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Accurate prediction of the expression of programmed death ligand 1 (PD-L1) in head and neck squamous cell carcinoma (HNSCC) before immunotherapy is crucial. This study was performed to construct and validate a contrast-enhanced computed tomography (CECT)-based radiomics signature to predict the expression of PD-L1 in HNSCC.In total, 157 patients with confirmed HNSCC who underwent CECT scans and immunohistochemical examination of tumor PD-L1 expression were enrolled in this study. The patients were divided into a training set (n = 104; 62 PD-L1-positive and 42 PD-L1-negative) and an external validation set (n = 53; 34 PD-L1-positive and 19 PD-L1-negative). A radiomics signature was constructed from radiomics features extracted from the CECT images, and a radiomics score was calculated. Performance of the radiomics signature was assessed using receiver operating characteristics analysis.Nine features were finally selected to construct the radiomics signature. The performance of the radiomics signature to distinguish between a PD-L1-positive and PD-L1-negative status in both the training and validation sets was good, with an area under the receiver operating characteristics curve of 0.852 and 0.802 for the training and validation sets, respectively.A CECT-based radiomics signature was constructed to predict the expression of PD-L1 in HNSCC. This model showed favorable predictive efficacy and might be useful for identifying patients with HNSCC who can benefit from anti-PD-L1 immunotherapy.• Accurate prediction of the expression of PD-L1 in HNSCC before immunotherapy is crucial. • A CECT-based radiomics signature showed favorable predictive efficacy in estimation of the PD-L1 expression status in patients with HNSCC.

Accurate pretreatment assessment of histological differentiation grade of head and neck squamous cell carcinoma (HNSCC) is crucial for prognosis evaluation. This study aimed to construct and validate a contrast-enhanced computed tomography (CECT)-based deep learning radiomics nomogram (DLRN) to predict histological differentiation grades of HNSCC.A total of 204 patients with HNSCC who underwent CECT scans were enrolled in this study. The participants recruited from two hospitals were split into a training set (n=124, 74 well/moderately differentiated and 50 poorly differentiated) of patients from one hospital and an external test set of patients from the other hospital (n=80, 49 well/moderately differentiated and 31 poorly differentiated). CECT-based manually-extracted radiomics (MER) features and deep learning (DL) features were extracted and selected. The selected MER features and DL features were then combined to construct a DLRN via multivariate logistic regression. The predictive performance of the DLRN was assessed using ROCs and decision curve analysis (DCA).Three MER features and seven DL features were finally selected. The DLRN incorporating the selected MER and DL features showed good predictive value for the histological differentiation grades of HNSCC (well/moderately differentiated vs. poorly differentiated) in both the training (AUC, 0.878) and test (AUC, 0.822) sets. DCA demonstrated that the DLRN was clinically useful for predicting histological differentiation grades of HNSCC.A CECT-based DLRN was constructed to predict histological differentiation grades of HNSCC. The DLRN showed good predictive efficacy and might be useful for prognostic evaluation of patients with HNSCC.

To construct and validate a contrast-enhanced computed tomography (CECT)-based radiomics nomogram to predict Ki-67 expression level in head and neck squamous cell carcinoma (HNSCC).A total of 217 patients with HNSCC who underwent CECT scans and immunohistochemical examination of their Ki-67 index were enrolled in this study. The patients were divided into a training set (n = 140; Ki-67: ≥ 50% [n = 72] and50% [n = 68]) and an external test set (n = 77; Ki-67: ≥ 50% [n = 38] and50% [n = 39]). The least absolute shrinkage and selection operator method was used to select key features for a CECT-image-based radiomics signature and a radiomics score (Rad-score) was calculated. A clinical model was established using clinical data and CT findings. The independent clinical factors and Rad-score were then combined to construct a radiomics nomogram. The performance characteristics of the Rad-score, clinical model, and nomogram were assessed using ROCs and decision curve analysis.Twenty features were finally selected to construct the Rad-score. The radiomics nomogram incorporating the Rad-score, low histological grade, and lymphatic spread showed higher predictive value for the Ki-67 index (≥ 50% vs.50%) than the clinical model on both the training (AUC, 0.919 vs. 0.648, p0.001) and test (AUC, 0.832 vs. 0.685, p = 0.030) sets. Decision curve analysis demonstrated that the radiomics nomogram was more clinically useful than the clinical model.A CECT-based radiomics nomogram was constructed to predict the expression of Ki-67 in HNSCC. This model showed favorable predictive efficacy and might be useful for prognostic evaluation and clinical decision-making in patients with HNSCC.• Accurate pre-treatment prediction of Ki-67 index in HNSCC is crucial. • A CECT-based radiomics nomogram showed favorable predictive efficacy in estimation of Ki-67 expression status in HNSCC patients.

Preoperative differentiation between benign lymphoepithelial lesion (BLEL) and mucosa-associated lymphoid tissue lymphoma (MALToma) in the parotid gland is important for treatment decisions. The purpose of this study was to develop and validate a CT-based radiomics nomogram combining radiomics signature and clinical factors for the preoperative differentiation of BLEL from MALToma in the parotid gland. A total of 101 patients with BLEL (n = 46) or MALToma (n = 55) were divided into a training set (n = 70) and validation set (n = 31). Radiomics features were extracted from non-contrast CT images, a radiomics signature was constructed, and a radiomics score (Rad-score) was calculated. Demographics and CT findings were assessed to build a clinical factor model. A radiomics nomogram combining the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The performance levels of the nomogram, radiomics signature, and clinical model were evaluated and validated on the training and validation datasets, and then compared among the three models. Seven features were used to build the radiomics signature. The radiomics nomogram incorporating the clinical factors and radiomics signature showed favorable predictive value for differentiating parotid BLEL from MALToma, with AUCs of 0.983 and 0.950 for the training set and validation set, respectively. Decision curve analysis showed that the nomogram outperformed the clinical factor model in terms of clinical usefulness. The CT-based radiomics nomogram incorporating the Rad-score and clinical factors showed favorable predictive efficacy for differentiating BLEL from MALToma in the parotid gland, and may help in the clinical decision-making process. • Differential diagnosis between BLEL and MALToma in parotid gland is rather difficult by conventional imaging modalities. • A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of BLEL from MALToma with improved diagnostic efficacy.

Objective:Pre-operative differentiation between renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) is critical due to their different clinical behavior and different clinical treatment decisions. The aim of this study was to develop and validate a CT-based radiomics nomogram for the pre-operative differentiation of RO from chRCC.Methods:A total of 141 patients (84 in training data set and 57 in external validation data set) with ROs (n = 47) or chRCCs (n = 94) were included. Radiomics features were extracted from tri-phasic enhanced-CT images. A clinical model was developed based on significant patient characteristics and CT imaging features. A radiomics signature model was developed and a radiomics score (Rad-score) was calculated. A radiomics nomogram model incorporating the Rad-score and independent clinical factors was developed by multivariate logistic regression analysis. The diagnostic performance was evaluated and validated in three models using ROC curves.Results:Twelve features from CT images were selected to develop the radiomics signature. The radiomics nomogram combining a clinical factor (segmental enhancement inversion) and radiomics signature showed an AUC value of 0.988 in the validation set. Decision curve analysis revealed that the diagnostic performance of the radiomics nomogram was better than the clinical model and the radiomics signature.Conclusions:The radiomics nomogram combining clinical factors and radiomics signature performed well for distinguishing RO from chRCC.Advances in knowledge:Differential diagnosis between renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) is rather difficult by conventional imaging modalities when a central scar was present. A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of RO from chRCC with improved diagnostic efficacy. The CT-based radiomics nomogram might spare unnecessary surgery for RO.

BackgroundAcute intracranial hypertension (IH) is commonly found in patients with cerebral venous thrombosis (CVT). Some magnetic resonance imaging (MRI) findings that are suggestive of acute IH an...

BACKGROUND Chondromyxoid fibroma (CMF) is a rare benign bone tumour of cartilaginous origin, which usually affects the metaphysis of the long bone. Involvement of the temporal bone is extremely rare. Patients with CMF in the temporal bone can present some neurological deficits due to involvement of surrounding neural structures. CASE SUMMARY We present the first case of histopathologically proven CMF originating in the temporal bone and involving the hypoglossal canal in a 40-year-old woman. Hypoglossal nerve paralysis was identified on the cranial nerve examination. The patient underwent surgical excision and was neurologically normal except for mild left facial palsy on 5-mo follow-up examination after surgery. In the current report, the major characteristics and computed tomography/magnetic resonance imaging features of the lesion are discussed. Furthermore, previous literature regarding this pathology is reviewed. CONCLUSION The current study presents the first case of temporal bone CMF involving the hypoglossal canal.

Objective： Preoperative differentiation between parotid Warthin’s tumor (WT) and pleomorphic adenoma (PMA) is crucial for treatment decisions. The purpose of this study was to establish and validate an MRI-based radiomics nomogram for preoperative differentiation between WT and PMA. Methods and materials: A total of 127 patients with histological diagnosis of WT or PMA from two clinical centres were enrolled in training set (n = 75; WT = 34, PMA = 41) and external test set (n = 52; WT = 24, PMA = 28). Radiomics features were extracted from axial T1WI and fs-T2WI images. A radiomics signature was constructed, and a radiomics score (Rad-score) was calculated. A clinical factors model was built using demographics and MRI findings. A radiomics nomogram combining the independent clinical factors and Rad-score was constructed. The receiver operating characteristic analysis was used to assess the performance levels of the nomogram, radiomics signature and clinical model. Results: The radiomics nomogram incorporating the age and radiomics signature showed favourable predictive value for differentiating parotid WT from PMA, with AUCs of 0.953 and 0.918 for the training set and test set, respectively. Conclusions: The MRI-based radiomics nomogram had good performance in distinguishing parotid WT from PMA, which could optimize clinical decision-making.

Background Assessment of optic nerve sheath diameter (ONSD) is a non-invasive measure of intracranial pressure (ICP). However, it is not clear whether healthy individuals exhibit ONSD variation or whether factors other than ICP affect the ONSD. Purpose To investigate whether ONSD was correlated with age, sex, height, weight, eyeball transverse diameter (ETD), or body mass index (BMI), and to develop a new diagnostic model to increase the diagnostic accuracy of intracranial hypertension (IH). Material and Methods A total of 145 relatively healthy adults and 40 patients with acute IH who underwent high-resolution magnetic resonance imaging (MRI) were enrolled in this study. Linear regression analyses were used to determine the relationship between ONSD and these variables. If correlations were identified, an index ONSDΔ removing variables effects was calculated. ROC analysis was used to assess the IH predictive value of ONSDΔ in terms of sensitivity and specificity. Results In relatively healthy adults, there was a correlation between ONSD and BMI ( P = 0.002), which can be presented as an index ONSDΔ. The ONSDΔ model better predicted IH than the ONSD model ( P = 0.035), with a sensitivity of 70.00%, a specificity of 71.72%, and an AUC of 0.755. Conclusion A correlation between ONSD and body mass index (BMI) was found using high-resolution MRI. This result indicates that the effects of BMI should be considered along with the ONSD during ICP monitoring. Meanwhile, the index ONSDΔ was better than the ONSD in predicting IH and could be used to obtain a more precise estimation of ICP.

Preoperative differentiation between benign parotid gland tumors (BPGT) and malignant parotid gland tumors (MPGT) is important for treatment decisions. The purpose of this study was to develop and validate an MRI-based radiomics nomogram for the preoperative differentiation of BPGT from MPGT. A total of 115 patients (80 in training set and 35 in external validation set) with BPGT (n = 60) or MPGT (n = 55) were enrolled. Radiomics features were extracted from T1-weighted and fat-saturated T2-weighted images. A radiomics signature model and a radiomics score (Rad-score) were constructed and calculated. A clinical-factors model was built based on demographics and MRI findings. A radiomics nomogram model combining the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The diagnostic performance of the three models was evaluated and validated using ROC curves on the training and validation datasets. Seventeen features from MR images were used to build the radiomics signature. The radiomics nomogram incorporating the clinical factors and radiomics signature had an AUC value of 0.952 in the training set and 0.938 in the validation set. Decision curve analysis showed that the nomogram outperformed the clinical-factors model in terms of clinical usefulness. The above-described radiomics nomogram performed well for differentiating BPGT from MPGT, and may help in the clinical decision-making process. • Differential diagnosis between BPGT and MPGT is rather difficult by conventional imaging modalities. • A radiomics nomogram integrated with the radiomics signature, clinical data, and MRI features facilitates differentiation of BPGT from MPGT with improved diagnostic efficacy.

Preoperative differentiation between benign lymphoepithelial lesion (BLEL) and mucosa-associated lymphoid tissue lymphoma (MALToma) in the parotid gland is important for treatment decisions. The purpose of this study was to develop and validate a CT-based radiomics nomogram combining radiomics signature and clinical factors for the preoperative differentiation of BLEL from MALToma in the parotid gland.A total of 101 patients with BLEL (n = 46) or MALToma (n = 55) were divided into a training set (n = 70) and validation set (n = 31). Radiomics features were extracted from non-contrast CT images, a radiomics signature was constructed, and a radiomics score (Rad-score) was calculated. Demographics and CT findings were assessed to build a clinical factor model. A radiomics nomogram combining the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The performance levels of the nomogram, radiomics signature, and clinical model were evaluated and validated on the training and validation datasets, and then compared among the three models.Seven features were used to build the radiomics signature. The radiomics nomogram incorporating the clinical factors and radiomics signature showed favorable predictive value for differentiating parotid BLEL from MALToma, with AUCs of 0.983 and 0.950 for the training set and validation set, respectively. Decision curve analysis showed that the nomogram outperformed the clinical factor model in terms of clinical usefulness.The CT-based radiomics nomogram incorporating the Rad-score and clinical factors showed favorable predictive efficacy for differentiating BLEL from MALToma in the parotid gland, and may help in the clinical decision-making process.• Differential diagnosis between BLEL and MALToma in parotid gland is rather difficult by conventional imaging modalities. • A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of BLEL from MALToma with improved diagnostic efficacy.

Accurate prediction of the expression level of programmed death ligand 1 (PD-L1) in head and neck squamous cell carcinoma (HNSCC) is crucial before immunotherapy. The purpose of this study was to construct and validate a contrast-enhanced computed tomography (CECT)-based radiomics signature to discriminate between high and low expression status of PD-L1.A total of 179 HNSCC patients who underwent immunohistochemical examination of tumor PD-L1 expression at one of two centers were enrolled in this study and divided into a training set (n = 122; 55 high PD-L1 expression and 67 low PD-L1 expression) and an external validation set (n = 57; 26 high PD-L1 expression and 31 low PD-L1 expression). The least absolute shrinkage and selection operator method was used to select the key features for a CECT-image-based radiomics signature. The performance of the radiomics signature was assessed using receiver operating characteristics analysis.Six features were finally selected to construct the radiomics signature. The performance of the radiomics signature in the discrimination between high and low PD-L1 expression status was good in both the training and validation sets, with areas under the receiver operating characteristics curve of 0.889 and 0.834 for the training and validation sets, respectively.The constructed CECT-based radiomics signature model showed favorable performance for discriminating between high and low PD-L1 expression status in HNSCC patients. It may be useful for screening out those patients with HNSCC who can best benefit from anti-PD-L1 immunotherapy.

Aim To evaluate whether some magnetic resonance imaging (MRI) signs suggesting idiopathic intracranial hypertension (IIH) could also be found in intracranial hypertension (IH) due to cerebral venous thrombosis (CVT) and to assess their possible contribution to diagnosing this disorder. Materials and methods Thirty-one patients with IH due to CVT were evaluated prospectively using MRI. A group of 33 age- and sex-matched healthy volunteers served as controls. The optic nerve and sheath, pituitary gland, and ventricles were assessed. The prevalence of each imaging feature was compared between the two groups. Results Optic nerve sheath (ONS) dilatation and decreased pituitary gland height were the most valid signs suggesting IH in CVT patients: sensitivity 70.97% and 87.1%, respectively; specificity 96.97% and 72.73%, respectively; area under the curve 0.840 and 0.809, respectively. The MRI finding that showed the strongest association with IH in CVT patients was ONS dilatation (odds ratio 78.5). Conclusions The combination of T1-weighted volumetric MRI and magnetic resonance venography could be helpful for diagnosing IH with CVT. Abnormalities of the ONS and the pituitary gland were reliable diagnostic signs for IH due to CVT.

In this paper, thermal postbuckling of a beam-like structure subjected to a uniform thermal loading is studied both theoretically and experimentally. In theory aspect, the equations governing the axial and transverse deformations of beams are derived. The two equations are reduced to a single nonlinear fourth-order integral-differential equation governing the transverse deformations. The analytical method presented here offers a simple yet efficient solution approach to analyze the bistable behavior of microbeam or beam-like structures under thermal loading. Then, microfabricated double-clamped beams are chosen as experimental object due to its precise dimensions and easy loading method. The lab-made HF vapor system was used to release the suspended structures with satisfactory results. After the fabrication and measurement, by comparing the theoretical results with experimental results, an excellent agreement is gotten. It proves not only the validity of the solution obtained here, on the other hand, importantly, it also demonstrates a new field for MEMS as another easy and accurate tool to investigate mechanics problems. With the accurate solutions for posbuckling beams, we apply it into new electrothermal postbuckling actuators, a big deflection promising the possibility of a new kind of actuator.