Digital Imaging and Communications in Medicine) to extract training data and implement 2 CNN networks dedicated to the segmentation task and on the other hand, the analysis of simple lumbar pathologies on the other hand.Two hundred forty-four MRI scans T2 weighted sagittal were selected at the university hospital Pasteur 2 of Nice - France.After accomplishing segmentation and classification task for all structures of interest, we trained two neural networks (U-Net++ and Yolov5x) to segment and detect discs and vertebras. Results: : Neural networks allowed semantic segmentations with a good accuracy of the order of 0.96 and 0.93 DICE index for intervertebral discs and vertebral bodies respectively.They are less effective in detecting of common pathologies (degenerative disc disease, disc herniation, vertebral fractures) with an area under the precision-recall curve of 0.88 for fractures and 0.76 for degenerative disc disease. Conclusion: : Our work has shown good efficiency for the segmentation of vertebral bodies and intervertebral discs, but progress remains to be made in the detection of degenerative discopathy and vertebral fractures.On this last point, we believe that the lower performance can be attributed to a lack of training images and that better performances will be achieved with the increase of the training data set on our home made PACS. We will also provide other regions of interest and conditions.